Sample records for aids vaccine initiative

  1. An Interview with AIDS Vaccine Researcher Chris Parks

    ERIC Educational Resources Information Center

    Sullivan, Megan

    2010-01-01

    The search for an AIDS (acquired immune deficiency syndrome) vaccine is truly a global effort, with university laboratories, biotech firms, pharmaceutical companies, nonprofit research organizations, hospitals, and clinics all working together to develop an effective vaccine as quickly as possible. The International AIDS Vaccine Initiative (IAVI)…

  2. Strengthening capacity for AIDS vaccine research: analysis of the Pfizer Global Health Fellows Program and the International AIDS Vaccine Initiative

    PubMed Central

    2013-01-01

    Background Industry partnerships can help leverage resources to advance HIV/AIDS vaccine research, service delivery, and policy advocacy goals. This often involves capacity building for international and local non-governmental organizations (NGOs). International volunteering is increasingly being used as a capacity building strategy, yet little is known about how corporate volunteers help to improve performance of NGOs in the fight against HIV/AIDS. Methods This case study helps to extend our understanding by analyzing how the Pfizer Global Health Fellows (GHF) program helped develop capacity of the International AIDS Vaccine Initiative (IAVI), looking specifically at Fellowship activities in South Africa, Kenya, and Uganda. From 2005–2009, 8 Pfizer GHF worked with IAVI and local research centers to strengthen capacity to conduct and monitor vaccine trials to meet international standards and expand trial activities. Data collection for the case study included review of Fellow job descriptions, online journals, evaluation reports, and interviews with Fellows and IAVI staff. Qualitative methods were used to analyze factors which influenced the process and outcomes of capacity strengthening. Results Fellows filled critical short-term expert staffing needs at IAVI as well as providing technical assistance and staff development activities. Capacity building included assistance in establishing operating procedures for the start-up period of research centers; training staff in Good Clinical Practice (GCP); developing monitoring capacity (staff and systems) to assure that centers are audit-ready at all times; and strategic planning for data management systems. Factors key to the success of volunteering partnerships included similarities in mission between the corporate and NGO partners, expertise and experience of Fellows, and attitudes of partner organization staff. Conclusion By developing standard operating procedures, ensuring that monitoring and regulatory

  3. Strengthening capacity for AIDS vaccine research: analysis of the Pfizer Global Health Fellows program and the International AIDS Vaccine Initiative.

    PubMed

    Vian, Taryn; Koseki, Sayaka; Feeley, Frank G; Beard, Jennifer

    2013-10-02

    Industry partnerships can help leverage resources to advance HIV/AIDS vaccine research, service delivery, and policy advocacy goals. This often involves capacity building for international and local non-governmental organizations (NGOs). International volunteering is increasingly being used as a capacity building strategy, yet little is known about how corporate volunteers help to improve performance of NGOs in the fight against HIV/AIDS. This case study helps to extend our understanding by analyzing how the Pfizer Global Health Fellows (GHF) program helped develop capacity of the International AIDS Vaccine Initiative (IAVI), looking specifically at Fellowship activities in South Africa, Kenya, and Uganda. From 2005-2009, 8 Pfizer GHF worked with IAVI and local research centers to strengthen capacity to conduct and monitor vaccine trials to meet international standards and expand trial activities. Data collection for the case study included review of Fellow job descriptions, online journals, evaluation reports, and interviews with Fellows and IAVI staff. Qualitative methods were used to analyze factors which influenced the process and outcomes of capacity strengthening. Fellows filled critical short-term expert staffing needs at IAVI as well as providing technical assistance and staff development activities. Capacity building included assistance in establishing operating procedures for the start-up period of research centers; training staff in Good Clinical Practice (GCP); developing monitoring capacity (staff and systems) to assure that centers are audit-ready at all times; and strategic planning for data management systems. Factors key to the success of volunteering partnerships included similarities in mission between the corporate and NGO partners, expertise and experience of Fellows, and attitudes of partner organization staff. By developing standard operating procedures, ensuring that monitoring and regulatory compliance systems were in place, training

  4. The International AIDS Vaccine Initiative's Capacity Building Activities in East Africa

    PubMed Central

    Cochrane, Gavin; Robin, Enora; Hanlin, Rebecca; Castle-Clarke, Sophie; MacLure, Calum; Parks, Sarah; Chataway, Joanna

    2016-01-01

    Abstract The International AIDS Vaccine Initiative (IAVI) is one of a number of Product Development Partnerships created to bridge the gap between scientific and technological potential and the needs of low income populations in low and middle income countries. Specifically IAVI is focused on creating a preventative vaccine for HIV/AIDS. Whilst the remit of IAVI is to create new science, technology and products, its work necessarily involves a wide range of stakeholders and different constituencies in industrially developing and developed countries. Its capacity building activities relate to strengthening the ability to conduct clinical trials and are broad based, spanning scientific and technological capacity through to organisational, advocacy and broader development capabilities. The aim of this study was to deepen IAVI's understanding of how it contributes to capacity building activities in East Africa (Uganda, Kenya and Rwanda), spanning scientific and technological capacity through to organisational, advocacy and broader development capabilities. IAVI's mission to develop an HIV vaccine has become increasingly connected to wider health systems strengthening, through its clinical research activities in East Africa. Since it began its operations in the region, IAVI has made a significant contribution to training interventions to support scientific excellence and good clinical practice and invested in infrastructure and laboratories at Clinical Research Centres in East Africa. Although clear challenges still exist with ensuring sustained investment, accessing marginalized populations and demonstrating progress in capacity building, the experiences of IAVI to date suggest that substantial progress is being made towards wider health systems strengthening in the region. PMID:28083400

  5. Gates Foundation donates $25 million for AIDS vaccine.

    PubMed

    1999-05-07

    The International AIDS Vaccine Initiative (IAVI) received a $25 million five-year grant from Bill and Melinda Gates through the William H. Gates Foundation. This is the largest gift seen in the AIDS epidemic, and will allow IAVI to more than double vaccine development efforts. IAVI is currently developing two potential vaccines, hopes to study three others, and is working with the business community to insure that a successful vaccine is affordable in developing countries. With 16,000 new infections occurring daily, a vaccine is seen as the most effective way to stop the epidemic. The William H. Gates Foundation had donated $1.5 million to IAVI and $100 million for programs to speed the delivery of vaccines to children in poor countries. Internet addresses are included for both IAVI and the William H. Gates Foundation.

  6. AIDS vaccines that allow HIV-1 to infect and escape immunologic control: a mathematic analysis of mass vaccination.

    PubMed

    van Ballegooijen, Marijn; Bogaards, Johannes A; Weverling, Gerrit-Jan; Boerlijst, Maarten C; Goudsmit, Jaap

    2003-10-01

    Cytotoxic T lymphocyte (CTL)-based HIV vaccine concepts shown to reduce viremia and postpone disease but not to prevent infection in monkeys are currently in human phase 1 trials. To evaluate the potential efficacy of vaccines that cannot prevent HIV-1 to infect and escape immunologic control, we designed a mathematic model that correlates the level of viremia to both infectiousness and disease progression. We speculate that vaccinees will have a virologic set point and disease progression rates comparable to untreated HIV-1-infected individuals with the best prognosis. Our model (illustrated with R0 = 3) shows that a sexually active population can ultimately be reduced to 26% of its initial size as a result of AIDS-related mortality in the absence of treatment or vaccination. Start of vaccination when HIV-1 prevalence is still low might postpone the peak incidence of infection and the dramatic decline in population size by up to 22 years. In conclusion, CTL-based vaccines that do not prevent HIV-1 infection but do postpone the time to onset of AIDS have considerable potential to curb the spread of HIV-1 and to postpone high AIDS-related mortality on a population level. The number of long-term survivors is substantially increased only when vaccination is initiated early in an AIDS epidemic, however.

  7. Recombinant Salmonella Bacteria Vectoring HIV/AIDS Vaccines

    PubMed Central

    Chin’ombe, Nyasha; Ruhanya, Vurayai

    2013-01-01

    HIV/AIDS is an important public health problem globally. An affordable, easy-to-deliver and protective HIV vaccine is therefore required to curb the pandemic from spreading further. Recombinant Salmonella bacteria can be harnessed to vector HIV antigens or DNA vaccines to the immune system for induction of specific protective immunity. These are capable of activating the innate, humoral and cellular immune responses at both mucosal and systemic compartments. Several studies have already demonstrated the utility of live recombinant Salmonella in delivering expressed foreign antigens as well as DNA vaccines to the host immune system. This review gives an overview of the studies in which recombinant Salmonella bacteria were used to vector HIV/AIDS antigens and DNA vaccines. Most of the recombinant Salmonella-based HIV/AIDS vaccines developed so far have only been tested in animals (mainly mice) and are yet to reach human trials. PMID:24478808

  8. Inactivated- or killed-virus HIV/AIDS vaccines.

    PubMed

    Sheppard, Haynes W

    2005-06-01

    Inactivated or "killed" virus (KV) is a "classical" approach that has produced safe and effective human and veterinary vaccines but has received relatively little attention in the effort to develop an HIV/AIDS vaccine. Initially, KV and rgp120 subunit vaccines were the two most obvious approaches but, unfortunately, rgp120 has not been efficacious and the KV approach has been limited by a variety of scientific, technical, and sociological factors. For example, when responses to cellular antigens, present on SIV grown in human cells, proved to be largely responsible for efficacy, the KV approach was widely discounted. Similarly, when lab-adapted HIV-1 appeared to lose envelope glycoprotein during preparation (not the case for primary isolates), this was viewed as a fundamental barrier to the KV concept. Also, a preference for "safer", genetically-engineered vaccines, and emphasis on cellular immunity, have left KV low on the priority list for funding agencies and investigators. The recent suggestion that "native" trimeric gp120 displays conserved conformational neutralization epitopes, along with the failure of rgp120, and difficulties in raising strong cellular responses with DNA or vectored vaccines, has restored some interest in the KV concept. In the past 15 years, several groups have initiated pre-clinical development of KV candidates for SIV or HIV and promising, albeit limited, information has been produced. In this chapter we discuss the rationale (including pros and cons) for producing and testing killed-HIV vaccines, the prospects for success, the nature and scope of research needed to test the KV concept, what has been learned to date, and what remains undone.

  9. Reasons for Ineligibility in Phase 1 and 2A HIV Vaccine Clinical Trials at Kenya Aids Vaccine Initiative (KAVI), Kenya

    PubMed Central

    Omosa-Manyonyi, Gloria S.; Jaoko, Walter; Anzala, Omu; Ogutu, Hilda; Wakasiaka, Sabina; Malogo, Roselyn; Nyange, Jacqueline; Njuguna, Pamela; Ndinya-Achola, Jeckoniah; Bhatt, Kirana; Farah, Bashir; Oyaro, Micah; Schmidt, Claudia; Priddy, Frances; Fast, Patricia

    2011-01-01

    Background With the persistent challenges towards controlling the HIV epidemic, there is an ongoing need for research into HIV vaccines and drugs. Sub-Saharan African countries - worst affected by the HIV pandemic - have participated in the conduct of clinical trials for HIV vaccines. In Kenya, the Kenya AIDS Vaccine Initiative (KAVI) at the University of Nairobi has conducted HIV vaccine clinical trials since 2001. Methodology Participants were recruited after an extensive informed consent process followed by screening to determine eligibility. Screening included an assessment of risk behavior, medical history and physical examination, and if clinically healthy, laboratory testing. In the absence of locally derived laboratory reference ranges, the ranges used in these trials were derived from populations in the West. Principal findings Two hundred eighty-one participants were screened between 2003 and 2006 for two clinical trials. Of these, 167 (59.4%) met the inclusion/exclusion criteria. Overall, laboratory abnormalities based on the non-indigenous laboratory references used were the most frequent reasons (61.4%) for ineligibility. Medical abnormalities contributed 30.7% of the total reasons for ineligibility. Based on the laboratory reference intervals now developed from East and Southern Africa, those ineligible due to laboratory abnormalities would have been 46.3%. Of the eligible participants, 18.6% declined enrolment. Conclusions Participant recruitment for HIV vaccine clinical trials is a rigorous and time-consuming exercise. Over 61% of the screening exclusions in clinically healthy people were due to laboratory abnormalities. It is essential that laboratory reference ranges generated from local populations for laboratory values be used in the conduct of clinical trials to avoid unnecessary exclusion of willing participants and to avoid over-reporting of adverse events for enrolled participants. Trial registration Protocol IAVI VRC V001 [1]. Clinical

  10. Private investment in AIDS vaccine development: obstacles and solutions.

    PubMed

    Batson, A; Ainsworth, M

    2001-01-01

    The development of vaccines for the prevention of AIDS, malaria, tuberculosis, and other diseases requires both public and private investment. Private investment, however, has been far lower than might have been hoped, given the massive human toll of these diseases, particularly in the poorest countries. With a view to understanding this situation and exploring potential solutions, the World Bank AIDS Vaccine Task Force commissioned a study on the perspectives of the biotechnology, vaccine, and pharmaceutical industries regarding investment in research and development work on an AIDS vaccine. It was found that different obstacles to the development of an AIDS vaccine arose during the product development cycle. During the earlier phases, before obtaining proof of product, the principal barriers were scientific. The lack of consensus on which approach was likely to be effective increased uncertainty and the risks associated with investing in expensive clinical trials. The later phases, which involved adapting, testing, and scaling up production for different populations, were most influenced by market considerations. In order to raise the levels of private research and development in an AIDS vaccine there will probably have to be a combination of push strategies, which reduce the cost and scientific risk of investment, and pull strategies, which guarantee a market.

  11. Private investment in AIDS vaccine development: obstacles and solutions.

    PubMed Central

    Batson, A.; Ainsworth, M.

    2001-01-01

    The development of vaccines for the prevention of AIDS, malaria, tuberculosis, and other diseases requires both public and private investment. Private investment, however, has been far lower than might have been hoped, given the massive human toll of these diseases, particularly in the poorest countries. With a view to understanding this situation and exploring potential solutions, the World Bank AIDS Vaccine Task Force commissioned a study on the perspectives of the biotechnology, vaccine, and pharmaceutical industries regarding investment in research and development work on an AIDS vaccine. It was found that different obstacles to the development of an AIDS vaccine arose during the product development cycle. During the earlier phases, before obtaining proof of product, the principal barriers were scientific. The lack of consensus on which approach was likely to be effective increased uncertainty and the risks associated with investing in expensive clinical trials. The later phases, which involved adapting, testing, and scaling up production for different populations, were most influenced by market considerations. In order to raise the levels of private research and development in an AIDS vaccine there will probably have to be a combination of push strategies, which reduce the cost and scientific risk of investment, and pull strategies, which guarantee a market. PMID:11545328

  12. Role of nanotechnology in HIV/AIDS vaccine development.

    PubMed

    Liu, Ying; Chen, Chunying

    2016-08-01

    HIV/AIDS is one of the worst crises affecting global health and influencing economic development and social stability. Preventing and treating HIV infection is a crucial task. However, there is still no effective HIV vaccine for clinical application. Nanotechnology has the potential to solve the problems associated with traditional HIV vaccines. At present, various nano-architectures and nanomaterials can function as potential HIV vaccine carriers or adjuvants, including inorganic nanomaterials, liposomes, micelles and polymer nanomaterials. In this review, we summarize the current progress in the use of nanotechnology for the development of an HIV/AIDS vaccine and discuss its potential to greatly improve the solubility, permeability, stability and pharmacokinetics of HIV vaccines. Although nanotechnology holds great promise for applications in HIV/AIDS vaccines, there are still many inadequacies that result in a variety of risks and challenges. The potential hazards to the human body and environment associated with some nano-carriers, and their underlying mechanisms require in-depth study. Non-toxic or low-toxic nanomaterials with adjuvant activity have been identified. However, studying the confluence of factors that affect the adjuvant activity of nanomaterials may be more important for the optimization of the dosage and immunization strategy and investigations into the exact mechanism of action. Moreover, there are no uniform standards for investigations of nanomaterials as potential vaccine adjuvants. These limitations make it harder to analyze and deduce rules from the existing data. Developing vaccine nano-carriers or adjuvants with high benefit-cost ratios is important to ensure their broad usage. Despite some shortcomings, nanomaterials have great potential and application prospects in the fields of AIDS treatment and prevention. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. HIV/AIDS vaccines for Africa: scientific opportunities, challenges and strategies

    PubMed Central

    Chin'ombe, Nyasha; Ruhanya, Vurayai

    2015-01-01

    More than decades have already elapsed since human immunodeficiency virus (HIV) was identified as the causative agent of acquired immunodeficiency syndrome (AIDS). The HIV has since spread to all parts of the world with devastating effects. In sub-saharan Africa, the HIV/AIDS epidemic has reached unprecedented proportions. Safe, effective and affordable HIV/AIDS vaccines for Africans are therefore urgently needed to contain this public health problem. Although, there are challenges, there are also scientific opportunities and strategies that can be exploited in the development of HIV/AIDS vaccines for Africa. The recent RV144 Phase III trial in Thailand has demonstrated that it is possible to develop a vaccine that can potentially elicit modest protective immunity against HIV infection. The main objective of this review is to outline the key scientific opportunities, challenges and strategies in HIV/AIDS vaccine development in Africa. PMID:26185576

  14. [Results of Booster Vaccination in Children with Primary Vaccine Failure after Initial Varicella Vaccination].

    PubMed

    Ozakiv, Takao; Nishimura, Naoko; Gotoh, Kensei; Funahashi, Keiji; Yoshii, Hironori; Okuno, Yoshinobu

    2016-05-01

    In October 2014, the varicella vaccination policy in Japan was changed from a single voluntary inoculation to two routine inoculations. This paper reports the results of booster vaccination in children who did not show seroconversion after initial vaccination (i.e., primary vaccine failure : PVF) over a 7-year period prior to the introduction of routine varicella vaccination. Between November 2007 and May 2014, 273 healthy children aged between 1.1 and 14.5 years (median : 1.7 years) underwent varicella vaccination. Before and 4 to 6 weeks after vaccination, the antibody titers were measured using an immune adherence hemagglutination (IAHA) assay and a glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). In addition, side reactions were examined during the four-week period after vaccination. Children who did not show IAHA seroconversion (PVF) were recommended to receive a booster vaccination, and the measurement of antibody titers and an assessment of side reactions were performed after the booster dose. In May 2015, a questionnaire was mailed to each of the 273 participants to investigate whether they had developed varicella and/or herpes zoster after vaccination. After initial vaccination, the IAHA seroconversion rate was 75% and the mean antibody titer (Log2) with seroconversion was 4.7, while the gpELISA seroconversion rate was 84% and the mean antibody titer (Log10) with seroconversion was 2.4. Among children with PVF, 54 received booster vaccination within 81 to 714 days (median : 139 days) after the initial vaccination. After booster vaccination, the IAHA seroconversion rate was 98% and the mean antibody titer (Log2) with seroconversion was 5.8. Both the seroconversion rate and the antibody titer were higher compared with the values after the initial vaccination (p < 0.01). After booster vaccination, the gpELISA seropositive rate was 100% and the mean positive antibody titer (Log 10) was 3.6 ; similar results were obtained for the IAHA assay, with

  15. European Vaccine Initiative: lessons from developing malaria vaccines.

    PubMed

    Geels, Mark J; Imoukhuede, Egeruan B; Imbault, Nathalie; van Schooten, Harry; McWade, Terry; Troye-Blomberg, Marita; Dobbelaer, Roland; Craig, Alister G; Leroy, Odile

    2011-12-01

    For over 10 years, the European Vaccine Initiative (EVI; European Malaria Vaccine Initiative until 2009) has contributed to the development of 24 malaria candidate vaccine antigens with 13 vaccine candidates being advanced into Phase I clinical trials, two of which have been transitioned for further clinical development in sub-Saharan Africa. Since its inception the EVI organization has operated as a funding agency, but with a clear service-oriented strategy. The scientific successes and difficulties encountered during these years and how these efforts have led to standardization and harmonization in vaccine development through large-scale European consortia are discussed. In the future, the EVI will remain instrumental in the pharmaceutical and clinical development of vaccines against 'diseases of poverty' with a continued focus on malaria. EVI will continue to focus on funding and managing preclinical evaluation up to Phase I/II clinical trials and strengthening the vaccine-development infrastructure in Europe, albeit with a global orientation.

  16. Subtype C gp140 Vaccine Boosts Immune Responses Primed by the South African AIDS Vaccine Initiative DNA-C2 and MVA-C HIV Vaccines after More than a 2-Year Gap

    PubMed Central

    Mayer, Kenneth H.; Elizaga, Marnie L.; Bekker, Linda-Gail; Allen, Mary; Morris, Lynn; Montefiori, David; De Rosa, Stephen C.; Sato, Alicia; Gu, Niya; Tomaras, Georgia D.; Tucker, Timothy; Barnett, Susan W.; Mkhize, Nonhlanhla N.; Shen, Xiaoying; Downing, Katrina; Williamson, Carolyn; Pensiero, Michael; Corey, Lawrence; Williamson, Anna-Lise

    2016-01-01

    A phase I safety and immunogenicity study investigated South African AIDS Vaccine Initiative (SAAVI) HIV-1 subtype C (HIV-1C) DNA vaccine encoding Gag-RT-Tat-Nef and gp150, boosted with modified vaccinia Ankara (MVA) expressing matched antigens. Following the finding of partial protective efficacy in the RV144 HIV vaccine efficacy trial, a protein boost with HIV-1 subtype C V2-deleted gp140 with MF59 was added to the regimen. A total of 48 participants (12 U.S. participants and 36 Republic of South Africa [RSA] participants) were randomized to receive 3 intramuscular (i.m.) doses of SAAVI DNA-C2 of 4 mg (months 0, 1, and 2) and 2 i.m. doses of SAAVI MVA-C of 1.45 × 109 PFU (months 4 and 5) (n = 40) or of a placebo (n = 8). Approximately 2 years after vaccination, 27 participants were rerandomized to receive gp140/MF59 at 100 μg or placebo, as 2 i.m. injections, 3 months apart. The vaccine regimen was safe and well tolerated. After the DNA-MVA regimen, CD4+ T-cell and CD8+ T-cell responses occurred in 74% and 32% of the participants, respectively. The protein boost increased CD4+ T-cell responses to 87% of the subjects. All participants developed tier 1 HIV-1C neutralizing antibody responses as well as durable Env binding antibodies that recognized linear V3 and C5 peptides. The HIV-1 subtype C DNA-MVA vaccine regimen showed promising cellular immunogenicity. Boosting with gp140/MF59 enhanced levels of binding and neutralizing antibodies as well as CD4+ T-cell responses to HIV-1 envelope. (This study has been registered at ClinicalTrials.gov under registration no. NCT00574600 and NCT01423825.) PMID:27098021

  17. AIDS vaccines and preexposure prophylaxis: is synergy possible?

    PubMed

    Excler, Jean-Louis; Rida, Wasima; Priddy, Frances; Gilmour, Jill; McDermott, Adrian B; Kamali, Anatoli; Anzala, Omu; Mutua, Gaudensia; Sanders, Eduard J; Koff, Wayne; Berkley, Seth; Fast, Patricia

    2011-06-01

    While the long-term goal is to develop highly effective AIDS vaccines, first generation vaccines may be only partially effective. Other HIV prevention modalities such as preexposure prophylaxis with antiretrovirals (PrEP) may have limited efficacy as well. The combined administration of vaccine and PrEP (VAXPREP), however, may have a synergistic effect leading to an overall benefit that is greater than the sum of the individual effects. We propose two test-of-concept trial designs for an AIDS vaccine plus oral or topical ARV. In one design, evidence that PrEP reduces the risk of HIV acquisition is assumed to justify offering it to all participants. A two-arm study comparing PrEP alone to VAXPREP is proposed in which 30 to 60 incident infections are observed to assess the additional benefit of vaccination on risk of infection and setpoint viral load. The demonstrated superiority of VAXPREP does not imply vaccine alone is efficacious. Similarly, the lack of superiority does not imply vaccine alone is ineffective, as antagonism could exist between vaccine and PrEP. In the other design, PrEP is assumed not to be in general use. A 2 × 2 factorial design is proposed in which high-risk individuals are randomized to one of four arms: placebo vaccine given with placebo PrEP, placebo vaccine given with PrEP, vaccine given with placebo PrEP, or VAXPREP. Between 60 and 210 infections are required to detect a benefit of vaccination with or without PrEP on risk of HIV acquisition or setpoint viral load, with fewer infections needed when synergy is present.

  18. Hepatitis B Vaccine Antibody Response and the Risk of Clinical AIDS or Death

    PubMed Central

    Landrum, Michael L.; Hullsiek, Katherine Huppler; O'Connell, Robert J.; Chun, Helen M.; Ganesan, Anuradha; Okulicz, Jason F.; Lalani, Tahaniyat; Weintrob, Amy C.; Crum-Cianflone, Nancy F.; Agan, Brian K.

    2012-01-01

    Background Whether seroresponse to a vaccine such as hepatitis B virus (HBV) vaccine can provide a measure of the functional immune status of HIV-infected persons is unknown.This study evaluated the relationship between HBV vaccine seroresponses and progression to clinical AIDS or death. Methods and Findings From a large HIV cohort, we evaluated those who received HBV vaccine only after HIV diagnosis and had anti-HBs determination 1–12 months after the last vaccine dose. Non-response and positive response were defined as anti-HBs <10 and ≥10 IU/L, respectively. Participants were followed from date of last vaccination to clinical AIDS, death, or last visit. Univariate and multivariable risk of progression to clinical AIDS or death were evaluated with Cox regression models. A total of 795 participants vaccinated from 1986–2010 were included, of which 41% were responders. During 3,872 person-years of observation, 122 AIDS or death events occurred (53% after 1995). Twenty-two percent of non-responders experienced clinical AIDS or death compared with 5% of responders (p<0.001). Non-response to HBV vaccine was associated with a greater than 2-fold increased risk of clinical AIDS or death (HR 2.47; 95% CI, 1.38–4.43) compared with a positive response, after adjusting for CD4 count, HIV viral load, HAART use, and delayed type hypersensitivity skin test responses (an in vivo marker of cell-mediated immunity). This association remained evident among those with CD4 count ≥500 cells/mm3 (HR 3.40; 95% CI, 1.39–8.32). Conclusions HBV vaccine responses may have utility in assessing functional immune status and risk stratificating HIV-infected individuals, including those with CD4 count ≥500 cells/mm3. PMID:22457767

  19. Exploring the Potential Health Impact and Cost-Effectiveness of AIDS Vaccine within a Comprehensive HIV/AIDS Response in Low- and Middle-Income Countries

    PubMed Central

    Harmon, Thomas M.; Fisher, Kevin A.; McGlynn, Margaret G.; Stover, John; Warren, Mitchell J.; Teng, Yu; Näveke, Arne

    2016-01-01

    Background The Investment Framework Enhanced (IFE) proposed in 2013 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs). This article describes additional modeling which looks more closely at the potential health impact and cost-effectiveness of AIDS vaccination in LMICs as part of UNAIDS IFE. Methods An epidemiological model was used to explore the potential impact of AIDS vaccination in LMICs in combination with other interventions through 2070. Assumptions were based on perspectives from research, vaccination and public health experts, as well as observations from other HIV/AIDS interventions and vaccination programs. Sensitivity analyses varied vaccine efficacy, duration of protection, coverage, and cost. Results If UNAIDS IFE goals were fully achieved, new annual HIV infections in LMICs would decline from 2.0 million in 2014 to 550,000 in 2070. A 70% efficacious vaccine introduced in 2027 with three doses, strong uptake and five years of protection would reduce annual new infections by 44% over the first decade, by 65% the first 25 years and by 78% to 122,000 in 2070. Vaccine impact would be much greater if the assumptions in UNAIDS IFE were not fully achieved. An AIDS vaccine would be cost-effective within a wide range of scenarios. Interpretation Even a modestly effective vaccine could contribute strongly to a sustainable response to HIV/AIDS and be cost-effective, even with optimistic assumptions about other interventions. Higher efficacy would provide even greater impact and cost-effectiveness, and would support broader access. Vaccine efficacy and cost per regimen are critical in achieving cost-effectiveness, with cost per regimen being particularly critical in low-income countries and at lower efficacy levels. PMID:26731116

  20. Progress towards development of an HIV vaccine: report of the AIDS Vaccine 2009 Conference.

    PubMed

    Ross, Anna Laura; Bråve, Andreas; Scarlatti, Gabriella; Manrique, Amapola; Buonaguro, Luigi

    2010-05-01

    The search for an HIV/AIDS vaccine is steadily moving ahead, generating and validating new concepts in terms of novel vectors for antigen delivery and presentation, new vaccine and adjuvant strategies, alternative approaches to design HIV-1 antigens for eliciting protective cross-neutralising antibodies, and identification of key mechanisms in HIV infection and modulation of the immune system. All these different perspectives are contributing to the unprecedented challenge of developing a protective HIV-1 vaccine. The high scientific value of this massive effort is its great impact on vaccinology as a whole, providing invaluable scientific information for the current and future development of new preventive vaccine as well as therapeutic knowledge-based infectious-disease and cancer vaccines. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa

    PubMed Central

    2010-01-01

    Background Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. Methods In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Results Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. Conclusion The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields. PMID:20211030

  2. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa.

    PubMed

    Mamotte, Nicole; Wassenaar, Douglas; Koen, Jennifer; Essack, Zaynab

    2010-03-09

    Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.

  3. Activism needed for vaccines to reach South.

    PubMed

    1998-06-30

    An AIDS vaccine remains the only feasible strategy for curbing the spread of HIV infection in resource-poor developing countries because of its low cost and logistic simplicity. However, the pace of vaccine development has been slowed by difficulties persuading pharmaceutical companies to invest time and money in such research. These companies do not perceive a financial advantage to vaccine development. The International AIDS Vaccine Initiative is attempting to create a market for an AIDS vaccine. It is also urging developing countries to develop their own vaccines so they have intellectual property rights. Any advances in this area will require political pressure from community activists.

  4. Initial lessons from public-private partnerships in drug and vaccine development.

    PubMed Central

    Wheeler, C.; Berkley, S.

    2001-01-01

    In recent years, venture capital approaches have delivered impressive results in identifying and funding promising health discoveries and bringing them to market. This success has inspired public sector experiments with "social venture capital" approaches to address the dearth of affordable treatment and prevention for diseases of the developing world. Employing the same focus on well-defined and measurable objectives, and the same type of connections to pool and deploy resources as their for-profit counterparts, social venture capitalists seek to use the tools and incentives of capitalism to solve one of its biggest failures: the lack of drugs and vaccines for diseases endemic to low-income populations. As part of a larger trend of partnerships emerging in health product donation and distribution, public-private partnerships for pharmaceutical development have led research and development (R&D) efforts to generate more accessible and efficacious products for diseases such as malaria, tuberculosis, and AIDS. In this article, three R&D-focused partnerships are explored: the International AIDS Vaccine Initiative; the Medicines for Malaria Venture; and the newly formed Global Alliance for TB Drug Development. The article highlights key elements essential to the success of these ventures. PMID:11545329

  5. Australia reports on AIDS: nef deletions, live vaccines, Chinese travelers.

    PubMed

    Mascolini, M

    1996-03-01

    Australian research shows that individuals who share HIV nef deletions and adjacent sequences in the long terminal repeat (LTR) segment of the viral genome may indicate a weakening of the virus. A cluster of long-term survivors who share this enfeebled virus has contributed to the attenuated HIV vaccine debate. The debate was discussed at the Seventh Annual Australian Conference for HIV Medicine. The story began when a researcher discovered a relationship between a gay male blood donor and five recipients, all of whom remain healthy today. This discovery has intensified discussions on the need for developing attenuated HIV vaccines. Vaccines have four potential dangers: they may mutate into an infectious strain, they may seem safe for several years but cause recipients to develop the disease later, they may cause cancer, or they may be passed in vitro from an infected pregnant woman to her fetus. Malpractice threats will probably dictate that they initially be held in developing countries, where the governments decree that the trial is worth the risk of potential AIDS infection. Other topics covered at the conference included a presentation linking Mycobacterium avium complex (MAC) with distal neuropathy, and another showed a relationship between HIV viral load and a heightened risk of dementia.

  6. Mucosal Vaccination for Prevention of HIV Infection and AIDS.

    PubMed

    Aldovini, Anna

    2016-01-01

    Most of HIV infections occur via the genital tract or the rectum and HIV replicates at high levels in lymphoid organs and intestinal mucosa, likely requiring a more diversified immunity than pathogens restricted to a single mucosal site, such as the gastrointestinal tract for Vibrio cholera, or the respiratory airways for the influenza virus. Numerous AIDS vaccine candidates are under development and a general observation obtained from preclinical trials in non-human primates that failed to provide sterilizing immunity is that some infection protection or delayed onset of disease is observed in the presence of anti-SIV immunity. Recent clinical trials support difficulties to reproduce in humans the results observed in simian models, but at least one of them indicated that some protection of infection can be achieved. However, given the limited efficacy observed in the RV144 trial and concerns voiced in its statistical interpretation, preclinical trials should explore more effective immunogens, whether new or as combinations of existing ones, and mucosal routes of vaccinations in addition to the systemic routes, with the goal to maximize vaccination-mediated protection. The rationale for generating both strong mucosal and systemic immunity comes from animal experiments, recent clinical trials, and other successful vaccines currently in use. Mucosal responses against SIV have been induced with a variety of SIV antigens and via different mucosal routes with a spectrum of effects on protection. This review covers the rational and the experimental data that support the validity to explore mucosal immunization for HIV infection and AIDS prevention.

  7. Quality Improvement Initiative to Improve HPV Vaccine Initiation at Nine Years of Age,.

    PubMed

    Goleman, Martha J; Dolce, Millie; Morack, Jennifer

    2018-05-26

    Adolescent human papillomavirus (HPV) vaccine rates remain low. Early vaccination may improve the efficacy of the vaccine and immunization rates. However, clinicians have not routinely made a strong recommendation to younger adolescents. This study assessed the feasibility of routine vaccination at nine years of age. Three sequential quality improvement (QI) interventions were implemented to shift the initiation of the HPV vaccine to nine years of age in a primary care network in low-income neighborhoods in Columbus, Ohio. The first intervention changed the electronic medical record (EMR) alert for the HPV vaccine from eleven to nine years of age and focused on cancer prevention when discussing the vaccine with families. The second intervention was formation of an HPV QI team. The third intervention was a clinic incentive for HPV captured opportunity rates. Immunization rates were monitored using statistical process control charts to compare the HPV immunization rate in a sample of nine and ten-year-old children with a sample of 11 and 12-year-old children. The percentage of patients receiving an HPV vaccine before 11 years increased from 4.6% to 35.7% during the six months after the QI initiative began and to 60.8% 18 months after the project began. In comparison, the HPV vaccination rate in the sample of 11 and 12 year-olds increased from 78.7% to 82.8% 18 months later. This QI project used multiple interventions to increase HPV vaccination at nine years of age in a large primary care network serving a diverse low-income population. Copyright © 2018. Published by Elsevier Inc.

  8. Influence of initial vaccination with 13-valent pneumococcal conjugate vaccine or 23-valent pneumococcal polysaccharide vaccine on anti-pneumococcal responses following subsequent pneumococcal vaccination in adults 50 years and older.

    PubMed

    Jackson, Lisa A; Gurtman, Alejandra; van Cleeff, Martin; Frenck, Robert W; Treanor, John; Jansen, Kathrin U; Scott, Daniel A; Emini, Emilio A; Gruber, William C; Schmoele-Thoma, Beate

    2013-08-02

    Unlike free polysaccharide vaccines, pneumococcal polysaccharide conjugate vaccines (PCVs) induce a T cell-dependent immune response and have the potential to provide an extended duration of protection with repeated vaccinations. This was an extension of a previous study in pneumococcal vaccine-naïve adults aged 50-64 years in which adults 60-64 years of age were given 13-valent PCV (PCV13) or 23-valent pneumococcal polysaccharide vaccine (PPSV23) and adults aged 50-59 were given PCV13. In this follow up study conducted about 4 years later, the 60-64 year olds initially given PCV13 received PCV13 or PPSV23, and those initially given PPSV23 received another PPSV23. All adults aged 50-59 years were re-vaccinated with PCV13. Anti-pneumococcal opsonophagocytic activity (OPA) titers were measured before and 1 month after vaccination. A second PCV13 given about 4 years after a first vaccination induced OPA titers that were significantly higher than those following the initial vaccination for 7 of 13 serotypes in the older group, and 6 of 13 serotypes in the younger group, and responses to the remaining serotypes were largely non-inferior. In contrast, OPA titers following revaccination with PPSV23 were statistically significantly lower for 9 of the 13 serotypes, and non-inferior for the remaining serotypes, when compared to the responses to the first PPSV23. OPA titers in the older adults who received PPSV23 after initial PCV13 were significantly higher than those following a first PPSV23 for 10 of the 13 serotypes. In adults 50 to 64 years of age, initial vaccination with PCV13 establishes an immune state that results in recall anti-pneumococcal responses upon subsequent vaccination with either conjugated or free polysaccharide vaccine. In contrast, initial vaccination with PPSV23 results in an immune state in which subsequent PPSV23 administration yields generally lower responses compared with the initial responses. Copyright © 2013 The Authors. Published by Elsevier

  9. Novel Vaccine Approach Achieves “Functional Cure” of AIDS Virus in Monkeys | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer, and Jeff Lifson, Guest Writer Scientists at the Oregon Health & Science University and the AIDS and Cancer Virus Program of the Frederick National Laboratory for Cancer Research have used a novel vaccine approach to achieve a “functional cure” and apparent eradication of infection with a monkey version of the AIDS virus.

  10. Remarks spoken before the audience at the final conference plenary session, entitled: "Future directions," at the International Conference on Advances in AIDS Vaccine Development. Fourth annual meeting of the National Cooperative Vaccine Development Groups for AIDS.

    PubMed

    Nzila, N

    1992-08-01

    Nzilambi Nzila, Visiting Scientist at the Johns Hopkins University Center for Immunization Research, responds to frequently asked questions about AIDS vaccine clinical trials in Africa. Conference attendees had asked him if the thinks the time is right to begin AIDS vaccine clinical trials in Africa; if African populations and decision makers want to be involved in the trials; and if he thinks that Africans will be used as guinea pigs. Given the magnitude of the AIDS pandemic in Africa and the general population desire for effective responses, Nzila feels that clinical trials could commence. Yes, Africans want to be involved in the early phases of clinical trials to both share their experiences and reap the benefits of an effective and safe vaccine should one be developed. Large IEC campaigns will simply not suffice to stem the spread of HIV. Further, decision makers in Africa should be involved as early as possible to allow then time to recruit HIV-negative volunteers for trials. Finally, Nzila does not equate involvement in vaccine trials with laboratory test animal status, especially since the target population is aware of its participation.

  11. Do correlates of HPV vaccine initiation differ between adolescent boys and girls?

    PubMed Central

    Moss, Jennifer L.; McRee, Annie-Laurie

    2012-01-01

    Background Guidelines now recommend that adolescents routinely receive human papillomavirus (HPV) vaccine. Because little is known about uptake among boys, we assessed HPV vaccine initiation in a population-based sample of adolescent boys and girls. Methods We analyzed weighted data from 751 parents who reported on an 11- to 17-year-old son or daughter for the 2010 North Carolina Child Health Assessment and Monitoring Program survey. Stratified multivariate logistic regression analyses identified correlates of HPV vaccine initiation separately for boys and girls. Results Only 14% of sons had received one or more doses of HPV vaccine compared to 44% of daughters (p<0.01). For both sons and daughters, vaccine initiation correlated with age and having received meningococcal vaccine. Among sons, initiation of HPV vaccine was lower for those living in high income households (odds ratio [OR]=0.22, 95% CI, 0.09–0.53) and higher for those whose race was neither white nor black (OR=3.26, 95% CI, 1.06–10.04). When asked to give the main reason for not vaccinating their child against HPV, parents of unvaccinated sons were more likely than those of daughters to report not getting a provider’s recommendation or not being aware the vaccine was available for their child, but less likely to report concern about safety (p<0.01). At least 86% of unvaccinated children had missed an opportunity to receive HPV vaccine. Conclusions HPV vaccine correlates and concerns varied for parents of boys and girls. To improve very low levels of uptake among boys, providers should recommend HPV vaccine concomitant with other adolescent vaccines. PMID:22841973

  12. Communication technologies to improve HPV vaccination initiation and completion: A systematic review.

    PubMed

    Francis, Diane B; Cates, Joan R; Wagner, Kyla P Garrett; Zola, Tracey; Fitter, Jenny E; Coyne-Beasley, Tamera

    2017-07-01

    This systematic review examines the effectiveness of communication technology interventions on HPV vaccination initiation and completion. A comprehensive search strategy was used to identify existing randomized controlled trials testing the impact of computer-, mobile- or internet-based interventions on receipt of any dose of the HPV vaccine. Twelve relevant studies were identified with a total of 38,945 participants. The interventions were delivered using several different methods, including electronic health record (i.e. recall/reminder) prompts, text messaging, automated phone calls, interactive computer videos, and email. Vaccine initiation and completion was greater for technology-based studies relative to their control conditions. There is evidence that interventions utilizing communication technologies as their sole or primary mode for HPV vaccination intervention delivery may increase vaccination coverage. Communication technologies hold much promise for the future of HPV vaccination efforts, especially initiatives in practice-based settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Correlates of HPV vaccine initiation and provider recommendation among male adolescents, 2014 NIS-Teen.

    PubMed

    Landis, Kathryn; Bednarczyk, Robert A; Gaydos, Laura M

    2018-05-08

    Vaccination is a safe and effective way to prevent Human Papillomavirus (HPV) infection and related cancers; however, HPV vaccine uptake remains low in the US. After the 2011 Advisory Committee on Immunization Practices (ACIP) recommendation for routine HPV vaccination of adolescent males, several studies have examined predictors for initiating the vaccine series in this population of interest, particularly with regard to provider recommendations. This study examined racial and ethnic differences for HPV vaccine initiation and provider recommendation in male adolescents. Based on prior HPV vaccine uptake estimates and healthcare utilization data, we hypothesized that minority adolescents would be more likely to initiate HPV vaccines, but less likely to receive a provider recommendation compared to white counterparts. We analyzed the 2014 National Immunization Survey-Teen (NIS-Teen), which included 10,753 male adolescents with provider-verified vaccination data in 50 US states, using multivariate logistic regression models to evaluate racial/ethnic differences in HPV vaccine initiation and provider recommendation. The odds of HPV vaccine initiation were 76 percent higher for Hispanic adolescents and 43 percent higher for non-Hispanic Other or Multiple race adolescents compared to white adolescents. Approximately half of parents reported receiving a provider recommendation for vaccination, with no significant difference in the odds of receiving a provider recommendation across racial/ethnic groups. Despite similar frequency of recommendations across racial and ethnic groups, male adolescents who are racial/ethnic minorities are more likely to initiate vaccination. Future research should focus on developing tailored interventions to increase HPV vaccine receipt among males of all racial/ethnic groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. New Animal Model Could Boost Research on AIDS Drugs and Vaccines | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer, and Jeff Lifson, Guest Writer In a research milestone reported in the June 20 issue of the journal Science, scientists have developed a minimally modified version of HIV-1, the virus that causes AIDS in infected humans, that is capable of causing progressive infection and AIDS in monkeys. The advance should help create more authentic animal models of the disease and provide a potentially invaluable approach for faster and better preclinical evaluation of new drugs and vaccines.

  15. Generation and Repair of AID-initiated DNA Lesions in B Lymphocytes

    PubMed Central

    Chen, Zhangguo; Wang, Jing H.

    2014-01-01

    Activation-induced deaminase (AID) initiates the secondary antibody diversification process in B lymphocytes. In mammalian B cells, this process includes somatic hypermutation (SHM) and class switch recombination (CSR), both of which require AID. AID induces U:G mismatch lesions in DNA that are subsequently converted into point mutations or DNA double stranded breaks during SHM/CSR. In a physiological context, AID targets immunoglobulin (Ig) loci to mediate SHM/CSR. However, recent studies reveal genome-wide access of AID to numerous non-Ig loci. Thus, AID poses a threat to the genome of B cells if AID-initiated DNA lesions cannot be properly repaired. In this review, we focus on the molecular mechanisms that regulate the specificity of AID targeting and the repair pathways responsible for processing AID-initiated DNA lesions. PMID:24748462

  16. Human Immunodeficiency Virus (HIV) Research (AIDS)

    DTIC Science & Technology

    1993-07-15

    Alamos, New Mexico . The Technical Working Group for HIV Isolation and Characterization, Vaccine Development Unit, Global Program on AIDS, World Health...remaining virus isolation positive. RVA 5 - IHIV-2 infection of rhesus macaques’- This study was initiated at another facility, the New Mexico Primate... Mexico were part of a previous titration study with SIVc 25 1 , a virus isolate which was proposed for use in future MMCARR vaccine and pathogenesis

  17. Predictors of Human Papillomavirus Vaccine Completion Among Female and Male Vaccine Initiators in Family Planning Centers.

    PubMed

    Simons, Hannah R; Unger, Zoe D; Lopez, Priscilla M; Kohn, Julia E

    2015-12-01

    We estimated human papillomavirus (HPV) vaccine series completion and examined predictors of completion among adolescents and young adults in a large family planning network. Our retrospective cohort study of vaccine completion within 12 months and time to completion used electronic health record data from 119 Planned Parenthood health centers in 11 US states for 9648 patients who initiated HPV vaccination between January 2011 and January 2013. Among vaccine initiators, 29% completed the series within 12 months. Patients who were male, younger than 22 years, or non-Hispanic Black or who had public insurance were less likely to complete within 12 months and completed more slowly than their counterparts. Gender appeared to modify the effect of public versus private insurance on completion (adjusted hazard ratio = 0.76 for women and 0.95 for men; relative excess risk due to interaction = 0.41; 95% confidence interval = 0.09, 0.73). Completion was low yet similar to previous studies conducted in safety net settings.

  18. The vaccines consistency approach project: an EPAA initiative.

    PubMed

    De Mattia, F; Hendriksen, C; Buchheit, K H; Chapsal, J M; Halder, M; Lambrigts, D; Redhead, K; Rommel, E; Scharton-Kersten, T; Sesardic, T; Viviani, L; Ragan, I

    2015-01-01

    The consistency approach for release testing of established vaccines promotes the use of in vitro, analytical, non-animal based systems allowing the monitoring of quality parameters during the whole production process. By using highly sensitive non-animal methods, the consistency approach has the potential to improve the quality of testing and to foster the 3Rs (replacement, refinement and reduction of animal use) for quality control of established vaccines. This concept offers an alternative to the current quality control strategy which often requires large numbers of laboratory animals. In order to facilitate the introduction of the consistency approach for established human and veterinary vaccine quality control, the European Partnership for Alternatives to Animal Testing (EPAA) initiated a project, the "Vaccines Consistency Approach Project", aiming at developing and validating the consistency approach with stakeholders from academia, regulators, OMCLs, EDQM, European Commission and industry. This report summarises progress since the project's inception.

  19. Vaccines of the future.

    PubMed

    Nossal, G J V

    2011-12-30

    Vaccines of the future can be divided into three broad groups, namely those of the near future (<10 years); the medium-term future (10-19 years); and the long-term future (20-50 years). For the near future, there is some "low hanging fruit" which is clearly on the horizon, such as a Vi-conjugate vaccine for typhoid or a protein-based vaccine for Neisseria meningitidis serogroup B. Just slightly more distant will be vaccines for shigellosis and a common protein vaccine for Streptococcus pneumoniae. Also in this group, but not as far advanced, will be a vaccine for Group A streptococcus. I place vaccines for the "big three", malaria, tuberculosis and HIV/AIDS in the medium term basket. The sporozoite malaria vaccine RTS-S is closest, but surely a definitive malaria vaccine will also require antigens from other stages of the life cycle. A tuberculosis vaccine will be either a re-engineered BCG; or a molecular vaccine with several protein antigens; or one based on prime-boost strategies. What will delay this is the high cost of clinical trials. For HIV/AIDS, the partial success of the Sanofi-Pasteur prime-boost vaccine has given some hope. I still place much faith in antibody-based vaccines and especially on mimotopes of the env transitional state assumed after initial CD4 binding. Monoclonal antibodies are also leading us in interesting directions. Longer term, the vaccine approach will be successful for autoimmune diseases, e.g. juvenile diabetes and coeliac disease. Cancer vaccines are also briefly surveyed. Adjunct issues needing to be addressed include more extensive combinations; alternate delivery systems; and more intelligently designed adjuvants based on knowledge of the innate immune system. Copyright © 2011. Published by Elsevier Ltd.

  20. Material aid for vaccines

    NASA Astrophysics Data System (ADS)

    Irvine, Darrell

    2018-06-01

    Darrell Irvine provides an overview of the recent advances in materials science that have enabled the use of innovative natural and synthetic compounds in vaccine development capable of regulating the potency and safety of new vaccines progressing towards the clinic.

  1. HIV vaccine: Can it be developed in the 21st century?

    PubMed

    Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj; Dhankar, Mukesh

    2016-01-01

    HIV infection is a major public health problem especially in the developing countries. Once a person infects with HIV, it remained infected for lifelong. The advanced stage developed after 10-15 y of HIV infection that stage is called acquired immunodeficiency syndrome (AIDS). From 1990 to 2000 the number of people living with HIV rose from 8 million to 27 million; since the beginning of the HIV/AIDS epidemic, AIDS has claimed almost 39million lives so far. Till now, there is no cure for HIV infection; however, after the introduction of effective treatment with antiretroviral (ARV) drugs the HIV individual can enjoy healthy and productive lives. Vaccine is safe and cost-effective to prevent illness, impairment, disability and death. Like other vaccines, a preventive HIV vaccine could help save millions of lives. All vaccines work the same way i.e. the antigen stimulate the immune system and develop antibodies. The ultimate goal is to develop a safe and effective vaccine that protects people worldwide from getting infected with HIV. However, some school of thought that vaccine may protects only some HIV people, it could have a major impact on the rates of transmission of HIV and this will help in control of epidemic, especially in populations where high rate of HIV transmission. In the past, some scientist doubted on the development of an effective polio vaccine, but now we are near to eradicate the polio from the world this is possible because of successful vaccination programmes. HIV vaccine research is aided by the not-for-profit International AIDS/HIV vaccine Initiative (IAVI), which helps to support and coordinate vaccine research, development, policy and advocacy around the world. Although the challenges for scientist are intimidating but scientists remain hopeful that they can develop safe and effective HIV vaccines for patients in future.

  2. Delayed-Type Hypersensitivity and Hepatitis B Vaccine Responses, in vivo Markers of Cellular and Humoral Immune Function, and the Risk of AIDS or Death

    PubMed Central

    Patterson, Shane B.; Landrum, Michael L; Okulicz, Jason F.

    2014-01-01

    Background Delayed-type hypersensitivity (DTH) test responsiveness is associated with HIV disease progression; however it is unknown whether other immune markers, such as hepatitis B virus (HBV) vaccine seroresponse, also predict HIV outcomes. Methods Eligible participants received HBV vaccine after HIV diagnosis, had non-anergic DTH testing at the time of last HBV vaccination, and available post-vaccine HBV antibody responses. The risk of progression to AIDS or death from the time of last HBV vaccination was evaluated. Results Of 369 eligible participants with non-anergic DTH responses, 148 (40%) were HBV vaccine responders. In a multivariate model adjusted for age, CD4 count, viral load, and number of vaccinations, HBV vaccine non-responders had an increased risk of progression to AIDS or death (HR 1.81; 95% CI, 1.03–3.19). Conclusions HBV vaccine seroresponses were independent of DTH responses which suggest that non-response to HBV vaccine is not solely due to cell-mediated immune dysfunction in HIV-infected persons. PMID:24793945

  3. Initiation & completion rates of hepatitis A vaccination among US pediatric populations born between 2005 and 2009.

    PubMed

    Weiss, Thomas; Zhang, Dongmu; Borse, Nagesh N; Walter, Emmanuel B

    2015-11-27

    To estimate hepatitis A vaccine series initiation and completion rates, assess time to vaccination, identify missed opportunities for the hepatitis A vaccine series, and examine factors associated with hepatitis A vaccine series initiation and completion. We conducted a retrospective, observational study using three healthcare claims databases separately. The study population was comprised of children born between years 2005 and 2009 that were continuously enrolled for at least three and a half years from the date of birth. Every child was followed from date of birth for three and a half years for hepatitis A vaccination. There were 93,735 eligible children from Clinformatics Data Mart, 202,513 from MarketScan Commercial, and 207,545 from MarketScan Medicaid. The overall hepatitis A vaccine series initiation rate was 63.8-79.4% and completion rate was 45.1-66.8% across the three databases. About 62.8-90.1% of the children who never initiated hepatitis A vaccine had at least one well visit from 1 year to three and a half years old. Children were more likely to initiate and complete the hepatitis A vaccine series if they were from more recent birth cohorts, from states with a hepatitis A vaccination recommendation prior to the ACIP universal recommendation, from states with daycare/school entry requirements, were enrolled in an HMO health plan, had pediatricians as primary providers, had more doctor's office/well visits and received MMR/Varicella vaccines. In this study, approximately one in every three to five children remained unvaccinated against hepatitis A. Although the hepatitis A vaccine series initiation and completion improved from 2005 to 2009, vaccine coverage has stabilized in recent years. It is important for providers to identify every opportunity for hepatitis A vaccination and to assure that children get protection from this vaccine-preventable disease. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Origins of the Children's Vaccine Initiative: the political foundations.

    PubMed

    Muraskin, W

    1996-06-01

    The Children's Vaccine Initiative (CVI) was founded in 1990-91 as a means to revolutionize the way that vaccines were developed for the South. The system for the creation of vaccines was a dis-articulated one in which basic research, product development and delivery were handled by different, often insufficiently linked groups. The public sector was deeply involved in research and delivery but not the vital product development area. That area was left to the private sector which was increasingly driven by the needs to maximize profits. Potential vaccines for diseases found in the South, where a hard currency market was limited, were often left undeveloped. The CVI was designed to change that situation. The CVI hoped to exploit the discoveries of biotechnology and produce not only new and improved vaccines, but ultimately to work towards a single multi-antigen vaccine given near birth that would immunize children for life. This article deals with the events that directly led to the creation of the CVI, and to the political problems caused by organizational and national rivalries that the new venture faced from its inception.

  5. CMV sinusitis as the initial manifestation of AIDS.

    PubMed

    Jütte, A; Fätkenheuer, G; Hell, K; Salzberger, B

    2000-03-01

    Cytomegalovirus (CMV) disease is a typical late-stage complication of AIDS. Only six cases of CMV sinusitis have been reported in the literature. This is the first case of CMV sinusitis leading to the diagnosis of HIV and CMV retinitis. Diseases of the sinonasal tract may represent an initial manifestation of HIV or AIDS.

  6. Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation among Adolescent Girls in the United States.

    PubMed

    Henry, Kevin A; Stroup, Antoinette M; Warner, Echo L; Kepka, Deanna

    2016-02-01

    This study is among the first to explore geographic factors that may be associated with human papillomavirus (HPV) vaccine uptake in the United States. Data from the 2011 and 2012 National Immunization Survey-Teen for 20,565 female adolescents aged 13 to 17 years were analyzed to examine associations of HPV vaccine initiation (receipt of at least one dose) with ZIP code-level geographic factors. Logistic regression including individual and geographic factors was used to estimate the odds of HPV vaccine initiation. Approximately 53% of girls initiated the HPV vaccine in both years. Girls in high poverty communities had higher HPV vaccine initiation compared with those in low poverty communities [61.1% vs. 52.4%; adjusted OR (AOR), 1.18; 95% confidence intervals (CI), 1.04-1.33]. Initiation was higher among girls in communities where the majority of the population was Hispanic (69.0% vs. 49.9%; AOR, 1.64; 95% CI, 1.43-1.87) or non-Hispanic mixed race (60.4% vs. 49.9%; AOR, 1.30; 95% CI, 1.17-1.44) compared with majority non-Hispanic white communities. Interactions between individual-level race/ethnicity and community racial-ethnic composition indicated significantly higher odds of initiation among Hispanic girls living in Hispanic communities compared with Hispanic girls living in predominantly non-Hispanic White (NHW) (AOR, 2.23; 95% CI, 1.87-2.65) or non-Hispanic Black (NHB) (AOR, 1.90; 95% CI, 1.20-3.04) communities, respectively. Initiation rates of HPV vaccination among teen girls were highest in the poorest communities and among Hispanics living in communities where the racial-ethnic composition was predominantly Hispanic or mixed race. Given low HPV vaccination rates in the United States, these results provide important evidence to inform public health interventions to increase HPV vaccination. ©2016 American Association for Cancer Research.

  7. Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation Among Adolescent Girls in the United States

    PubMed Central

    Henry, Kevin A.; Stroup, Antoinette M.; Warner, Echo L; Kepka, Deanna

    2015-01-01

    Background This study is among the first to explore geographic factors that may be associated with HPV vaccine uptake in the United States. Methods Data from the 2011 and 2012 National Immunization Survey-Teen for 20,565 female adolescents aged 13-17 years were analyzed to examine associations of HPV vaccine initiation (receipt of at least one dose) with ZIP code-level geographic factors. Logistic regression including individual and geographic factors was used to estimate the odds of HPV vaccine initiation. Results Approximately 53% of girls initiated the HPV vaccine in both years. Girls in high poverty communities had higher HPV vaccine initiation compared to those in low poverty communities (61.1% vs .52.4%; Adjusted Odds Ratio [AOR] 1.18,95%CI 1.04-1.33). Initiation was higher among girls in communities where the majority of the population was Hispanic (69.0% vs. 49.9%;AOR 1.64, 95%CI 1.43-1.87) or non-Hispanic mixed race (60.4% vs. 49.9%; AOR 1.30, 95%CI 1.17-1.44) compared to majority non-Hispanic white communities. Interactions between individual-level race/ethnicity and community racial–ethnic composition indicated significantly higher odds of initiation among Hispanic girls living in Hispanic communities compared to Hispanic girls living in predominately NHW (AOR 2.23;95%CI 1.87-2.65) or NHB (AOR 1.90; 95%CI 1.20-3.04)communities, respectively Conclusion Initiation rates of HPV vaccination among teen girls were highest in the poorest communities and among Hispanics living in communities where the racial–ethnic composition was predominantly Hispanic or mixed race. Impact Given low HPV vaccination rates in the United States, these results provide important evidence to inform public health interventions to increase HPV vaccination. PMID:26768989

  8. HIV vaccines advocacy: the role of UNAIDS. Research and accessibility.

    PubMed

    Piot, P

    1996-01-01

    This article presents an interview with Dr. Peter Piot, executive director of the Joint UN Program on HIV/AIDS (UNAIDS) on the role of UNAIDS in the advocacy of HIV vaccines. Piot stressed that an efficient HIV vaccine, truly protective against HIV infection, could make all the difference in the campaign against AIDS. To this effect, the role of the UNAIDS is to carry out advocacy in favor of research as well as to collaborate with the diverse private initiatives that already exist. Commenting on the issue of guaranteed accessibility of HIV vaccine for developing countries, Piot states that it is possible to sell the product through seeking the support of donor organizations. When vaccine trials in a country are supported, it will also be made sure that the basic guarantees exist for making that product accessible to the population. Moreover, considering the impact of the pandemic on the business and economic community, Piot emphasized that alliance between the public and private sector is necessary in the struggle against AIDS. In general, the role of UNAIDS in the evaluation of a preventive vaccine for HIV is centered around communication, impact on community, and impact on prevention programs.

  9. Scientific and regulatory challenges in evaluating clinical trial protocols for HIV-1/AIDS vaccines - A review from a regulatory perspective.

    PubMed

    Sheets, Rebecca L; Zhou, TieQun; Knezevic, Ivana

    2016-03-01

    Clinical development of prophylactic HIV/AIDS vaccines presents many scientific challenges that result in challenges for regulators reviewing clinical trial applications (CTAs). The World Health Organization (WHO) has the responsibility to provide technical support to these regulators. The search for an HIV/AIDS vaccine will only succeed through well-designed, -conducted and -controlled human efficacy studies reviewed and approved by regulators in countries worldwide, particularly in countries where the epidemic has hit hardest, such as in sub-Saharan Africa and Asia. This review summarizes the current candidates in development and focuses on challenges regulators face when reviewing CTAs, such as the evolving landscape of "standard of prevention," trials in adolescents, adaptive trial designs, correlates of protection and their analysis, and access to successful vaccines. There are many unknowns in the field of HIV/AIDS vaccine development and often, there is not a clear right or wrong approach because of the scientific challenges described in this review. Consequently, regulators should not feel that decisions need be made in isolation, when there are many available international collaborative efforts and opportunities to seek expert advice. The WHO provides many such opportunities and support to regulators across the globe. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Equal Access Initiative HIV/AIDS Information Resources from NLM

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Templin-Branner W. and N. Dancy

    The Equal Access Initiative: HIV/AIDS Information Resources from the National Library of Medicine training is designed specifically for the National Minority AIDS Council 2010 Equal Access Initiative (EAI) Computer Grants Program awardees to provide valuable health information resources from the National Library of Medicine and other reliable sources to increase awareness of the wealth of treatment information and educational materials that are available on the Internet and to improve prevention and treatment education for their clients. These resources will also meet the needs of community-based

  11. Childhood vaccination: achievements and challenges.

    PubMed

    Ndumbe, P

    1996-09-01

    As the goal of eradicating smallpox was being met, the World Health Organization created its Expanded Programme on Immunisation (EPI) in 1974 and reached its initial goal of achieving full vaccination of 80% of the world's children by 1990. This effort was aided by the creation of "cold chain" delivery systems and resulted in the annual saving of 3.5 million children in less-developed countries. Current EPI vaccination goals include 1) eradication of poliomyelitis by the year 2000, 2) elimination of neonatal tetanus by the year 1995, 3) control of measles and hepatitis B, and 4) immunization of 90% of the world's children 1 year or younger by the year 2000. Goals of the Children's Vaccine Initiative (formed in 1991) include 1) provision of an adequate supply of affordable, safe, and effective vaccines; 2) production of improved and new vaccines; and 3) simplification of the logistics of vaccine delivery. Future challenges are to sustain high vaccination coverage, reach the unreached, achieve proper storage of vaccines and reduce waste, integrate new vaccines into national programs, and achieve vaccine self-sufficiency. The fact that these challenges will be difficult to achieve is illustrated by the situation in Africa where the high immunization levels achieved in 1990 have dropped dramatically. Those who must act to implement immunization programs are health personnel, families, governments, and development partners. In order to achieve equity in health, every child must be reached, governments must be made accountable for programs, health workers must convince families of the importance of vaccination, delivery systems must be in place to take advantage of the new vaccines being delivered, and a multisectoral approach must be taken to assure sustainability.

  12. Lessons in AIDS Vaccine Development Learned from Studies of Equine Infectious, Anemia Virus Infection and Immunity

    PubMed Central

    Craigo, Jodi K.; Montelaro, Ronald C.

    2013-01-01

    Equine infectious anemia (EIA), identified in 1843 [1] as an infectious disease of horses and as a viral infection in 1904, remains a concern in veterinary medicine today. Equine infectious anemia virus (EIAV) has served as an animal model of HIV-1/AIDS research since the original identification of HIV. Similar to other lentiviruses, EIAV has a high propensity for genomic sequence and antigenic variation, principally in its envelope (Env) proteins. However, EIAV possesses a unique and dynamic disease presentation that has facilitated comprehensive analyses of the interactions between the evolving virus population, progressive host immune responses, and the definition of viral and host correlates of immune control and vaccine efficacy. Summarized here are key findings in EIAV that have provided important lessons toward understanding long term immune control of lentivirus infections and the parameters for development of an enduring broadly protective AIDS vaccine. PMID:24316675

  13. Accelerating Next Generation Vaccine Development for Global Disease Prevention

    PubMed Central

    Koff, Wayne C; Burton, Dennis R.; R.Johnson, Philip; Walker, Bruce D.; King, Charles R.; Nabel, Gary J.; Ahmed, Rafi; Bhan, Maharaj Kishan; Plotkin, Stanley A.

    2014-01-01

    Summary Vaccines are among the greatest successes in the history of public health. However, past strategies for vaccine development are unlikely to succeed in the future against major global diseases such as AIDS, TB, and malaria. For such diseases, the correlates of protection are poorly defined and the pathogens evade immune detection and/or exhibit extensive genetic variability. Recent advances have heralded in a new era of vaccine discovery. However, translation of these advances into vaccines remains impeded by lack of understanding of key vaccinology principles in humans. We review these advances towards vaccine discovery and suggest that for accelerating successful vaccine development, new human immunology-based clinical research initiatives be implemented with the goal of elucidating and more effectively inducing vaccine-induced protective immune responses. PMID:23723240

  14. Teenagers' knowledge about HPV infection and HPV vaccination in the first year of the public vaccination programme.

    PubMed

    Sopracordevole, F; Cigolot, F; Gardonio, V; Di Giuseppe, J; Boselli, F; Ciavattini, A

    2012-09-01

    The aim of this study was to assess teens' knowledge of HPV infection and vaccination one year after the initiation of the public vaccination programme and information campaign on the disease and the opportunity of vaccination. Between 15 May and 15 June 2009, a survey was carried out on 1,105 teenagers attending high schools in a town in the northeast of Italy by means of an anonymous and unannounced questionnaire covering the knowledge of HPV infection, transmission, prevention, vaccination and post-vaccination behaviours. Only 75% of teens knew what HPV infection is (92% of girls vs 51% of boys, p < 0.001); only 70% knew that it is a sexually-transmitted infection. Only 69.3% associated condoms with HPV disease prevention (72.6% girls vs 61.5% boys, p = 0.002). About 18.8% of girls and 33.2% of boys believe that HPV can lead to AIDS (p < 0.001). Among teens aware of HPV vaccination, 7.6% of girls and 21.8% of boys believe that it can prevent AIDS (p < 0.001). Only 75.5% of girls and 51.1% of boys (p < 0.001) believe that condom use remains useful for HPV prevention after vaccination. The need for regular pap smears after vaccination is reported by 93.3% of girls. Teens' knowledge about HPV infection and vaccination remains insufficient, despite a broad information campaign. Erroneous information may increase risky sexual behaviours. Without complete information about HPV infection and vaccination and information about other sexually-transmitted diseases, the latter might become difficult to control among teenagers, while some misunderstandings about the usefulness of secondary prevention might linger.

  15. HIV-2 and its role in conglutinated approach towards Acquired Immunodeficiency Syndrome (AIDS) Vaccine Development.

    PubMed

    Diwan, Batul; Saxena, Rupali; Tiwari, Archana

    2013-12-01

    Acquired Immunodeficiency Syndrome (AIDS) is one of the most critically acclaimed endemic diseases, caused by two lentiviruses HIV-1 and 2. HIV-2 displays intimate serological and antigenic resemblance to Simian Immunodeficiency Virus (SIV) along with less pathogenicity, lower infectivity and appreciable cross reactivity with HIV-1 antigens. The present era is confronted with the challenge to fabricate a vaccine effective against all clades of both the species of HIV. But vaccine development against HIV-1 has proven highly intricate, moreover the laborious and deficient conventional approaches has slackened the pace regarding the development of new vaccines. These concerns may be tackled with the development of HIV-2 vaccine as a natural control of HIV-1 that has been found in ancestors of HIV-2 i.e. African monkeys, mangabeys and macaques. Thereby, suggesting the notion of cross protection among HIV-2 and HIV-1. Assistance of bioinformatics along with vaccinomics strategy can bring about a quantum leap in this direction for surpassing the bottleneck in conventional approaches. These specifics together can add to our conception that HIV-2 vaccine design by in silico strategy will surely be a constructive approach for HIV-1 targeting.

  16. The Children's Vaccine Initiative and vaccine supply: the role of the public sector.

    PubMed

    van Noort, R B

    1992-01-01

    'Children represent the most vulnerable segment of every society--and they are our present and future. Good health, especially of children, promotes personal and national development. Scientific progress, matched with improved capacities of all countries to immunize their children, provides an unparalleled opportunity to save additional lives and prevent additional millions of disabilities annually through a Children's Vaccine Initiative.' (The Netherlands Minister for Development Co-operation.)

  17. Increasing Human Papillomavirus Vaccine Initiation among Publically-Insured Florida Adolescents

    PubMed Central

    Staras, Stephanie A. S.; Vadaparampil, Susan T.; Livingston, Melvin D.; Thompson, Lindsay A.; Sanders, Ashley H.; Shenkman, Elizabeth A.

    2014-01-01

    Purpose We evaluated the feasibility of a multi-level intervention to increase HPV vaccine initiation among adolescents. Methods We used a four-arm factorial quasi-experimental trial to assess feasibility and short-term, preliminary effectiveness of a health system-level, gender-specific postcard campaign and an in-clinic health information technology (HIT) system. Between August to November 2013, we tested the intervention among 11–17 year olds without prior HPV vaccine claims in Florida Medicaid or Children’s Health Insurance Program encounters (2773 girls and 3350 boys) who attended or were assigned to primary care clinics in North Central Florida. Results At least one postcard was deliverable to 95% of parents. Most parents (91% boys’ and 80% girls’) who participated in the process evaluation survey (n=162) reported seeking additional information about the vaccine after receiving the postcard. Only 8% (57 of the 1062) of adolescents assigned to a HIT provider with an office visit during the study used the HIT system. When compared with arms not containing that component, HPV vaccine initiation increased with the postcard campaign [girls Odds Ratio (OR) = 1.6, 95% Confidence Interval (CI) = 1.1–2.3 and boys = not significant], the HIT system (girls OR = 1.5, 95% CI =1.0–2.3 and boys OR = 1.4, 95% CI=1.0–2.0), and the combined HIT and postcard intervention (girls OR = 2.4, 95% CI =1.4–4.3 and boys OR = 1.6, 95% CI=1.0–2.5). Conclusions A system-level postcard campaign was feasible. Despite low recruitment to the inclinic HIT system, the intervention demonstrated short-term, preliminary effectiveness similar to prior HPV vaccine interventions. PMID:25863554

  18. Correlates of human papillomavirus (HPV) vaccination initiation and completion among 18-26 year olds in the United States.

    PubMed

    Adjei Boakye, Eric; Lew, Daphne; Muthukrishnan, Meera; Tobo, Betelihem B; Rohde, Rebecca L; Varvares, Mark A; Osazuwa-Peters, Nosayaba

    2018-04-30

    To examine correlates of HPV vaccination uptake in a nationally representative sample of 18-26-year-old adults. Young adults aged 18-26 years were identified from the 2014 and 2015 National Health Interview Survey (n = 7588). Survey-weighted multivariable logistic regression models estimated sociodemographic factors associated with HPV vaccine initiation (≥1 dose) and completion (≥3 doses). Approximately 27% of study participants had initiated the HPV vaccine and 16% had completed the HPV vaccine. Participants were less likely to initiate the vaccine if they were men [(adjusted odds ratio) 0.19; (95% confidence interval) 0.16-0.23], had a high school diploma (0.40; 0.31-0.52) or less (0.46; 0.32-0.64) vs. college graduates, and were born outside the United States (0.52; 0.40-0.69). But, participants were more likely to initiate the HPV vaccine if they visited the doctor's office 1-5 times (2.09; 1.56-2.81), or ≥ 6 times (1.86; 1.48-2.34) within the last 12 months vs. no visits. Odds of completing HPV vaccine uptake followed the same pattern as initiation. And after stratifying the study population by gender and foreign-born status, these variables remained statistically significant. In our nationally representative study, only one out of six 18-26 year olds completed the required vaccine doses. Men, individuals with high school or less education, and those born outside the United States were less likely to initiate and complete the HPV vaccination. Our findings suggest that it may be useful to develop targeted interventions to promote HPV vaccination among those in the catch-up age range.

  19. Computer-Aided Design of an Epitope-Based Vaccine against Epstein-Barr Virus

    PubMed Central

    Alonso-Padilla, Julio

    2017-01-01

    Epstein-Barr virus is a very common human virus that infects 90% of human adults. EBV replicates in epithelial and B cells and causes infectious mononucleosis. EBV infection is also linked to various cancers, including Burkitt's lymphoma and nasopharyngeal carcinomas, and autoimmune diseases such as multiple sclerosis. Currently, there are no effective drugs or vaccines to treat or prevent EBV infection. Herein, we applied a computer-aided strategy to design a prophylactic epitope vaccine ensemble from experimentally defined T and B cell epitopes. Such strategy relies on identifying conserved epitopes in conjunction with predictions of HLA presentation for T cell epitope selection and calculations of accessibility and flexibility for B cell epitope selection. The T cell component includes 14 CD8 T cell epitopes from early antigens and 4 CD4 T cell epitopes, targeted during the course of a natural infection and providing a population protection coverage of over 95% and 81.8%, respectively. The B cell component consists of 3 experimentally defined B cell epitopes from gp350 plus 4 predicted B cell epitopes from other EBV envelope glycoproteins, all mapping in flexible and solvent accessible regions. We discuss the rationale for the formulation and possible deployment of this epitope vaccine ensemble. PMID:29119120

  20. Novel Vaccine Approach Achieves “Functional Cure” of AIDS Virus in Monkeys | Frederick National Laboratory for Cancer Research

    Cancer.gov

    Scientists at the Oregon Health & Science University and the AIDS and Cancer Virus Program of the Frederick National Laboratory for Cancer Research have used a novel vaccine approach to achieve a “functional cure” and apparent eradication of infe

  1. Researchers See New Patterns in Spread of AIDS Virus; Progress in Development of a Vaccine Sparks Optimism.

    ERIC Educational Resources Information Center

    Wheeler, David L.

    1990-01-01

    Reports presented at the Sixth International Conference on Aids are summarized including efforts to develop a vaccine, expansion of the epidemic into new areas, the high rate of infection among Romanian children, the crisis in Africa, and evidence of relapsing behaviors among homosexual men in the United States. (MLW)

  2. Development and initial feedback about a human papillomavirus (HPV) vaccine comic book for adolescents.

    PubMed

    Katz, Mira L; Oldach, Benjamin R; Goodwin, Jennifer; Reiter, Paul L; Ruffin, Mack T; Paskett, Electra D

    2014-06-01

    Human papillomavirus (HPV) vaccination rates do not meet the Healthy People 2020 objective of 80% coverage among adolescent females. We describe the development and initial feedback about an HPV vaccine comic book for young adolescents. The comic book is one component of a multilevel intervention to improve HPV vaccination rates among adolescents. Parents suggested and provided input into the development of a HPV vaccine comic book. Following the development of the comic book, we conducted a pilot study to obtain initial feedback about the comic book among parents (n = 20) and their adolescents ages 9 to 14 (n = 17) recruited from a community-based organization. Parents completed a pre-post test including items addressing HPV knowledge, HPV vaccine attitudes, and about the content of the comic book. Adolescents completed a brief interview after reading the comic book. After reading the comic book, HPV knowledge improved (2.7 to 4.6 correct answers on a 0-5 scale; p < 0.01) and more positive attitudes toward HPV vaccination (p < 0.05) were reported among parents. Parents confirmed that the comic book's content was acceptable and adolescents liked the story, found it easy to read, and thought the comic book was a good way to learn about being healthy. Parents provided valuable information in the development of a theoretically-based comic book and the comic book appears to be an acceptable format for providing HPV vaccine information to adolescents. Future research will include the comic book in an intervention study to improve HPV vaccination rates.

  3. Development and initial feedback about a human papillomavirus (HPV) vaccine comic book for adolescents

    PubMed Central

    Katz, Mira L.; Oldach, Benjamin R.; Goodwin, Jennifer; Reiter, Paul L.; Ruffin, Mack T.; Paskett, Electra D.

    2014-01-01

    Human papillomavirus (HPV) vaccination rates do not meet the Healthy People 2020 objective of 80% coverage among adolescent females. We describe the development and initial feedback about an HPV vaccine comic book for young adolescents. The comic book is one component of a multi-level intervention to improve HPV vaccination rates among adolescents. Parents suggested and provided input into the development of a HPV vaccine comic book. Following the development of the comic book, we conducted a pilot study to obtain initial feedback about the comic book among parents (n=20) and their adolescents ages 9 to 14 (n=17) recruited from a community-based organization. Parents completed a pre-post test including items addressing HPV knowledge, HPV vaccine attitudes, and about the content of the comic book. Adolescents completed a brief interview after reading the comic book. After reading the comic book, HPV knowledge improved (2.7 to 4.6 correct answers on a 0–5 scale; p<0.01) and more positive attitudes toward HPV vaccination (p<0.05) were reported among parents. Parents confirmed that the comic book’s content was acceptable and adolescents liked the story, found it easy to read, and thought the comic book was a good way to learn about being healthy. Parents provided valuable information in the development of a theoretically-based comic book and the comic book appears to be an acceptable format for providing HPV vaccine information to adolescents. Future research will include the comic book in an intervention study to improve HPV vaccination rates. PMID:24420004

  4. HPV literacy and its link to initiation and completion of HPV vaccine among young adults in Minnesota.

    PubMed

    Lee, H Y; Lee, J; Henning-Smith, C; Choi, J

    2017-11-01

    This study identifies whether, and how, human papillomavirus (HPV) literacy and predisposing, enabling, and need factors are associated with HPV vaccine initiation and completion among young adults in Minnesota. Cross-sectional survey design. Using a sample of 170 young adults (aged 18-26 years), we used logistic regression models to identify factors associated with HPV vaccination initiation and completion, including HPV literacy, adjusting for relevant predisposing, enabling, and need factors. Consistent with national estimates, we found relatively low rates of HPV vaccination initiation (46%) and completion (36%). Better HPV literacy was significantly associated with higher rates of both initiation and completion, as was being female and having an annual check-up. Being married/partnered was significantly associated with lower odds of HPV vaccination. Public health programs, policy-makers, and healthcare providers can use these results to increase HPV vaccination rates by making concerted efforts to improve HPV vaccination literacy through individual and public education campaigns and by improving access to annual check-ups. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Now that you want to take your HIV/AIDS vaccine/biological product research concept into the clinic: what are the "cGMP"?

    PubMed

    Sheets, Rebecca L; Rangavajhula, Vijaya; Pullen, Jeffrey K; Butler, Chris; Mehra, Vijay; Shapiro, Stuart; Pensiero, Michael

    2015-04-08

    The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of "cGMP" and know that they are supposed to make a "GMP product" to take into the clinic, but often they are not very familiar with what "cGMP" means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked "can't we use the material we made in the lab in the clinic?" or "aren't Phase 1 studies exempt from cGMP?" Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. Published by Elsevier Ltd.

  6. Engineered human vaccines

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandhu, J.S.

    1994-01-01

    The limitations of human vaccines in use at present and the design requirements for a new generation of human vaccines are discussed. The progress in engineering of human vaccines for bacteria, viruses, parasites, and cancer is reviewed, and the data from human studies with the engineered vaccines are discussed, especially for cancer and AIDS vaccines. The final section of the review deals with the possible future developments in the field of engineered human vaccines and the requirement for effective new human adjuvants.

  7. A fresh injection of interest for vaccines.

    PubMed

    1998-02-01

    In recent years, HIV/AIDS funding has gone largely to prevention measures, drug therapy for people who are already infected with HIV, and basic related science. HIV/AIDS vaccine development has been of only low priority, and almost no effort is targeted toward vaccines appropriate for use in developing countries. A vaccine, however, is theoretically the only way to end the epidemic. An attempt was made at the Abidjan AIDS Conference to reinvigorate the AIDS vaccine research program, but because the potential market for such a vaccine is in the poorer developing countries, it will be difficult to convince the pharmaceutical industry to renew investment in vaccine research. Pharmaceutical companies see no profit potential in vaccine development and marketing. The World Bank's suggestion on how to encourage the pharmaceutical industry to invest again in vaccine research is discussed. The gp120(E) vaccine is undergoing an early-stage trial in Thailand, and another trial is scheduled for later in 1998 in Uganda. However, none of the 25 possible vaccine types which have been developed in the laboratory and tested for safety on humans has gone into efficacy trials. Experts calculate that even if more intensive work were to begin now, a vaccine could not become generally available before 2005, due to the 8-year product evaluation cycle. Whether a vaccine based upon one HIV subtype will be effective against other subtypes, and the need for governments and donors to invest in the development of a vaccine are discussed.

  8. AID-initiated purposeful mutations in immunoglobulin genes.

    PubMed

    Goodman, Myron F; Scharff, Matthew D; Romesberg, Floyd E

    2007-01-01

    Exposure brings risk to all living organisms. Using a remarkably effective strategy, higher vertebrates mitigate risk by mounting a complex and sophisticated immune response to counter the potentially toxic invasion by a virtually limitless army of chemical and biological antagonists. Mutations are almost always deleterious, but in the case of antibody diversification there are mutations occurring at hugely elevated rates within the variable (V) and switch regions (SR) of the immunoglobulin (Ig) genes that are responsible for binding to and neutralizing foreign antigens throughout the body. These mutations are truly purposeful. This chapter is centered on activation-induced cytidine deaminase (AID). AID is required for initiating somatic hypermutation (SHM) in the V regions and class switch recombination (CSR) in the SR portions of Ig genes. By converting C --> U, while transcription takes place, AID instigates a cascade of mutational events involving error-prone DNA polymerases, base excision and mismatch repair enzymes, and recombination pathways. Together, these processes culminate in highly mutated antibody genes and the B cells expressing antibodies that have achieved optimal antigenic binding undergo positive selection in germinal centers. We will discuss the biological role of AID in this complex process, primarily in terms of its biochemical properties in relation to SHM in vivo. The chapter also discusses recent advances in experimental methods to characterize antibody dynamics as a function of SHM to help elucidate the role that the AID-induced mutations play in tailoring molecular recognition. The emerging experimental techniques help to address long-standing conundrums concerning evolution-imposed constraints on antibody structure and function.

  9. Now That You Want to Take Your HIV/AIDS Vaccine/Biological Product Research Concept into the Clinic: What are “cGMP”?

    PubMed Central

    Sheets, Rebecca L.; Rangavajhula, Vijaya; Pullen, Jeffrey K.; Butler, Chris; Mehra, Vijay; Shapiro, Stuart

    2015-01-01

    The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of “cGMP” and know that they are supposed to make a “GMP product” to take into the clinic, but often they are not very familiar with what “cGMP” means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked “can’t we use the material we made in the lab in the clinic?” or “aren’t Phase 1 studies exempt from cGMP?” Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. PMID:25698494

  10. HIV/AIDS and the Flu

    MedlinePlus

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other HIV/AIDS and the Flu Questions & Answers Language: English ( ... people with HIV and AIDS. Should people with HIV/AIDS receive the inactivated influenza vaccine? People with ...

  11. A decade of vaccines: Integrating immunology and vaccinology for rational vaccine design.

    PubMed

    D'Argenio, David A; Wilson, Christopher B

    2010-10-29

    Vaccination stands as one of the most successful public health measures of the last century. New approaches will be needed, however, to develop highly effective vaccines to prevent tuberculosis, HIV-AIDS, and malaria and to eradicate polio. Current advances in immunology and technology have set the stage for rational vaccine design to begin a "Decade of Vaccines." Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Factors influencing adolescent girls' decision in initiation for human papillomavirus vaccination: a cross-sectional study in Hong Kong.

    PubMed

    Lee, Albert; Ho, Mandy; Cheung, Calvin Ka Man; Keung, Vera Mei Wen

    2014-09-08

    Cervical cancer is one of the common cancers among women worldwide. Despite HPV vaccination being one of the effective preventive measures, it is not included in government vaccination programme in Hong Kong. This study aimed to assess the knowledge of and attitude towards cervical cancer prevention among Chinese adolescent girls in Hong Kong, and to identify factors influencing the initiation of HPV vaccination. This was a cross-sectional study conducted in Hong Kong during the period of October 2010 to November 2010. A self-administered questionnaire was used, with 1,416 girls from 8 secondary schools completing the questionnaire. Knowledge scores were composited and initiation of HPV vaccination was staged based on stage of change. Analyses were conducted to identify the association of initiation of HPV vaccination with participant's personal and family factors as well as their knowledge and attitude towards cervical cancer prevention. The uptake rate of HPV vaccination was low (7%) with 58% respondents in pre-contemplation and contemplation stage. The survey identified a significant gap in knowledge on cervical cancer prevention. The main channels of information were from media and very few from schools or parents. However, 70% expressed their wishes to have more information on cancer prevention, and 78% stated that they were willing to change their lifestyles if they knew the ways of prevention. Multivariate analysis identified three independent significant factors for initiation of vaccination (action and intention): perceived cancer as terrifying disease, school should provide more information on cancer prevention, and comments from relatives and friends having received the vaccine. The cost of vaccination and socio-economic background were not found to be significant. Public education on cervical cancer needs to be well penetrated into the community for more sharing among friends and relatives. School as setting to provide source of information would

  13. Human papillomavirus vaccine initiation in Asian Indians and Asian subpopulations: a case for examining disaggregated data in public health research.

    PubMed

    Budhwani, H; De, P

    2017-12-01

    Vaccine disparities research often focuses on differences between the five main racial and ethnic classifications, ignoring heterogeneity of subpopulations. Considering this knowledge gap, we examined human papillomavirus (HPV) vaccine initiation in Asian Indians and Asian subpopulations. National Health Interview Survey data (2008-2013), collected by the National Center for Health Statistics, were analyzed. Multiple logistic regression analysis was conducted on adults aged 18-26 years (n = 20,040). Asian Indians had high income, education, and health insurance coverage, all positive predictors of preventative health engagement and vaccine uptake. However, we find that Asian Indians had comparatively lower rates of HPV vaccine initiation (odds ratio = 0.41; 95% confidence interval = 0.207-0.832), and foreign-born Asian Indians had the lowest rate HPV vaccination of all subpopulations (2.3%). Findings substantiate the need for research on disaggregated data rather than evaluating vaccination behaviors solely across standard racial and ethnic categories. We identified two populations that were initiating HPV vaccine at abysmal levels: foreign-born persons and Asian Indians. Development of culturally appropriate messaging has the potential to improve these initiation rates and improve population health. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Evaluation of Pharmacist-Initiated Interventions on Vaccination Rates in Patients with Asthma or COPD.

    PubMed

    Klassing, Haley M; Ruisinger, Janelle F; Prohaska, Emily S; Melton, Brittany L

    2018-04-01

    To determine if pharmacy-initiated interventions improved the rate of influenza and pneumococcal vaccinations in adult patients with asthma and/or chronic obstructive pulmonary disease (COPD). Adult patients who filled prescriptions at one of three community pharmacies, who had a dispensing history indicative of an asthma and/or COPD diagnosis were randomized to receive a personal phone call or standardized mailed letter recommending influenza and pneumococcal vaccinations, or control with no vaccination information. The rate of influenza and pneumococcal vaccinations was measured for each group and measured using Chi square. Of 831 eligible participants, 210 patients completed the study, and self-reported a diagnosis of asthma and/or COPD. The influenza vaccine was administered to 56 (72.7%), 55 (87.3%), and 62 (88.6%) patients (p = 0.019); pneumococcal vaccine was administered to 46 (59.7%), 39 (61.9%), and 39 (55.7%) patients in the phone call, letter, and control groups, respectively. While the control group had significantly more influenza vaccinations, between the interventions the letter showed a higher rate of influenza vaccination over the phone call. Reviewing patients under age 65, the letter had a significantly higher rate of influenza vaccination than the phone call (p = 0.021). No significant improvement was found for the pneumococcal vaccination. Patients under age 65 who received a mailed letter had a significantly higher rate of influenza vaccination than those who received a phone call, and had a higher rate of pneumococcal vaccination. A standardized, mailed letter may help community pharmacists improve vaccination rates in patients with asthma and/or COPD.

  15. Aerogenic Vaccination With a Burkholderia mallei Auxotroph Protects Against Aerosol-Initiated Glanders in Mice

    DTIC Science & Technology

    2005-03-14

    Vaccine 23 (2005) 1986–1992 Aerogenic vaccination with a Burkholderia mallei auxotroph protects against aerosol-initiated glanders in mice Ricky L...October 2004 Available online 11 November 2004 Abstract Burkholderia mallei is an obligate mammalian pathogen that causes the zoonotic disease glanders ... Burkholderia mallei , the causative agent of glanders , is gram-negative bacillus. It is a highly adapted parasite of quines and cannot persist in nature

  16. Accelerating the development of a safe and effective HIV vaccine: HIV vaccine case study for the Decade of Vaccines.

    PubMed

    Koff, Wayne C; Russell, Nina D; Walport, Mark; Feinberg, Mark B; Shiver, John W; Karim, Salim Abdool; Walker, Bruce D; McGlynn, Margaret G; Nweneka, Chidi Victor; Nabel, Gary J

    2013-04-18

    Human immunodeficiency virus (HIV), the etiologic agent that causes AIDS, is the fourth largest killer in the world today. Despite the remarkable achievements in development of anti-retroviral therapies against HIV, and the recent advances in new prevention technologies, the rate of new HIV infections continue to outpace efforts on HIV prevention and control. Thus, the development of a safe and effective vaccine for prevention and control of AIDS remains a global public health priority and the greatest opportunity to eventually end the AIDS pandemic. Currently, there is a renaissance in HIV vaccine development, due in large part to the first demonstration of vaccine induced protection, albeit modest, in human efficacy trials, a generation of improved vaccine candidates advancing in the clinical pipeline, and newly defined targets on HIV for broadly neutralizing antibodies. The main barriers to HIV vaccine development include the global variability of HIV, lack of a validated animal model, lack of correlates of protective immunity, lack of natural protective immune responses against HIV, and the reservoir of infected cells conferred by integration of HIV's genome into the host. Some of these barriers are not unique to HIV, but generic to other variable viral pathogens such as hepatitis C and pandemic influenza. Recommendations to overcome these barriers are presented in this document, including but not limited to expansion of efforts to design immunogens capable of eliciting broadly neutralizing antibodies against HIV, expansion of clinical research capabilities to assess multiple immunogens concurrently with comprehensive immune monitoring, increased support for translational vaccine research, and engaging industry as full partners in vaccine discovery and development. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Predictors of HPV vaccine initiation and completion among Hispanic mothers of 11- to 17-year-old daughters living along the Texas-Mexico border

    PubMed Central

    Parra-Medina, Deborah

    2016-01-01

    Few Texas Latino girls initiate and complete the HPV vaccine series, but few studies have examined predictors of initiation and completion in this group. Mothers are crucial to vaccine uptake. Using self-reported data from mothers of unvaccinated girls (n=317), we examined the association between predictors (HPV and HPV vaccine knowledge, vaccine self-efficacy) and outcomes (initiation and completion). Despite an increase in HPV and HPV vaccine knowledge from baseline to follow-up (n=195), we found no association between the predictors and the outcomes. Findings showed that health insurance status and study group participation (Entre Madre e Hija program or brochure only) were associated with initiation and completion. PMID:28207677

  18. [AIDS: "We will win"].

    PubMed

    Chabrier, H

    1989-11-13

    An international colloquium on AIDS held near Paris from October 26-28, 1989, unlike the World Conference on AIDS in Montreal the year before, was able to find reasons for optimism. Significant progress was reported in immunotherapy and in chemotherapy. Successful experiments in vaccinating monkeys against the AIDS virus were reported from the US, France, and Zaire. Time is needed to prove the efficacy of the vaccines because of the slow development in AIDS. A vaccine is being tested by Jonas Salk and collaborators in 75 seropositive volunteers who do not yet show full blown disease but who have very low levels of T4 lymphocytes. Plans are underway for a larger test on 500 seropositive patients at different stages of infection. According to Salk, the new chemical and logical approach toward AIDS will allow combinations of immunotherapy and chemotherapy to destroy the virus. R. Gallo of France listed as accomplishments of the past year a better understanding of the virus, improved case management techniques, increased ability to control Kaposi's sarcoma, considerable progress in the search for a vaccine, and detection of immune proteins that affect the virus. New biological markers permit establishment of correlations between cellular modifications and the progress of the disease as well as the precise effects of treatment. The new immune system drugs immuthiol and DDI are expected to reach the market soon. Patients very soon will be able to receive less toxic alternative treatments, which can be combined for greater efficacy once their toxic interactions are understood.

  19. Convergent Transcription At Intragenic Super-Enhancers Targets AID-initiated Genomic Instability

    PubMed Central

    Meng, Fei-Long; Du, Zhou; Federation, Alexander; Hu, Jiazhi; Wang, Qiao; Kieffer-Kwon, Kyong-Rim; Meyers, Robin M.; Amor, Corina; Wasserman, Caitlyn R.; Neuberg, Donna; Casellas, Rafael; Nussenzweig, Michel C.; Bradner, James E.; Liu, X. Shirley; Alt, Frederick W.

    2015-01-01

    Summary Activation-induced cytidine deaminase (AID) initiates both somatic hypermutation (SHM) for antibody affinity maturation and DNA breakage for antibody class switch recombination (CSR) via transcription-dependent cytidine deamination of single stranded DNA targets. While largely specific for immunoglobulin genes, AID also acts on a limited set of off-targets, generating oncogenic translocations and mutations that contribute to B cell lymphoma. How AID is recruited to off-targets has been a long-standing mystery. Based on deep GRO-Seq studies of mouse and human B lineage cells activated for CSR or SHM, we report that most robust AID off-target translocations occur within highly focal regions of target genes in which sense and antisense transcription converge. Moreover, we found that such AID-targeting “convergent” transcription arises from antisense transcription that emanates from Super-Enhancers within sense transcribed gene bodies. Our findings provide an explanation for AID off-targeting to a small subset of mostly lineage-specific genes in activated B cells. PMID:25483776

  20. HIV vaccine development: would more (public) money bring quicker results?

    PubMed

    Winsbury, R

    1999-01-01

    Globally, $200-250 million/year are devoted to HIV vaccine research. Most of those funds pay for basic research rather than product development. Moreover, most of the funds are aimed at the HIV strain commonly found in the US and Europe, and not at the strains common to Africa and other developing countries. While US President Bill Clinton set in 1997 a 10-year target for the development of an HIV vaccine, that target date is looking increasingly unlikely. International vaccine and pharmaceutical companies typically drive vaccine research and development. However, concern over the ultimate profitability of developing and marketing an HIV vaccine, and the fear of major litigation should an eventual vaccine go awry have caused such firms to shy away from investing large amounts of money into HIV vaccine development. These companies somehow have to be attracted back into the field. A World Bank special task force is slated to present its report by mid-1999 on possible funding mechanisms to promote HIV vaccine development. It remains to be resolved whether public funds could and should be used, perhaps through a pooled international vaccine development fund. 2 new International AIDS Vaccine Initiative projects are described.

  1. A critical role for AID in the initiation of reprogramming to induced pluripotent stem cells

    PubMed Central

    Bhutani, Nidhi; Decker, Matthew N.; Brady, Jennifer J.; Bussat, Rose T.; Burns, David M.; Corbel, Stephane Y.; Blau, Helen M.

    2013-01-01

    Mechanistic insights into the reprogramming of fibroblasts to induced pluripotent stem cells (iPSCs) are limited, particularly for early acting molecular regulators. Here we use an acute loss of function approach to demonstrate that activation-induced deaminase (AID) activity is necessary for the initiation of reprogramming to iPSCs. While AID is well known for antibody diversification, it has also recently been shown to have a role in active DNA demethylation in reprogramming toward pluripotency and development. These findings suggested a potential role for AID in iPSC generation, yet, iPSC yield from AID-knockout mouse fibroblasts was similar to that of wild-type (WT) fibroblasts. We reasoned that an acute loss of AID function might reveal effects masked by compensatory mechanisms during development, as reported for other proteins. Accordingly, we induced an acute reduction (>50%) in AID levels using 4 different shRNAs and determined that reprogramming to iPSCs was significantly impaired by 79 ± 7%. The deaminase activity of AID was critical, as coexpression of WT but not a catalytic mutant AID rescued reprogramming. Notably, AID was required only during a 72-h time window at the onset of iPSC reprogramming. Our findings show a critical role for AID activity in the initiation of reprogramming to iPSCs.—Bhutani, N., Decker, M. N., Brady, J. J., Bussat, R. T., Burns, D. M., Corbel, S. Y., Blau, H. M. A critical role for AID in the initiation of reprogramming to induced pluripotent stem cells. PMID:23212122

  2. Using simulation to aid trial design: Ring-vaccination trials.

    PubMed

    Hitchings, Matt David Thomas; Grais, Rebecca Freeman; Lipsitch, Marc

    2017-03-01

    The 2014-6 West African Ebola epidemic highlights the need for rigorous, rapid clinical trial methods for vaccines. A challenge for trial design is making sample size calculations based on incidence within the trial, total vaccine effect, and intracluster correlation, when these parameters are uncertain in the presence of indirect effects of vaccination. We present a stochastic, compartmental model for a ring vaccination trial. After identification of an index case, a ring of contacts is recruited and either vaccinated immediately or after 21 days. The primary outcome of the trial is total vaccine effect, counting cases only from a pre-specified window in which the immediate arm is assumed to be fully protected and the delayed arm is not protected. Simulation results are used to calculate necessary sample size and estimated vaccine effect. Under baseline assumptions about vaccine properties, monthly incidence in unvaccinated rings and trial design, a standard sample-size calculation neglecting dynamic effects estimated that 7,100 participants would be needed to achieve 80% power to detect a difference in attack rate between arms, while incorporating dynamic considerations in the model increased the estimate to 8,900. This approach replaces assumptions about parameters at the ring level with assumptions about disease dynamics and vaccine characteristics at the individual level, so within this framework we were able to describe the sensitivity of the trial power and estimated effect to various parameters. We found that both of these quantities are sensitive to properties of the vaccine, to setting-specific parameters over which investigators have little control, and to parameters that are determined by the study design. Incorporating simulation into the trial design process can improve robustness of sample size calculations. For this specific trial design, vaccine effectiveness depends on properties of the ring vaccination design and on the measurement window, as

  3. AIDS wars.

    PubMed

    Several evidences were presented during the meeting in London entitled "Origins of AIDS and the HIV epidemic," debating the idea that AIDS was an accidental result of a polio vaccination campaign conducted by a virologist, Hilary Koprowski, and colleagues in the late 1950s among thousands of people in the Belgian Congo. The meeting carefully examined the CHAT theory presented by a writer, Edward Hooper, in his book "The River" and has raised questions on the correlation between vaccination sites and early records of HIV-1, and on the estimated amount of HIV particles that would get through each stage of the process of creating CHAT. Overall, the meeting agreed to reject the CHAT theory of AIDS for it has no basis, since Koprowski and colleagues denied the use of chimpanzee kidneys, which Hooper openly suggests in his book. The meeting noted that the disease's origins remain a mystery.

  4. Aerogenic vaccination with a Burkholderia mallei auxotroph protects against aerosol-initiated glanders in mice.

    PubMed

    Ulrich, Ricky L; Amemiya, Kei; Waag, David M; Roy, Chad J; DeShazer, David

    2005-03-14

    Burkholderia mallei is an obligate mammalian pathogen that causes the zoonotic disease glanders. Two live attenuated B. mallei strains, a capsule mutant and a branched-chain amino acid auxotroph, were evaluated for use as vaccines against aerosol-initiated glanders in mice. Animals were aerogenically vaccinated and serum samples were obtained before aerosol challenge with a high-dose (>300 times the LD50) of B. mallei ATCC 23344. Mice vaccinated with the capsule mutant developed a Th2-like Ig subclass antibody response and none survived beyond 5 days. In comparison, the auxotrophic mutant elicited a Th1-like Ig subclass antibody response and 25% of the animals survived for 1 month postchallenge. After a low-dose (5 times the LD50) aerosol challenge, the survival rates of auxotroph-vaccinated and unvaccinated animals were 50 and 0%, respectively. Thus, live attenuated strains that promote a Th1-like Ig response may serve as promising vaccine candidates against aerosol infection with B. mallei.

  5. WHO influenza vaccine technology transfer initiative: role and activities of the Technical Advisory Group.

    PubMed

    Francis, Donald P; Grohmann, Gary

    2011-07-01

    In May 2006, the WHO published a Global Pandemic Influenza Action Plan. A significant part of that plan involves the transfer of technology necessary to build production capacity in developing countries. The WHO influenza technology transfer initiative has been successful. Clearly the relatively small WHO investments made in these companies to develop their own influenza vaccine production facilities have had quite dramatic results. A few companies are already producing large amounts of influenza vaccine. Others will soon follow. Whether they are developing egg-based or planning non-egg based influenza vaccine production, all companies are optimistic that their efforts will come to fruition. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Vaccine-Induced Enhancement of EIAV Replication and Disease

    DTIC Science & Technology

    1994-01-14

    funding was to initiate the expansion of ongoing research in which the equine infectious anemia virus (EIAV)/Shetland pony animal lentivirus system is...enhancement of EIAV replication and disease. 14. SUBJECT TERMS 15. NUMBER OF PAGES AIDS vaccines, equine infectious anemia virus, 16. PRICE CODE...Znstitutes of Health . RCM In the conduct of research utilizing recombinant DNA, the investigator(s) idhered to the NIH Guidelines for Research Involving

  7. Predictors of Human Papillomavirus Vaccine Initiation and Completion Among Latino Mothers of 11- to 17-Year-Old Daughters Living Along the Texas-Mexico Border.

    PubMed

    Morales-Campos, Daisy Y; Parra-Medina, Deborah

    Few Texas Latino girls initiate and complete the human papillomavirus (HPV) vaccine series, but few studies have examined predictors of initiation and completion in this group. Mothers are crucial to vaccine uptake. Using self-reported data from mothers of unvaccinated girls (n = 317), we examined the association between predictors (HPV and HPV vaccine knowledge, vaccine self-efficacy) and outcomes (initiation and completion). Despite an increase in HPV and HPV vaccine knowledge from baseline to follow-up (n = 195), we found no association between the predictors and the outcomes. Findings showed that health insurance status and study group participation (Entre Madre e Hija program or brochure only) were associated with initiation and completion.

  8. Decision support in vaccination policies.

    PubMed

    Piso, B; Wild, C

    2009-10-09

    Looking across boarders reveals that the national immunization programs of various countries differ in their vaccination schedules and decisions regarding the implementation and funding of new vaccines. The aim of this review is to identify decision aids and crucial criteria for a rational decision-making process on vaccine introduction and to develop a theoretical framework for decision-making based on available literature. Systematic literature search supplemented by hand-search. We identified five published decision aids for vaccine introduction and program planning in industrialized countries. Their comparison revealed an overall similarity with some differences in the approach as well as criteria. Burden of disease and vaccine characteristics play a key role in all decision aids, but authors vary in their views on the significance of cost-effectiveness analyses. Other relevant factors that should be considered before vaccine introduction are discussed to highly differing extents. These factors include the immunization program itself as well as its conformity with other programs, its feasibility, acceptability, and equity, as well as ethical, legal and political considerations. Assuming that the most comprehensive framework possible will not provide a feasible tool for decision-makers, we suggest a stepwise procedure. Though even the best rational approach and most comprehensive evaluation is limited by remaining uncertainties, frameworks provide at least a structured approach to evaluate the various aspects of vaccine implementation decision-making. This process is essential in making consistently sound decisions and will facilitate the public's confidence in the decision and its realization.

  9. Predictors of Initial Uptake of Human Papillomavirus Vaccine Uptake Among Rural Appalachian Young Women

    PubMed Central

    Crosby, Richard A.; Vanderpool, Robin C.; Dignan, Mark; Bates, Wallace

    2016-01-01

    Women in Appalachian Kentucky experience a high burden of cervical cancer and have low rates of human papillomavirus (HPV) vaccination. The purpose of this study was to identify normative influences predicting initial HPV vaccine uptake among a sample of young women in southeastern Kentucky. Women (N = 495), ages 18 through 26 years, were recruited from clinics and community colleges. After completing a questionnaire, women received a free voucher for HPV vaccination. Whether women redeemed the voucher for Dose 1 served as the primary outcome variable. Hierarchical logistic regression was used to estimate the influence of healthcare providers, friends, mothers, and fathers on vaccine uptake. One-quarter of the total sample (25.9 %) received Dose 1. Uptake was higher in the clinic sample (45.1 %) than in the college sample (6.9 %). On multivariate analysis, women indicating that their healthcare provider suggested the vaccine, that their friends would “definitely” want them to be vaccinated, and that their fathers would “definitely” want them to receive the vaccine all were 1.6 times more likely to receive Dose 1. Interaction effects occurred between recruitment site (clinic vs. community college) and all three of the normative influences retaining multivariate significance, indicating that the associations only applied to the clinic sample. HPV vaccine interventions may benefit from highlighting paternal endorsement, healthcare provider recommendation, and peer support. PMID:23325057

  10. The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza.

    PubMed

    Macias, Alejandro E; Precioso, Alexander R; Falsey, Ann R

    2015-08-01

    There is a heavy disease burden due to seasonal influenza in pregnant women, their fetuses, and their newborns. The main aim of this study was to review and analyze current evidence on safety, immunogenicity, and clinical benefits of the inactivated influenza vaccine (IIV) in pregnant women. Current evidence shows that in pregnant women, the seasonal and pandemic IIVs are safe and well tolerated. After vaccination, pregnant women have protective concentrations of anti-influenza antibodies, conferring immunogenicity in newborns. The best evidence, to date, suggests that influenza vaccination confers clinical benefits in both pregnant women and their newborns. Vaccination with either the seasonal or pandemic vaccine has been shown to be cost-effective in pregnancy. There are scarce data from randomized clinical trials; fortunately, new phase 3 clinical trials are under way. In the Northern and Southern Hemispheres, data suggest that the greatest clinical benefit for infants occurs if the IIV is administered within the first weeks of availability of the vaccine, at the beginning of the influenza season, regardless of the pregnancy trimester. The optimal timing to vaccinate pregnant women who live in tropical regions is unclear. Based on evaluation of the evidence, the Global Influenza Initiative (GII) recommends that to prevent seasonal influenza morbidity and mortality in infants and their mothers, all pregnant women, regardless of trimester, should be vaccinated with the IIV. For countries where vaccination against influenza is starting or expanding, the GII recommends that pregnant women have the highest priority. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  11. Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls: A National Survey.

    PubMed

    Agénor, Madina; Peitzmeier, Sarah; Gordon, Allegra R; Haneuse, Sebastien; Potter, Jennifer E; Austin, S Bryn

    2015-07-21

    Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners. To examine the association between sexual orientation identity and HPV vaccination among U.S. women and girls. Cross-sectional, using 2006-2010 National Survey of Family Growth data. U.S. civilian noninstitutionalized population. The 2006-2010 National Survey of Family Growth used stratified cluster sampling to establish a national probability sample of 12,279 U.S. women and girls aged 15 to 44 years. Analyses were restricted to 3253 women and girls aged 15 to 25 years who were asked about HPV vaccination. Multivariable logistic regression was used to obtain prevalence estimates of HPV vaccine awareness and initiation adjusted for sociodemographic and health care factors for each sexual orientation identity group. Among U.S. women and girls aged 15 to 25 years, 84.4% reported having heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. After adjustment for covariates, 8.5% (P = 0.007) of lesbians and 33.2% (P = 0.33) of bisexual women and girls who had heard of the vaccine had initiated vaccination compared with 28.4% of their heterosexual counterparts. Self-reported, cross-sectional data, and findings may not be generalizable to periods after 2006 to 2010 or all U.S. lesbians aged 15 to 25 years (because of the small sample size for this group). Adolescent and young adult lesbians may be less likely to initiate HPV vaccination than their heterosexual counterparts. Programs should facilitate access to HPV vaccination services among young lesbians. National Cancer Institute.

  12. The Journalists Initiatives on Immunisation Against Polio and Improved Acceptance of the Polio Vaccine in Northern Nigeria 2007-2015.

    PubMed

    Warigon, Charity; Mkanda, Pascal; Banda, Richard; Zakari, Furera; Damisa, Eunice; Idowu, Audu; Bawa, Samuel; Gali, Emmanuel; Tegegne, Sisay G; Hammanyero, Kulchumi; Nsubuga, Peter; Korir, Charles; Vaz, Rui G

    2016-05-01

    The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers' sources of information about SIAs in 2007 before and after the JAP was formed. Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria. © 2016 World Health Organization; licensee Oxford Journals.

  13. Cost-effectiveness of dog rabies vaccination programs in East Africa

    PubMed Central

    Borse, Rebekah H.; Atkins, Charisma Y.; Gambhir, Manoj; Undurraga, Eduardo A.; Blanton, Jesse D.; Kahn, Emily B.; Dyer, Jessie L.; Rupprecht, Charles E.

    2018-01-01

    Background Dog rabies annually causes 24,000–70,000 deaths globally. We built a spreadsheet tool, RabiesEcon, to aid public health officials to estimate the cost-effectiveness of dog rabies vaccination programs in East Africa. Methods RabiesEcon uses a mathematical model of dog-dog and dog-human rabies transmission to estimate dog rabies cases averted, the cost per human rabies death averted and cost per year of life gained (YLG) due to dog vaccination programs (US 2015 dollars). We used an East African human population of 1 million (approximately 2/3 living in urban setting, 1/3 rural). We considered, using data from the literature, three vaccination options; no vaccination, annual vaccination of 50% of dogs and 20% of dogs vaccinated semi-annually. We assessed 2 transmission scenarios: low (1.2 dogs infected per infectious dog) and high (1.7 dogs infected). We also examined the impact of annually vaccinating 70% of all dogs (World Health Organization recommendation for dog rabies elimination). Results Without dog vaccination, over 10 years there would a total of be approximately 44,000–65,000 rabid dogs and 2,100–2,900 human deaths. Annually vaccinating 50% of dogs results in 10-year reductions of 97% and 75% in rabid dogs (low and high transmissions scenarios, respectively), approximately 2,000–1,600 human deaths averted, and an undiscounted cost-effectiveness of $451-$385 per life saved. Semi-annual vaccination of 20% of dogs results in in 10-year reductions of 94% and 78% in rabid dogs, and approximately 2,000–1,900 human deaths averted, and cost $404-$305 per life saved. In the low transmission scenario, vaccinating either 50% or 70% of dogs eliminated dog rabies. Results were most sensitive to dog birth rate and the initial rate of dog-to-dog transmission (Ro). Conclusions Dog rabies vaccination programs can control, and potentially eliminate, dog rabies. The frequency and coverage of vaccination programs, along with the level of dog rabies

  14. Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania

    PubMed Central

    Kayombo, Edmund J; Uiso, Febronia C; Mbwambo, Zakaria H; Mahunnah, Rogasian L; Moshi, Mainen J; Mgonda, Yasin H

    2007-01-01

    Collaboration between traditional healers and biomedical practitioners is now being accepted by many African countries south of the Sahara because of the increasing problem of HIV/AIDS. The key problem, however, is how to initiate collaboration between two health systems which differ in theory of disease causation and management. This paper presents findings on experience learned by initiation of collaboration between traditional healers and the Institute of Traditional Medicine in Arusha and Dar-es-Salaam Municipalities, Tanzania where 132 and 60 traditional healers respectively were interviewed. Of these 110 traditional healers claimed to be treating HIV/AIDS. The objective of the study was to initiate sustainable collaboration with traditional healers in managing HIV/AIDS. Consultative meetings with leaders of traditional healers' associations and government officials were held, followed by surveys at respective traditional healers' "vilinge" (traditional clinics). The findings were analysed using both qualitative and quantitative methods. The findings showed that influential people and leaders of traditional healers' association appeared to be gatekeepers to access potential good healers in the two study areas. After consultative meetings these leaders showed to be willing to collaborate; and opened doors to other traditional healers, who too were willing to collaborate with the Institute of Traditional Medicine in managing HIV/AIDS patients. Seventy five percent of traditional healers who claimed to be treating HIV/AIDS knew some HIV/AIDS symptoms; and some traditional healers attempted to manage these symptoms. Even though, they were willing to collaborate with the Institute of Traditional Medicine there were nevertheless some reservations based on questions surrounding sharing from collaboration. The reality of past experiences of mistreatment of traditional healers in the colonial period informed these reservations. General findings suggest that initiating

  15. Elementary School-Located Influenza Vaccine Programs: Key Stakeholder Experiences from Initiation to Continuation

    ERIC Educational Resources Information Center

    Williams, Valerie; Rousculp, Matthew D.; Price, Mark; Coles, Theresa; Therrien, Michelle; Griffin, Jane; Hollis, Kelly; Toback, Seth

    2012-01-01

    This study examined the initiation and logistics, funding, perceived barriers and benefits, and disruption of school activities by school-located influenza vaccination (SLIV) programs conducted during the 2008-2009 influenza season. Seventy-two interviews using a structured protocol were conducted with 26 teachers, 16 school administrators, and 30…

  16. The California HIV/AIDS Research Program: History, Impact, and HIV Cure Initiative.

    PubMed

    Stanga, Lisa Loeb; Mujeeb, Anwer; Packel, Laura; Martz, Tyler; Lemp, George

    2017-11-01

    This Special Issue of AIDS Research and Human Retroviruses features results from the HIV Cure Initiative, funded by the California HIV/AIDS Research Program (CHRP). As a publicly funded grant maker, CHRP has served for more than three decades as a unique resource for innovative researchers in California, whose work seeks to address all aspects of the HIV epidemic and the communities affected by it. Early initiatives at CHRP pioneered what would become enduring cornerstones of HIV science: isolation of the virus; efficacy and toxicities of the first HIV treatments; the emergence of drug resistance; the first biospecimen banks for HIV-related research; the first community-based laboratory service for HIV diagnostic serology; and the first longitudinal case-control study of progression from HIV to AIDS-The San Francisco General Hospital Cohort. More recently, CHRP-funded conceptual studies of zinc-finger nuclease-mediated disruption of CCR5 genomic sequences and the safety of solid organ transplantation for HIV-positive patients have progressed from brilliant ideas to clinical realities, and CHRP is currently funding the first multisite trial of HIV preexposure prophylaxis for transgender persons in the United States. The present article outlines the founding of CHRP, our current grantmaking process, and our impact on HIV research over time. In 2013, CHRP launched a new initiative aimed at moving the then nascent frontier of HIV cure science forward: the CHRP HIV Cure Initiative provided over $1.4 million to multiple basic biomedical research projects, and selected results are presented in this Special Issue.

  17. Increasing adult Tdap vaccination rates by vaccinating infant caregivers in the pediatric office.

    PubMed

    Camenga, Deepa R; Kyanko, Kelly; Stepczynski, Jadwiga; Flaherty-Hewitt, Maryellen; Curry, Leslie; Sewell, Diana; Smart, Cameale; Rosenthal, Marjorie S

    2012-01-01

    To increase adult caregiver Tdap vaccination rates by offering Tdap vaccine during infant well-child visits. We developed a pilot vaccine initiative wherein pediatricians offered Tdap vaccine to mothers and non-mother caregivers attending the 2-week well-child visit at a hospital-based clinic serving predominantly low-income families. We evaluated this initiative by asking mothers and caregivers to participate in a survey after the 2-week visit to determine self-reported Tdap vaccination status, demographics, and the source of their adult primary care. Seventy (69%) participants received the Tdap vaccine during the newborns' 2-week well-child visit. Forty-six percent of the infants' 152 adult household contacts were vaccinated through this initiative. Of those mothers and caregivers, more caregivers reported not having insurance (38% vs 15%, P < .001), and no routine medical care (23% vs 8%, P = .007). Through this pilot initiative, we vaccinated 69% of mothers and non-mother caregivers presenting to the 2-week well-child visit. A large proportion of caregivers did not receive routine medical care or have insurance, which suggests that they otherwise may have poor access to the vaccine. Tdap vaccination in the pediatric office represents a substantial opportunity to increase vaccination rates. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. The Center for HIV/AIDS Vaccine Immunology (CHAVI) Multi-site Quality Assurance Program for Cryopreserved Human Peripheral Blood Mononuclear Cells

    PubMed Central

    Sarzotti-Kelsoe, Marcella; Needham, Leila K.; Rountree, Wes; Bainbridge, John; Gray, Clive M.; Fiscus, Susan A.; Ferrari, Guido; Stevens, Wendy S.; Stager, Susan L.; Binz, Whitney; Louzao, Raul; Long, Kristy O.; Mokgotho, Pauline; Moodley, Niranjini; Mackay, Melanie; Kerkau, Melissa; McMillion, Takesha; Kirchherr, Jennifer; Soderberg, Kelly A.; Haynes, Barton F.; Denny, Thomas N.

    2014-01-01

    The Center for HIV/AIDS Vaccine Immunology (CHAVI) consortium was established to determine the host and virus factors associated with HIV transmission, infection and containment of virus replication, with the goal of advancing the development of an HIV protective vaccine. Studies to meet this goal required the use of cryopreserved Peripheral Blood Mononuclear Cell (PBMC) specimens, and therefore it was imperative that a quality assurance (QA) oversight program be developed to monitor PBMC samples obtained from study participants at multiple international sites. Nine site-affiliated laboratories in Africa and the USA collected and processed PBMCs, and cryopreserved PBMC were shipped to CHAVI repositories in Africa and the USA for long-term storage. A three-stage program was designed, based on Good Clinical Laboratory Practices (GCLP), to monitor PBMC integrity at each step of this process. The first stage evaluated the integrity of fresh PBMCs for initial viability, overall yield, and processing time at the site-affiliated laboratories (Stage 1); for the second stage, the repositories determined post-thaw viability and cell recovery of cryopreserved PBMC, received from the site-affiliated laboratories (Stage 2); the third stage assessed the long-term specimen storage at each repository (Stage 3). Overall, the CHAVI PBMC QA oversight program results highlight the relative importance of each of these stages to the ultimate goal of preserving specimen integrity from peripheral blood collection to long-term repository storage. PMID:24910414

  19. The Journalists Initiatives on Immunisation Against Polio and Improved Acceptance of the Polio Vaccine in Northern Nigeria 2007–2015

    PubMed Central

    Warigon, Charity; Mkanda, Pascal; Banda, Richard; Zakari, Furera; Damisa, Eunice; Idowu, Audu; Bawa, Samuel; Gali, Emmanuel; Tegegne, Sisay G.; Hammanyero, Kulchumi; Nsubuga, Peter; Korir, Charles; Vaz, Rui G.

    2016-01-01

    Background. The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. Methods. We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers’ sources of information about SIAs in 2007 before and after the JAP was formed. Results. Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. Conclusions. The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria. PMID:26721745

  20. Multiple Low-Dose Challenges in a Rhesus Macaque AIDS Vaccine Trial Result in an Evolving Host Response That Affects Protective Outcome

    PubMed Central

    Selinger, Christian; Strbo, Natasa; Gonzalez, Louis; Aicher, Lauri; Weiss, Jeffrey M.; Law, G. Lynn; Palermo, Robert E.; Vaccari, Monica; Franchini, Genoveffa; Podack, Eckhard R.

    2014-01-01

    Using whole-blood transcriptional profiling, we investigated differences in the host response to vaccination and challenge in a rhesus macaque AIDS vaccine trial. Samples were collected from animals prior to and after vaccination with live, irradiated vaccine cells secreting the modified endoplasmic reticulum chaperone gp96-Ig loaded with simian immunodeficiency virus (SIV) peptides, either alone or in combination with a SIV-gp120 protein boost. Additional samples were collected following multiple low-dose rectal challenges with SIVmac251. Animals in the boosted group had a 73% reduced risk of infection. Surprisingly, few changes in gene expression were observed during the vaccination phase. Focusing on postchallenge comparisons, in particular for protected animals, we identified a host response signature of protection comprised of strong interferon signaling after the first challenge, which then largely abated after further challenges. We also identified a host response signature, comprised of early macrophage-mediated inflammatory responses, in animals with undetectable viral loads 5 days after the first challenge but with unusually high viral titers after subsequent challenges. Statistical analysis showed that prime-boost vaccination significantly lowered the probability of infection in a time-consistent manner throughout several challenges. Given that humoral responses in the prime-boost group were highly significant prechallenge correlates of protection, the strong innate signaling after the first challenge suggests that interferon signaling may enhance vaccine-induced antibody responses and is an important contributor to protection from infection during repeated low-dose exposure to SIV. PMID:25274805

  1. Correlations between Learners' Initial EFL Proficiency and Variables of Clicker-Aided Flipped EFL Class

    ERIC Educational Resources Information Center

    Yu, Zhonggen; Yu, Liheng

    2017-01-01

    Although the flipped class has been hotly discussed, the clicker-aided flipped EFL class (CFEC) still remains a mystery for most scholars. This study aims to determine the correlations between the initial EFL proficiency and other variables of the clicker-aided EFL flipped class. The sample was made up of randomly selected 79 participants (Female…

  2. What is a Therapeutic HIV Vaccine?

    MedlinePlus

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Overview Home Understanding HIV/AIDS Fact Sheets What ... Send us an email What is a Therapeutic HIV Vaccine? Last Reviewed: August 16, 2017 Key Points ...

  3. What is a Preventive HIV Vaccine?

    MedlinePlus

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Overview Home Understanding HIV/AIDS Fact Sheets What ... Send us an email What is a Preventive HIV Vaccine? Last Reviewed: August 16, 2017 Key Points ...

  4. Risk factors for adverse events after vaccinations performed during the initial hospitalization of infants born prematurely.

    PubMed

    Wilińska, Maria; Warakomska, Małgorzata; Głuszczak-Idziakowska, Ewa; Jackowska, Teresa

    There are significant delays in implementing vaccination among preterm infants. Description of the frequency and kinds of adverse events following immunization in preterms. Establishment of the group of preterms who will distinctively be susceptible to adverse events. Demographical, clinical data and the occurrence of adverse events after DTaP, HIB and pneumococcal vaccination among preterms during their initial hospitalization were prospectively collected with the use of an electronic data form between 1st June 2011 and 31st May 2015. The analysis was conducted on 138 patients. The groups were divided according to maturity (I: ≤ GA 28w n=73 and GA 29-36 w n=65). There were no statistically significant differences between the groups in the occurrence of adverse events. Out of the total group, following vaccination apnoea developed in 6 newborns (4%) and activity dysfunctions were observed in 13 newborns (10%). The occurrence of apnoea after vaccination positively correlated with the time of non-invasive ventilation and the occurrence of late infection. There were no statistically significant demographical or clinical risk factors for the development of activity dysfunctions following vaccination. Term vaccination in clinically stable preterm infants is a safe medical procedure. However, long-term non-invasive respiratory support and late infections are risk factors for apnea following vaccinations. In these patients vaccinations should be considered during hospitalization.

  5. Footrot vaccines and vaccination.

    PubMed

    Dhungyel, Om; Hunter, James; Whittington, Richard

    2014-05-30

    Research on footrot in small ruminants, which is caused by Dichelobacter nodosus, has led to development of vaccines and their application for control, treatment and eradication of the disease in sheep. Footrot vaccines have evolved over decades to contain monovalent whole cell, multivalent recombinant fimbrial, and finally mono or bivalent recombinant fimbrial antigens. Initially whole cell vaccines made against the few known serogroups of D. nodosus were found to be inefficient in control of the disease in the field, which was attributed to the presence of other unidentified serogroups and also the use of inefficient adjuvants. Fimbriae or pili, which are the basis for antigenic variation, were found to be the major protective and also curative antigens but they are not cross protective between the different serogroups. Multivalent vaccines incorporating all the known serogroups have been proven to be of limited efficacy due to the phenomenon of antigenic competition. Recent studies in Nepal, Bhutan and Australia have shown that outbreak-specific vaccination which involves targeting identified serogroups with mono- or bivalent recombinant fimbrial vaccines, can be very effective in sheep and goats. Where multiple serogroups are present in a flock, antigenic competition can be overcome by sequentially targeting the serogroups with different bivalent vaccines every 3 months. A common antigen which would confer immunity to all serogroups would be the ideal immunogen but the initial studies were not successful in this area. Until universal antigen/s are available, flock specific mono or bivalent fimbrial vaccines are likely to be the most effective tool for control and eradication of footrot in sheep and goats. Future research in footrot vaccines should be focused on improving the duration of prophylaxis by incorporating new and emerging immunomodulators or adjuvants with modified delivery vehicles, discovering a common antigen and understanding the mechanisms of

  6. Cytomegalovirus retinitis in patients with AIDS after initiating antiretroviral therapy

    PubMed Central

    Jabs, Douglas A.; Van Natta, Mark L.; Holland, Gary N.; Danis, Ronald

    2016-01-01

    Purpose To evaluate the rates of new-onset cytomegalovirus (CMV) retinitis and worsening existing CMV retinitis in patients with AIDS after initiating combination antiretroviral therapy (cART) and the role of an immune recovery inflammatory syndrome (IRIS). Design Cohort study Methods Immune recovery was defined as an increase in CD4+ T cells to ≥100 cells/μL; rates of new-onset CMV retinitis and of worsening of CMV retinitis (either increasing border activity or retinitis progression) were compared between those with and without immune recovery. Results Among patients without CMV retinitis, 1 of 75 patients with immune recovery developed CMV retinitis in the first 6 months after initiating cART vs. 1 of 31 without immune recovery (P=0.14). Among patients with CMV retinitis, the rates of retinitis progression and increasing retinitis border activity among patients during the first 6 months after initiating cART in those with immune recovery were 0.11/PY (95% confidence interval [CI] 0, 0.62) and 0.11/PY (95% CI 0, 0.62), respectively, vs. 0.67/PY (95% CI 0.22, 1.56) and 0.40/PY (95% CI 0.08, 1.17), respectively, for those without immune recovery (P=0.11 and 0.47). Conclusions Among persons with AIDS who experience immune recovery, there was neither an increased rate of new-onset CMV retinitis nor worsening of existing CMV retinitis in the first 6 months after initiating cART vs. those without immune recovery. These data are consistent with the known 3–6 month lag in recovery of specific immunity to CMV after initiating cART and suggest that “immune recovery retinitis”, a proposed IRIS phenomenon, is rare. PMID:27984023

  7. Executive summary and recommendations from the WHO/UNAIDS/IAVI expert group consultation on 'Phase IIB-TOC trials as a novel strategy for evaluation of preventive HIV vaccines', 31 January-2 February 2006, IAVI, New York, USA.

    PubMed

    2007-02-19

    This report summarizes the discussions and recommendations from a consultation held in New York City, USA (31 January-2 February 2006) organized by the joint World Health Organization-United Nations Programme on HIV/AIDS HIV Vaccine Initiative and the International AIDS Vaccine Initiative. The consultation discussed issues related to the design and implementation of phase IIB 'test of concept' trials (phase IIB-TOC), also referred to as 'proof of concept' trials, in evaluating candidate HIV vaccines and their implications for future approval and licensure. The results of a single phase IIB-TOC trial would not be expected to provide sufficient evidence of safety or efficacy required for licensure. In many instances, phase IIB-TOC trials may be undertaken relatively early in development, before manufacturing processes and capacity are developed sufficiently to distribute the vaccine on a large scale. However, experts at this meeting considered the pressure that could arise, particularly in regions hardest hit by AIDS, if a phase IIB-TOC trial showed high levels of efficacy. The group largely agreed that full-scale phase III trials would still be necessary to demonstrate that the vaccine candidate was safe and effective, but emphasized that governments and organizations conducting trials should consider these issues in advance. The recommendations from this meeting should be helpful for all organizations involved in HIV vaccine trials, in particular for the national regulatory authorities in assessing the utility of phase IIB-TOC trials in the overall HIV vaccine research and development process.

  8. Transmissibility and persistence of oral polio vaccine viruses: implications for the global poliomyelitis eradication initiative.

    PubMed

    Fine, P E; Carneiro, I A

    1999-11-15

    The global poliomyelitis eradication initiative has been a tremendous success, with current evidence suggesting that wild poliovirus will cease to circulate anywhere in the world soon after the year 2000. As the goal of wild poliovirus eradication is approached, concern has been raised about the potential for persistent transmission of oral polio vaccine (OPV) viruses, as these viruses are known to revert toward wild-type neurovirulence. This paper has been extracted from a document prepared for the World Health Organization on the implications of OPV transmissibility for the strategy of stopping OPV vaccination after global eradication of wild polioviruses. The authors review the empirical evidence on OPV transmissibility available from household and community transmission studies and from mass-vaccination experiences. They then consider theoretical measures of transmissibility and persistence for wild and OPV viruses (secondary attack rate, basic reproduction number, and critical populations' size), to assess whether transmissibility of OPV viruses is sufficient to allow persistence of these viruses after cessation of vaccination. The findings indicate that OPV viruses could persist under various plausible circumstances, and that this potential should be a major consideration when planning the cessation of OPV vaccination.

  9. Vaccination of school children with live mumps virus vaccine.

    PubMed

    Furesz, J; Nagler, F P

    1970-05-30

    Live, attenuated mumps virus vaccine (Mumpsvax) was administered to 146 school children 6 to 9 years of age. One child developed clinical mumps nine days after vaccination; epidemiological and serological data strongly suggest that this child had become infected before vaccination. Apart from this single instance there were no apparent clinical reactions that could be ascribed to the administration of the vaccine. Sixty-three of the 146 children with no clinical history of mumps had an initial serum neutralizing antibody titre of less than 1:2. Specific antibodies to mumps virus were detected in 93.5% of the sera of the susceptible children 28 days after vaccination, and the geometric mean antibody titre of these sera was low (1:6). Of the 80 initially seropositive children 21 (26.2%) showed a significant antibody response to the vaccine and this was influenced by the pre-existing antibody level. These data have further demonstrated the safety and efficacy of the live mumps vaccine in children.

  10. Vaccination of School Children With Live Mumps Virus Vaccine

    PubMed Central

    Furesz, J.; Nagler, F. P.

    1970-01-01

    Live, attenuated mumps virus vaccine (Mumpsvax) was administered to 146 school children 6 to 9 years of age. One child developed clinical mumps nine days after vaccination; epidemiological and serological data strongly suggest that this child had become infected before vaccination. Apart from this single instance there were no apparent clinical reactions that could be ascribed to the administration of the vaccine. Sixty-three of the 146 children with no clinical history of mumps had an initial serum neutralizing antibody titre of less than 1:2. Specific antibodies to mumps virus were detected in 93.5% of the sera of the susceptible children 28 days after vaccination, and the geometric mean antibody titre of these sera was low (1:6). Of the 80 initially seropositive children 21 (26.2%) showed a significant antibody response to the vaccine and this was influenced by the pre-existing antibody level. These data have further demonstrated the safety and efficacy of the live mumps vaccine in children. PMID:5420994

  11. HIV vaccines: current challenges and future directions.

    PubMed

    Avrett, Sam; Collins, Chris

    2002-07-01

    Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vaccines in the context of efforts to increase global access to public health measures and technologies.

  12. Ethical and legal challenges of vaccines and vaccination: Reflections.

    PubMed

    Jesani, Amar; Johari, Veena

    2017-01-01

    Vaccines and vaccination have emerged as key medical scientific tools for prevention of certain diseases. Documentation of the history of vaccination shows that the initial popular resistance to universal vaccination was based on false assumptions and eventually gave way to acceptance of vaccines and trust in their ability to save lives. The successes of the global eradication of smallpox, and now of polio, have only strengthened the premier position occupied by vaccines in disease prevention. However, the success of vaccines and public trust in their ability to eradicate disease are now under challenge, as increasing numbers of people refuse vaccination, questioning the effectiveness of vaccines and the need to vaccinate.

  13. Vaccine approaches to malaria control and elimination: Insights from mathematical models.

    PubMed

    White, Michael T; Verity, Robert; Churcher, Thomas S; Ghani, Azra C

    2015-12-22

    A licensed malaria vaccine would provide a valuable new tool for malaria control and elimination efforts. Several candidate vaccines targeting different stages of the malaria parasite's lifecycle are currently under development, with one candidate, RTS,S/AS01 for the prevention of Plasmodium falciparum infection, having recently completed Phase III trials. Predicting the public health impact of a candidate malaria vaccine requires using clinical trial data to estimate the vaccine's efficacy profile--the initial efficacy following vaccination and the pattern of waning of efficacy over time. With an estimated vaccine efficacy profile, the effects of vaccination on malaria transmission can be simulated with the aid of mathematical models. Here, we provide an overview of methods for estimating the vaccine efficacy profiles of pre-erythrocytic vaccines and transmission-blocking vaccines from clinical trial data. In the case of RTS,S/AS01, model estimates from Phase II clinical trial data indicate a bi-phasic exponential profile of efficacy against infection, with efficacy waning rapidly in the first 6 months after vaccination followed by a slower rate of waning over the next 4 years. Transmission-blocking vaccines have yet to be tested in large-scale Phase II or Phase III clinical trials so we review ongoing work investigating how a clinical trial might be designed to ensure that vaccine efficacy can be estimated with sufficient statistical power. Finally, we demonstrate how parameters estimated from clinical trials can be used to predict the impact of vaccination campaigns on malaria using a mathematical model of malaria transmission. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. [AIDS. In the West, nothing new].

    PubMed

    Fisch, A

    1989-07-12

    The June 1989 International Conference on AIDS in Montreal had a record attendance of 11,000 including several thousand journalists, representatives of pharmaceutical companies, sociologists, psychologists, and numerous AIDS patients primarily from the US. The opening session was postponed for several hours by demonstrators protesting the government response to AIDS. The initial plenary sessions failed to present information on scientific progress against AIDS but focused on topics such as tolerance, the faults of humanity, and the difficult life of homosexuals. The 6000 communications presented a pessimistic picture of the prospects for controlling the epidemic, especially in Africa. Several studies indicated that condom use is very limited in Africa and that no national policy has succeeded in reducing the rate of new infections. The few notes of hope concerned the improved management of AIDS cases in the industrialized countries, which have increased 18-month survival rates from 30% in 1982 to 60% in 1988. The difficulty and expense of treatments however mean that they are unlikely to be adopted in countries with limited health resources. Vaccines under development in France and the US show promise, but there is little hope of a cure in the near future. AZT is believed to improve the quality of survival time rather than the duration. Some new antivirals under study are too highly toxic for practical use.

  15. Can We Capitalize on the Virtues of Vaccines? Insights from the Polio Eradication Initiative

    PubMed Central

    Aylward, R. Bruce; Heymann, David L.

    2005-01-01

    Twenty-five years after the eradication of smallpox, the ongoing effort to eradicate poliomyelitis has grown into the largest international health initiative ever undertaken. By 2004, however, the polio eradication effort was threatened by a challenge regularly faced by public health policymakers everywhere—misperception about the benefits and risks of vaccines. The propagation of false rumors about oral poliovirus vaccine safety led to the reinfection of 13 previously polio-free countries and the largest polio epidemic in Africa in recent years. With deft management of such challenges by local, national, and international health authorities, poliomyelitis, a disease that threatened children everywhere just 2 generations ago, could soon be relegated to history like smallpox before it. PMID:15855451

  16. Evidence-based decision-making for vaccine introductions: Overview of the ProVac International Working Group's experience.

    PubMed

    Jauregui, Barbara; Garcia, Ana Gabriela Felix; Bess Janusz, Cara; Blau, Julia; Munier, Aline; Atherly, Deborah; Mvundura, Mercy; Hajjeh, Rana; Lopman, Benjamin; Clark, Andrew David; Baxter, Louise; Hutubessy, Raymond; de Quadros, Ciro; Andrus, Jon Kim

    2015-05-07

    Pan American Health Organization's (PAHO) ProVac Initiative aims to strengthen countries' technical capacity to make evidence-based immunization policy. With financial support from the Bill and Melinda Gates Foundation, PAHO established the ProVac International Working Group (IWG), a platform created for two years to transfer the ProVac Initiative's tools and methods to support decisions in non-PAHO regions. In 2011, WHO Regional Offices and partner agencies established the IWG to transfer the ProVac framework for new vaccine decision support, including tools and trainings to other regions of the world. During the two year period, PAHO served as the coordinating secretariat and partner agencies played implementing or advisory roles. Fifty nine national professionals from 17 countries received training on the use of economic evaluations to aid vaccine policy making through regional workshops. The IWG provided direct technical support to nine countries to develop cost-effectiveness analyses to inform decisions. All nine countries introduced the new vaccine evaluated or their NITAGs have made a recommendation to the Ministry of Health to introduce the new vaccine. Developing countries around the world are increasingly interested in weighing the potential health impact due to new vaccine introduction against the investments required. During the two years, the ProVac approach proved valuable and timely to aid the national decision making processes, even despite the different challenges and idiosyncrasies encountered in each region. The results of this work suggest that: (1) there is great need and demand for technical support and for capacity building around economic evaluations; and (2) the ProVac method of supporting country-owned analyses is as effective in other regions as it has been in the PAHO region. Decision support for new vaccine introduction in low- and middle-income countries is critical to guiding the efficient use of resources and prioritizing high impact

  17. Macromolecular systems for vaccine delivery.

    PubMed

    MuŽíková, G; Laga, R

    2016-10-20

    Vaccines have helped considerably in eliminating some life-threatening infectious diseases in past two hundred years. Recently, human medicine has focused on vaccination against some of the world's most common infectious diseases (AIDS, malaria, tuberculosis, etc.), and vaccination is also gaining popularity in the treatment of cancer or autoimmune diseases. The major limitation of current vaccines lies in their poor ability to generate a sufficient level of protective antibodies and T cell responses against diseases such as HIV, malaria, tuberculosis and cancers. Among the promising vaccination systems that could improve the potency of weakly immunogenic vaccines belong macromolecular carriers (water soluble polymers, polymer particels, micelles, gels etc.) conjugated with antigens and immunistumulatory molecules. The size, architecture, and the composition of the high molecular-weight carrier can significantly improve the vaccine efficiency. This review includes the most recently developed (bio)polymer-based vaccines reported in the literature.

  18. Meeting report: Initial World Health Organization consultation on herpes simplex virus (HSV) vaccine preferred product characteristics, March 2017.

    PubMed

    Gottlieb, Sami L; Giersing, Birgitte K; Hickling, Julian; Jones, Rebecca; Deal, Carolyn; Kaslow, David C

    2017-12-07

    The development of vaccines against herpes simplex virus (HSV) is an important global goal for sexual and reproductive health. A key priority to advance development of HSV vaccines is the definition of preferred product characteristics (PPCs), which provide strategic guidance on World Health Organization (WHO) preferences for new vaccines, specifically from a low- and middle-income country (LMIC) perspective. To start the PPC process for HSV vaccines, the WHO convened a global stakeholder consultation in March 2017, to define the priority public health needs that should be addressed by HSV vaccines and discuss the key considerations for HSV vaccine PPCs, particularly for LMICs. Meeting participants outlined an initial set of overarching public health goals for HSV vaccines in LMICs, which are: to reduce the acquisition of HIV associated with HSV-2 infection in high HIV-prevalence populations and to reduce the burden of HSV-associated disease, including mortality and morbidity due to neonatal herpes and impacts on sexual and reproductive health. Participants also considered the role of prophylactic versus therapeutic vaccines, whether both HSV-2 and HSV-1 should be targeted, important target populations, and infection and disease endpoints for clinical trials. This article summarizes the main discussions from the consultation. Copyright © 2017.

  19. 'teen Mental Health First Aid': a description of the program and an initial evaluation.

    PubMed

    Hart, Laura M; Mason, Robert J; Kelly, Claire M; Cvetkovski, Stefan; Jorm, Anthony F

    2016-01-01

    Many adolescents have poor mental health literacy, stigmatising attitudes towards people with mental illness, and lack skills in providing optimal Mental Health First Aid to peers. These could be improved with training to facilitate better social support and increase appropriate help-seeking among adolescents with emerging mental health problems. teen Mental Health First Aid (teen MHFA), a new initiative of Mental Health First Aid International, is a 3 × 75 min classroom based training program for students aged 15-18 years. An uncontrolled pilot of the teen MHFA course was undertaken to examine the feasibility of providing the program in Australian secondary schools, to test relevant measures of student knowledge, attitudes and behaviours, and to provide initial evidence of program effects. Across four schools, 988 students received the teen MHFA program. 520 students with a mean age of 16 years completed the baseline questionnaire, 345 completed the post-test and 241 completed the three-month follow-up. Statistically significant improvements were found in mental health literacy, confidence in providing Mental Health First Aid to a peer, help-seeking intentions and student mental health, while stigmatising attitudes significantly reduced. teen MHFA appears to be an effective and feasible program for training high school students in Mental Health First Aid techniques. Further research is required with a randomized controlled design to elucidate the causal role of the program in the changes observed.

  20. Summaries from the Eleventh Annual Houston Conference on AIDS in America.

    PubMed

    1999-07-01

    A number of significant papers from the Eleventh Annual Houston Conference on AIDS in America are summarized. Topics include the current concepts in pathogenesis of HIV infection, the use of anti-HIV therapies, and drug interactions in HIV treatment. A session on HIV disease in children focused on the epidemiology and prevention of vertical transmission with Zidovudine, when to initiate therapy, and options for children who have failed current therapies. Studies using immune-based therapy have shown promise in treating HIV disease. New data from a study with sargramostim, an investigational agent for opportunistic infection prophylaxis, shows that the drug reduces viral loads and delays time to treatment failure. Pentafuside (T-20), the first of a new class of HIV drugs, fusion inhibitors, has been found to be safe and effective against HIV, although drug resistance may be associated with its use. Other sessions summarized progress in clearing HIV from viral reservoirs, the ethics of HIV research support from the drug industry and drug marketing, and a review of immune reconstitution studies among people on antiretroviral therapy. Sam Avrett of the AIDS Vaccine Advocacy Coalition (AVAC) summarized in his session the characteristics of a successful HIV vaccine and the need to have more people involved in vaccine advocacy as a means to ending the epidemic. Contact information is provided.

  1. Vaccines against poverty

    PubMed Central

    MacLennan, Calman A.; Saul, Allan

    2014-01-01

    With the 2010s declared the Decade of Vaccines, and Millennium Development Goals 4 and 5 focused on reducing diseases that are potentially vaccine preventable, now is an exciting time for vaccines against poverty, that is, vaccines against diseases that disproportionately affect low- and middle-income countries (LMICs). The Global Burden of Disease Study 2010 has helped better understand which vaccines are most needed. In 2012, US$1.3 billion was spent on research and development for new vaccines for neglected infectious diseases. However, the majority of this went to three diseases: HIV/AIDS, malaria, and tuberculosis, and not neglected diseases. Much of it went to basic research rather than development, with an ongoing decline in funding for product development partnerships. Further investment in vaccines against diarrheal diseases, hepatitis C, and group A Streptococcus could lead to a major health impact in LMICs, along with vaccines to prevent sepsis, particularly among mothers and neonates. The Advanced Market Commitment strategy of the Global Alliance for Vaccines and Immunisation (GAVI) Alliance is helping to implement vaccines against rotavirus and pneumococcus in LMICs, and the roll out of the MenAfriVac meningococcal A vaccine in the African Meningitis Belt represents a paradigm shift in vaccines against poverty: the development of a vaccine primarily targeted at LMICs. Global health vaccine institutes and increasing capacity of vaccine manufacturers in emerging economies are helping drive forward new vaccines for LMICs. Above all, partnership is needed between those developing and manufacturing LMIC vaccines and the scientists, health care professionals, and policy makers in LMICs where such vaccines will be implemented. PMID:25136089

  2. Knowledge of HPV infection and vaccination among vaccinated and unvaccinated teenaged girls.

    PubMed

    Sopracordevole, Francesco; Cigolot, Federica; Mancioli, Francesca; Agarossi, Alberto; Boselli, Fausto; Ciavattini, Andrea

    2013-07-01

    To assess the knowledge of teenaged girls on human papillomavirus (HPV) infection and vaccination 12 months after the start of a vaccine administration and information campaign. Between May 15 and June 15, 2009, an anonymous questionnaire was given to 629 girls attending a secondary school in a northeastern Italian city (286 were vaccinated against HPV, 343 were unvaccinated) to investigate their knowledge on HPV infection, transmission, prevention, vaccination, and post-vaccination behaviors. The responses were evaluated with respect to the vaccination status of the participants. Vaccinated teenaged girls had no more knowledge than unvaccinated ones about the route of HPV transmission, and the relationship between HPV and AIDS. Vaccinated girls had less knowledge than unvaccinated girls about preventing transmission by condom (P=0.003) and about the correlation between HPV and penile cancer (P=0.034) and warts (P=0.001). Furthermore, compared with unvaccinated girls, more vaccinated girls believed that contraceptive pills might prevent HPV-related disease (P=0.001). Vaccinated girls better understood the importance of performing regular Pap smears after vaccination (P=0.021). Knowledge on HPV infection and vaccination remains suboptimal, especially among vaccinated teenaged girls, despite a broad information campaign. Misconceptions about the utility of secondary prevention may increase risky sexual behaviors. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Meeting the needs of people with AIDS: local initiatives and Federal support.

    PubMed Central

    Sundwall, D N; Bailey, D

    1988-01-01

    The Health Resources and Services Administration (HRSA), one of the seven agencies of the Public Health Service, is working to meet some of the resource and patient service needs engendered by the epidemic of acquired immune deficiency syndrome (AIDS). Those actions derived from, and support the continuation, expansion, and replication of, initiatives at the community and State levels. HRSA is carrying out many of the recommendations of the Intragovernmental Task Force on AIDS Health Care Delivery by enhancing the AIDS training of health care personnel in prevention, diagnosis, and care and by counseling and encouraging the expansion of facilities outside hospitals to care for AIDS patients. The agency, through its pediatric AIDS demonstration projects, is working on models for the care of children with HIV infections. The needs of AIDS patients are being addressed through a drug therapy reimbursement program; demonstration grants to 13 projects to promote coordinated, integrated systems of care in the community; and grants for the development of intermediate and long-term care facilities for patients. Ten regional education and training centers, funded in 1987 and 1988, will increase the supply of health care providers prepared to diagnose and treat persons with HIV infections. Programs will be conducted for several thousand providers over the next 3 years, using such modalities as televised programs and train-the-trainer courses. The centers will also offer support and referral services for providers. PMID:3131821

  4. Librarian-initiated HIV/AIDS prevention intervention program outcome in rural communities in Oyo State, Nigeria.

    PubMed

    Ajuwon, G A; Komolafe-Opadeji, H O; Ikhizama, B

    2013-01-01

    The objective of this study was to meet the HIV/AIDS information and service needs of citizens living in selected rural, underserved communities in Oyo State, Nigeria. This was a librarian-initiated intervention program (pre-post) study of heads of rural households in Oyo State. A questionnaire was used for pre- and post-intervention assessment. The education covered knowledge about HIV/AIDS, routes of transmission, prevention strategies, and attitude toward persons living with HIV. It increased participants' knowledge about AIDS and improved attitude toward those living with HIV. Provision and dissemination of information on HIV/AIDS through librarians to rural settlers is an important prevention strategy and librarians can make major contributions.

  5. Vaccines Through Centuries: Major Cornerstones of Global Health

    PubMed Central

    Hajj Hussein, Inaya; Chams, Nour; Chams, Sana; El Sayegh, Skye; Badran, Reina; Raad, Mohamad; Gerges-Geagea, Alice; Leone, Angelo; Jurjus, Abdo

    2015-01-01

    Multiple cornerstones have shaped the history of vaccines, which may contain live-attenuated viruses, inactivated organisms/viruses, inactivated toxins, or merely segments of the pathogen that could elicit an immune response. The story began with Hippocrates 400 B.C. with his description of mumps and diphtheria. No further discoveries were recorded until 1100 A.D. when the smallpox vaccine was described. During the eighteenth century, vaccines for cholera and yellow fever were reported and Edward Jenner, the father of vaccination and immunology, published his work on smallpox. The nineteenth century was a major landmark, with the “Germ Theory of disease” of Louis Pasteur, the discovery of the germ tubercle bacillus for tuberculosis by Robert Koch, and the isolation of pneumococcus organism by George Miller Sternberg. Another landmark was the discovery of diphtheria toxin by Emile Roux and its serological treatment by Emil Von Behring and Paul Ehrlih. In addition, Pasteur was able to generate the first live-attenuated viral vaccine against rabies. Typhoid vaccines were then developed, followed by the plague vaccine of Yersin. At the beginning of World War I, the tetanus toxoid was introduced, followed in 1915 by the pertussis vaccine. In 1974, The Expanded Program of Immunization was established within the WHO for bacille Calmette–Guerin, Polio, DTP, measles, yellow fever, and hepatitis B. The year 1996 witnessed the launching of the International AIDS Vaccine Initiative. In 1988, the WHO passed a resolution to eradicate polio by the year 2000 and in 2006; the first vaccine to prevent cervical cancer was developed. In 2010, “The Decade of vaccines” was launched, and on April 1st 2012, the United Nations launched the “shot@Life” campaign. In brief, the armamentarium of vaccines continues to grow with more emphasis on safety, availability, and accessibility. This mini review highlights the major historical events and pioneers in the course of development

  6. Human papilloma virus vaccination in Nepal: an initial experience in Nepal.

    PubMed

    Singh, Yogendra; Shah, Aarti; Singh, Meeta; Verma, Sheela; Shrestha, Bhakta Man; Vaidya, Prabhu; Nakarmi, Radha Pyari; Shrestha, Surendra Bb

    2010-01-01

    Cervical cancer is the most common cancer among women in Nepal. Human papilloma virus (HPV) infection, a recognized cause of cervical cancer, is very common in sexually active women and HPV vaccination has been recommended as a prophylactic therapy. If HPV infection is prevented by the HPV vaccination to the adolescent girls, cervical cancer is also prevented. We received 3,300 vials of quadrivalent human papilloma virus (types 6, 11, 16, 18) recombinant vaccine (Gardasil; Merck and Co.) as a gift from the Australian Cervical Cancer Foundation (ACCF) which has a mission to provide life-saving HPV cervical cancer vaccines for women in developing countries, who cannot otherwise afford vaccination. HPV vaccine was offered to 1,096 of 10 to 26 year aged girls attending 17 secondary schools. In total, 1,091 (99.5%) received the second dose and 1,089 (99.3%) received the third dose of the vaccine. The remaining 5 girls at second dose and 2 girls at third dose remained unvaccinated. No serious vaccine related adverse events were reported except mild pain at the injection site in 7.8% of the vaccine recipients. High cost and low public awareness are the key barriers for successful implementation of the vaccination program in resource limited developing countries. In conclusion, HPV vaccine is safe with high acceptability in Nepalese school girls. However a large population study for longer follow up is warranted to validate the findings of this vaccination program.

  7. Executive summary and recommendations from WHO/UNAIDS and AAVP consultation on: 'The inclusion of adolescents in HIV vaccine trials', 16-18 March 2006 in Gaborone, Botswana.

    PubMed

    Osmanov, Saladin

    2007-09-12

    This report summarizes the discussions and recommendations from a consultation held in Gaborone, Botswana (16-19 March 2006), organized by the joint World Health Organization (WHO)/United Nations Programme on HIV/AIDS (UNAIDS) HIV Vaccine Initiative (HVI) and the African AIDS Vaccine Programme (AAVP). The consultation considered key challenges and strategies in enrolling adolescents into HIV vaccine clinical trials, relevant to developing countries, in particular in eastern and southern Africa. Approaches were identified that might address and resolve country-specific challenges related to scientific, legal, ethical, regulatory and community aspects of the involvement of adolescents in HIV vaccine trials. This executive summary is formulated for a broader dissemination of the outcomes of the meeting to the general clinical, scientific and regulatory community involved in the review, approval and monitoring of clinical trials and potential licensing of HIV vaccine candidates. Four major topics were discussed and recommendations developed with regard to: (i) criteria for products selection and clinical trial design; (ii) ethical and legal issues; (iii) community acceptance and participation; and (iv) regulatory considerations. The recommendations of this meeting were further discussed and endorsed by the WHO/UNAIDS HIV Vaccine Advisory Committee.

  8. [The royal philanthropic expedition of the vaccine (Xavier de Balmis/Josep Salvany). 1803-1806].

    PubMed

    Botet, Francesc Asensi

    2009-12-01

    Six years after Jenner discovered the anti-smallpox vaccine, King Charles IV mandated the initiation of vaccination campaigns throughout his kingdom. The overseas campaign was coordinated by the Valencian military doctor Xavier de Balmis with the aid of the Catalan Josep Salvany. The vaccine was transported to America "in vivo" in 22 children. The expedition departed from La Coruña on November 1806 and arrived to the Venezuelan port of La Guayra where it was split in two: One sub expedition under the order of Josep Salvany, continued by land to Colombia, Ecuador, Peru and Bolivia. Salvany died in the Bolivian city of Cochabamba. The other sub expedition, leaded by Balmis himself, continued by sea to Cuba and Mexico. From Acapulco it arrived to Manila and from there to Macau followed by inland penetration into China.

  9. Introduction of a new Rotavirus vaccine: Initial results of uptake and impact on laboratory confirmed cases in Anglia and Essex, United Kingdom, July 2015.

    PubMed

    Inns, Thomas; Trindall, Amy; Dunling-Hall, Sara; Shankar, Ananda Giri

    2016-04-02

    Rotavirus gastroenteritis accounts for an estimated 130,000 GP consultations and 13,000 hospitalisations for children under 5 y old each year in England and Wales. In July 2013, an oral live attenuated rotavirus vaccine (Rotarix®) was introduced into the UK infant immunisation program as a 2 dose schedule at 2 and 3 months of age. We collected vaccination uptake from October 2013 to March 2015 and laboratory confirmed cases data on children under the age of 5 y from 1 January 2004 to 31 May 2015. The vaccine uptake rates and laboratory confirmed cases were compared to provide evidence of the impact of this vaccination program. Vaccine uptake rates were available from sentinel data with between 91-98% of GP practices in Anglia and Essex providing data every month. These data showed from February 2014 to March 2015 between 90-92% of infants received the recommended 2 doses of Rotarix® each month. The numbers of rotavirus cases reported by laboratories decreased on average by 82% in the post vaccination seasons. The mean number of cases reported in weeks 1-22 for 2004-2013 in Anglia and Essex was 1,318. For the same period in 2014, 256 cases were reported and initial data for 2015 report 226 cases. In the first 5 months 2014 the greatest reduction in cases (89%) was seen in those under 1 yr (who would have been directly affected by vaccination) with case numbers falling to 59 from a mean 537 cases in the equivalent period for 2004-2013. Initially data suggests a 92% reduction in 2015 compared to the same pre-vaccination periods. For those aged 1 to <5 y who would not have been vaccinated, a reduction of 75% was also evident in 2014 and 77% in 2015, suggesting indirect protection in this group. In conclusion, initial results following the introduction of the Rotavirus vaccine clearly indicates a very good uptake of the vaccine and a significant reduction in the numbers of laboratory confirmed cases.

  10. Introduction of a new Rotavirus vaccine: Initial results of uptake and impact on laboratory confirmed cases in Anglia and Essex, United Kingdom, July 2015

    PubMed Central

    Inns, Thomas; Trindall, Amy; Dunling-Hall, Sara; Shankar, Ananda Giri

    2016-01-01

    abstract Rotavirus gastroenteritis accounts for an estimated 130,000 GP consultations and 13,000 hospitalisations for children under 5 y old each year in England and Wales. In July 2013, an oral live attenuated rotavirus vaccine (Rotarix®) was introduced into the UK infant immunisation program as a 2 dose schedule at 2 and 3 months of age. We collected vaccination uptake from October 2013 to March 2015 and laboratory confirmed cases data on children under the age of 5 y from 1 January 2004 to 31 May 2015. The vaccine uptake rates and laboratory confirmed cases were compared to provide evidence of the impact of this vaccination program. Vaccine uptake rates were available from sentinel data with between 91–98% of GP practices in Anglia and Essex providing data every month. These data showed from February 2014 to March 2015 between 90–92% of infants received the recommended 2 doses of Rotarix® each month. The numbers of rotavirus cases reported by laboratories decreased on average by 82% in the post vaccination seasons. The mean number of cases reported in weeks 1–22 for 2004–2013 in Anglia and Essex was 1,318. For the same period in 2014, 256 cases were reported and initial data for 2015 report 226 cases. In the first 5 months 2014 the greatest reduction in cases (89%) was seen in those under 1 yr (who would have been directly affected by vaccination) with case numbers falling to 59 from a mean 537 cases in the equivalent period for 2004–2013. Initially data suggests a 92% reduction in 2015 compared to the same pre-vaccination periods. For those aged 1 to <5 y who would not have been vaccinated, a reduction of 75% was also evident in 2014 and 77% in 2015, suggesting indirect protection in this group. In conclusion, initial results following the introduction of the Rotavirus vaccine clearly indicates a very good uptake of the vaccine and a significant reduction in the numbers of laboratory confirmed cases. PMID:26618660

  11. Animal models for HIV/AIDS research

    PubMed Central

    Hatziioannou, Theodora; Evans, David T.

    2015-01-01

    The AIDS pandemic continues to present us with unique scientific and public health challenges. Although the development of effective antiretroviral therapy has been a major triumph, the emergence of drug resistance requires active management of treatment regimens and the continued development of new antiretroviral drugs. Moreover, despite nearly 30 years of intensive investigation, we still lack the basic scientific knowledge necessary to produce a safe and effective vaccine against HIV-1. Animal models offer obvious advantages in the study of HIV/AIDS, allowing for a more invasive investigation of the disease and for preclinical testing of drugs and vaccines. Advances in humanized mouse models, non-human primate immunogenetics and recombinant challenge viruses have greatly increased the number and sophistication of available mouse and simian models. Understanding the advantages and limitations of each of these models is essential for the design of animal studies to guide the development of vaccines and antiretroviral therapies for the prevention and treatment of HIV-1 infection. PMID:23154262

  12. Live Attenuated Influenza Vaccines by Computer-Aided Rational Design

    PubMed Central

    Mueller, Steffen; Coleman, J. Robert; Papamichail, Dimitris; Ward, Charles B.; Nimnual, Anjaruwee; Futcher, Bruce; Skiena, Steven; Wimmer, Eckard

    2010-01-01

    Influenza claims 250,000 - 500,000 lives annually worldwide. Despite existing vaccines and enormous efforts in biomedical research, these staggering numbers have not changed significantly over the last two decades1, motivating the search for new, more effective, vaccines that can be rapidly designed and easily produced. Using influenza virus strain A/PR/8/34, we describe a systematic, rational approach, termed Synthetic Attenuated Virus Engineering (SAVE), to develop new, efficacious live attenuated influenza virus vaccine candidates through genome-scale changes in codon pair bias. Attenuation is based on many hundreds of nucleotide changes across the viral genome, offering high genetic stability and a wide margin of safety. The method can be applied rapidly to any emerging influenza virus in its entirety, an advantage that is significant for dealing with seasonal epidemics and pandemic threats, such as H5N1- or 2009-H1N1 influenza. PMID:20543832

  13. In "Step" with HIV Vaccines? A Content Analysis of Local Recruitment Campaigns for an International HIV Vaccine Study.

    PubMed

    Frew, Paula M; Macias, Wendy; Chan, Kayshin; Harding, Ashley C

    2009-01-01

    During the past two decades of the HIV/AIDS pandemic, several recruitment campaigns were designed to generate community involvement in preventive HIV vaccine clinical trials. These efforts utilized a blend of advertising and marketing strategies mixed with public relations and community education approaches to attract potential study participants to clinical trials (integrated marketing communications). Although more than 30,000 persons worldwide have participated in preventive HIV vaccine studies, no systematic analysis of recruitment campaigns exists. This content analysis study was conducted to examine several United States and Canadian recruitment campaigns for one of the largest-scale HIV vaccine trials to date (the "Step Study"). This study examined persuasive features consistent with the Elaboration Likelihood Model (ELM) including message content, personal relevance of HIV/AIDS and vaccine research, intended audiences, information sources, and other contextual features. The results indicated variation in messages and communication approaches with gay men more exclusively targeted in these regions. Racial/ethnic representations also differed by campaign. Most of the materials promote affective evaluation of the information through heuristic cueing. Implications for subsequent campaigns and research directions are discussed.

  14. Military Infectious Diseases Update on Vaccine Development

    DTIC Science & Technology

    2011-01-24

    Research Program (MIDRP) Insect Vector ControlDiagnostics Prevention Treatment Infectious diseases adversely impact military operations. Vaccines...appropriate treatment and aids commanders in the field. Most militarily relevant infectious diseases are transmitted by biting insects and other...based Insect Repellent (1946) Vaccines Protectants Antiparasitic Drugs Research Effort Advanced Development Fielded Products Malaria Rapid

  15. Vaccines today, vaccines tomorrow: a perspective.

    PubMed

    Loucq, Christian

    2013-01-01

    Vaccines are considered as one of the major contributions of the 20th century and one of the most cost effective public health interventions. The International Vaccine Institute has as a mission to discover, develop and deliver new and improved vaccines against infectious diseases that affects developing nations. If Louis Pasteur is known across the globe, vaccinologists like Maurice Hilleman, Jonas Salk and Charles Mérieux are known among experts only despite their contribution to global health. Thanks to a vaccine, smallpox has been eradicated, polio has nearly disappeared, Haemophilus influenzae B, measles and more recently meningitis A are controlled in many countries. While a malaria vaccine is undergoing phase 3, International Vaccine Institute, in collaboration with an Indian manufacturer has brought an oral inactivated cholera vaccine to pre-qualification. The field of vaccinology has undergone major changes thanks to philanthropists such as Bill and Melinda Gates, initiatives like the Decade of Vaccines and public private partnerships. Current researches on vaccines have more challenging targets like the dengue viruses, malaria, human immunodeficiency virus, the respiratory syncytial virus and nosocomial diseases. Exciting research is taking place on new adjuvants, nanoparticles, virus like particles and new route of administration. An overcrowded infant immunization program, anti-vaccine groups, immunizing a growing number of elderlies and delivering vaccines to difficult places are among challenges faced by vaccinologists and global health experts.

  16. Vaccine administration decision making: the case of yellow fever vaccine.

    PubMed

    Lown, Beth A; Chen, Lin H; Wilson, Mary E; Sisson, Emily; Gershman, Mark; Yanni, Emad; Jentes, Emily S; Hochberg, Natasha S; Hamer, Davidson H; Barnett, Elizabeth D

    2012-09-01

    Providers must counsel travelers to yellow fever (YF)-endemic areas, although risk estimates of disease and vaccine serious adverse events (SAEs) may be imprecise. The impact of risk information and patients' requests for participation in vaccine decisions on providers' recommendations is unknown. Vaccine providers were surveyed regarding decisions for 4 patient scenarios before and after being presented information about risk of YF disease vs vaccine SAEs. Participants' theoretical attitudes were compared with actual responses to scenarios in which patients wanted to share vaccine decisions. Analyses were done by using χ(2) tests with significance level of .05. Forty-six percent of respondents made appropriate initial YF vaccine administration decisions for a pregnant woman, 73% for an immunosuppressed man, and 49% for an 8-month-old infant. After receiving scenario-specific information, 20%, 54%, and 23% of respondents respectively who initially responded incorrectly changed to a more appropriate decision. Thirty-one percent of participants made consistently appropriate decisions. Among participants who made ≥1 incorrect decision, 35.7% made no decision changes after receiving information. In the scenario in which either a decision to withhold or to administer vaccine was acceptable, 19% of respondents refused a patient's request for vaccine. Targeted information is necessary but insufficient to change the process of vaccine administration decision making. Providers need additional education to enable them to apply evidence, overcome cognitive decision-making errors, and involve patients in vaccine decisions.

  17. A School-Located Vaccination Adolescent Pilot Initiative in Chicago: Lessons Learned.

    PubMed

    Caskey, Rachel N; Macario, Everly; Johnson, Daniel C; Hamlish, Tamara; Alexander, Kenneth A

    2013-09-01

    Many adolescents underutilize preventive services and are underimmunized. To promote medical homes and increase immunization rates, we conceptualized and implemented a 3-year, 8-school pilot school-located vaccination collaborative program. We sought community, parent, and school nurse input the year prior to implementation. We selected schools with predominantly Medicaid-enrolled or Medicaid-eligible students to receive Vaccines For Children stock vaccines. Nurses employed by a mass immunizer delivered these vaccines at participating schools 3 times a year. Over 3 years, we delivered approximately 1800 vaccines at schools. School administrators, health centers, and neighboring private physicians generally welcomed the program. Parents did not express overt concerns about school-located vaccination. School nurses were not able to participate because of multiple school assignments. Obtaining parental consent via backpack mail was an inefficient process, and classroom incentives did not increase consent form return rate. The influenza vaccine had the most prolific uptake. The optimal time for administering vaccines was during regular school hours. Although school-located vaccination for adolescents is feasible, this is a paradigm shift for community members and thus accompanies challenges in implementation. High principal or school personnel turnover led to a consequent lack of institutional memory. It was difficult to communicate directly with parents. Because we were uncertain about the proportion of parents who received consent forms, we are exploring Internet-based and back-to-school registration options for making the consent form distribution and return process more rigorous. Securing an immunization champion at each school helped the immunization processes. Identifying a financially sustainable school-located vaccination model is critical for national expansion of school-located vaccination. © The Author 2013. Published by Oxford University Press on behalf of

  18. Vaccine hesitancy: More than a movement

    PubMed Central

    Callender, David

    2016-01-01

    ABSTRACT Vaccines are some of if not the most successful public health endeavors ever put into practice. Countless lives have been saved and the occurrences of vaccine preventable diseases are at a fraction of the rate experienced before vaccines. Vaccines and the realization of their compulsory scheduling are highly studied, safe, and purposeful. Despite these realities, there are an alarming number of parents who do not permit the vaccination of their children as scheduled. This is known in the health community as vaccine hesitancy and commonly portrayed in popular media as anti-vaccination sediment. This analysis opens with the topic as it was addressed during a September 2015 debate for the Republic Party's 2016 presidential nomination. Some key historical aspects of vaccine hesitancy are presented. This history leads to a description of the 2014–2015 measles outbreak in California. The factors that aide in the recruitment of under vaccination are then explored. Finally, select strategies to control, combat, and potentially attenuate vaccine hesitancy are presented. PMID:27159558

  19. Influenza vaccines: an Asia-Pacific perspective.

    PubMed

    Jennings, Lance C

    2013-11-01

    This article provides an overview of some aspects of seasonal, pre-pandemic and pandemic influenza vaccines and initiatives aimed to increase influenza vaccine use within the Asia-Pacific region. Expanding the use of influenza vaccines in the Asia-Pacific region faces many challenges. Despite the recent regional history for the emergence of novel viruses, SARS, the H5N1 and H7N9, and the generation of and global seeding of seasonal influenza viruses and initiatives by WHO and other organisations to expand influenza awareness, the use of seasonal influenza vaccines remains low. The improvement in current vaccine technologies with the licensing of quadrivalent, live-attenuated, cell culture-based, adjuvanted and the first recombinant influenza vaccine is an important step. The development of novel influenza vaccines able to provide improved protection and with improved manufacturing capacity is also advancing rapidly. However, of ongoing concern are seasonal influenza impact and the low use of seasonal influenza vaccines in the Asia-Pacific region. Improved influenza control strategies and their implementation in the region are needed. Initiatives by the World Health Organization (WHO), and specifically the Western Pacific Regional Office of WHO, are focusing on consistent vaccine policies and guidelines in countries in the region. The Asian-Pacific Alliance for the Control of Influenza (APACI) is contributing through the coordination of influenza advocacy initiates. © 2013 Blackwell Publishing Ltd.

  20. Human Immunodeficiency Virus Vaccine Trials

    PubMed Central

    O’Connell, Robert J.; Kim, Jerome H.; Corey, Lawrence; Michael, Nelson L.

    2012-01-01

    More than 2 million AIDS-related deaths occurred globally in 2008, and more than 33 million people are living with HIV/AIDS. Despite promising advances in prevention, an estimated 2.7 million new HIV infections occurred in that year, so that for every two patients placed on combination antiretroviral treatment, five people became infected. The pandemic poses a formidable challenge to the development, progress, and stability of global society 30 years after it was recognized. Experimental preventive HIV-1 vaccines have been administered to more than 44,000 human volunteers in more than 187 separate trials since 1987. Only five candidate vaccine strategies have been advanced to efficacy testing. The recombinant glycoprotein (rgp)120 subunit vaccines, AIDSVAX B/B and AIDSVAX B/E, and the Merck Adenovirus serotype (Ad)5 viral-vector expressing HIV-1 Gag, Pol, and Nef failed to show a reduction in infection rate or lowering of postinfection viral set point. Most recently, a phase III trial that tested a heterologous prime-boost vaccine combination of ALVAC-HIV vCP1521 and bivalent rgp120 (AIDSVAX B/E) showed 31% efficacy in protection from infection among community-risk Thai participants. A fifth efficacy trial testing a DNA/recombinant(r) Ad5 prime-boost combination is currently under way. We review the clinical trials of HIV vaccines that have provided insight into human immunogenicity or efficacy in preventing HIV-1 infection. PMID:23209178

  1. Trans-nodal migration of resident dendritic cells into medullary interfollicular regions initiates immunity to influenza vaccine

    PubMed Central

    Woodruff, Matthew C.; Heesters, Balthasar A.; Herndon, Caroline N.; Groom, Joanna R.; Thomas, Paul G.; Luster, Andrew D.; Turley, Shannon J.

    2014-01-01

    Dendritic cells (DCs) are well established as potent antigen-presenting cells critical to adaptive immunity. In vaccination approaches, appropriately stimulating lymph node–resident DCs (LNDCs) is highly relevant to effective immunization. Although LNDCs have been implicated in immune response, their ability to directly drive effective immunity to lymph-borne antigen remains unclear. Using an inactive influenza vaccine model and whole node imaging approaches, we observed surprising responsiveness of LNDC populations to vaccine arrival resulting in a transnodal repositioning into specific antigen collection sites within minutes after immunization. Once there, LNDCs acquired viral antigen and initiated activation of viral specific CD4+ T cells, resulting in germinal center formation and B cell memory in the absence of skin migratory DCs. Together, these results demonstrate an unexpected stimulatory role for LNDCs where they are capable of rapidly locating viral antigen, driving early activation of T cell populations, and independently establishing functional immune response. PMID:25049334

  2. The effects of a brief educational intervention on human papillomavirus knowledge and intention to initiate HPV vaccination in 18-26 year old young adults.

    PubMed

    Kester, Laura M; Shedd-Steele, Rivienne B; Dotson-Roberts, Crystal A; Smith, Jennifer; Zimet, Gregory D

    2014-03-01

    Despite the Advisory Committee on Immunization Practices (ACIP) recommendations for young adult females and males to receive the three-dose human papillomavirus (HPV) vaccine, most recent findings show that only 30% of the U.S. females aged 19-26, 2.8% of males aged 19-21, and only 1.7% of males aged 22-26 are initiating vaccination. This study evaluates the effects of a brief (5-10 min) group HPV educational intervention on knowledge and intent to vaccinate among young adults. A sample of 131 18-26 year old females and males was recruited from the 2012 INShape Black and Minority Health Fair in Indiana. We randomized participants into one of two groups: (1) survey completion prior to education (control group) or (2) survey completion following education (intervention group). Written surveys assessed HPV knowledge, vaccination history, and vaccination intent (for unvaccinated participants). Respondents were primarily female (70%), single (85%), and the majority self-identified as non-Hispanic Black (77%). Thirty-seven percent had initiated HPV vaccination (≥1 dose) and 19% had completed the series. The intervention group had higher HPV knowledge scores (M=9.1; SD=1.8) than the control group (M=7.0; SD=2.9; F=22.53). Among unvaccinated individuals (n=79), the intervention group had higher HPV vaccination intent (86%) compared to the control group (67%) (OR=3.09; 95%CI=1.02-9.36). Despite ACIP recommendations, young adults continue to have low awareness of vaccine benefits and low vaccination rates. This study suggests that educational interventions to increase HPV awareness and vaccination may help to boost vaccination rates. Copyright © 2013. Published by Elsevier Inc.

  3. Military Vaccines in Today’s Environment

    DTIC Science & Technology

    2012-08-01

    vaccines for anthrax, plague, influenza, rubella, ade- noviruses, meningococci, hepatitis B, typhoid , Japanese encephalitis, and hepa- titis A...licensed vaccines for naturally occurring diseases, such as those for yellow fever , mumps, measles, chickenpox and polio, were developed with the...HIV-AIDS, Chikungunya, Rift Valley fever , Argentinian hemorrhagic fever , and hemorrhagic fever with renal syndrome (HFRS), have been developed and

  4. [Vaccine for human immunodeficiency virus (HIV)--relevance of these days].

    PubMed

    Laiskonis, Alvydas; Pukenyte, Evelina

    2005-01-01

    Since 1980 more than 25 million people have died from acquired immunodeficiency syndrome (AIDS), which results from infection with human immunodeficiency virus (HIV). Number of new cases increases very threateningly. One and the most effective method to stop the progress of epidemic is the development of the vaccine for HIV. There is the presentation of the first stage of the vaccine for HIV testing (structure, methodology), which is now on trial in St. Pierre hospital, Brussels University. HIV characteristics which inflame the process of the vaccine development, historical facts and facts about vaccines on trial in these days are reviewed in this article. More than 10,000 volunteers have been participating in various clinical trials since 1987. The development of the vaccine is a very difficult, long-terming (about 8-10 years) and costly process. The process of the vaccine testing is very difficult in developing countries where the infection spreads the most rapidly. Available data confirm that the vaccine must be multi-componential, inducing cellular, humoral immunity against various subtypes of HIV. The vaccine cannot protect fully but the changes of the natural infection course could decrease virulence, distance the stage of AIDS, and retard the spread of the epidemic.

  5. Gauging the Acceptability of HIV Vaccines: An Exploratory Study Examining Knowledge, Attitudes, and Beliefs among Injecting Drug Users in Viet Nam

    ERIC Educational Resources Information Center

    Nguyen, France

    2007-01-01

    In contrast to other countries in Southeast Asia, the HIV/ AIDS epidemic is in the initial stages in Viet Nam, although the rates have increased notably since 1997. This study examined attitudes towards the use of an HIV vaccine (when one becomes available) as a means for preventing the disease. Since injecting drug users are the great majority of…

  6. HIV vaccine acceptability among communities at risk: the impact of vaccine characteristics.

    PubMed

    Newman, Peter A; Duan, Naihua; Lee, Sung-Jae; Rudy, Ellen T; Seiden, Danielle S; Kakinami, Lisa; Cunningham, William E

    2006-03-15

    HIV vaccines offer the best long-term hope of controlling the AIDS pandemic; yet, the advent of HIV vaccines will not ensure their acceptability. We conducted a cross-sectional survey (n=143), incorporating conjoint analysis, to assess HIV vaccine acceptability among participants recruited using multi-site (n=9), venue-based sampling in Los Angeles. We used a fractional factorial experimental design to construct eight hypothetical HIV vaccines, each with seven dichotomous attributes. The acceptability of each vaccine was assessed individually and then averaged across participants. Next, the impact of each attribute on vaccine acceptability was estimated for each participant using ANOVA and then analyzed across participants. Acceptability of the eight hypothetical HIV vaccines ranged from 33.2 (S.D. 34.9) to 82.2 (S.D. 31.3) on a 0-100 scale; mean=60.0 (S.D. 21.9). Efficacy had the greatest impact on acceptability (22.7; CI: 18.5-27.1; p<0.0001), followed by cross-clade protection (12.5; CI: 8.7-16.3, p<0.0001), side effects (11.5; CI: 7.4-15.5; p<0.0001), and duration of protection (6.1; CI: 3.2-9.0; p<.0001). Route of administration, number of doses and cost were not significant. Low acceptability of "partial efficacy" vaccines may present obstacles to future HIV vaccine dissemination. Educational and social marketing interventions may be necessary to ensure broad HIV vaccine uptake.

  7. Human papillomavirus vaccination among adolescents in Georgia.

    PubMed

    Underwood, Natasha L; Weiss, Paul; Gargano, Lisa M; Seib, Katherine; Rask, Kimberly J; Morfaw, Christopher; Murray, Dennis; DiClemente, Ralph J; Hughes, James M; Sales, Jessica M

    2015-01-01

    Human papillomavirus (HPV) vaccination coverage for adolescent females and males remains low in the United States. We conducted a 3-arm randomized controlled trial (RCT) conducted in middle and high schools in eastern Georgia from 2011-2013 to determine the effect of 2 educational interventions used to increase adolescent vaccination coverage for the 4 recommended adolescent vaccines: Tdap, MCV4, HPV and influenza. As part of this RCT, this article focuses on: 1) describing initiation and completion of HPV vaccine series among a diverse population of male and female adolescents; 2) assessing parental attitudes toward HPV vaccine; and 3) examining correlates of HPV vaccine series initiation and completion. Parental attitude score was the strongest predictor of HPV vaccine initiation among adolescents (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.80, 2.39). Other correlates that significantly predicted HPV series initiation were gender, study year, and intervention arm. Parental attitudes remained a significant predictor of receipt of 3 doses of HPV vaccine along with gender, race, school type and insurance type. This study demonstrates that positive parental attitudes are important predictors of HPV vaccination and critical to increasing coverage rates. Our findings suggest that more research is needed to understand how parental attitudes are developed and evolve over time.

  8. Laser vaccine adjuvants

    PubMed Central

    Kashiwagi, Satoshi; Brauns, Timothy; Gelfand, Jeffrey; Poznansky, Mark C

    2014-01-01

    Immunologic adjuvants are essential for current vaccines to maximize their efficacy. Unfortunately, few have been found to be sufficiently effective and safe for regulatory authorities to permit their use in vaccines for humans and none have been approved for use with intradermal vaccines. The development of new adjuvants with the potential to be both efficacious and safe constitutes a significant need in modern vaccine practice. The use of non-damaging laser light represents a markedly different approach to enhancing immune responses to a vaccine antigen, particularly with intradermal vaccination. This approach, which was initially explored in Russia and further developed in the US, appears to significantly improve responses to both prophylactic and therapeutic vaccines administered to the laser-exposed tissue, particularly the skin. Although different types of lasers have been used for this purpose and the precise molecular mechanism(s) of action remain unknown, several approaches appear to modulate dendritic cell trafficking and/or activation at the irradiation site via the release of specific signaling molecules from epithelial cells. The most recent study, performed by the authors of this review, utilized a continuous wave near-infrared laser that may open the path for the development of a safe, effective, low-cost, simple-to-use laser vaccine adjuvant that could be used in lieu of conventional adjuvants, particularly with intradermal vaccines. In this review, we summarize the initial Russian studies that have given rise to this approach and comment upon recent advances in the use of non-tissue damaging lasers as novel physical adjuvants for vaccines. PMID:25424797

  9. AIDS: Are Children at Risk? ERIC Digest 16.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Teacher Education, Washington, DC.

    Lack of knowledge and misinformation about Acquired Immune Deficiency Syndrome (AIDS), a fatal disease with no cure or vaccine, has caused widespread public concern. Education is an effective way to reduce fears and prevent the spread of the disease. Public school personnel must have accurate information about AIDS in order to make suitable…

  10. Molecular analyses of oral polio vaccine samples.

    PubMed

    Poinar, H; Kuch, M; Pääbo, S

    2001-04-27

    It has been suggested that the human immunodeficiency virus (HIV), and thus the acquired immunodeficiency syndrome (AIDS) it causes, was inadvertently introduced to humans by the use of an oral polio vaccine (OPV) during a vaccination campaign launched by the Wistar Institute, Philadelphia, PA, USA, in the Belgian Congo in 1958 and 1959. The "OPV/AIDS hypothesis" suggests that the OPV used in this campaign was produced in chimpanzee kidney epithelial cell cultures rather than in monkey kidney cell cultures, as stated by H. Koprowski and co-workers, who produced the OPV. If chimpanzee cells were indeed used, this would lend support to the OPV/AIDS hypothesis, since chimpanzees harbor a simian immunodeficiency virus, widely accepted to be the origin of HIV-1. We analyzed several early OPV pools and found no evidence for the presence of chimpanzee DNA; by contrast, monkey DNA is present.

  11. Posttrial HIV vaccine adoption: concerns, motivators, and intentions among persons at risk for HIV.

    PubMed

    Newman, Peter A; Duan, Naihua; Rudy, Ellen T; Roberts, Kathleen J; Swendeman, Dallas

    2004-11-01

    Suboptimal uptake of existing vaccines, potential obstacles specific to HIV/AIDS stigma and mistrust, and marked health disparities suggest that it is vital to investigate consumer concerns, motivations, and adoption intentions regarding posttrial HIV vaccines before a vaccine is publicly available. Nine focus groups were conducted with participants (n = 99; median age, 33 years; 48% female; 22% African American, 44% Latino, and 28% white) recruited from 7 high-risk venues in Los Angeles using purposive venue-based sampling. A semistructured interview guide elicited concerns, motivators, and adoption intentions regarding hypothetical U.S. Food and Drug Administration-approved HIV vaccines. Data were analyzed using narrative thematic analysis and Ethnograph qualitative software. Concerns included vaccine efficacy, vaccine-induced infection, vaccine-induced HIV seropositivity, side effects, cost/access, trustworthiness, and relationship issues. Motivators included protection against HIV infection and the ability to safely engage in unprotected sex. Participants expressed reluctance to adopt partial efficacy vaccines and likelihood of increased sexual risk behaviors in response to vaccine availability. Tailored interventions to facilitate uptake of future U.S. Food and Drug Administration-approved HIV vaccines and to prevent risk behavior increases may be vital to the effectiveness of vaccines in controlling the AIDS pandemic.

  12. Global Health Initiatives and aid effectiveness: insights from a Ugandan case study

    PubMed Central

    2011-01-01

    Background The emergence of Global Health Initiatives (GHIs) has been a major feature of the aid environment of the last decade. This paper seeks to examine in depth the behaviour of two prominent GHIs in the early stages of their operation in Uganda as well as the responses of the government. Methods The study adopted a qualitative and case study approach to investigate the governance of aid transactions in Uganda. Data sources included documentary review, in-depth and semi-structured interviews and observation of meetings. Agency theory guided the conceptual framework of the study. Results The Ugandan government had a stated preference for donor funding to be channelled through the general or sectoral budgets. Despite this preference, two large GHIs opted to allocate resources and deliver activities through projects with a disease-specific approach. The mixed motives of contributor country governments, recipient country governments and GHI executives produced incentive regimes in conflict between different aid mechanisms. Conclusion Notwithstanding attempts to align and harmonize donor activities, the interests and motives of the various actors (GHIs and different parts of the government) undermine such efforts. PMID:21726431

  13. A Small Dose of HIV? HIV Vaccine Mental Models and Risk Communication

    ERIC Educational Resources Information Center

    Newman, Peter A.; Seiden, Danielle S.; Roberts, Kathleen J.; Kakinami, Lisa; Duan, Naihua

    2009-01-01

    Existing knowledge and beliefs related to HIV vaccines provide an important basis for the development of risk communication messages to support future HIV vaccine dissemination. This study explored HIV vaccine mental models among adults from segments of the population disproportionately affected by HIV/AIDS. Nine focus groups were conducted with…

  14. Scientific challenges and opportunities in developing novel vaccines for the emerging and developing markets: New Technologies in Emerging Markets, October 16th-18th 2012, World Vaccine Congress, Lyon.

    PubMed

    Kochhar, Sonali

    2013-04-01

    Vaccines have had a major role in enhancing the quality of life and increasing life expectancy. Despite these successes and the development of new vaccine technologies, there remain multiple infectious diseases including AIDS, malaria and tuberculosis that require effective prophylactic vaccines. New and traditional technologies have a role in the development and delivery of the new vaccine candidates. The scientific challenges, opportunities and funding models for developing vaccines for low resource settings are highlighted here.

  15. Analysis of B Cell Repertoire Dynamics Following Hepatitis B Vaccination in Humans, and Enrichment of Vaccine-specific Antibody Sequences.

    PubMed

    Galson, Jacob D; Trück, Johannes; Fowler, Anna; Clutterbuck, Elizabeth A; Münz, Márton; Cerundolo, Vincenzo; Reinhard, Claudia; van der Most, Robbert; Pollard, Andrew J; Lunter, Gerton; Kelly, Dominic F

    2015-12-01

    Generating a diverse B cell immunoglobulin repertoire is essential for protection against infection. The repertoire in humans can now be comprehensively measured by high-throughput sequencing. Using hepatitis B vaccination as a model, we determined how the total immunoglobulin sequence repertoire changes following antigen exposure in humans, and compared this to sequences from vaccine-specific sorted cells. Clonal sequence expansions were seen 7 days after vaccination, which correlated with vaccine-specific plasma cell numbers. These expansions caused an increase in mutation, and a decrease in diversity and complementarity-determining region 3 sequence length in the repertoire. We also saw an increase in sequence convergence between participants 14 and 21 days after vaccination, coinciding with an increase of vaccine-specific memory cells. These features allowed development of a model for in silico enrichment of vaccine-specific sequences from the total repertoire. Identifying antigen-specific sequences from total repertoire data could aid our understanding B cell driven immunity, and be used for disease diagnostics and vaccine evaluation.

  16. In “Step” with HIV Vaccines? A Content Analysis of Local Recruitment Campaigns for an International HIV Vaccine Study

    PubMed Central

    Frew, Paula M.; Macias, Wendy; Chan, Kayshin; Harding, Ashley C.

    2009-01-01

    During the past two decades of the HIV/AIDS pandemic, several recruitment campaigns were designed to generate community involvement in preventive HIV vaccine clinical trials. These efforts utilized a blend of advertising and marketing strategies mixed with public relations and community education approaches to attract potential study participants to clinical trials (integrated marketing communications). Although more than 30,000 persons worldwide have participated in preventive HIV vaccine studies, no systematic analysis of recruitment campaigns exists. This content analysis study was conducted to examine several United States and Canadian recruitment campaigns for one of the largest-scale HIV vaccine trials to date (the “Step Study”). This study examined persuasive features consistent with the Elaboration Likelihood Model (ELM) including message content, personal relevance of HIV/AIDS and vaccine research, intended audiences, information sources, and other contextual features. The results indicated variation in messages and communication approaches with gay men more exclusively targeted in these regions. Racial/ethnic representations also differed by campaign. Most of the materials promote affective evaluation of the information through heuristic cueing. Implications for subsequent campaigns and research directions are discussed. PMID:19609373

  17. Cost Effectiveness of a Shingles Vaccine Booster for Currently Vaccinated Adults in the U.S.

    PubMed

    Le, Phuc; Rothberg, Michael B

    2017-12-01

    The Advisory Committee on Immunization Practices recommends a single dose of the live attenuated herpes zoster vaccine in people aged ≥60 years. Because vaccine-induced protection decreases to zero after 10 years, many vaccinated people will soon be subject to an increased risk of the disease. The study objective was to determine the cost effectiveness of a herpes zoster vaccine booster and its optimal timing among immunocompetent adults first vaccinated at aged ≥60 years. A Markov model was built to follow vaccinated individuals for a lifetime. From the societal perspective, costs and quality-adjusted life years were compared between no booster versus booster options. A booster was given any time between 1 and 20 years after the first dose, and for those who had the first dose at different ages: 60, 70, and 80 years. Because people entered the model already vaccinated, costs and side effects of the first dose were not included. The booster was assumed to have the same efficacy and waning rate as the initial vaccination. Model inputs were based on published literature. A cost effectiveness threshold of $100,000/quality-adjusted life year was used. The analysis was conducted in 2016. Cost effectiveness of a booster varied by age and time since vaccination. The booster cost <$100,000/quality-adjusted life year if given >5 years after the initial dose, but was most cost effective at around 10 years. The finding was robust to wide variations in model inputs. Under current assumptions, a booster dose of herpes zoster vaccine would be cost effective for all vaccinated people 10 years after initial vaccination. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Measles vaccination before the measles-mumps-rubella vaccine.

    PubMed

    Hendriks, Jan; Blume, Stuart

    2013-08-01

    At the beginning of the 1960s, it was clear that a vaccine against measles would soon be available. Although measles was (and remains) a killer disease in the developing world, in the United States and Western Europe this was no longer so. Many parents and many medical practitioners considered measles an inevitable stage of a child's development. Debating the desirability of measles immunization, public health experts reasoned differently. In the United States, introduction of the vaccine fit well with Kennedy's and Johnson's administrations' political commitments. European policymakers proceeded cautiously, concerned about the acceptability of existing vaccination programs. In Sweden and the Netherlands, recent experience in controlling polio led researchers to prefer an inactivated virus vaccine. Although in the early 1970s attempts to develop a sufficiently potent inactivated vaccine were abandoned, we have argued that the debates and initiatives of the time during the vaccine's early history merit reflection in today's era of standardization and global markets.

  19. Introduction to a Special Issue of the Journal of Immunological Methods: Building global resource programs to support HIV/AIDS clinical trial studies.

    PubMed

    Sanchez, Ana M; Denny, Thomas N; O'Gorman, Maurice

    2014-07-01

    This Special Issue of the Journal of Immunological Methods includes 16 manuscripts describing quality assurance activities related to virologic and immunologic monitoring of six global laboratory resource programs that support international HIV/AIDS clinical trial studies: Collaboration for AIDS Vaccine Discovery (CAVD); Center for HIV/AIDS Vaccine Immunology (CHAVI); External Quality Assurance Program Oversight Laboratory (EQAPOL); HIV Vaccine Trial Network (HVTN); International AIDS Vaccine Initiative (IAVI); and Immunology Quality Assessment (IQA). The reports from these programs address the many components required to develop comprehensive quality control activities and subsequent quality assurance programs for immune monitoring in global clinical trials including: all aspects of processing, storing, and quality assessment of PBMC preparations used ubiquitously in HIV clinical trials, the development and optimization of assays for CD8 HIV responses and HIV neutralization, a comprehensive global HIV virus repository, and reports on the development and execution of novel external proficiency testing programs for immunophenotyping, intracellular cytokine staining, ELISPOT and luminex based cytokine measurements. In addition, there are articles describing the implementation of Good Clinical Laboratory Practices (GCLP) in a large quality assurance laboratory, the development of statistical methods specific for external proficiency testing assessment, a discussion on the ability to set objective thresholds for measuring rare events by flow cytometry, and finally, a manuscript which addresses a framework for the structured reporting of T cell immune function based assays. It is anticipated that this series of manuscripts covering a wide range of quality assurance activities associated with the conduct of global clinical trials will provide a resource for individuals and programs involved in improving the harmonization, standardization, accuracy, and sensitivity of

  20. New Vaccines for the World's Poorest People.

    PubMed

    Hotez, Peter J; Bottazzi, Maria Elena; Strych, Ulrich

    2016-01-01

    The 2000 Millennium Development Goals helped stimulate the development of life-saving childhood vaccines for pneumococcal and rotavirus infections while greatly expanding coverage of existing vaccines. However, there remains an urgent need to develop new vaccines for HIV/AIDS, malaria, and tuberculosis, as well as for respiratory syncytial virus and those chronic and debilitating (mostly parasitic) infections known as neglected tropical diseases (NTDs). The NTDs represent the most common diseases of people living in extreme poverty and are the subject of this review. The development of NTD vaccines, including those for hookworm infection, schistosomiasis, leishmaniasis, and Chagas disease, is being led by nonprofit product development partnerships (PDPs) working in consortia of academic and industrial partners, including vaccine manufacturers in developing countries. NTD vaccines face unique challenges with respect to their product development and manufacture, as well as their preclinical and clinical testing. We emphasize global efforts to accelerate the development of NTD vaccines and some of the hurdles to ensuring their availability to the world's poorest people.

  1. Therapeutic vaccination to treat chronic infectious diseases

    PubMed Central

    Boukhebza, Houda; Bellon, Nadine; Limacher, Jean Marc; Inchauspé, Geneviève

    2012-01-01

    A famous milestone in the vaccine field has been the first successful vaccination against smallpox, in 1798, by Edward Jenner. Using the vaccinia cowpox virus, Jenner was able to protect vaccinees from variola or smallpox. The Modified Virus Ankara (MVA) poxvirus strain has been one of the vaccines subsequently developed to prevent smallpox infection and was selected by the US government in their Biodefense strategy. Progress in molecular biology and immunology associated with MVA infection has led to the development of MVA as vaccine platform, both in the field of preventive and therapeutic vaccines. This later class of therapeutics has witnessed growing interest that has translated into an increasing number of vaccine candidates reaching the clinics. Among those, MVA-based therapeutic vaccines have addressed four major chronic infections including viral hepatitis, AIDS, human papillomavirus-linked pathologies and tuberculosis. Clinical trials encompass phase 1 and 2 and have started to show significant results and promises. PMID:22894957

  2. A self-affirmation exercise does not improve intentions to vaccinate among parents with negative vaccine attitudes (and may decrease intentions to vaccinate)

    PubMed Central

    Ebbs, Jacob B.; Onunkwo, Adaobi K.; Sage, L. Mariah

    2017-01-01

    Two studies investigated the effectiveness of a self-affirmation exercise on vaccine safety beliefs and intent to vaccinate future children. In Study 1, a sample of 585 parents with at least one child under the age of 18 in the home participated through Amazon’s MTurk. Participants were randomly assigned to one of four conditions in a 2 x 2 design. Participants read either correcting information refuting a link between the measles, mumps, and rubella (MMR) vaccine and autism or a control passage about bird feeding. Additionally, participants either completed a self-affirmation exercise where they reflected on their personal values or in a control condition in which they reflected on least-personally-important values that might be important to others. Participants exposed to the correcting information were less likely to believe that vaccines cause serious side effects, but no less likely to believe that the MMR vaccine causes autism. For parents with initially positive vaccine attitudes, there was no effect of condition on intent to vaccinate a future child. For parents with initially negative vaccine attitudes, self-affirmation was ineffective in the presence of correcting information and resulted in less intention to vaccinate in the absence of correcting information. This effect was partially replicated in Study 2 (N = 576), which provided no correcting information but otherwise followed the same procedure as Study 1. PMID:28704520

  3. A self-affirmation exercise does not improve intentions to vaccinate among parents with negative vaccine attitudes (and may decrease intentions to vaccinate).

    PubMed

    Reavis, Rachael D; Ebbs, Jacob B; Onunkwo, Adaobi K; Sage, L Mariah

    2017-01-01

    Two studies investigated the effectiveness of a self-affirmation exercise on vaccine safety beliefs and intent to vaccinate future children. In Study 1, a sample of 585 parents with at least one child under the age of 18 in the home participated through Amazon's MTurk. Participants were randomly assigned to one of four conditions in a 2 x 2 design. Participants read either correcting information refuting a link between the measles, mumps, and rubella (MMR) vaccine and autism or a control passage about bird feeding. Additionally, participants either completed a self-affirmation exercise where they reflected on their personal values or in a control condition in which they reflected on least-personally-important values that might be important to others. Participants exposed to the correcting information were less likely to believe that vaccines cause serious side effects, but no less likely to believe that the MMR vaccine causes autism. For parents with initially positive vaccine attitudes, there was no effect of condition on intent to vaccinate a future child. For parents with initially negative vaccine attitudes, self-affirmation was ineffective in the presence of correcting information and resulted in less intention to vaccinate in the absence of correcting information. This effect was partially replicated in Study 2 (N = 576), which provided no correcting information but otherwise followed the same procedure as Study 1.

  4. The Global Context of Vaccine Refusal: Insights from a Systematic Comparative Ethnography of the Global Polio Eradication Initiative.

    PubMed

    Closser, Svea; Rosenthal, Anat; Maes, Kenneth; Justice, Judith; Cox, Kelly; Omidian, Patricia A; Mohammed, Ismaila Zango; Dukku, Aminu Mohammed; Koon, Adam D; Nyirazinyoye, Laetitia

    2016-09-01

    Many of medical anthropology's most pressing research questions require an understanding how infections, money, and ideas move around the globe. The Global Polio Eradication Initiative (GPEI) is a $9 billion project that has delivered 20 billion doses of oral polio vaccine in campaigns across the world. With its array of global activities, it cannot be comprehensively explored by the traditional anthropological method of research at one field site. This article describes an ethnographic study of the GPEI, a collaborative effort between researchers at eight sites in seven countries. We developed a methodology grounded in nuanced understandings of local context but structured to allow analysis of global trends. Here, we examine polio vaccine acceptance and refusal to understand how global phenomena-in this case, policy decisions by donors and global health organizations to support vaccination campaigns rather than building health systems-shape local behavior. © 2016 by the American Anthropological Association.

  5. Uptake of HPV vaccine: demographics, sexual history and values, parenting style, and vaccine attitudes.

    PubMed

    Rosenthal, Susan L; Rupp, Richard; Zimet, Gregory D; Meza, Heather M; Loza, Melissa L; Short, Mary B; Succop, Paul A

    2008-09-01

    To examine the relationships of demographics, parenting, and vaccine attitudes with the acceptance of the human papillomavirus (HPV) vaccine or to the intent to vaccinate in the next 12 months. Mothers (n = 153) with daughters ages 11 to 17 years were recruited through the pediatric clinic waiting room/announcements to complete a questionnaire. Eighteen percent of the daughters had not received the vaccine, although it had been offered; 34% had not been offered the vaccine and did not intend to get it in the next 12 months; 22% had not been offered the vaccine but intended to get it in the next 12 months; 26% had started vaccination or completed the series. In a multinomial, multivariable logistic regression model, those mothers who had less than a high school degree, had a history of a sexually transmitted infection, supervised their daughter more when she was with peers, and whose daughter would not mind three shots were more likely to be favorable about their daughter being vaccinated. The following variables were not related to their attitudes about getting the vaccine: mothers' and daughters' ages, race/ethnicity, mothers' self-reported history of HPV disease and age of sexual initiation, daughters' dating status and anticipated age of sexual initiation, the number of sexual topics discussed and level of comfort, mother's sexual values, and the family environment. Mothers' decisions about the HPV vaccine were not related to their sexual values or their daughters' sexual behavior, but rather their parenting, sense of vulnerability, and vaccine attitudes. Mothers who were not planning to vaccinate did not appear to not feel an urgency given the newness of the vaccine, and many planned to vaccinate eventually.

  6. A Tonsillar PolyICLC/AT-2 SIV Therapeutic Vaccine Maintains Low Viremia Following Antiretroviral Therapy Cessation

    PubMed Central

    Vagenas, Panagiotis; Aravantinou, Meropi; Williams, Vennansha G.; Jasny, Edith; Piatak, Michael; Lifson, Jeffrey D.; Salazar, Andres M.; Blanchard, James L.; Gettie, Agegnehu; Robbiani, Melissa

    2010-01-01

    Background HIV-infected individuals rely on antiretroviral therapy (ART) to control viral replication. Despite abundant demonstrable benefits, the multiple limitations of ART point to the potential advantages of therapeutic vaccination approaches that could provide sustained host control of viral replication after discontinuation of ART. We provide evidence from a non-human primate model that a therapeutic vaccine applied to the tonsils can maintain low viral loads after cessation of ART. Methodology/Principal Findings Animals received 40 weeks of ART initiated 9 weeks after rectal SIVmac239 infection. During ART, animals were vaccinated (or not) with AT-2 inactivated SIVmac239 using CpG-C ISS-ODN (C274) or polyICLC as adjuvants. PolyICLC/AT-2 SIV vaccinated animals maintained viral loads <3×103 copies/ml for up to 16 weeks post-ART, whereas the C274/AT-2 SIV vaccinated and non-vaccinated animals' viremia ranged between 1×104–4×105 copies/ml (p<0.03). Neutralizing Ab activity in plasma was increased by polyICLC/AT-2 tonsillar vaccination under ART, compared to controls (p<0.03). Subsequent vaccination of all animals with polyICLC/AT-2 SIV in the absence of ART did not alter viral loads. Other immune parameters measured in blood and tissues were comparable between groups. Conclusions/Significance These results provide support for the potential benefit of mucosally delivered vaccines in therapeutic immunization strategies for control of AIDS virus infection. PMID:20877632

  7. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control

    PubMed Central

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-01-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries’ national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions. PMID:19491291

  8. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control.

    PubMed

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-07-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries' national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions.

  9. WHO initiative to increase global and equitable access to influenza vaccine in the event of a pandemic: supporting developing country production capacity through technology transfer.

    PubMed

    Friede, Martin; Palkonyay, Laszlo; Alfonso, Claudia; Pervikov, Yuri; Torelli, Guido; Wood, David; Kieny, Marie Paule

    2011-07-01

    Should a highly pathogenic avian influenza virus, such as the H5N1 virus type currently circulating in birds, become transmissible among humans, an effective vaccine, rapidly available in vast quantities, would be the best tool to prevent high case-fatalities and the breakdown of health and social services. The number of vaccine doses that could be produced on demand has risen sharply over the last few years; however, it is still alarmingly short of the 13 billion doses that would be needed if two doses were required to protect fully the world's population. Most developing countries would be last in the queue to benefit from a pandemic vaccine. The World Health Organization, together with governments, the pharmaceutical industry and other stakeholders, has been implementing the global pandemic influenza action plan to increase vaccine supply since 2006. Building capacity in developing countries to manufacture influenza vaccine is an integral part of this plan, as well as research and development into more efficacious technologies, e.g. those that allow significant dose-sparing. To this end, the influenza vaccine technology transfer initiative was launched in 2007 and, to date, vaccine manufacturers in 11 developing countries have received grants to acquire the capacity to produce inactivated or live attenuated influenza vaccine for their populations. In addition, a centralized 'hub' has been established to facilitate training in the new technologies for scientists and regulators in the countries. This supplement of Vaccine is devoted to showcasing the interim results of the WHO initiative and the impressive progress made by the developing country manufacturers. Copyright © 2011 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  10. "Communicate to vaccinate": the development of a taxonomy of communication interventions to improve routine childhood vaccination.

    PubMed

    Willis, Natalie; Hill, Sophie; Kaufman, Jessica; Lewin, Simon; Kis-Rigo, John; De Castro Freire, Sara Bensaude; Bosch-Capblanch, Xavier; Glenton, Claire; Lin, Vivian; Robinson, Priscilla; Wiysonge, Charles S

    2013-05-11

    Vaccination is a cost-effective public health measure and is central to the Millennium Development Goal of reducing child mortality. However, childhood vaccination coverage remains sub-optimal in many settings. While communication is a key feature of vaccination programmes, we are not aware of any comprehensive approach to organising the broad range of communication interventions that can be delivered to parents and communities to improve vaccination coverage. Developing a classification system (taxonomy) organised into conceptually similar categories will aid in: understanding the relationships between different types of communication interventions; facilitating conceptual mapping of these interventions; clarifying the key purposes and features of interventions to aid implementation and evaluation; and identifying areas where evidence is strong and where there are gaps. This paper reports on the development of the 'Communicate to vaccinate' taxonomy. The taxonomy was developed in two stages. Stage 1 included: 1) forming an advisory group; 2) searching for descriptions of interventions in trials (CENTRAL database) and general health literature (Medline); 3) developing a sampling strategy; 4) screening the search results; 5) developing a data extraction form; and 6) extracting intervention data. Stage 2 included: 1) grouping the interventions according to purpose; 2) holding deliberative forums in English and French with key vaccination stakeholders to gather feedback; 3) conducting a targeted search of grey literature to supplement the taxonomy; 4) finalising the taxonomy based on the input provided. The taxonomy includes seven main categories of communication interventions: inform or educate, remind or recall, teach skills, provide support, facilitate decision making, enable communication and enhance community ownership. These categories are broken down into 43 intervention types across three target groups: parents or soon-to-be-parents; communities, community

  11. The AIDS scare in India could be aid-induced.

    PubMed

    Mohan, S

    1996-01-01

    Peter Piot, head of the Joint United Nations Program on HIV/AIDS (UNAIDS), told the World AIDS Conference in Vancouver that India had 3 million people infected with HIV. The Indian government, however, gave no estimate because it has no baseline data upon which a realistic projection can be made. The National AIDS Control Organization (NACO) officially questioned Dr. Piot on the basis of his estimates. Piot attributes his figure to World Health Organization estimates made in consultation with NACO at the end of 1994 that there were 1.75 million people living with HIV in India. Alarmist reports have appeared in the media based upon Dr. Piot's comments. Some health experts, however, believe that the figures are being inflated by the West to pressure India into accepting vaccine trials and other research on HIV-infected people. For now, neither the Indian government nor the country's general population seem concerned about the reported statistics.

  12. Evaluation of the persistence of vaccine-induced protection with human vaccines.

    PubMed

    Vidor, E

    2010-01-01

    The persistence of protection induced by vaccines is a key aspect of the implementation of human vaccination policies, particularly for ageing populations. At the time of initial licensure, the duration of protection induced by a vaccine is generally only documented by longitudinal follow up of cohorts of subjects enrolled in the pre-licensure trials over a period of 1-5 years. The follow up of these cohorts provides two types of data: antibody kinetics (or another clinically relevant immunological parameter) over time and the disease incidence. Generally, the latter trials, if implemented during the pre-licensure period, are designed to follow-up cohorts in order to demonstrate vaccine efficacy above the minimal level required for the license. For vaccines already licensed, additional tools exist. The use of immunological surrogate markers of protection is a practical way to monitor the duration of protection. Measuring the persistence of circulating antibodies is widely used in human vaccines. For several vaccines, observed data have allowed the creation of mathematical models to predict the antibody persistence over periods of time longer than those effectively documented. Clinical trials assessing the capacity of the immune system to mount a quick anamnestic response upon re-stimulation a long time after initial priming (measurement of immune memory) is also a tool employed to document the duration of protection. The waning of protection can also be demonstrated by an increase of disease incidence in the subsequent 'time-to-last-vaccine administration' age segments. Seroprevalence studies in a given age group of people that were vaccinated under real-life conditions are another way to document the persistence of protection. Finally, case-control studies in outbreak situations or in situations of persisting endemicity can also be used to document the persistence of the vaccine efficacy. All of these tools are used in the development of new vaccines, and also

  13. The Impact of Quality Assurance Initiatives and Workplace Policies and Procedures on HIV/AIDS-Related Stigma Experienced by Patients and Nurses in Regions with High Prevalence of HIV/AIDS.

    PubMed

    Hewko, Sarah J; Cummings, Greta G; Pietrosanu, Matthew; Edwards, Nancy

    2018-02-23

    Stigma is commonly experienced by people living with HIV/AIDS and by those providing care to HIV/AIDS patients. Few intervention studies have explored the impact of workplace policies and/or quality improvement on stigma. We examine the contribution of health care workplace policies, procedures and quality assurance initiatives, and self- and peer-assessed individual nurse practices, to nurse-reported HIV/AIDS-stigma practices toward patients living with HIV/AIDS and nurses in health care settings. Our sample of survey respondents (n = 1157) included managers (n = 392) and registered/enrolled nurses (n = 765) from 29 facilities in 4 countries (South Africa, Uganda, Jamaica, Kenya). This is one of the first studies in LMIC countries to use hierarchical linear modeling to examine the contributions of organizational and individual factors to HIV/AIDS stigma. Based on our results, we argue that organizational interventions explicitly targeting HIV/AIDS stigma are required to reduce the incidence, prevalence and morbidity of HIV/AIDS.

  14. Barcelona 2002: law, ethics, and human rights. Advancing research and access to HIV vaccines: a framework for action.

    PubMed

    Avrett, Sam

    2002-12-01

    In light of the continuing spread of HIV infection and the devastating impact of the disease on lives, communities, and economies, particularly in the developing world, the investment in new treatments, vaccines, and microbicides has clearly been inadequate. Efforts must be intensified to develop effective HIV vaccines and to ensure that they are accessible to people in all parts of the world. This article is a summary of a paper by Sam Avrett presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India. In the article, Avrett calls for immediate action to increase commitment and funding for HIV vaccines, enhance public support and involvement, accelerate vaccine development, and plan for the eventual delivery of the vaccines. The article briefly outlines steps that governments need to take to implement each of these objectives. The article also provides a menu of potential actions for vaccine advocates to consider as they lobby governments.

  15. Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents?

    PubMed

    Trogdon, Justin G; Shafer, Paul R; Shah, Parth D; Calo, William A

    2016-08-31

    We explored whether state laws allowing pharmacists to administer human papillomavirus (HPV) vaccinations to adolescents are associated with a higher likelihood of HPV vaccine uptake. We examined provider-reported HPV vaccination among 13-17year olds in the National Immunization Survey-Teen: 2008-2014 for girls (N=48,754) and 2010-2014 for boys (N=31,802). Outcome variables were HPV vaccine initiation (⩾1 dose) and completion (⩾3 doses). The explanatory variable of interest was a categorical variable for the type of pharmacist authority regarding HPV vaccination for adolescents (<18years) in the state: not permitted (reference), by prescription, by collaborative practice protocol, or independent authority. We ran separate difference-in-difference regression models by sex. During 2008-2014, 15 states passed laws allowing pharmacists to administer HPV vaccine to adolescents. Pharmacist authority laws were not statistically significantly associated with increased HPV vaccine initiation or completion. As currently implemented, state laws allowing pharmacists to administer HPV vaccine to adolescents were not associated with uptake. Possible explanations that need further research include restrictions on pharmacists' third-party billing ability and the lack of promotion of pharmacy vaccination services to age-eligible adolescents. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. [AIDS in Russia. It is still possible to stop the epidemic. Interview with Dr. A.P. Koslov].

    PubMed

    Bertrand, P

    1996-01-01

    According to A.P. Koslov, president of the Fourth International Conference on AIDS, Cancer, and Associated Diseases held in Russia in 1996, the conference represents the first high level discussion of AIDS risk management in Russia. Russia has a strong potential for development of a vaccine, having been a key player in the smallpox eradication program in the late 1950s. Conditions are difficult at present, but it is possible that Russia will be able to develop a practical vaccine for distribution in the Third World. Efforts to develop an HIV vaccine underway in different countries have been examined, and a list has been compiled of Russian institutions able to participate in HIV vaccine development. International assistance for vaccine development in Russia would help both the medical establishment in Russia, which has suffered because of the economic and social crisis, and the international community. A meeting is planned for December 1996 in St. Petersburg to organize an AIDS control organization for all of Russia. Mobilization of support for AIDS prevention activities is necessary but very difficult. If nothing is done, the epidemic in Ukraine will soon spread to Russia. But Russia and China are among the few countries where an HIV epidemic could still be prevented or stopped. The association in St. Petersburg cooperates with other former Soviet republics in AIDS control activities, although attendance at international meetings and conferences is frequently curtailed for financial reasons.

  17. The Global Context of Vaccine Refusal: Insights from a Systematic Comparative Ethnography of the Global Polio Eradication Initiative.

    PubMed

    Closser, Svea; Rosenthal, Anat; Maes, Kenneth; Justice, Judith; Cox, Kelly; Omidian, Patricia A; Mohammed, Ismaila Zango; Dukku, Aminu Mohammed; Koon, Adam D; Nyirazinyoye, Laetitia

    2015-06-18

    Many of medical anthropology's most pressing research questions require an understanding how infections, money and ideas move around the globe. The Global Polio Eradication Initiative (GPEI) is a $9 billion project that has delivered 20 billion doses of oral polio vaccine in campaigns across the world. With its array of global activities, it cannot be comprehensively explored by the traditional anthropological method of research at one field site. This paper describes an ethnographic study of the GPEI, a collaborative effort between researchers at eight sites in seven countries. We developed a methodology grounded in nuanced understandings of local context but structured to allow analysis of global trends. Here, we examine polio vaccine acceptance and refusal to understand how global phenomena-in this case, policy decisions by donors and global health organizations to support vaccination campaigns rather than building health systems-shape local behavior. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. When to Initiate Combined Antiretroviral Therapy to Reduce Mortality and AIDS-Defining Illness in HIV-Infected Persons in Developed Countries

    PubMed Central

    2012-01-01

    Background Most clinical guidelines recommend that AIDS-free, HIV-infected persons with CD4 cell counts below 0.350 × 109 cells/L initiate combined antiretroviral therapy (cART), but the optimal CD4 cell count at which cART should be initiated remains a matter of debate. Objective To identify the optimal CD4 cell count at which cART should be initiated. Design Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 109 cells/L. Setting HIV clinics in Europe and the Veterans Health Administration system in the United States. Patients 20 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 109 cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 109 cells/L and were included in the analysis. Measurements Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death. Results Compared with initiating cART at the CD4 cell count threshold of 0.500 × 109 cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death. Limitations CD4 cell count at cART initiation was not randomized. Residual confounding may exist. Conclusion Initiation of cART at a threshold CD4 count of 0.500 × 109 cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 ×109 cells/L. Primary Funding Source National Institutes of Health. PMID:21502648

  19. From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): a retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities.

    PubMed

    Lefevere, Eva; Theeten, Heidi; Hens, Niel; De Smet, Frank; Top, Geert; Van Damme, Pierre

    2015-09-22

    School-based, free HPV vaccination for girls in the first year of secondary school was introduced in Flanders (Belgium) in 2010. Before that, non school-based, co-payment vaccination for girls aged 12-18 was in place. We compared vaccination coverage, age-specific coverage and socio-economic inequalities in coverage - 3 important parameters contributing to the effectiveness of the vaccination programs - under both vaccination systems. We used retrospective administrative data from different sources. Our sample consisted of all female members of the National Alliance of Christian Mutualities born in 1995, 1996, 1998 or 1999 (N=66,664). For each vaccination system we described the cumulative proportion HPV vaccination initiation and completion over time. We used life table analysis to calculate age-specific rates of HPV vaccination initiation and completion. Analyses were done separately for higher income and low income groups. Under non school-based, co-payment vaccination the proportions HPV vaccination initiation and completion slowly rose over time. By age 17, the proportion HPV vaccination initiation/completion was 0.75 (95% CI 0.74-076)/0.66 (95% CI 0.65-0.67). The median age at vaccination initiation/completion was 14.4 years (95% CI 14.4-14.5)/15.4 years (95% CI 15.3-15.4). Socio-economic inequalities in coverage widened over time and with age. Under school-based, free vaccination rates of HPV vaccination initiation were substantially higher. By age 14,the proportion HPV vaccination initiation/completion was 0.90 (95% CI 0.90-0.90)/0.87 (95% CI 0.87-0.88). The median age at vaccination initiation/completion was 12.7 years (95% CI 12.7-12.7)/13.3 years (95% CI 13.3-13.3). Socio-economic inequalities in coverage and in age-specific coverage were substantially smaller. Copyright © 2015. Published by Elsevier Ltd.

  20. Young multiethnic women's attitudes toward the HPV vaccine and HPV vaccination.

    PubMed

    Wong, Li Ping

    2008-11-01

    To investigate the acceptability of the HPV vaccine among a multiethnic sample of young women in Malaysia. A qualitative study of 40 young women aged between 13 and 27 years recruited into 7 focus groups to discuss their knowledge of HPV infection, and their attitudes toward and acceptance of the HPV vaccine. The women were divided into Malay, Chinese, and Indian groups to allow for comparison among ethnicities. Poor knowledge about HPV did not influence the HPV vaccine's acceptability. Although participants were in favor of the vaccine, the majority preferred to delay vaccination because it is newly introduced, they did not perceive themselves to be at risk of HPV infection, or because of cost factors. Concerns were raised regarding the vaccine's safety, the potential to be perceived as promiscuous and sexually active, and whether the vaccine was halal. Promotion of the HPV vaccine should take account of social and cultural acceptability. The findings will help develop strategies for effective vaccination initiatives in a multiethnic and multireligious Asian society.

  1. Size of clinical trials and Introductory prices of prophylactic vaccine series

    PubMed Central

    Weinberg, Steven H.; Butchart, Amy T.; Davis, Matthew M.

    2012-01-01

    Costs of completing the recommended immunization schedule have increased over the last decade. Access to prophylactic vaccines may become limited due to financing obstacles within current delivery systems. Vaccine prices reflect research and development expenses incurred by vaccine manufacturers, including costs associated with evaluating candidate vaccines in human subjects. If the number of subjects in clinical trials is increasing over time and associated with vaccine price, this may help explain increases in prices of vaccine series. We examined whether: (A) the initial public- and private-sector prices for recommended prophylactic vaccine series licensed and recommended in the US increased from 2000–2011, (B) the number of human subjects per licensed vaccine increased during the time period, and (C) the number of human subjects was associated with the initial public–and private–sector prices of the vaccine series. In regression analyses of 13 vaccines, approval year was not significantly associated with the number of human subjects, initial public-sector prices, or initial private-sector prices. While the number of phase II subjects was not significantly associated with prices, the numbers of phase III and combined late phase (phases II + III) subjects were significantly associated with initial public- and private-sector series prices (p < 0.05). The association between number of subjects and initial prices demonstrated diminishing marginal increases in price with increasing numbers of subjects. These findings may help guide the number of subjects required by the FDA in clinical trials, in order to reduce expenses for manufacturers and thereby help mitigate increases in initial vaccine series prices. PMID:22854668

  2. Size of clinical trials and Introductory prices of prophylactic vaccine series.

    PubMed

    Weinberg, Steven H; Butchart, Amy T; Davis, Matthew M

    2012-08-01

    Costs of completing the recommended immunization schedule have increased over the last decade. Access to prophylactic vaccines may become limited due to financing obstacles within current delivery systems. Vaccine prices reflect research and development expenses incurred by vaccine manufacturers, including costs associated with evaluating candidate vaccines in human subjects. If the number of subjects in clinical trials is increasing over time and associated with vaccine price, this may help explain increases in prices of vaccine series. We examined whether: (A) the initial public- and private-sector prices for recommended prophylactic vaccine series licensed and recommended in the US increased from 2000-2011, (B) the number of human subjects per licensed vaccine increased during the time period, and (C) the number of human subjects was associated with the initial public-and private-sector prices of the vaccine series. In regression analyses of 13 vaccines, approval year was not significantly associated with the number of human subjects, initial public-sector prices, or initial private-sector prices. While the number of phase II subjects was not significantly associated with prices, the numbers of phase III and combined late phase (phases II + III) subjects were significantly associated with initial public- and private-sector series prices (p < 0.05). The association between number of subjects and initial prices demonstrated diminishing marginal increases in price with increasing numbers of subjects. These findings may help guide the number of subjects required by the FDA in clinical trials, in order to reduce expenses for manufacturers and thereby help mitigate increases in initial vaccine series prices.

  3. Household demand for preventive HIV/AIDS vaccines in Thailand: do husbands' and wives' preferences differ?

    PubMed

    Whittington, Dale; Suraratdecha, Chutima; Poulos, Christine; Ainsworth, Martha; Prabhu, Vimalanand; Tangcharoensathien, Viroj

    2008-01-01

    The aims of this study were to estimate household demand in the general population of Thailand for a (hypothetical) preventive HIV vaccine; to determine whether spouses in the same household would purchase the same number of vaccines for household members and have the same demand function; to determine whether spouses would allocate vaccines to the same household members; and to estimate household and per capita average willingness to pay (WTP) for an HIV vaccine price. The data come from a national contingent valuation survey of 2524 residents (aged 18-20 years) of 1235 households in Thailand during the period 2000 to 2001. In a subsample of 561 households, both head of household and spouse completed independent (separate) interviews. Respondents were asked whether they would purchase an HIV vaccine for themselves and for other household members if one were available at a specified price. For the full sample, average household WTP for the vaccine was substantial (US$610 at 50% vaccine effectiveness, US$671 at 95% effectiveness); the average per capita WTP for household members was US$220 at 50% effectiveness and US$242 at 95% effectiveness. Although spouses reported that they would purchase the same total number of vaccines, and had essentially the same demand functions, at lower vaccine prices wives were significantly more likely than husbands to allocate vaccines to their daughters than to sons. Because wives are more likely to allocate vaccines to daughters, vaccination programs aimed at women and girls might have different outcomes than programs directed at males or at all potential adults without regard to sex.

  4. America's College Promise: Situating President Obama's Initiative in the History of Federal Higher Education Aid and Access Policy

    ERIC Educational Resources Information Center

    Palmadessa, Allison L.

    2017-01-01

    Purpose: America's College Promise (ACP) is a legislative initiative introduced by President Obama to increase access to higher education, to build the economy, and to support his earlier American Graduation Initiative. This legislation has the potential to settle among the ranks of the most influential federal higher education aid and access…

  5. Antibody response and protective immunity of chickens vaccinated with booster dose of recombinant oil-adjuvanted Leucocytozoon caulleryi subunit vaccine.

    PubMed

    Umali, Dennis V; Ito, Akira; Del Valle, Fletcher P; Shirota, Kazutoshi; Katoh, Hiromitsu

    2014-12-01

    Leucocytozoon caulleryi is an economically important poultry pathogen that causes subclinical to fatal disease in chickens. Because of limited preventive and treatment options against this disease, an oil-adjuvanted recombinant vaccine (O-rR7) targeting the R7 protein of L. caulleryi second-generation schizonts was developed. Different vaccination programs, namely, single vaccination at 45 days (0.1-ml dose), single vaccination at 130 days (0.25 ml), and initial vaccination at 45 days (0.1 ml) followed by a booster dose at 130 days (0.25 ml) were explored to compare the effects of single and booster vaccination on antibody response, duration of protective immunity, and degree of clinical signs after experimental L. caulleryi infection. Of the three treatments groups, initial vaccination at 45 days followed by a booster vaccination at 130 days of age resulted to rapid increase in antibody titers, which persisted for up to 182 days. Antibody titers reached peak values 35 days and 14 days after initial and booster vaccination, respectively. In comparison, single vaccination at 45 days of age resulted in production of antibodies above 1600 ELISA units for 56 days postvaccination, and single vaccination at 130 days of age produced peak antibody titers 35 days postvaccination, which remained above 1600 ELISA units for 126 days. Experimental infection of L. caulleryi at 256 days, when antibody titers had waned, did not result to severe clinical disease in chickens that received booster vaccination, whereas mild to severe disease was observed in chickens that received a single vaccination. Evaluation of immune response at 15 and 21 days postinfection showed that chickens that received booster vaccination had a twofold increase (P < 0.01) in antibody titers as compared to those receiving a single vaccination. Administering booster shots of O-rR7 is therefore recommended, especially in farms located in areas where Leucocytozoon is endemic.

  6. Recommend, but also Discuss: Different Patterns of Physician-Perceived Barriers to Discussing HPV Vaccination and Their Association with Vaccine Administration in 11-12 Year-Old Girls.

    PubMed

    Kulczycki, Andrzej; Qu, Haiyan; Shewchuk, Richard

    2016-12-01

    Objectives We examined variation in primary care physicians' (PCPs') perceptions of barriers to physician-initiated discussion of HPV vaccination, and how this is associated with the rates at which they discuss, initiate and continue to administer vaccination with 11-12 year-old girls. Methods We surveyed 301 PCPs using systematic random sampling. PCP variation in perceived barriers to discussing HPV vaccination was modeled using latent class analysis (LCA). The distinct PCP groups identified were compared with each other using three iterative logistic regression models to predict the likelihood of initiating vaccine discussion and the reported percentages of 11-12 year-old patients who initiated HPV vaccination and received follow-up shots. Results LCA revealed three groups of PCPs who perceived major, moderately significant and relatively minor barriers (17.9, 41.9 and 40.2 % of respondents, respectively). Pediatricians, PCPs who were female, had minority racial/ethnic status and who perceived only minor barriers had significantly higher odds of initiating discussion. PCPs were more likely to initiate HPV vaccination if they had initiated discussion and perceived minor or moderate communication barriers. Increased likelihood to administer follow-up HPV vaccine was associated with having initiated discussion, perceiving only minor barriers and working outside Deep South states, but not with having initiated vaccination. Conclusions for Practice PCPs who discuss HPV vaccination with girls aged 11-12 and their mothers are more likely to start and sustain vaccine administration. However, different PCPs perceive barriers to discussion in different ways. Interventions tailored to different groups of PCPs should assist them in overcoming barriers to discussing their recommendations when necessary.

  7. Economics of vaccines revisited.

    PubMed

    Postma, Maarten J; Standaert, Baudouin A

    2013-05-01

    Performing a total health economic analysis of a vaccine newly introduced into the market today is a challenge when using the conventional cost-effectiveness analysis we normally apply on pharmaceutical products. There are many reasons for that, such as: the uncertainty in the total benefit (direct and indirect) to be measured in a population when using a cohort model; (1) appropriate rules about discounting the long-term impact of vaccines are absent jeopardizing therefore their value at the initial investment; (2) the presence of opposite contexts when introducing the vaccine in developed vs. the developing world with high benefits, low initial health care investment for the latter vs. marginal benefit and high cost for the former; with a corresponding paradox for the vaccine becoming very cost-effective in low income countries but rather medium in middle low to high middle income countries; (3) and the type of trial assessment for the newer vaccines is now often performed with immunogenicity reaction instead of clinical endpoints which still leaves questions on their real impact and their head-to-head comparison. (4.)

  8. Plant Viruses as Nanoparticle-Based Vaccines and Adjuvants.

    PubMed

    Lebel, Marie-Ève; Chartrand, Karine; Leclerc, Denis; Lamarre, Alain

    2015-08-05

    Vaccines are considered one of the greatest medical achievements in the battle against infectious diseases. However, the intractability of various diseases such as hepatitis C, HIV/AIDS, malaria, tuberculosis, and cancer poses persistent hurdles given that traditional vaccine-development methods have proven to be ineffective; as such, these challenges have driven the emergence of novel vaccine design approaches. In this regard, much effort has been put into the development of new safe adjuvants and vaccine platforms. Of particular interest, the utilization of plant virus-like nanoparticles and recombinant plant viruses has gained increasing significance as an effective tool in the development of novel vaccines against infectious diseases and cancer. The present review summarizes recent advances in the use of plant viruses as nanoparticle-based vaccines and adjuvants and their mechanism of action. Harnessing plant-virus immunogenic properties will enable the design of novel, safe, and efficacious prophylactic and therapeutic vaccines against disease.

  9. [Adverse ocular effects of vaccinations].

    PubMed

    Ness, T; Hengel, H

    2016-07-01

    Vaccinations are very effective measures for prevention of infections but are also associated with a long list of possible side effects. Adverse ocular effects following vaccination have been rarely reported or considered to be related to vaccinations. Conjunctivitis is a frequent sequel of various vaccinations. Oculorespiratory syndrome and serum sickness syndrome are considered to be related to influenza vaccinations. The risk of reactivation or initiation of autoimmune diseases (e. g. uveitis) cannot be excluded but has not yet been proven. Overall the benefit of vaccination outweighs the possible but very low risk of ocular side effects.

  10. An extended model of reasoned action to understand the influence of individual- and network-level factors on African Americans' participation in HIV vaccine research.

    PubMed

    Frew, Paula M; Archibald, Matthew; Diallo, Dazon Dixon; Hou, Su-I; Horton, Takeia; Chan, Kayshin; Mulligan, Mark J; del Rio, Carlos

    2010-06-01

    In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS, their participation in HIV clinical research continues to have unique challenges. We theorize that interaction among multilevel factors creates ideal alignment for minority participation in HIV clinical studies. Thus, we initially set out to test an extended model of reasoned action with 362 participants to understand the interplay of sociopsychological and network-level considerations influencing minority participation in HIV prevention research efforts. In this study, we linked the intrapersonal dimensions of attitudes, beliefs, and normative concerns to community-level components, appraisal of involvement with the clinical research organization, an entity which operates within a networked structure of community partner agencies, and identification with coalition advocacy aims. Various participatory outcomes were explored including involvement in future HIV vaccine community functions, participation in community promotion of HIV vaccine research, and community mobilization. Three-stage least squares estimates indicated similar findings across three models. Significant effects demonstrate the importance of positive attitudes toward HIV vaccine research, favorable health research beliefs, perceived social support for participation, HIV/AIDS issue engagement, and perceived relevance of the clinical research site's mission and values. Identification of these nuanced pathway effects provides implications for tailored community program development.

  11. Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

    PubMed

    Gebru, Teklemichael; Lentiro, Kifle; Jemal, Abdulewhab

    2018-05-22

    The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016. The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts [OR = 8.46 (95% CI 3.92, 18.26)]. HIV infected individuals who did not perceived severity of delayed ART initiation were 6.13 time more likely to delay than HIV infected individuals who perceived its severity [OR = 6.13 (95% CI 2.95, 12.73)]. HIV positive individuals who didn't have self-efficacy were 2.35 times more likely delay to start HIV/AIDS care than HIV positive individuals who have self-efficacy [OR = 2.35 (95% CI 1.09, 5.05)]. The study revealed that high incidence density rates of delayed initiation for HIV care and variations were explained by poor wealth, and perceived threat and benefit. Therefore, interventions should be designed to initiate care at their diagnosis time.

  12. Evidence-based decision-making for vaccine introductions: Overview of the ProVac International Working Group’s experience

    PubMed Central

    Jauregui, Barbara; Garcia, Ana Gabriela Felix; Janusz, Cara Bess; Blau, Julia; Munier, Aline; Atherly, Deborah; Mvundura, Mercy; Hajjeh, Rana; Lopman, Benjamin; Clark, Andrew David; Baxter, Louise; Hutubessy, Raymond; de Quadros, Ciro; Andrus, Jon Kim

    2015-01-01

    Introduction Pan American Health Organization’s (PAHO) ProVac Initiative aims to strengthen countries’ technical capacity to make evidence-based immunization policy. With financial support from the Bill and Melinda Gates Foundation, PAHO established the ProVac International Working Group (IWG), a platform created for two years to transfer the ProVac Initiative’s tools and methods to support decisions in non-PAHO regions. Methods In 2011, WHO Regional Offices and partner agencies established the IWG to transfer the ProVac framework for new vaccine decision support, including tools and trainings to other regions of the world. During the two year period, PAHO served as the coordinating secretariat and partner agencies played implementing or advisory roles. Results Fifty nine national professionals from 17 countries received training on the use of economic evaluations to aid vaccine policy making through regional workshops. The IWG provided direct technical support to nine countries to develop cost-effectiveness analyses to inform decisions. All nine countries introduced the new vaccine evaluated or their NITAGs have made a recommendation to the Ministry of Health to introduce the new vaccine. Discussion Developing countries around the world are increasingly interested in weighing the potential health impact due to new vaccine introduction against the investments required. During the two years, the ProVac approach proved valuable and timely to aid the national decision making processes, even despite the different challenges and idiosyncrasies encountered in each region. The results of this work suggest that: (1) there is great need and demand for technical support and for capacity building around economic evaluations; and (2) the ProVac method of supporting country-owned analyses is as effective in other regions as it has been in the PAHO region. Conclusion Decision support for new vaccine introduction in low- and middle-income countries is critical to guiding

  13. Vaccine strategies: Optimising outcomes.

    PubMed

    Hardt, Karin; Bonanni, Paolo; King, Susan; Santos, Jose Ignacio; El-Hodhod, Mostafa; Zimet, Gregory D; Preiss, Scott

    2016-12-20

    Successful immunisation programmes generally result from high vaccine effectiveness and adequate uptake of vaccines. In the development of new vaccination strategies, the structure and strength of the local healthcare system is a key consideration. In high income countries, existing infrastructures are usually used, while in less developed countries, the capacity for introducing new vaccines may need to be strengthened, particularly for vaccines administered beyond early childhood, such as the measles or human papillomavirus (HPV) vaccine. Reliable immunisation service funding is another important factor and low income countries often need external supplementary sources of finance. Many regions also obtain support in generating an evidence base for vaccination via initiatives created by organisations including World Health Organization (WHO), the Pan American Health Organization (PAHO), the Agence de Médecine Préventive and the Sabin Vaccine Institute. Strong monitoring and surveillance mechanisms are also required. An example is the efficient and low-cost approaches for measuring the impact of the hepatitis B control initiative and evaluating achievement of goals that have been established in the WHO Western Pacific region. A review of implementation strategies reveals differing degrees of success. For example, in the Americas, PAHO advanced a measles-mumps-rubella vaccine strategy, targeting different population groups in mass, catch-up and follow-up vaccination campaigns. This has had much success but coverage data from some parts of the region suggest that children are still not receiving all appropriate vaccines, highlighting problems with local service infrastructures. Stark differences in coverage levels are also observed among high income countries, as is the case with HPV vaccine implementation in the USA versus the UK and Australia, reflecting differences in delivery settings. Experience and research have shown which vaccine strategies work well and the

  14. A coordinated cross-disciplinary research initiative to address an increased incidence of narcolepsy following the 2009-2010 Pandemrix vaccination programme in Sweden.

    PubMed

    Feltelius, N; Persson, I; Ahlqvist-Rastad, J; Andersson, M; Arnheim-Dahlström, L; Bergman, P; Granath, F; Adori, C; Hökfelt, T; Kühlmann-Berenzon, S; Liljeström, P; Maeurer, M; Olsson, T; Örtqvist, Å; Partinen, M; Salmonson, T; Zethelius, B

    2015-10-01

    In response to the 2009-2010 influenza A(H1N1)pdm09 pandemic, a mass vaccination programme with the AS03-adjuvanted influenza A(H1N1) vaccine Pandemrix was initiated in Sweden. Unexpectedly, there were a number of narcolepsy cases amongst vaccinated children and adolescents reported. In this review, we summarize the results of a joint cross-disciplinary national research effort to investigate the adverse reaction signal from the spontaneous reporting system and to better understand possible causative mechanisms. A three- to fourfold increased risk of narcolepsy in vaccinated children and adolescents was verified by epidemiological studies. Of importance, no risk increase was observed for the other neurological and autoimmune diseases studied. Genetic studies confirmed the association with the allele HLA-DQB1*06:02, which is known to be related to sporadic narcolepsy. Furthermore, a number of studies using cellular and molecular experimental models investigated possible links between influenza vaccination and narcolepsy. Serum analysis, using a peptide microarray platform, showed that individuals who received Pandemrix exhibited a different epitope reactivity pattern to neuraminidase and haemagglutinin, as compared to individuals who were infected with H1N1. Patients with narcolepsy were also found to have increased levels of interferon-gamma production in response to streptococcus-associated antigens. The chain of patient-related events and the study results emerging over time were subjected to intense nationwide media attention. The importance of transparent communication and collaboration with patient representatives to maintain public trust in vaccination programmes is also discussed in the review. Organizational challenges due to this unexpected event delayed the initiation of some of the research projects, still the main objectives of this joint, cross-disciplinary research effort were reached, and important insights were acquired for future, similar

  15. Utilization of feline ELISPOT for mapping vaccine epitopes.

    PubMed

    Abbott, Jeffrey R; Pu, Ruiyu; Coleman, James K; Yamamoto, Janet K

    2012-01-01

    A commercial feline immunodeficiency virus (FIV) vaccine consisting of inactivated dual-subtype viruses was released in the USA in 2002 and released subsequently over the next 6 years in Canada, Australia, New Zealand, and Japan. Based on the genetic, morphologic, and biochemical similarities between FIV and human immunodeficiency virus-1 (HIV-1), FIV infection of domestic cats is being used as a small animal model of HIV/AIDS vaccine. Studies on prototype and commercial FIV vaccines provide new insights to the types of immunity and the vaccine epitopes required for an effective human HIV-1 vaccine. ELISPOT assays to detect cytokines, chemokines, and cytolytic mediators are widely used to measure the magnitude and the types of cellular immunity produced by vaccination. Moreover, such approach has identified regions on both HIV-1 and FIV proteins that induce robust antiviral cellular immunity in infected hosts. Using the same strategy, cats immunized with prototype and commercial FIV vaccines are being analyzed by feline interferon-γ and IL-2 ELISPOT systems to identify the vaccine epitope repertoire for prophylaxis.

  16. Correlates of human papillomavirus vaccine coverage: a state-level analysis.

    PubMed

    Moss, Jennifer L; Reiter, Paul L; Brewer, Noel T

    2015-02-01

    We tested the hypothesis that states with higher rates of cancers associated with human papillomavirus (HPV) would have lower HPV vaccine coverage. We gathered state-level data on HPV-related cancer rates and HPV vaccine initiation coverage for girls and boys, separately, and HPV vaccine follow-through (i.e., receipt of 3 doses among those initiating the series) for girls only. In addition, we gathered state-level data on demographic composition and contact with the health care system. We calculated Pearson correlations for these ecological relationships. Human papillomavirus vaccine initiation among girls was lower in states with higher levels of cervical cancer incidence and mortality (r = -0.29 and -0.46, respectively). In addition, vaccine follow-through among girls was lower in states with higher levels of cervical cancer mortality (r = -0.30). Other cancer rates were associated with HPV vaccine initiation and follow-through among girls, but not among boys. Human papillomavirus vaccine initiation among girls was lower in states with higher proportions of non-Hispanic black residents and lower proportions of higher-income residents. Human papillomavirus vaccine follow-through was higher in states with greater levels of adolescents' contact with the health care system. Human papillomavirus vaccine coverage for girls was lower in states with higher HPV-related cancer rates. Public health efforts should concentrate on geographic areas with higher cancer rates. Strengthening adolescent preventive health care use may be particularly important to increase vaccine follow-through. Cost-effectiveness analyses may overestimate the benefits of current vaccination coverage and underestimate the benefits of increasing coverage.

  17. Perceptions of human papillomavirus vaccination of adolescent schoolgirls in western Uganda and their implications for acceptability of HPV vaccination: a qualitative study.

    PubMed

    Turiho, Andrew Kampikaho; Okello, Elialilia Sarikieli; Muhwezi, Wilson Winstons; Katahoire, Anne Ruhweza

    2017-08-30

    Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member's perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls' and parents' acceptance of HPV vaccination. Parents' increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. The perceived benefits and safety of HPV vaccination enhanced girls' and parents' acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and

  18. Evaluation of an Intervention Providing HPV Vaccine in Schools

    PubMed Central

    Stubbs, Brenda W.; Panozzo, Catherine A.; Moss, Jennifer L.; Reiter, Paul L.; Whitesell, Dianne H.; Brewer, Noel T.

    2014-01-01

    Objectives To conduct outcome and process evaluations of school-located HPV vaccination clinics in partnership with a local health department. Methods Temporary clinics provided the HPV vaccine to middle school girls in Guilford County, North Carolina, in 2009–2010. Results HPV vaccine initiation was higher among girls attending host schools than satellite schools (6% vs. 1%, OR = 6.56, CI = 3.99–10.78). Of the girls who initiated HPV vaccine, 80% received all 3 doses. Private insurance or federal programs paid for most vaccine doses. Conclusions Lessons learned for creating more effective school-health department partnerships include focusing on host schools and delivering several vaccines to adolescents, not just HPV vaccine alone. PMID:24034684

  19. The role of vaccines in the control of STDs: HPV vaccines.

    PubMed Central

    Frazer, I H

    1996-01-01

    Prophylactic vaccines for genital human papillomavirus (HPV) infection have been shown to be feasible in animal models, and suitable vaccine material based on virus-like particles can be produced in bulk at reasonable cost. Initiation of phase III clinical trials will follow definition of trial outcome measures through further epidemiological studies, and development of assays of host protective immunity. Vaccines could in principle eliminate HPV-related disease, as the human race is the only natural host for the relevant papillomaviruses (PVs). Therapeutic vaccines for genital HPV infection are also possible, but have not yet been demonstrated as feasible in practice because the choice of vaccine antigens is difficult, the method of their optimal delivery is uncertain, and the nature of the relevant antiviral immunity is unknown. PV species specificity will require trials to be conducted in man, which will slow definition of an ideal vaccine. PMID:9038634

  20. Vaccines, inspiring innovation in health.

    PubMed

    Pagliusi, Sonia; Dennehy, Maureen; Kim, Hun

    2018-05-19

    This report covers the topics of pandemics, epidemics and partnerships, including regulatory convergence initiatives, new technologies and novel vaccines, discussed by leading public and private sector stakeholders at the 18th Annual General Meeting (AGM) of the Developing Countries Vaccine Manufacturers' Network (DCVMN). Contributions of Gavi and the vaccine industry from emerging countries to the growing global vaccine market, by improving the supply base from manufacturers in developing countries and contributing to 58% of doses, were highlighted. The Coalition for Epidemic Preparedness Innovations (CEPI), the International Vaccine Institute (IVI) and others reported on new strategies to ensure speedy progress in preclinical and clinical development of innovative vaccines for future MERS, Zika or other outbreak response. Priorities for vaccine stockpiling, to assure readiness during emergencies and to prevent outbreaks due to re-emerging diseases such as yellow fever, cholera and poliomyelitis, were outlined. The role of partnerships in improving global vaccine access, procurement and immunization coverage, and shared concerns were reviewed. The World Health Organization (WHO) and other international collaborating partners provided updates on the Product, Price and Procurement database, the prequalification of vaccines, the control of neglected tropical diseases, particularly the new rabies elimination initiative, and regulatory convergence proposals to accelerate vaccine registration in developing countries. Updates on supply chain innovations and novel vaccine platforms were presented. The discussions enabled members and partners to reflect on efficiency of research & development, supply chain tools and trends in packaging technologies improving delivery of existing vaccines, and allowing a deeper understanding of the current public-health objectives, industry financing, and global policies, required to ensure optimal investments, alignment and stability of

  1. Development and Initial Testing of Messages to Encourage Tuberculosis Testing and Treatment Among Bacille Calmette-Guerin (BCG) Vaccinated Persons

    PubMed Central

    Galindo-Gonzalez, Sebastian; Irani, Tracy A.

    2017-01-01

    Misperceptions surrounding the Bacille Calmette-Guerin (BCG) vaccine can lead some vaccinated individuals to resist being tested and treated for tuberculosis (TB). Educational messages to best explain the risk of TB to BCG-vaccinated, Hispanic persons were systematically developed and tested. First, TB program staff provided messages they considered effective. These were analyzed and validated by TB experts, and then presented in group interviews initially to foreign-born Hispanic persons with a TB diagnosis, and then persons without a prior TB diagnosis. Based on interviewees’ feedback, preferred statements were used to develop one long and three short comprehensive messages. One-on-one interviews were conducted with Hispanic persons to assess the saliency of the comprehensive educational messages. Participants preferred messages that were gain or positively-framed and explained that BCG does not confer lifelong protection against TB. Participants confirmed the messages would likely have a positive impact on patient decisions to undergo TB testing and treatment. PMID:24141428

  2. The Global Meningococcal Initiative: global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection.

    PubMed

    Borrow, Ray; Alarcón, Pedro; Carlos, Josefina; Caugant, Dominique A; Christensen, Hannah; Debbag, Roberto; De Wals, Philippe; Echániz-Aviles, Gabriela; Findlow, Jamie; Head, Chris; Holt, Daphne; Kamiya, Hajime; Saha, Samir K; Sidorenko, Sergey; Taha, Muhamed-Kheir; Trotter, Caroline; Vázquez Moreno, Julio A; von Gottberg, Anne; Sáfadi, Marco A P

    2017-04-01

    The 2015 Global Meningococcal Initiative (GMI) meeting discussed the global importance of meningococcal disease (MD) and its continually changing epidemiology. Areas covered: Although recent vaccination programs have been successful in reducing incidence in many countries (e.g. Neisseria meningitidis serogroup [Men]C in Brazil, MenA in the African meningitis belt), new clones have emerged, causing outbreaks (e.g. MenW in South America, MenC in Nigeria and Niger). The importance of herd protection was highlighted, emphasizing the need for high vaccination uptake among those with the highest carriage rates, as was the need for boosters to maintain individual and herd protection following decline of immune response after primary immunization. Expert commentary: The GMI Global Recommendations for Meningococcal Disease were updated to include a recommendation to enable access to whole-genome sequencing as for surveillance, guidance on strain typing to guide use of subcapsular vaccines, and recognition of the importance of advocacy and awareness campaigns.

  3. Racial disparities in human papillomavirus vaccination: does access matter?

    PubMed

    Gelman, Amanda; Miller, Elizabeth; Schwarz, Eleanor Bimla; Akers, Aletha Y; Jeong, Kwonho; Borrero, Sonya

    2013-12-01

    To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population. Published by Elsevier Inc.

  4. Vaccination to prevent varicella and shingles

    PubMed Central

    Breuer, J

    2001-01-01

    Vaccination of healthy children against varicella using the live attenuated Oka vaccine has been available in Japan and south Korea for several years. In 1996, a programme of universal vaccination of children to prevent varicella was introduced in the USA and other countries, including Canada, Germany, and Sweden, have licensed the vaccine for use in healthy children. This article reviews the origin of the Oka vaccine and the evidence for vaccine safety and efficacy in children and adults. Universal vaccination of children and targeted vaccination of groups at risk of severe varicella are discussed. The possible use of the Oka vaccine to prevent zoster is reviewed, and initiatives to develop new varicella zoster virus vaccines are outlined. Key Words: chickenpox • varicella zoster • herpes zoster • vaccination • leukaemia PMID:11577118

  5. Contribution of polio eradication initiative to effective new vaccine introduction in Africa, 2010-2015.

    PubMed

    Carole Tevi-Benissan, Mable; Moturi, Edna; Anya, Blanche-Philomene Melanga; Aschalew, Teka; Dicky, Akanmori Barthlomew; Nyembo, Poy Alain; Mbulu, Leon Kinuam; Okeibunor, Joseph; Mihigo, Richard; Zawaira, Felicitas

    2016-10-10

    Significant progress has been made to increase access to vaccines in Africa since the 1974 launch of the Expanded Programme on Immunization (EPI). Successes include the introduction of several new vaccines across the continent and likely eradication of polio. We examined the contribution of polio eradication activities (PEI) on new vaccine introduction in the countries of the African Region. We reviewed country specific PEI reports to identify best practices relevant to new vaccine introduction (NVI), and analyzed trends in vaccine coverage during 2010-2015 from immunization estimates provided by WHO/UNICEF. Of the 47 countries in African Region 35 (74%) have introduced PCV, 27 (57%) have introduced rotavirus, and 14 (30%) have introduced IPV. National introductions for HPV vaccine have been done in 5 countries, while 15 countries have held demonstration and pilot projects. In 2014, the regional coverage for the third dose of PCV (PCV3) and rotavirus vaccines was 50% and 30% respectively. By end of 2015, all countries within the meningitis belt will have introduced MenAfriVac™ vaccine. PEI activities had a positive effect in strengthening the process of new vaccine introduction in the African Region. The major contribution was in availing immunization funding and providing trained and experienced technical staff to introduce vaccines. More investment is needed to advocate and sustain funding levels to maintain the momentum gained in introducing new vaccines in the region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Who pays for cooperation in global health? A comparative analysis of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance.

    PubMed

    Clinton, Chelsea; Sridhar, Devi

    2017-07-15

    In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage. We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Intradermal delivery of vaccines: potential benefits and current challenges

    PubMed Central

    Hickling, JK; Jones, KR; Friede, M; Chen, D; Kristensen, D

    2011-01-01

    Abstract Delivery of vaccine antigens to the dermis and/or epidermis of human skin (i.e. intradermal delivery) might be more efficient than injection into the muscle or subcutaneous tissue, thereby reducing the volumes of antigen. This is known as dose-sparing and has been demonstrated in clinical trials with some, but not all, vaccines. Dose-sparing could be beneficial to immunization programmes by potentially reducing the costs of purchase, distribution and storage of vaccines; increasing vaccine availability and effectiveness. The data obtained with intradermal delivery of some vaccines are encouraging and warrant further study and development; however significant gaps in knowledge and operational challenges such as reformulation, optimizing vaccine presentation and development of novel devices to aid intradermal vaccine delivery need to be addressed. Modelling of the costs and potential savings resulting from intradermal delivery should be done to provide realistic expectations of the potential benefits and to support cases for investment. Implementation and uptake of intradermal vaccine delivery requires further research and development, which depends upon collaboration between multiple stakeholders in the field of vaccination. PMID:21379418

  8. AIDS: resource materials for school personnel.

    PubMed

    Fulton, G B; Metress, E; Price, J H

    1987-01-01

    The AIDS dilemma continues to escalate, leaving a legacy that probably will affect the nation for years to come. The U.S. Centers for Disease Control, the National Academy of Sciences, and the U.S. Surgeon General have noted that in the absence of a vaccine or treatment for AIDS, education remains the only effective means to prevent the spread of the disease. Thus, schools have an important role in protecting the public health. To respond appropriately to the situation, school personnel must become familiar with relevant information and resources available concerning AIDS. This article first provides essential information about AIDS using a question-and-answer format. Second, policy statements addressing school attendance by students infected with the virus that causes AIDS are presented. Third, hotlines that can be used to obtain more detailed information about AIDS are described. Fourth, organizations that can provide information for school health education about AIDS are identified. Fifth, an annotated list of audiovisual materials that schools can use to provide education about AIDS is provided. Sixth, a bibliography of publications relevant to school health education about AIDS is offered.

  9. Human papillomavirus vaccine and sexual behavior among adolescent and young women.

    PubMed

    Liddon, Nicole C; Leichliter, Jami S; Markowitz, Lauri E

    2012-01-01

    Vaccines to prevent certain types of human papillomavirus (HPV) and associated cancers are recommended for routine use among young women. Nationally representative reports of vaccine uptake have not explored the relationship between HPV vaccine initiation and various sexual behaviors. Explore sexual behavior and demographic correlates of HPV vaccine initiation from a nationally representative survey of adolescent and young adult women. In 2007-2008, a total of 1243 girls/women aged 15-24 years responded to questions about receiving HPV vaccine in the National Survey of Family Growth (NSFG). In 2010, demographic and sexual behavior correlates were evaluated in bivariate and multivariate analyses by age. HPV vaccine initiation was higher among those aged 15-19 years than those aged 20-24 years (30.3% vs 15.9%, p<0.001). No differences existed by race/ethnicity for those aged 15-19 years, but among women aged 20-24 years, non-Hispanic blacks were less likely than non-Hispanic whites to have received the HPV vaccine (AOR=0.15). HPV vaccine initiation was greater for those with insurance regardless of age. HPV vaccination was not associated with being sexually active or number of sex partners at either age. Among sexually active adolescents aged 15-19 years, those who received HPV vaccine were more likely to always wear a condom (AOR=3.0). This study highlights disparities in HPV vaccine initiation by insurance status among girls/women aged 15-24 years and by race/ethnicity among women aged >19 years. No association was found between HPV vaccination and risky sexual behavior. Published by Elsevier Inc.

  10. Framework for Optimal Global Vaccine Stockpile Design for Vaccine-Preventable Diseases: Application to Measles and Cholera Vaccines as Contrasting Examples.

    PubMed

    Thompson, Kimberly M; Duintjer Tebbens, Radboud J

    2016-07-01

    Managing the dynamics of vaccine supply and demand represents a significant challenge with very high stakes. Insufficient vaccine supplies can necessitate rationing, lead to preventable adverse health outcomes, delay the achievements of elimination or eradication goals, and/or pose reputation risks for public health authorities and/or manufacturers. This article explores the dynamics of global vaccine supply and demand to consider the opportunities to develop and maintain optimal global vaccine stockpiles for universal vaccines, characterized by large global demand (for which we use measles vaccines as an example), and nonuniversal (including new and niche) vaccines (for which we use oral cholera vaccine as an example). We contrast our approach with other vaccine stockpile optimization frameworks previously developed for the United States pediatric vaccine stockpile to address disruptions in supply and global emergency response vaccine stockpiles to provide on-demand vaccines for use in outbreaks. For measles vaccine, we explore the complexity that arises due to different formulations and presentations of vaccines, consideration of rubella, and the context of regional elimination goals. We conclude that global health policy leaders and stakeholders should procure and maintain appropriate global vaccine rotating stocks for measles and rubella vaccine now to support current regional elimination goals, and should probably also do so for other vaccines to help prevent and control endemic or epidemic diseases. This work suggests the need to better model global vaccine supplies to improve efficiency in the vaccine supply chain, ensure adequate supplies to support elimination and eradication initiatives, and support progress toward the goals of the Global Vaccine Action Plan. © 2014 Society for Risk Analysis.

  11. Vaccines and future global health needs

    PubMed Central

    Nossal, G. J. V.

    2011-01-01

    Increased international support for both research into new vaccines and their deployment in developing countries has been evident over the past decade. In particular, the GAVI Alliance has had a major impact in increasing uptake of the six common infant vaccines as well as those against hepatitis B and yellow fever. It further aims to introduce pneumococcal and rotavirus vaccines in the near future and several others, including those against human papillomavirus, meningococcal disease, rubella and typhoid not long after that. In addition, there is advanced research into vaccines against malaria, HIV/AIDS and tuberculosis. By 2030, we may have about 20 vaccines that need to be used in the developing world. Finding the requisite funds to achieve this will pose a major problem. A second and urgent question is how to complete the job of global polio eradication. The new strategic plan calls for completion by 2013, but both pre-eradication and post-eradication challenges remain. Vaccines will eventually become available beyond the field of infectious diseases. Much interesting work is being done in both autoimmunity and cancer. Cutting across disease groupings, there are issues in methods of delivery and new adjuvant formulations. PMID:21893548

  12. Autoimmune disorders after immunisation with Influenza A/H1N1 vaccines with and without adjuvant: EudraVigilance data and literature review.

    PubMed

    Isai, Alina; Durand, Julie; Le Meur, Steven; Hidalgo-Simon, Ana; Kurz, Xavier

    2012-11-19

    All suspected autoimmune disorders (AID) reported as adverse reactions to EudraVigilance from 1 October 2009 to 31 December 2010 for adjuvanted (Celtura™, Fluval P™, Focetria™ and Pandemrix™) and non-adjuvanted (Cantgrip™, Celvapan™ and Panenza™) pandemic Influenza A/H1N1 vaccines were analysed to determine whether adjuvanted vaccines were associated with higher reporting of AID than non-adjuvanted ones. AID were identified based on the corresponding MedDRA High Level Group Term. Reports of type 1 diabetes mellitus and multiple sclerosis were also included in the analysis. Causality was assessed based on WHO causality assessment for adverse events following immunisation and Brighton Collaboration criteria for Guillain-Barré syndrome (GBS), idiopathic thrombocytopenic purpura and acute disseminated encephalomyelitis. Of the 50,221 adverse reactions received in EudraVigilance for A/H1N1 vaccines (adjuvanted: 46,173, non-adjuvanted: 4048), 314 were AID (adjuvanted: 276, non-adjuvanted: 38). GBS was the AID with the highest number of reports (125, adjuvanted: 109, non-adjuvanted: 16). Reporting ratios as calculated by the percentages of AID amongst all reported adverse reactions were 0.60% (95% CI: 0.53-0.67) and 0.94% (95% CI: 0.64-1.24) for adjuvanted and non-adjuvanted vaccines, and were 0.26% (95% CI: 0.22-0.31) and 0.37% (95% CI: 0.18-0.56) in a restricted analysis based on diagnostic certainty, causal relationship and plausible temporal association. Reporting rates for all reports of AID using the estimated number of vaccinees as denominator were 6.87 (95% CI: 6.06-7.68) and 9.98 (95% CI: 6.81-13.16) per million for adjuvanted and non-adjuvanted vaccines, and 3.01 (95% CI: 2.47-3.55) and 3.94 (95% CI: 1.95-5.94) per million in the restricted analysis. These results do not suggest a difference in the reporting of AID between adjuvanted and non-adjuvanted A/H1N1 vaccines. In a literature review performed on 31 August 2011, GBS was also the AID the

  13. AIDS in India: emerging from initial chaos.

    PubMed

    Chatterjee, A

    1991-01-01

    India's response to AIDS has ranged from a 3-phase official surveillance program begun by the India Council of Medical Research (ICMR) in 1985, to legislation criticized as "bigoted and superficial", to conflicting messages, panic and confusion. The ICMR has determined that HIV is transmitted mainly by heterosexual contacts in India. In the media the Director-General of the ICMR was cited as recommending that sex with foreign visitors be banned, as a way to contain the HIV epidemic. Media also reported that defective ELISA screening kits were imported into India that infection control in some hospitals is sub-optimal, that the blood and blood products supply is grossly contaminated with HIV and that certain commercial blood donors were infected from giving blood. All foreign students currently must be HIV-negative to get a visa. It is a major problem to plan an AIDS education campaign with India's large illiterate population and dozens of languages. An AIDS network is emerging incorporating ICMR, the All India Institute of Medical Science, the Central Health Education Bureau, Mother Teresa's order, and a newly formed gay awareness group with the newsletter "Bombay Dost."

  14. Human Papillomavirus (HPV) Risk Factors, Vaccination Patterns, and Vaccine Perceptions among a Sample of Male College Students

    ERIC Educational Resources Information Center

    Fontenot, Holly B.; Collins Fantasia, Heidi; Charyk, Anna; Sutherland, Melissa A.

    2014-01-01

    Objective: To examine human papillomavirus (HPV) vaccination rates, including initiation and completion of the vaccine series, and barriers to vaccination in a sample of male college students. Participants: Male students between the ages of 18 and 25 who reported being currently or previously sexually active (N = 735). Methods: A cross-sectional…

  15. HPV vaccination among lesbian and bisexual women: Findings from a national survey of young adults

    PubMed Central

    McRee, Annie-Laurie; Katz, Mira L.; Paskett, Electra D.; Reiter, Paul L.

    2014-01-01

    Background Human papillomavirus (HPV) infection and associated cervical disease are common among all women, regardless of sexual identity, yet limited research has examined HPV vaccination among lesbian and bisexual women. Methods A national sample of lesbian and bisexual women ages 18-26 (n=543) completed our online survey during Fall 2013. We used multivariable logistic regression to identify correlates of HPV vaccine initiation (receipt of at least 1 dose) and completion (receipt of all 3 recommended doses among initiators). Results Overall, 45% of respondents had initiated HPV vaccine, and 70% of initiators reported completing the series. HPV vaccine initiation was higher among respondents who: were students, had received a healthcare provider's recommendation, perceived greater positive social vaccination norms, or anticipated greater regret if they did not get vaccinated and later got HPV. Initiation was lower among those who perceived greater HPV vaccine harms or greater barriers to getting the vaccine (all p<.05). HPV vaccine completion was higher among initiators who had a college degree while it was lower among those who perceived a greater likelihood of acquiring HPV or who anticipated greater regret if they got the vaccine and fainted (all p<.05). Among HPV vaccine initiators who had not yet completed the series, about half (47%) intended to get the remaining doses. Conclusions Many lesbian and bisexual women are not getting vaccinated against HPV. Healthcare provider recommendations and women's health beliefs may be important leverage points for increasing vaccination among this population. PMID:25038312

  16. Recent sexually transmitted disease prevention efforts and their implications for AIDS health education.

    PubMed

    Solomon, M Z; DeJong, W

    1986-01-01

    In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are currently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts.

  17. Ontology-based Brucella vaccine literature indexing and systematic analysis of gene-vaccine association network.

    PubMed

    Hur, Junguk; Xiang, Zuoshuang; Feldman, Eva L; He, Yongqun

    2011-08-26

    Vaccine literature indexing is poorly performed in PubMed due to limited hierarchy of Medical Subject Headings (MeSH) annotation in the vaccine field. Vaccine Ontology (VO) is a community-based biomedical ontology that represents various vaccines and their relations. SciMiner is an in-house literature mining system that supports literature indexing and gene name tagging. We hypothesize that application of VO in SciMiner will aid vaccine literature indexing and mining of vaccine-gene interaction networks. As a test case, we have examined vaccines for Brucella, the causative agent of brucellosis in humans and animals. The VO-based SciMiner (VO-SciMiner) was developed to incorporate a total of 67 Brucella vaccine terms. A set of rules for term expansion of VO terms were learned from training data, consisting of 90 biomedical articles related to Brucella vaccine terms. VO-SciMiner demonstrated high recall (91%) and precision (99%) from testing a separate set of 100 manually selected biomedical articles. VO-SciMiner indexing exhibited superior performance in retrieving Brucella vaccine-related papers over that obtained with MeSH-based PubMed literature search. For example, a VO-SciMiner search of "live attenuated Brucella vaccine" returned 922 hits as of April 20, 2011, while a PubMed search of the same query resulted in only 74 hits. Using the abstracts of 14,947 Brucella-related papers, VO-SciMiner identified 140 Brucella genes associated with Brucella vaccines. These genes included known protective antigens, virulence factors, and genes closely related to Brucella vaccines. These VO-interacting Brucella genes were significantly over-represented in biological functional categories, including metabolite transport and metabolism, replication and repair, cell wall biogenesis, intracellular trafficking and secretion, posttranslational modification, and chaperones. Furthermore, a comprehensive interaction network of Brucella vaccines and genes were identified. The asserted

  18. Ontology-based Brucella vaccine literature indexing and systematic analysis of gene-vaccine association network

    PubMed Central

    2011-01-01

    Background Vaccine literature indexing is poorly performed in PubMed due to limited hierarchy of Medical Subject Headings (MeSH) annotation in the vaccine field. Vaccine Ontology (VO) is a community-based biomedical ontology that represents various vaccines and their relations. SciMiner is an in-house literature mining system that supports literature indexing and gene name tagging. We hypothesize that application of VO in SciMiner will aid vaccine literature indexing and mining of vaccine-gene interaction networks. As a test case, we have examined vaccines for Brucella, the causative agent of brucellosis in humans and animals. Results The VO-based SciMiner (VO-SciMiner) was developed to incorporate a total of 67 Brucella vaccine terms. A set of rules for term expansion of VO terms were learned from training data, consisting of 90 biomedical articles related to Brucella vaccine terms. VO-SciMiner demonstrated high recall (91%) and precision (99%) from testing a separate set of 100 manually selected biomedical articles. VO-SciMiner indexing exhibited superior performance in retrieving Brucella vaccine-related papers over that obtained with MeSH-based PubMed literature search. For example, a VO-SciMiner search of "live attenuated Brucella vaccine" returned 922 hits as of April 20, 2011, while a PubMed search of the same query resulted in only 74 hits. Using the abstracts of 14,947 Brucella-related papers, VO-SciMiner identified 140 Brucella genes associated with Brucella vaccines. These genes included known protective antigens, virulence factors, and genes closely related to Brucella vaccines. These VO-interacting Brucella genes were significantly over-represented in biological functional categories, including metabolite transport and metabolism, replication and repair, cell wall biogenesis, intracellular trafficking and secretion, posttranslational modification, and chaperones. Furthermore, a comprehensive interaction network of Brucella vaccines and genes were

  19. Investigating the Use of an Enterotropic Newcastle Disease Virus as a Recombinant Vaccine Platform Targeting Poultry Enteric Viruses

    USDA-ARS?s Scientific Manuscript database

    Control strategies for poultry viral enteric disease must include vaccine platforms that have been specifically designed to improve flock performance, lessen disease severity, and reduce viral transmission. With the exception of certain autogenous vaccines, no vaccines currently exist to aid in the ...

  20. SIV Infection-mediated Changes in Gastrointestinal Bacterial Microbiome and Virome are Associated With Immunodeficiency and Prevented by Vaccination

    PubMed Central

    Handley, Scott A.; Desai, Chandni; Zhao, Guoyan; Droit, Lindsay; Monaco, Cynthia L.; Schroeder, Andrew C.; Nkolola, Joseph P.; Norman, Megan E.; Miller, Andrew D.; Wang, David; Barouch, Dan H.; Virgin, Herbert W.

    2016-01-01

    SUMMARY AIDS caused by simian immunodeficiency virus (SIV) infection is associated with gastrointestinal disease, systemic immune activation and, in cross sectional studies, changes in the enteric virome. Here we performed a longitudinal study of a vaccine cohort to define the natural history of changes in the fecal metagenome in SIV-infected monkeys. Matched rhesus macaques were either uninfected or intrarectally challenged with SIV, with a subset receiving the Ad26 vaccine, an adenovirus vector expressing the viral Env/Gag/Pol antigens. Progression of SIV infection to AIDS was associated with increased detection of potentially pathogenic viruses and bacterial enteropathogens. Specifically, adenoviruses were associated with an increased incidence of gastrointestinal disease and AIDS-related mortality. Viral and bacterial enteropathogens were largely absent from animals protected by the vaccine. These data suggest that the SIV-associated gastrointestinal disease is associated with the presence of both viral and bacterial enteropathogens and protection against SIV infection by vaccination prevents enteropathogen emergence. PMID:26962943

  1. Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV) Vaccine Series among Parents of Girls in a Safety Net System

    PubMed Central

    O’Leary, Sean T.; Lockhart, Steven; Barnard, Juliana; Furniss, Anna; Dickinson, Miriam; Dempsey, Amanda F.; Stokley, Shannon; Federico, Steven; Bronsert, Michael; Kempe, Allison

    2018-01-01

    Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI) or not completed (NC) the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From August 2013–October 2013, we conducted a mail survey among parents of girls aged 12–15 years randomly selected from administrative data in a Denver safety net system; 400 parents from each group (NI and NC) were targeted. Surveys were in English or Spanish. Results: The response rate was 37% (244/660; 140 moved or gone elsewhere; 66% English-speaking, 34% Spanish-speaking). Safety attitudes of NIs and NCs differed, with 40% NIs vs. 14% NCs reporting they thought HPV vaccine was unsafe (p < 0.0001) and 43% NIs vs. 21% NCs that it may cause long-term health problems (p < 0.001). Among NCs, 42% reported they did not know their daughter needed more shots (English-speaking, 20%, Spanish-speaking 52%) and 39% reported that “I wasn’t worried about the safety of the HPV vaccine before, but now I am” (English-speaking, 23%, Spanish-speaking, 50%). Items rated as very important among NIs in the decision regarding vaccination included: more information about safety (74%), more information saying it prevents cancer (70%), and if they knew HPV was spread mainly by sexual contact (61%). Conclusions: Safety concerns, being unaware of the need for multiple doses, and low perceived risk of infection remain significant barriers to HPV vaccination for at-risk adolescents. Some parents’ safety concerns do not appear until initial vaccination. PMID:29360785

  2. Challenges and opportunities for meningococcal vaccination in the developing world.

    PubMed

    Shaker, Rouba; Fayad, Danielle; Dbaibo, Ghassan

    2018-05-04

    Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.

  3. Randomized Trials Comparing Inactivated Vaccine After Medium- or High-titer Measles Vaccine With Standard Titer Measles Vaccine After Inactivated Vaccine: A Meta-analysis.

    PubMed

    Aaby, Peter; Ravn, Henrik; Benn, Christine S; Rodrigues, Amabelia; Samb, Badara; Ibrahim, Salah A; Libman, Michael D; Whittle, Hilton C

    2016-11-01

    Observational studies have suggested that girls have higher mortality if their most recent immunization is an inactivated vaccine rather than a live vaccine. We therefore reanalyzed 5 randomized trials of early measles vaccine (MV) in which it was possible to compare an inactivated vaccines [after medium-titer MV (MTMV) or high-titer MV (HTMV)] and a live standard titer MV (after an initial inactivated vaccine). The trials were conducted in Sudan, Senegal, The Gambia and Guinea-Bissau. The intervention group received live MTMV or HTMV from 4 to 5 months and then an inactivated vaccine from 9 to 10 months of age; the control children received inactivated vaccine/placebo from 4 to 5 months and standard titer MV from 9 to 10 months of age. We compared mortality from 9 months until end of study at 3 to 5 years of age for children who received inactivated vaccine (after MTMV or HTMV) and standard titer MV (after inactivated vaccine), respectively. The original datasets were analyzed using a Cox proportional hazards model stratified by trial. The mortality rate ratio (MRR) was 1.38 (95% confidence interval: 1.05-1.83) after an inactivated vaccine (after MTMV or HTMV) compared with a standard titer MV (after inactivated vaccine). Girls had a MRR of 1.89 (1.27-2.80), whereas there was no effect for boys, the sex-differential effect being significant (P = 0.02). Excluding measles cases did not alter these conclusions, the MRR after inactivated vaccines (after MTMV or HTMV) being 1.40 (1.06-1.86) higher overall and 1.92 (1.29-2.86) for girls. Control for variations in national immunization schedules for other vaccines did not modify these results. After 9 months of age, all children had been immunized against measles, and mortality in girls was higher when they had received inactivated vaccines (after MTMV or HTMV) rather than live standard titer MV (after an inactivated vaccine).

  4. Vaccine development for syphilis.

    PubMed

    Lithgow, Karen V; Cameron, Caroline E

    2017-01-01

    Syphilis, caused by the spirochete Treponema pallidum subspecies pallidum, continues to be a globally prevalent disease despite remaining susceptible to penicillin treatment. Syphilis vaccine development is a viable preventative approach that will serve to complement public health-oriented syphilis prevention, screening and treatment initiatives to deliver a two-pronged approach to stemming disease spread worldwide. Areas covered: This article provides an overview of the need for development of a syphilis vaccine, summarizes significant information that has been garnered from prior syphilis vaccine studies, discusses the critical aspects of infection that would have to be targeted by a syphilis vaccine, and presents the current understanding within the field of the correlates of protection needed to be achieved through vaccination. Expert commentary: Syphilis vaccine development should be considered a priority by industry, regulatory and funding agencies, and should be appropriately promoted and supported.

  5. When to initiate combined antiretroviral therapy to reduce mortality and AIDS-defining illness in HIV-infected persons in developed countries: an observational study.

    PubMed

    Cain, Lauren E; Logan, Roger; Robins, James M; Sterne, Jonathan A C; Sabin, Caroline; Bansi, Loveleen; Justice, Amy; Goulet, Joseph; van Sighem, Ard; de Wolf, Frank; Bucher, Heiner C; von Wyl, Viktor; Esteve, Anna; Casabona, Jordi; del Amo, Julia; Moreno, Santiago; Seng, Remonie; Meyer, Laurence; Perez-Hoyos, Santiago; Muga, Roberto; Lodi, Sara; Lanoy, Emilie; Costagliola, Dominique; Hernan, Miguel A

    2011-04-19

    Most clinical guidelines recommend that AIDS-free, HIV-infected persons with CD4 cell counts below 0.350 × 10(9) cells/L initiate combined antiretroviral therapy (cART), but the optimal CD4 cell count at which cART should be initiated remains a matter of debate. To identify the optimal CD4 cell count at which cART should be initiated. Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 10(9) cells/L. HIV clinics in Europe and the Veterans Health Administration system in the United States. 20, 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 10(9) cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 10(9) cells/L and were included in the analysis. Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death. Compared with initiating cART at the CD4 cell count threshold of 0.500 × 10(9) cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death. CD4 cell count at cART initiation was not randomized. Residual confounding may exist. Initiation of cART at a threshold CD4 count of 0.500 × 10(9) cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 × 10(9) cells/L.

  6. HPV vaccination: Population approaches for improving rates.

    PubMed

    Oliver, Kristin; Frawley, Alean; Garland, Elizabeth

    2016-06-02

    To review the literature on interventions to increase HPV vaccinations and assess whether The Community Preventive Services Task Force recommendations are supported by current evidence. We used a PubMed search to identify studies that assessed interventions that looked at provider assessment and feedback, provider reminders, client reminder and recall, and clinic based education programs. Of the 13 studies identified, 8 included client reminder and recall interventions, 4 included provider assessment and feedback and/or provider reminders and 2 included clinic based education. 11 of the 13 studies demonstrated a positive effect on HPV vaccine initiation or completion. Provider assessment and feedback studies were more likely to report a positive effect on HPV vaccine initiation than on series completion, while client reminder recall interventions more frequently produced an effect on series completion than on initiation. There is evidence to support the application of the Community Preventive Services Task Force recommendations specifically to HPV vaccination both for client reminder and recall programs and for provider assessment and feedback interventions. Multiple targeted approaches will be needed to substantially impact HPV vaccine rates.

  7. An Extended Model of Reasoned Action to Understand the Influence of Individual- and Network-Level Factors on African Americans’ Participation in HIV Vaccine Research

    PubMed Central

    Frew, Paula M.; Archibald, Matthew; Diallo, Dazon Dixon; Hou, Su-I; Horton, Takeia; Chan, Kayshin; Mulligan, Mark J.; del Rio, Carlos

    2010-01-01

    In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS, their participation in HIV clinical research continues to have unique challenges. We theorize that interaction among multilevel factors creates ideal alignment for minority participation in HIV clinical studies. Thus, we initially set out to test an extended model of reasoned action with 362 participants to understand the interplay of sociopsychological and network-level considerations influencing minority participation in HIV prevention research efforts. In this study, we linked the intrapersonal dimensions of attitudes, beliefs, and normative concerns to community-level components, appraisal of involvement with the clinical research organization, an entity which operates within a networked structure of community partner agencies, and identification with coalition advocacy aims. Various participatory outcomes were explored including involvement in future HIV vaccine community functions, participation in community promotion of HIV vaccine research, and community mobilization. Three-stage least squares estimates indicated similar findings across three models. Significant effects demonstrate the importance of positive attitudes toward HIV vaccine research, favorable health research beliefs, perceived social support for participation, HIV/AIDS issue engagement, and perceived relevance of the clinical research site’s mission and values. Identification of these nuanced pathway effects provides implications for tailored community program development. PMID:20012200

  8. Immunogenicity of HPV prophylactic vaccines: Serology assays and their use in HPV vaccine evaluation and development.

    PubMed

    Pinto, Ligia A; Dillner, Joakim; Beddows, Simon; Unger, Elizabeth R

    2018-01-17

    When administered as standard three-dose schedules, the licensed HPV prophylactic vaccines have demonstrated extraordinary immunogenicity and efficacy. We summarize the immunogenicity of these licensed vaccines and the most commonly used serology assays, with a focus on key considerations for one-dose vaccine schedules. Although immune correlates of protection against infection are not entirely clear, both preclinical and clinical evidence point to neutralizing antibodies as the principal mechanism of protection. Thus, immunogenicity assessments in vaccine trials have focused on measurements of antibody responses to the vaccine. Non-inferiority of antibody responses after two doses of HPV vaccines separated by 6 months has been demonstrated and this evidence supported the recent WHO recommendations for two-dose vaccination schedules in both boys and girls 9-14 years of age. There is also some evidence suggesting that one dose of HPV vaccines may provide protection similar to the currently recommended two-dose regimens but robust data on efficacy and immunogenicity of one-dose vaccine schedules are lacking. In addition, immunogenicity has been assessed and reported using different methods, precluding direct comparison of results between different studies and vaccines. New head-to-head vaccine trials evaluating one-dose immunogenicity and efficacy have been initiated and an increase in the number of trials relying on immunobridging is anticipated. Therefore, standardized measurement and reporting of immunogenicity for the up to nine HPV types targeted by the current vaccines is now critical. Building on previous HPV serology assay standardization and harmonization efforts initiated by the WHO HPV LabNet in 2006, new secondary standards, critical reference reagents and testing guidelines will be generated as part of a new partnership to facilitate harmonization of the immunogenicity testing in new HPV vaccine trials. Copyright © 2018 Elsevier Ltd. All rights

  9. Vaccines in historic evolution and perspective: a narrative of vaccine discoveries.

    PubMed

    Hilleman, M R

    2000-01-01

    The sciences of vaccinology and immunology were created only two centuries ago by Jenner's scientific studies of prevention of smallpox through inoculation with cowpox virus. This rudimentary beginning was expanded greatly by the giants of late 19th- and early 20th-century biomedical sciences. The period from 1930 to 1950 was a transitional era, with the introduction of chick embryos and minced tissues for propagating viruses and rickettsiae in vitro for vaccines. Modern vaccinology began about 1950 as a continuum following notable advances made during the 1940s and World War II. Its pursuit has been based largely on breakthroughs in cell culture, bacterial polysaccharide chemistry, molecular biology, and immunology which have yielded many live and killed viral and bacterial vaccines plus the recombinant-expressed hepatitis B vaccine. The present paper was presented as a lecture given at a Meeting of the Institute of Human Virology entitled A Symposium on HIV-AIDS and Cancer Biology, Baltimore, Maryland, on August 30, 1999 and recounts, by invitation, more than 55 years of vaccine research from the venue of personal experience and attainment by the author. The paper is intentionally brief and truncated with focus only on highlights and limited referencing. Detailed recounting and referencing are given elsewhere in text references 1 and 2. This narration will have achieved its purpose if it provides a background of understanding and guidelines that will assist others who seek to engage in creation of new vaccines.

  10. Dilemmas of a vitalizing vaccine market: lessons from the MMR vaccine/autism debate.

    PubMed

    Bragesjö, Fredrik; Hallberg, Margareta

    2011-03-01

    A number of issues related to vaccines and vaccinations in society are discussed in this paper. Our purpose is to merge an analysis of some recent changes in the vaccine market with social science research on the relationship between citizens and authorities. The article has two empirical parts. The first shows how the vaccine market, which for many years has had immense financial problems, nowadays seems to becoming economically vitalized, mostly due to the production of new and profitable vaccines. However prosperous the future may appear, certain reactions from the public regarding vaccination initiatives offer insight into inherent problems of vaccine policies in many Western countries. In the second part of the article, these problems are exemplified with the recent controversy over the MMR (measles, mumps, and rubella) vaccine. We conclude that in spite of the improving profit-margins, the vaccine market remains vulnerable and insecure. Vaccines are permeated by society, even more so than pharmaceutics that are used to cure or alleviate illnesses. Radical changes in financial conditions with promises of a more profitable market will not, we argue, solve other even more fundamental problems.

  11. Antibody persistence 5 years after vaccination at 2 to 10 years of age with Quadrivalent MenACWY-CRM conjugate vaccine, and responses to a booster vaccination.

    PubMed

    Block, Stan L; Christensen, Shane; Verma, Bikash; Xie, Fang; Keshavan, Pavitra; Dull, Peter M; Smolenov, Igor

    2015-04-27

    In a multi-center extension study, children 2-10 years of age, initially vaccinated with one or two doses (2-5 year-olds) or one dose (6-10 year-olds) of quadrivalent meningococcal CRM197-conjugate vaccine (MenACWY-CRM), were assessed five years later for antibody persistence and booster response using serum bactericidal assay with human complement (hSBA). Children 7-10 and 11-15 years of age, who received MenACWY-CRM in the original study, and age-matched vaccine-naïve children, were enrolled in this extension study. After an initial blood draw, children received one dose of MenACWY-CRM as booster or primary dose, with a second blood draw 28 days later. hSBA titers decreased five years after primary vaccination, but were higher than in non-vaccinated controls against serogroups C, W and Y, with substantial proportions having titers ≥8: 7-22% for A, 32-57% for C, 74-83% for W, and 48-54% for Y. Previously-vaccinated children demonstrated booster responses to revaccination against all four serogroups. Responses to primary vaccination in vaccine-naïve controls were lower and similar to primary responses observed in the original study. All vaccinations were generally well tolerated, with no safety concern raised. Approximately half the children vaccinated as 2-10 year-olds maintained protective antibodies against serogroups C, W and Y five years later, but fewer did against serogroup A. Declining titers five years after vaccination and robust booster responses suggest that five years may be an appropriate interval to revaccinate children, subject to epidemiology and delivery considerations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Vaccine supply, demand, and policy: a primer.

    PubMed

    Muzumdar, Jagannath M; Cline, Richard R

    2009-01-01

    To provide an overview of supply and demand issues in the vaccine industry and the policy options that have been implemented to resolve these issues. Medline, Policy File, and International Pharmaceutical Abstracts were searched to locate academic journal articles. Other sources reviewed included texts on the topics of vaccine history and policy, government agency reports, and reports from independent think tanks. Keywords included vaccines, immunizations, supply, demand, and policy. Search criteria were limited to English language and human studies. Articles pertaining to vaccine demand, supply, and public policy were selected and reviewed for inclusion. By the authors. Vaccines are biologic medications, therefore making their development and production more difficult and costly compared with "small-molecule" drugs. Research and development costs for vaccines can exceed $800 million, and development may require 10 years or more. Strict manufacturing regulations and facility upgrades add to these costs. Policy options to increase and stabilize the supply of vaccines include those aimed at increasing supply, such as government subsidies for basic vaccine research, liability protection for manufacturers, and fast-track approval for new vaccines. Options to increase vaccine demand include advance purchase commitments, government stockpiles, and government financing for select populations. High development costs and multiple barriers to entry have led to a decline in the number of vaccine manufacturers. Although a number of vaccine policies have met with mixed success in increasing the supply of and demand for vaccines, a variety of concerns remain, including developing vaccines for complex pathogens and increasing immunization rates with available vaccines. New policy innovations such as advance market commitments and Medicare Part D vaccine coverage have been implemented and may aid in resolving some of the problems in the vaccine industry.

  13. Inspecting the Mechanism: A Longitudinal Analysis of Socioeconomic Status Differences in Perceived Influenza Risks, Vaccination Intentions, and Vaccination Behaviors during the 2009-2010 Influenza Pandemic.

    PubMed

    Maurer, Jürgen

    2016-10-01

    Influenza vaccination is strongly associated with socioeconomic status, but there is only limited evidence on the respective roles of socioeconomic differences in vaccination intentions versus corresponding differences in follow-through on initial vaccination plans for subsequent socioeconomic differences in vaccine uptake. Nonparametric mean smoothing, linear regression, and probit models were used to analyze longitudinal survey data on perceived influenza risks, behavioral vaccination intentions, and vaccination behavior of adults during the 2009-2010 influenza A/H1N1 ("swine flu") pandemic in the United States. Perceived influenza risks and behavioral vaccination intentions were elicited prior to the availability of H1N1 vaccine using a probability scale question format. H1N1 vaccine uptake was assessed at the end of the pandemic. Education, income, and health insurance coverage displayed positive associations with behavioral intentions to get vaccinated for pandemic influenza while employment was negatively associated with stated H1N1 vaccination intentions. Education and health insurance coverage also displayed significant positive associations with pandemic vaccine uptake. Moreover, behavioral vaccination intentions showed a strong and statistically significant positive partial association with later H1N1 vaccination. Incorporating vaccination intentions in a statistical model for H1N1 vaccine uptake further highlighted higher levels of follow-through on initial vaccination plans among persons with higher education levels and health insurance. Sampling bias, misreporting in self-reported data, and limited generalizability to nonpandemic influenza are potential limitations of the analysis. Closing the socioeconomic gap in influenza vaccination requires multipronged strategies that not only increase vaccination intentions by improving knowledge, attitudes, and beliefs but also facilitate follow-through on initial vaccination plans by improving behavioral

  14. Inspecting the Mechanism: A Longitudinal Analysis of Socioeconomic Status Differences in Perceived Influenza Risks, Vaccination Intentions and Vaccination Behaviors during the 2009-2010 Influenza Pandemic

    PubMed Central

    Maurer, Jürgen

    2015-01-01

    Background Influenza vaccination is strongly associated with socioeconomic status, but there is only limited evidence on the respective roles of socioeconomic differences in vaccination intentions vs. corresponding differences in follow through on initial vaccination plans for subsequent socioeconomic differences in vaccine uptake. Methods Nonparametric mean smoothing, linear regression and Probit models were used to analyze longitudinal survey data on perceived influenza risks, behavioral vaccination intentions and vaccination behavior of adults during the 2009-10 influenza A/H1N1 (“Swine Flu”) pandemic in the United States. Perceived influenza risks and behavioral vaccination intentions were elicited prior to the availability of H1N1 vaccine using a probability scale question format. H1N1 vaccine uptake was assessed at the end of the pandemic. Results Education, income and health insurance coverage displayed positive associations with behavioral intentions to get vaccinated for pandemic influenza while employment was negatively associated with stated H1N1 vaccination intentions. Education and health insurance coverage also displayed significant positive associations with pandemic vaccine uptake. Moreover, behavioral vaccination intentions showed a strong and statistically significant positive partial association with later H1N1 vaccination. Incorporating vaccination intentions in a statistical model for H1N1 vaccine uptake further highlighted higher levels of follow through on initial vaccination plans among persons with higher education levels and health insurance. Limitations Sampling bias, misreporting in self-reported data, and limited generalizability to non-pandemic influenza are potential limitations of the analysis. Conclusions Closing the socioeconomic gap in influenza vaccination requires multi-pronged strategies that not only increase vaccination intentions by improving knowledge, attitudes and beliefs but also facilitate follow through on initial

  15. HPV vaccination uptake among Cambodian mothers.

    PubMed

    Taylor, Victoria M; Burke, Nancy; Do, Hoai; Liu, Qi; Yasui, Yutaka; Bastani, Roshan

    2012-03-01

    Women of Southeast Asian descent have higher cervical cancer incidence rates than any other group. Widespread use of HPV vaccination could prevent up to 70% of cervical cancers. There is little published information addressing HPV vaccination uptake among Asian Americans. We conducted a survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators, and uptake. Only 26% of the survey participants reported any of their age-eligible daughters had received vaccination, and only 40% reported a previous physician recommendation for vaccination. Higher levels of vaccine uptake were strongly associated with having received a doctor's recommendation for vaccination (p < 0.001) and having asked a doctor for vaccination (p = 0.002). HPV vaccine uptake was relatively low in our Cambodian study group. Educational initiatives should encourage health care providers who serve Cambodian families to recommend HPV vaccination and empower Cambodian mothers to ask their daughters' doctors for vaccination.

  16. Influenza A virus vaccines for swine.

    PubMed

    Vincent, Amy L; Perez, Daniel R; Rajao, Daniela; Anderson, Tavis K; Abente, Eugenio J; Walia, Rasna R; Lewis, Nicola S

    2017-07-01

    Economic losses due to influenza A virus (IAV) infections are substantial and a global problem, ranking among the top three major health challenges in the swine industry. Currently, H1 and H3 subtypes circulate in pigs globally associated with different combinations of N1 and N2 subtypes; however, the origin, gene constellation, and antigenic makeup of IAV vary greatly on different continents. Vaccination is one means of mitigating the effects of IAV disease, and vaccines are most effective if the strains included closely match the currently circulating strains in pigs. Genetic analyses provide panoramic views of the virus landscape at the sequence level and, thus, can aid in the selection of well-matched swine IAV vaccine strains, but is not sufficient alone. Additionally, a major challenge in selecting appropriate swine IAV vaccine strains is the co-circulation of multiple lineages of viruses in the same region, requiring multivalent or broadly cross-reacting antigens. Due to this complex IAV ecology in swine, new vaccination strategies and vaccine platforms are needed. The hemagglutinin (HA) viral protein is the major target of neutralizing antibodies, which are widely considered to be correlated with protection. Virus variants that are not recognized by previously elicited antibodies can render traditional vaccines that primarily elicit humoral responses ineffective, and therefore result in the need for vaccine strain reformulation and re-vaccination. In the future, new vaccine platforms may be on the market that will provide alternative options to those currently available. Nonetheless, a collaborative approach is needed to improve IAV vaccine strain selection for use in swine. Published by Elsevier B.V.

  17. [Update on vaccine research. Proceedings of the 15th annual conference on vaccine research organized by the National Foundation for Infectious Diseases].

    PubMed

    Aubert, M; Beytout, J; Callamand, P; Cheymol, J; Combadière, B; Dahlab, A; Denis, F; Dodet, B; Dommergues, M-A; Gagneur, A; Gaillat, J; Gavazzi, G; Gras-le-Guen, C; Haas, H; Hau-Rainsard, I; Malvy, D; de Monléon, J-V; Picherot, G; Pinquier, D; Pretet, J-L; Pulcini, C; Rabaud, C; Regnier, F; Rogeaux, O; Savagner, C; Soubeyrand, B; Valdiguié, M; Weil-Olivier, C

    2013-04-01

    Every year, the National Foundation for Infectious Diseases brings together more than 300 participants to review progress in vaccine research and development and identify the most promising avenues of research. These conferences are among the most important scientific meetings entirely dedicated to vaccine research for both humans and animals, and provide a mix of plenary sessions with invited presentations by acknowledged international experts, parallel sessions, poster sessions, and informal exchanges between experts and young researchers. During the Fifteenth Conference that took place in Baltimore in May 2012, various topics were addressed, including the scientific basis for vaccinology; exploration of the immune response; novel vaccine design; new adjuvants; evaluation of the impact of newly introduced vaccines (such as rotavirus, HPV vaccines); vaccine safety; and immunization strategies. The new techniques of systems biology allow for a more comprehensive approach to the study of immune responses in order to identify correlates of protection and to design novel vaccines against chronic diseases such as AIDS or malaria, against which natural immunity is incomplete. Copyright © 2013. Published by Elsevier SAS.

  18. Initial Aid is Puzzle to Track

    ERIC Educational Resources Information Center

    McNeil, Michele

    2009-01-01

    States and federal agencies are off to a slow and uneven start in allowing the public to track the first allotments from up to $100 billion in new education funding under the federal economic-stimulus package, despite strong pledges of transparency for the program from the Obama administration. Although about $145 million in aid has been sent from…

  19. Vaccine development for syphilis

    PubMed Central

    Lithgow, Karen V.

    2017-01-01

    Introduction Syphilis, caused by the spirochete Treponema pallidum subspecies pallidum, continues to be a globally prevalent disease despite remaining susceptible to penicillin treatment. Syphilis vaccine development is a viable preventative approach that will serve to complement public health-oriented syphilis prevention, screening and treatment initiatives to deliver a two-pronged approach to stemming disease spread worldwide. Areas covered This article provides an overview of the need for development of a syphilis vaccine, summarizes significant information that has been garnered from prior syphilis vaccine studies, discusses the critical aspects of infection that would have to be targeted by a syphilis vaccine, and presents the current understanding within the field of the correlates of protection needed to be achieved through vaccination. Expert commentary Syphilis vaccine development should be considered a priority by industry, regulatory and funding agencies, and should be appropriately promoted and supported. PMID:27328030

  20. Primary vaccine failure to routine vaccines: Why and what to do?

    PubMed

    Wiedermann, Ursula; Garner-Spitzer, Erika; Wagner, Angelika

    2016-01-01

    There are 2 major factors responsible for vaccine failures, the first is vaccine-related such as failures in vaccine attenuation, vaccination regimes or administration. The other is host-related, of which host genetics, immune status, age, health or nutritional status can be associated with primary or secondary vaccine failures. The first describes the inability to respond to primary vaccination, the latter is characterized by a loss of protection after initial effectiveness. Our studies concentrate on the evaluation of immunological characteristics responsible for primary vaccine failures in different (risk) populations for which the underlying mechanisms are currently unknown. Here we summarise current knowledge and findings from our studies. About 2-10% of healthy individuals fail to mount antibody levels to routine vaccines. Comparing the immune responses to different vaccines in non-responder and high-responder vaccinees revealed that hypo-responsiveness is antigen/vaccine-specific at the humoral but not at the cellular level. We found that T-regulatory as well as B-regulatory cells and the production of IL-10 are involved in non/hypo-responsiveness. Non-responsiveness increases with age and in particular vaccination to a novel vaccine in persons > 65 years is associated with a high low/non-responder rate, indicating that vaccine schedules and doses (at least for primary vaccination) should be adapted according to age. In light of the growing number of allergic but also obese people, our current studies concentrate on these risk groups to reveal whether different vaccination approaches are necessary for optimal protection compared to healthy individuals. These studies are in line with the significant paradigm shift taking place in many fields of medical research and care, and will extend the concept of personalised medicine into the field of vaccinology.

  1. Hookworm vaccines.

    PubMed

    Diemert, David J; Bethony, Jeffrey M; Hotez, Peter J

    2008-01-15

    Hookworm infection caused by the soil-transmitted nematodes Necator americanus and Ancylostoma duodenale is one of the most common parasitic infections worldwide. Although not directly responsible for substantial mortality, it causes significant morbidity in the form of chronic anemia and protein malnutrition. Current global control efforts based on periodic mass anthelmintic administration are unsustainable, and new control strategies must be developed. This review describes progress in the development of vaccines against hookworm infection, including the preclinical and initial clinical testing of the N. americanus Ancylostoma Secreted Protein-2 Hookworm Vaccine. Plans call for eventual development of a vaccine that will combine at least 2 hookworm antigens--one targeting the larval stage of the life cycle and another targeting the adult worm living in the gastrointestinal tract.

  2. A novel, disruptive vaccination technology: self-adjuvanted RNActive(®) vaccines.

    PubMed

    Kallen, Karl-Josef; Heidenreich, Regina; Schnee, Margit; Petsch, Benjamin; Schlake, Thomas; Thess, Andreas; Baumhof, Patrick; Scheel, Birgit; Koch, Sven D; Fotin-Mleczek, Mariola

    2013-10-01

    Nucleotide based vaccines represent an enticing, novel approach to vaccination. We have developed a novel immunization technology, RNActive(®) vaccines, that have two important characteristics: mRNA molecules are used whose protein expression capacity has been enhanced by 4 to 5 orders of magnitude by modifications of the nucleotide sequence with the naturally occurring nucleotides A (adenosine), G (guanosine), C (cytosine), U (uridine) that do not affect the primary amino acid sequence. Second, they are complexed with protamine and thus activate the immune system by involvement of toll-like receptor (TLR) 7. Essentially, this bestows self-adjuvant activity on RNActive(®) vaccines. RNActive(®) vaccines induce strong, balanced immune responses comprising humoral and cellular responses, effector and memory responses as well as activation of important subpopulations of immune cells, such as Th1 and Th2 cells. Pre-germinal center and germinal center B cells were detected in human patients upon vaccination. RNActive(®) vaccines successfully protect against lethal challenges with a variety of different influenza strains in preclinical models. Anti-tumor activity was observed preclinically under therapeutic as well as prophylactic conditions. Initial clinical experiences suggest that the preclinical immunogenicity of RNActive(®) could be successfully translated to humans.

  3. General Assembly pledges support for war against AIDS.

    PubMed

    1988-03-01

    At a special meeting held in October 1987, the World Health Organization called for a concerted, international response to acquired immunodeficiency syndrome (AIDS). Announced was the creation of a WHO Global Commission on AIDS comprised of experts in health, social, economic, legal, ethical, and biomedical fields who will advise WHO officials of developments in various aspects of the disease. Member States were united in terms of the need for open communication and support of WHO efforts to combat AIDS. By December 1987, 129 countries had reported 73,747 AIDS cases to WHO and another 3 million new cases are likely to develop by 1982. The WHO strategy is based on several concepts: 1) even in the absence of a vaccine, AIDS is controllable through widespread education; 2) longterm commitment to eradication is necessary; 3) AIDS prevention and control must be integrated into national health systems; and 4) international cooperation, coordination, and leadership is vital. National AIDS committees have been established in over 100 countries.

  4. Initial viral load determines the magnitude of the human CD8 T cell response to yellow fever vaccination.

    PubMed

    Akondy, Rama S; Johnson, Philip L F; Nakaya, Helder I; Edupuganti, Srilatha; Mulligan, Mark J; Lawson, Benton; Miller, Joseph D; Pulendran, Bali; Antia, Rustom; Ahmed, Rafi

    2015-03-10

    CD8 T cells are a potent tool for eliminating intracellular pathogens and tumor cells. Thus, eliciting robust CD8 T-cell immunity is the basis for many vaccines under development. However, the relationship between antigen load and the magnitude of the CD8 T-cell response is not well-described in a human immune response. Here we address this issue by quantifying viral load and the CD8 T-cell response in a cohort of 80 individuals immunized with the live attenuated yellow fever vaccine (YFV-17D) by sampling peripheral blood at days 0, 1, 2, 3, 5, 7, 9, 11, 14, 30, and 90. When the virus load was below a threshold (peak virus load < 225 genomes per mL, or integrated virus load < 400 genome days per mL), the magnitude of the CD8 T-cell response correlated strongly with the virus load (R(2) ∼ 0.63). As the virus load increased above this threshold, the magnitude of the CD8 T-cell responses saturated. Recent advances in CD8 T-cell-based vaccines have focused on replication-incompetent or single-cycle vectors. However, these approaches deliver relatively limited amounts of antigen after immunization. Our results highlight the requirement that T-cell-based vaccines should deliver sufficient antigen during the initial period of the immune response to elicit a large number of CD8 T cells that may be needed for protection.

  5. Coverage with Tetanus, Diphtheria, and Acellular Pertussis Vaccine and Influenza Vaccine Among Pregnant Women - Minnesota, March 2013-December 2014.

    PubMed

    Barber, Alexandra; Muscoplat, Miriam Halstead; Fedorowicz, Anna

    2017-01-20

    Pertussis and influenza infections can result in severe disease in infants. The diphtheria, tetanus, acellular pertussis (DTaP) vaccine is recommended for infants beginning at age 2 months, and influenza vaccine is recommended for infants aged ≥6 months. Vaccination of pregnant women induces the production of antibodies that are transferred across the placenta to the fetus and provide passive protection until infants are old enough to receive DTaP and influenza vaccines (1-3). To protect young infants before they are age-eligible for vaccination, the Advisory Committee on Immunization Practices (ACIP) has recommended since 2004 that all women who are or will be pregnant during influenza season receive inactivated influenza vaccine (1), and since 2013 that all pregnant women receive the tetanus, diphtheria, acellular pertussis (Tdap) vaccine (3). Tdap and influenza vaccination coverage was assessed among pregnant women in Minnesota. Vital records data containing maternal demographic characteristics, prenatal care data, and delivery payment methods were matched with vaccination data from the Minnesota Immunization Information Connection (MIIC) to assess vaccination coverage. MIIC stores vaccination records for Minnesota residents. Overall, coverage with Tdap vaccine was 58.2% and with influenza vaccine was 45.9%. Coverage was higher for each vaccine among women who received adequate prenatal care compared with those who received inadequate or intermediate care, based on the initiation of prenatal care and the number of recommended prenatal visits attended. Coverage also varied based on mother's race, country of birth or region, and other demographic characteristics. Further study is needed to better understand the maternal vaccination disparities found in this study and to inform future public health initiatives.

  6. Correlates of human papillomavirus vaccination rates in low-income, minority adolescents: a multicenter study.

    PubMed

    Perkins, Rebecca B; Brogly, Susan B; Adams, William G; Freund, Karen M

    2012-08-01

    Low rates of human papillomavirus (HPV) vaccination in low-income, minority adolescents may exacerbate racial disparities in cervical cancer incidence. Using electronic medical record data and chart abstraction, we examined correlates of HPV vaccine series initiation and completion among 7702 low-income and minority adolescents aged 11-21 receiving primary care at one of seven medical centers between May 1, 2007, and June 30, 2009. Our population included 61% African Americans, 13% Caucasians, 15% Latinas, and 11% other races; 90% receive public insurance (e.g., Medicaid). We used logistic regression to estimate the associations between vaccine initiation and completion and age, race/ethnicity, number of contacts with the healthcare system, provider documentation, and clinical site of care. Of the 41% of adolescent girls who initiated HPV vaccination, 20% completed the series. A higher proportion of girls aged 11-<13 (46%) and 13-<18 (47%) initiated vaccination than those aged 18-21 (28%). In adjusted analyses, receipt of other recommended adolescent vaccines was associated with vaccine initiation, and increased contact with the medical system was associated with both initiation and completion of the series. Conversely, provider failure to document risky health behaviors predicted nonvaccination. Manual review of a subset of unvaccinated patients' charts revealed no documentation of vaccine discussions in 67% of cases. Fewer than half of low-income and minority adolescents receiving health maintenance services initiated HPV vaccination, and only 20% completed the series. Provider failure to discuss vaccination with their patients appears to be an important contributor to nonvaccination. Future research should focus on improving both initiation and completion of HPV vaccination in high-risk adolescents.

  7. Quick assessment of the influence of the Hepatitis B vaccine event on children's vaccination.

    PubMed

    Yue, Chenyan; Sun, Xiaojin; Wei, Ning; Yu, Wenzhou; Cui, Fuqiang; Wang, Huaqing; Li, Li; Zhang, Lijie; Shi, Guoqing; An, Zhijie

    2016-10-02

    From December 2013 to January 2014, a large number of medias in China reported negative information about Hepatitis B vaccine (HepB) safety issues using eye-catching titles, such as "3 infants in Hunan inoculated with HepB occurred adverse event, and 2 died," and that caused crisis of confidence in vaccination, which we called "HepB event." The progress of "HepB event" could be divided into 3 stages which were initiation, peak and ending stages. In order to evaluate the influence of "HepB event" on the attitudes of participants toward Hepatitis B vaccine safety and their intention of vaccinating their children in different stages, and provide evidence for authority departments as soon as possible to take measures to prevent decrease of HepB coverage rate, a quick field investigation was carried out. Using convenience sampling methods during the initiation, peak and ending stages of the "HepB event." In the 3 stages of the "HepB event," the awareness rate of the event among participants was rapidly rising, showing that the participants paid great attention to the event, and the information was spread very quickly. The proportion of participants who knew the event but thought that the Hepatitis B vaccine was unsafe were 31%, 37% and 26% respectively in 3 stages. In addition, the acceptance of vaccination by the participants was influenced, the proportion of participants who would like to delay or reject vaccinating their children was up to 43% in the peak stage of the event. The "HepB event" had impacted on the participants' confidence in the safety of Hepatitis B vaccine. For such event, relevant authority departments need effectively communicate with the media and the public, and promptly issue positive information and the investigation result, thereby reducing the negative impact of the event, and improve the vaccine confidence among the public.

  8. Impact of BRICS’ investment in vaccine development on the global vaccine market

    PubMed Central

    Milstien, Julie; Schmitt, Sarah

    2014-01-01

    Abstract Brazil, the Russian Federation, India, China and South Africa – the countries known as BRICS – have made considerable progress in vaccine production, regulation and development over the past 20 years. In 1993, all five countries were producing vaccines but the processes used were outdated and non-standardized, there was little relevant research and there was negligible international recognition of the products. By 2014, all five countries had strong initiatives for the development of vaccine technology and had greatly improved their national regulatory capacity. South Africa was then the only BRICS country that was not completely producing vaccines. South Africa is now in the process of re-establishing its own vaccine production and passing beyond the stage of simply importing, formulating and filling vaccine bulks. Changes in the public sector’s price per dose of selected vaccines, the global market share represented by products from specific manufacturers, and the attractiveness, for multinational companies, of partnership and investment opportunities in BRICS companies have all been analysed. The results indicate that the BRICS countries have had a major impact on vaccine price and availability, with much of that impact attributable to the output of Indian vaccine manufacturers. China is expected to have a greater impact soon, given the anticipated development of Chinese vaccine manufacturers in the near future. BRICS’ accomplishments in the field of vaccine development are expected to reshape the global vaccine market and accelerate access to vaccines in the developing world. The challenge is to turn these expectations into strategic actions and practical outcomes. PMID:24940018

  9. Impact of BRICS' investment in vaccine development on the global vaccine market.

    PubMed

    Kaddar, Miloud; Milstien, Julie; Schmitt, Sarah

    2014-06-01

    Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--have made considerable progress in vaccine production, regulation and development over the past 20 years. In 1993, all five countries were producing vaccines but the processes used were outdated and non-standardized, there was little relevant research and there was negligible international recognition of the products. By 2014, all five countries had strong initiatives for the development of vaccine technology and had greatly improved their national regulatory capacity. South Africa was then the only BRICS country that was not completely producing vaccines. South Africa is now in the process of re-establishing its own vaccine production and passing beyond the stage of simply importing, formulating and filling vaccine bulks. Changes in the public sector's price per dose of selected vaccines, the global market share represented by products from specific manufacturers, and the attractiveness, for multinational companies, of partnership and investment opportunities in BRICS companies have all been analysed. The results indicate that the BRICS countries have had a major impact on vaccine price and availability, with much of that impact attributable to the output of Indian vaccine manufacturers. China is expected to have a greater impact soon, given the anticipated development of Chinese vaccine manufacturers in the near future. BRICS' accomplishments in the field of vaccine development are expected to reshape the global vaccine market and accelerate access to vaccines in the developing world. The challenge is to turn these expectations into strategic actions and practical outcomes.

  10. Status of vaccine research and development of vaccines for HIV-1.

    PubMed

    Safrit, Jeffrey T; Fast, Patricia E; Gieber, Lisa; Kuipers, Hester; Dean, Hansi J; Koff, Wayne C

    2016-06-03

    Human immunodeficiency virus (HIV) is the cause of one of the most lethal pandemics in human history, although in recent years access to highly effective anti-retroviral therapy has provided new hope worldwide. Transmission of HIV by sexual contact, childbirth and injection drug use has been reduced, but 2 million are newly infected each year, and much of the transmission is from people who do not know their status. In addition to known methods, a preventive vaccine is needed to end the pandemic. The extraordinary mutability and genetic diversity of HIV is an enormous challenge, but vaccines are being designed for broad coverage. Computer-aided design of mosaic immunogens, incorporating many epitopes from the entire genome or from conserved regions aim to induce CD8+ T cells to kill virus-infected cells or inhibit virus replication, while trimeric envelope proteins or synthetic mimics aim to induce broadly reactive neutralizing antibodies similar to those cloned from some infected patients. Induction of more potent and durable responses may require new adjuvants or replicating chimeric vectors chimeras that bear HIV genes. Passive or genetic delivery of broadly neutralizing antibodies may provide broad protection and/or lead to insights for vaccine designers. Proof-of-concept trials in non-human primates and in one human efficacy trial have provided scientific clues for a vaccine that could provide broad and durable protection against HIV. The use of vaccines to destroy HIV reservoirs as part of therapy or cure is now also being explored. Copyright © 2016 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  11. The analysis of HIV/AIDS drug-resistant on networks

    NASA Astrophysics Data System (ADS)

    Liu, Maoxing

    2014-01-01

    In this paper, we present an Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) drug-resistant model using an ordinary differential equation (ODE) model on scale-free networks. We derive the threshold for the epidemic to be zero in infinite scale-free network. We also prove the stability of disease-free equilibrium (DFE) and persistence of HIV/AIDS infection. The effects of two immunization schemes, including proportional scheme and targeted vaccination, are studied and compared. We find that targeted strategy compare favorably to a proportional condom using has prominent effect to control HIV/AIDS spread on scale-free networks.

  12. [Obligatory vaccination reporting in Saxony-Anhalt. Possibilities and limitations of establishing a computerized vaccination registry].

    PubMed

    Oppermann, H; Wahl, G; Borrmann, M; Fleischer, J

    2009-11-01

    Vaccination registries are databases intended to assess and manage complete vaccination data of as many individuals as possible in a population under survey. The task of these registries is to identify low vaccination rates on the individual and population level, to enable systems of reminding individuals, to focus vaccination campaigns and to maximize overall vaccination coverage. Saxony-Anhalt is the only federal state of Germany to have a law that prescribes the reporting of vaccinations. Vaccinations of children up to the age of 7 are reported to the regional public health services. However, as the law provides no regulations as to how the data should be registered and processed, the development of a vaccination registry depends entirely on the initiative and cooperation of the "players in vaccination". The key players in vaccination in Saxony-Anhalt have recently created a Vaccination-Committee, which set out to develop the theoretical standards and a software prototype for the establishment of a computerized vaccination registry. Recent developments in the public health reporting system of Saxony-Anhalt (which strives to modernize its computerized assessment of child and adolescent health) are now opening the possibility to integrate the vaccination registry into the commercially available child health software.

  13. Status of DOE and AID stand-alone photovoltaic system field tests

    NASA Astrophysics Data System (ADS)

    Bifano, W. J.; Delombard, R.; Ratajczak, A. F.; Scudder, L. R.

    The NASA Lewis Research Center (LeRC) is managing stand-alone photovoltaic (PV) system projects sponsored by the U.S. Department of Energy (DOE) and the U.S. Agency for International Development (AID). The DOE project includes village PV power demonstration projects in Gabon (four sites) and the Marshall Islands, and PV-powered vaccine refrigerator systems in six countries. The AID project includes a large village power system, a farmhouse system and two water pumping-irrigation systems in Tunisia, a water pumping/grain grinding system in Upper Volta, five medical clinic systems in four countries, PV-powered vaccine refrigerator systems in 18 countries and a PV-powered remote earth station in Indonesia. This paper reviews these PV projects and summarizes significant findings to date.

  14. Status of DOE and AID stand-alone photovoltaic system field tests

    NASA Technical Reports Server (NTRS)

    Bifano, W. J.; Delombard, R.; Ratajczak, A. F.; Scudder, L. R.

    1984-01-01

    The NASA Lewis Research Center (LeRC) is managing stand-alone photovoltaic (PV) system projects sponsored by the U.S. Department of Energy (DOE) and the U.S. Agency for International Development (AID). The DOE project includes village PV power demonstration projects in Gabon (four sites) and the Marshall Islands, and PV-powered vaccine refrigerator systems in six countries. The AID project includes a large village power system, a farmhouse system and two water pumping-irrigation systems in Tunisia, a water pumping/grain grinding system in Upper Volta, five medical clinic systems in four countries, PV-powered vaccine refrigerator systems in 18 countries and a PV-powered remote earth station in Indonesia. This paper reviews these PV projects and summarizes significant findings to date.

  15. The Influence of Race and Comorbidity on the Timely Initiation of Antiretroviral Therapy Among Older Persons Living With HIV/AIDS

    PubMed Central

    Smith, Lerissa; Zhang, Shun; Fairchild, Amanda J.; Heiman, Harry J.; Rust, George

    2014-01-01

    Objectives. We examined whether the timely initiation of antiretroviral therapy (ART) differed by race and comorbidity among older (≥ 50 years) people living with HIV/AIDS (PLWHA). Methods. We conducted frequency and descriptive statistics analysis to characterize our sample, which we drew from 2005–2007 Medicaid claims data from 14 states. We employed univariate and multivariable Cox regression analyses to evaluate the relationship between race, comorbidity, and timely ART initiation (≤ 90 days post-HIV/AIDS diagnosis). Results. Approximately half of the participants did not commence ART promptly. After we adjusted for covariates, we found that older PLWHA who reported a comorbidity were 40% (95% confidence interval = 0.26, 0.61) as likely to commence ART promptly. We found no racial differences in the timely initiation of ART among older PLWHA. Conclusions. Comorbidities affect timely ART initiation in older PLWHA. Older PLWHA may benefit from integrating and coordinating HIV care with care for other comorbidities and the development of ART treatment guidelines specific to older PLWHA. Consistent Medicaid coverage helps ensure consistent access to HIV treatment and care and may eliminate racial disparities in timely ART initiation among older PLWHA. PMID:25211735

  16. Could Poor Parental Recall of HPV Vaccination Contribute to Low Vaccination Rates?

    PubMed

    Apte, Gauri; Pierre-Joseph, Natalie; Vercruysse, Jessica L; Perkins, Rebecca B

    2015-09-01

    Rates of initiation and completion of the human papillomavirus (HPV) vaccine series remain below national goals. Because parents are responsible for ensuring vaccination of their children, we examined the accuracy of parental recall of the number of shots their daughters received. Parents/guardians of girls aged 11 to 17 years were asked to recall the number of HPV doses received by their daughters. Dose number was confirmed using provider-verified medical records. Logistic regression assessed variables associated with correct recall. A total of 79 (63%) parents/guardians correctly identified the number of shots their daughters received. Ninety-one (73%) were aware of whether their daughter started the series at all. The only factor significantly associated with accurate recall in logistic regression models was female gender of parent/guardian. Nearly 40% of parents/guardians inaccurately recalled the number of HPV shots their children received, which may contribute to low rates of vaccine initiation and completion. © The Author(s) 2015.

  17. Comparing risk behaviours of human papillomavirus-vaccinated and non-vaccinated women.

    PubMed

    Sadler, Laura; Roberts, Stephen A; Hampal, Gail; McManus, Dona; Mandal, Debashis; Brabin, Loretta

    2015-10-01

    Since September 2008, a national vaccine programme in the UK has offered routine human papillomavirus (HPV) vaccination to young women aged 12-13 years. A catch-up programme also offered HPV vaccination to women born after 1 September 1990. To compare indicators of risk and preventive behaviours among young women attending genitourinary medicine (GUM) clinics who had, and had not, received at least one dose of HPV vaccine. Clinical histories and HPV vaccination status were obtained from 363 participants eligible for HPV vaccination (Cervarix(®)) in the UK vaccination programme (born after 1 September 1990) attending GUM clinics in the North West of England. Using logistic regression, markers of sexual and non-sexual risk behaviours were compared between vaccinated and unvaccinated women. At least one dose of HPV vaccine had been received by 63.6% (n=231) of participants. Unvaccinated women demonstrated higher levels of risky behaviour than those who had undergone HPV vaccination. Unvaccinated women were significantly more likely to have had three or more partners in the last 6 months, attended the clinic with symptoms, not used a condom at first sexual intercourse, had anal intercourse with their last sexual contact, to have tested positive for Chlamydia trachomatis diagnosis at the clinic visit and to be a current smoker. In the UK, where vaccine coverage is high, failure to initiate HPV vaccination amongst GUM attendees is a marker of high-risk behaviours. As a result, HPV vaccination status should be ascertained as part of an individual's clinical history by sexual health services to ensure advice and counselling is provided to those at greatest risk of HPV-associated disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. [Vaccinations and malaria prophylaxis for international travelers].

    PubMed

    Alberer, Martin; Löscher, Thomas

    2015-05-01

    The prevention of infectious diseases by vaccination and by counselling about malaria prophylaxis is a central aspect of travel medicine. Besides mandatory vaccinations required for entry to certain countries various vaccinations may be indicated depending on destination and type of travel as well as on individual risks of the traveler. In addition, pre-travel counselling should always include a check-up of standard vaccinations. Protection against mosquito bites is the basis of malaria prophylaxis. The addition of chemoprophylaxis is warranted in high risk areas. When regular chemoprophylaxis is not applied it is recommended to carry an appropriate antimalarial drug which can be used for emergency stand-by treatment in case of unexplained fever and when medical attention is not available within 24 hours. Travelers should realize that self-treatment is a first-aid measure and that they should still seek medical advice as soon as possible. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Capacity building among african american faith leaders to promote HIV prevention and vaccine research.

    PubMed

    Alio, Amina P; Lewis, Cindi A; Bunce, Catherine A; Wakefield, Steven; Thomas, Weldon G; Sanders, Edwin; Keefer, Michael C

    2014-01-01

    In light of the increasing rates of HIV infection in African Americans, it is essential that black faith leaders become more proactive in the fight against the epidemic. The study aim was to engage faith leaders in a sustainable partnership to increase community participation in preventive HIV vaccine clinical research while improving their access to and utilization of HIV/AIDS prevention services. Leadership Development Seminars were adapted for faith leaders in Rochester, NY, with topics ranging from the importance of preventive HIV vaccine research to social issues surrounding HIV/AIDs within a theological framework. Seminars were taught by field-specific experts from the black community and included the development of action plans to institute HIV preventive ministries. To assess the outcome of the Seminars, baseline and post-training surveys were administered and analyzed through paired sample t Tests and informal interviews. 19 faith leaders completed the intervention. In general, the majority of clergy felt that their understanding of HIV vaccine research and its goals had increased postintervention. A critical outcome was the subsequent formation of the Rochester Faith Collaborative by participating clergy seeking to sustain the collaborative and address the implementation of community action plans. Providing scientific HIV/AIDS knowledge within the context of clergy members' belief structure was an effective method for engaging black Church leaders in Rochester, NY. Collaborative efforts with various local institutions and community-based organizations were essential in building trust with the faith leaders, thereby building bridges for better understanding of HIV/AIDS prevention efforts, including HIV vaccine research.

  20. International behavioral responses to a health hazard: AIDS.

    PubMed

    Earickson, R J

    1990-01-01

    This paper expands on Jonathan Mann's third wave of the AIDS pandemic: the epidemic of economic, social, political, and cultural reaction and response to the HIV infection and to AIDS. This worldwide epidemic is a major economic challenge, especially in Third World countries, which can ill afford additional health care costs. AIDS is also a harbinger of political and cultural conflicts between and among nations, states, institutions, and people everywhere. It may ultimately transform law as radically as it has health care practices. In terms of management, it is possible to approach AIDS much as we do natural and technological hazards. The biology and epidemiology of AIDS require a coordinated attack, involving research on vaccines and drugs, modification of human behavior and education of populations to arrest the disease. All of these require money, of which the United States was the major contributor before the Reagan years. Funding to the United Nations and WHO has since languished, jeopardizing the AIDS efforts of those two organizations.

  1. Differences in HIV vaccine acceptability between genders

    PubMed Central

    Kakinami, Lisa; Newman, Peter A.; Lee, Sung-Jae; Duan, Naihua

    2010-01-01

    The development of safe and efficacious preventive HIV vaccines offers the best long-term hope of controlling the AIDS pandemic. Nevertheless, suboptimal uptake of safe and efficacious vaccines that already exist suggest that HIV vaccine acceptability cannot be assumed, particularly among communities most vulnerable to HIV. The present study aimed to identify barriers and motivators to future HIV vaccine acceptability among low socioeconomic, ethnically diverse men and women in Los Angeles County. Participants completed a cross-sectional survey assessing their attitudes and beliefs regarding future HIV vaccines. Hypothetical HIV vaccine scenarios were administered to determine HIV vaccine acceptability. Two-sided t-tests were performed, stratified by gender, to examine the association between vaccine acceptability and potential barriers and motivators. Barriers to HIV vaccine acceptability differed between men and women. For women, barriers to HIV vaccine acceptability were related to their intimate relationships (p <0.05), negative experiences with health care providers (p <0.05) and anticipated difficulties procuring insurance (p <0.01). Men were concerned that the vaccine would weaken the immune system (p <0.005) or would affect their HIV test results (p <0.05). Motivators for women included the ability to conceive a child without worrying about contracting HIV (p <0.10) and support from their spouse/significant other for being vaccinated (p <0.10). Motivators for men included feeling safer with sex partners (p <0.05) and social influence from friends to get vaccinated (p <0.005). Family support for HIV immunization was a motivator for both men and women (p <0.10). Gender-specific interventions may increase vaccine acceptability among men and women at elevated risk for HIV infection. Among women, interventions need to focus on addressing barriers due to gendered power dynamics in relationships and discrimination in health care. Among men, education that

  2. Which Dengue Vaccine Approach Is the Most Promising, and Should We Be Concerned about Enhanced Disease after Vaccination? The Path to a Dengue Vaccine: Learning from Human Natural Dengue Infection Studies and Vaccine Trials.

    PubMed

    de Silva, Aravinda M; Harris, Eva

    2018-06-01

    Dengue virus (DENV) is the most common arthropod-borne viral disease of humans. Although effective vaccines exist against other flaviviral diseases like yellow fever and Japanese encephalitis, dengue vaccine development is complicated by the presence of four virus serotypes and the possibility of partial immunity enhancing dengue disease severity. Several live attenuated dengue vaccines are being tested in human clinical trials. Initial results are mixed, with variable efficacy depending on DENV serotype and previous DENV exposure. Here, we highlight recent discoveries about the human antibody response to DENV and propose guidelines for advancing development of safe and effective dengue vaccines. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.

  3. The future of human DNA vaccines

    PubMed Central

    Li, Lei; Saade, Fadi; Petrovsky, Nikolai

    2012-01-01

    DNA vaccines have evolved greatly over the last 20 years since their invention, but have yet to become a competitive alternative to conventional protein or carbohydrate based human vaccines. Whilst safety concerns were an initial barrier, the Achilles heel of DNA vaccines remains their poor immunogenicity when compared to protein vaccines. A wide variety of strategies have been developed to optimize DNA vaccine immunogenicity, including codon optimization, genetic adjuvants, electroporation and sophisticated prime-boost regimens, with each of these methods having its advantages and limitations. Whilst each of these methods has contributed to incremental improvements in DNA vaccine efficacy, more is still needed if human DNA vaccines are to succeed commercially. This review foresees a final breakthrough in human DNA vaccines will come from application of the latest cutting-edge technologies, including “epigenetics” and “omics” approaches, alongside traditional techniques to improve immunogenicity such as adjuvants and electroporation, thereby overcoming the current limitations of DNA vaccines in humans PMID:22981627

  4. The future of human DNA vaccines.

    PubMed

    Li, Lei; Saade, Fadi; Petrovsky, Nikolai

    2012-12-31

    DNA vaccines have evolved greatly over the last 20 years since their invention, but have yet to become a competitive alternative to conventional protein or carbohydrate based human vaccines. Whilst safety concerns were an initial barrier, the Achilles heel of DNA vaccines remains their poor immunogenicity when compared to protein vaccines. A wide variety of strategies have been developed to optimize DNA vaccine immunogenicity, including codon optimization, genetic adjuvants, electroporation and sophisticated prime-boost regimens, with each of these methods having its advantages and limitations. Whilst each of these methods has contributed to incremental improvements in DNA vaccine efficacy, more is still needed if human DNA vaccines are to succeed commercially. This review foresees a final breakthrough in human DNA vaccines will come from application of the latest cutting-edge technologies, including "epigenetics" and "omics" approaches, alongside traditional techniques to improve immunogenicity such as adjuvants and electroporation, thereby overcoming the current limitations of DNA vaccines in humans. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Using the impact of pneumococcal vaccines on nasopharyngeal carriage to aid licensing and vaccine implementation; a PneumoCarr meeting report March 27-28, 2012, Geneva.

    PubMed

    Goldblatt, David; Ramakrishnan, Meena; O'Brien, Katherine

    2013-12-17

    An international consultation was convened in March 2012 to provide feedback on the Case for Carriage, a summary statement by the Pneumococcal Carriage Consortium (PneumoCarr) proposing nasopharyngeal (NP) colonization as a supplementary or alternative endpoint in vaccine licensure. PneumoCarr members provided information to vaccine manufacturers, regulators and the WHO on the evidence for NP carriage as a precursor to pneumococcal disease, standardization of laboratory methods for the detection of multiple serotype carriage, definition and estimation of pneumococcal vaccine efficacy against carriage (VE-col), and the direct and indirect impact of vaccination on carriage. Manufacturers and regulators had the opportunity to respond to the information compiled by PneumoCarr and share their perspectives. VE-col as a licensure endpoint may be more useful for the next generation pneumococcal vaccine products, particularly those for which the immunological correlate of protection is not established, whereas it may be less needed for pneumococcal conjugate vaccines which have an established licensure pathway. The consultation supported the importance of NP carriage data as a critical element linking vaccine impact on the individual direct risk of disease to the population-level impact: indirect effects such as herd protection and serotype replacement. The indirect effects of vaccination, however, are not currently established as part of the licensure process and to include them would be a paradigm shift for regulatory agencies who currently consider this information in the post-licensure setting. More discussion and consensus-building is needed around the rationale and optimal mechanism to include carriage data in the licensure pathway for new pneumococcal vaccines. The WHO and national advisory groups on immunization policy may have an important role in considering the evidence for the indirect benefit of vaccination as informed by its impact on NP carriage. Copyright

  6. Outcomes and factors associated with survival of patients with HIV/AIDS initiating antiretroviral treatment in Liangshan Prefecture, southwest of China

    PubMed Central

    Zhang, Guang; Gong, Yuhan; Wang, Qixing; Deng, Ling; Zhang, Shize; Liao, Qiang; Yu, Gang; Wang, Ke; Wang, Ju; Ye, Shaodong; Liu, Zhongfu

    2016-01-01

    Abstract Human immunodeficiency virus (HIV)–positive cases have been reported among people who injected drugs in Liangshan Prefecture in southwest of China since 1995 and Liangshan has become one of the most seriously affected epidemic areas in China. In 2004, several patients with HIV/acquired immunodeficiency syndrome (AIDS) initiated antiretroviral treatment (ART) at the Central Hospital of Liangshan Prefecture. From 2005 to 2013, the number of patients receiving ART dramatically increased. We conducted a retrospective cohort study to analyze the long-term survival time and associated factors among patients with HIV/AIDS who received ART in Liangshan Prefecture for the first time. Data were collected from the Chinese AIDS Antiretroviral Therapy DATAFax Information System. A life table and the Kaplan–Meier and Cox proportion hazard regression were used to calculate the survival time and its associated factors, respectively. Among 8310 ART-naïve patients with HIV/AIDS who initiated ART, 436 patients died of AIDS-related diseases, and their median time of receiving ART was 15.0 ± 12.3 months, whereas 28.7% of them died within the first 6 months after treatment. The cumulative survival rates of those receiving ART in 1, 2, 3, 4, and 5 years were 97.1%, 93.4%, 90.6%, 88.8%, and 86.0%, respectively. Multivariate Cox regression analysis showed that male patients on ART were at a higher risk of death from AIDS-related diseases (adjusted hazard ratio [AHR] = 1.5, 95% confidence interval [CI]: 1.1–2.1) than female patients. Patients infected with HIV through injection drug use (IDU) were at a higher risk of death (AHR = 1.6, 95% CI: 1.2–2.2) than those infected through heterosexual transmission. Patients with a baseline CD4 cell count <50/mm3 (AHR = 9.8, 95% CI: 6.0–15.9), 50–199/mm3 (AHR = 3.3, 95% CI: 2.3–4.6), and 200–349/mm3 (AHR = 1.7, 95% CI: 1.2–2.3) were at a higher risk of death than those with a CD4 cell count ≥350/mm3. ART prolonged

  7. Proteomic analysis of Mycoplasma gallisepticum vaccine strain F

    USDA-ARS?s Scientific Manuscript database

    The persistence and displacement abilities of the Mycoplasma gallisepticum vaccine strain F (F-strain) are well documented. Understanding the mechanism(s) of colonization and persistence of F-strain will aid in the current intervention strategies to diagnose and control MG infections in poultry. In ...

  8. Hepatitis A, B, and A/B vaccination series completion among US adults: a claims-based analysis.

    PubMed

    Ghaswalla, Parinaz K; Patterson, Brandon J; Cheng, Wendy Y; Duchesneau, Emilie; Macheca, Monica; Duh, Mei Sheng

    2018-06-20

    Hepatitis A and B disease burden persists in the US. We assessed hepatitis A and hepatitis B vaccination series completion rates among 350,240 commercial/Medicare and 12,599 Medicaid enrollees aged ≥19 years. A vaccination series was considered as completed provided that the minimum interval between doses, as defined by the CDC, and the minimum number of doses were reached. We stratified completion rates by vaccine type (i.e. monovalent or bivalent) at initial vaccination for each cohort. In the commercial/Medicare cohort, the series completion rate was 32.0% for hepatitis A and 39.6% for hepatitis B among those who initiated with a monovalent vaccine, and it was 36.2% for hepatitis A and 48.9% for hepatitis B among those who initiated with a bivalent vaccine. In the Medicaid cohort, the series completion rate was 21.0% for hepatitis A and 24.0% for hepatitis B among those who initiated with a monovalent vaccine, and it was 19.0% for hepatitis A and 24.6% for hepatitis B among those who initiated with a bivalent vaccine. In conclusion, hepatitis A and B vaccination series completion rates were low, and appeared to be lower among Medicaid than among commercial/Medicare enrollees. Commercial/Medicare enrollees who initiated with a bivalent vaccine had higher series completion rates than those who initiated with monovalent vaccines - an observation that was not made among Medicaid enrollees.

  9. Biomedical and development paradigms in AIDS prevention.

    PubMed Central

    Wolffers, I.

    2000-01-01

    In the fight against the HIV/AIDS pandemic different approaches can be distinguished, reflecting professional backgrounds, world views and political interests. One important distinction is between the biomedical and the development paradigms. The biomedical paradigm is characterized by individualization and the concept of "risk". This again is related to the concept of the market where health is a product of services and progress a series of new discoveries that can be marketed. The development paradigm is characterized by participation of the different stakeholders and by community work. The concept "vulnerability" is important in the development paradigm and emphasis is placed on efforts to decrease this vulnerability in a variety of sustainable ways. Biomedical technology is definitely one of the tools in these efforts. In the beginning of the pandemic the biomedical approach was important for the discovery of the virus and understanding its epidemiology. Later, stakeholders became involved. In the light of absence of treatment or vaccines, the development paradigm became more important and the two approaches were more in balance. However, since the reports about effective treatment of AIDS and hope of development of vaccines, the biomedical paradigm has become a leading principle in many HIV/AIDS prevention programmes. There is a need for a better balance between the two paradigms. Especially in developing countries, where it is not realistic to think that sustainable biomedical interventions can be organized on a short-term basis, it would be counterproductive to base our efforts to deal with HIV/AIDS exclusively on the biomedical approach. PMID:10743300

  10. Evaluation of novel oral vaccine candidates and validation of a caprine model of Johne's disease

    USDA-ARS?s Scientific Manuscript database

    A Mycobacterium avium subspecies paratuberculosis (MAP) vaccine that reduced the incidence of clinical disease and/or reduced fecal shedding of MAP would aid control of Johne’s disease (JD). The objectives of this study were 1) to evaluate the efficacy of 5 attenuated strains of MAP as vaccine candi...

  11. HPV Vaccination among Adolescent Females from Appalachia: Implications for Cervical Cancer Disparities

    PubMed Central

    Reiter, Paul L.; Katz, Mira L.; Paskett, Electra D.

    2012-01-01

    Background Appalachia is a geographic region with high cervical cancer incidence and mortality rates, yet little is known about human papillomavirus (HPV) vaccination in this region. We determined HPV vaccine coverage among adolescent females from Appalachia, made comparisons to non-Appalachian females, and examined how coverage differs across subregions within Appalachia. Methods We analyzed 2008–2010 data from the National Immunization Survey-Teen (NIS-Teen) for adolescent females ages 13–17 (n=1,951 Appalachian females and n=25,468 non-Appalachian females). We examined HPV vaccine initiation (receipt of at least one dose), completion (receipt of at least three doses), and follow-through (completion among initiators). Analyses used weighted logistic regression. Results HPV vaccine initiation (Appalachian=40.8% vs. non-Appalachian=43.6%; OR=0.92, 95% CI: 0.79–1.07) and completion (Appalachian=27.7% vs. non-Appalachian=25.3%; OR=1.12, 95% CI: 0.95–1.32) were similar between Appalachian and non-Appalachian females. HPV vaccine follow-through was higher among Appalachian females than non-Appalachian females (67.8% vs. 58.1%; OR=1.36, 95% CI: 1.07–1.72). Vaccination outcomes tended to be higher in the Northern (completion and follow-through) and South Central (follow-through) subregions of Appalachia compared to non-Appalachian U.S. Conversely, vaccination outcomes tended to be lower in the Central (initiation and completion) and Southern (initiation and completion) subregions. Conclusions In general, HPV vaccination in Appalachia is mostly similar to the rest of the U.S. However, vaccination is lagging in regions of Appalachia where cervical cancer incidence and mortality rates are highest. Impact Current cervical cancer disparities could potentially worsen if HPV vaccine coverage is not improved in regions of Appalachia with low HPV vaccine coverage. PMID:23136141

  12. Determinants of geographic inequalities in HPV vaccination in the most populated region of France.

    PubMed

    Héquet, Delphine; Rouzier, Roman

    2017-01-01

    In France, there are recommendations and reimbursements for human papillomavirus (HPV) vaccination but no HPV vaccination programs. Therefore, vaccination is largely determined by parents' initiative, which can lead to inequalities. The objective of this study was to determine the factors associated with poorer vaccination coverage rates in the most populated region of France. The data of this study were obtained from the National Health Insurance between 2011 and 2013. Correlations between vaccination initiation rate (at least 1 dose reimbursed) and socio-demographic/cultural factors were assessed using Pearson's product-moment correlation coefficient. Multivariate analyses were performed using logistic regression. In total, 121,636 girls received at least one HPV vaccine dose. The vaccination rate for girls born from 1996 to 1999 was 18.7%. Disparities in vaccination coverage rates were observed between the 8 departments of the region, ranging from 12.9% to 22.6%. At the department level, unemployment, proportion of immigrants and foreigners, and coverage by CMU health insurance ("Couverture Maladie Universelle", a health insurance plan for those who are not otherwise covered through business or employment and who have a low income) were significantly inversely correlated with vaccination rates, whereas urban residence, medical density, income and use of medical services were not related to coverage. In the multivariate model, only the percentage of foreigners remained independently associated with lower vaccination coverage. At the individual level, the use of medical services was a strong driver of HPV vaccination initiation. We observed geographic disparities in HPV vaccination initiation coverage. Even if no clear factor was identified as a vaccination determinant, we observed a failure of vaccination only based on parents' initiative. Therefore, an organized policy on HPV vaccination, such as school-based programs, can help improve coverage rates.

  13. Laser vaccine adjuvants. History, progress, and potential.

    PubMed

    Kashiwagi, Satoshi; Brauns, Timothy; Gelfand, Jeffrey; Poznansky, Mark C

    2014-01-01

    Immunologic adjuvants are essential for current vaccines to maximize their efficacy. Unfortunately, few have been found to be sufficiently effective and safe for regulatory authorities to permit their use in vaccines for humans and none have been approved for use with intradermal vaccines. The development of new adjuvants with the potential to be both efficacious and safe constitutes a significant need in modern vaccine practice. The use of non-damaging laser light represents a markedly different approach to enhancing immune responses to a vaccine antigen, particularly with intradermal vaccination. This approach, which was initially explored in Russia and further developed in the US, appears to significantly improve responses to both prophylactic and therapeutic vaccines administered to the laser-exposed tissue, particularly the skin. Although different types of lasers have been used for this purpose and the precise molecular mechanism(s) of action remain unknown, several approaches appear to modulate dendritic cell trafficking and/or activation at the irradiation site via the release of specific signaling molecules from epithelial cells. The most recent study, performed by the authors of this review, utilized a continuous wave near-infrared laser that may open the path for the development of a safe, effective, low-cost, simple-to-use laser vaccine adjuvant that could be used in lieu of conventional adjuvants, particularly with intradermal vaccines. In this review, we summarize the initial Russian studies that have given rise to this approach and comment upon recent advances in the use of non-tissue damaging lasers as novel physical adjuvants for vaccines.

  14. Introduction of a HIV vaccine in developing countries: social and cultural dimensions.

    PubMed

    Streefland, P H

    2003-03-28

    Using insights from studies on social and cultural aspects of immunization in Africa and Asia the paper discusses the introduction of a HIV vaccine from three perspectives. Firstly, it shows how at the side of public health programs local differences will impact on the introduction of a new vaccine. Secondly, it elaborates how at the side of the users of vaccinations acceptance, non-acceptance and demand of and for a new vaccine are related to local vaccination cultures, images of the HIV/AIDS epidemic, and perceptions of vaccine potency and efficacy. Thirdly, it points out socio-cultural aspects of the introductory process. Tailoring health education and social marketing to local conditions and local interpretations of globally provided information will be decisive for a successful introduction. Strong public health programs with highly motivated and appropriately supported staff are another necessary condition.

  15. Immune responses of bison and efficacy after booster vaccination with Brucella abortus strain RB51.

    PubMed

    Olsen, S C; McGill, J L; Sacco, R E; Hennager, S G

    2015-04-01

    Thirty-one bison heifers were randomly assigned to receive saline or a single vaccination with 10(10) CFU of Brucella abortus strain RB51. Some vaccinated bison were randomly selected for booster vaccination with RB51 at 11 months after the initial vaccination. Mean antibody responses to RB51 were greater (P < 0.05) in vaccinated bison after initial and booster vaccination than in nonvaccinated bison. The proliferative responses by peripheral blood mononuclear cells (PBMC) from the vaccinated bison were greater (P < 0.05) than those in the nonvaccinated bison at 16 and 24 weeks after the initial vaccination but not after the booster vaccination. The relative gene expression of gamma interferon (IFN-γ) was increased (P < 0.05) in the RB51-vaccinated bison at 8, 16, and 24 weeks after the initial vaccination and at 8 weeks after the booster vaccination. The vaccinated bison had greater (P < 0.05) in vitro production of IFN-γ at all sampling times, greater interleukin-1β (IL-1β) production in various samplings after the initial and booster vaccinations, and greater IL-6 production at one sampling time after the booster vaccination. Between 170 and 180 days of gestation, the bison were intraconjunctivally challenged with approximately 1 × 10(7) CFU of B. abortus strain 2308. The incidences of abortion and infection were greater (P < 0.05) in the nonvaccinated bison after experimental challenge than in the bison receiving either vaccination treatment. Booster-vaccinated, but not single-vaccinated bison, had a reduced (P < 0.05) incidence of infection in fetal tissues and maternal tissues compared to that in the controls. Compared to the nonvaccinated bison, both vaccination treatments lowered the colonization (measured as the CFU/g of tissue) of Brucella organisms in all tissues, except in retropharyngeal and supramammary lymph nodes. Our study suggests that RB51 booster vaccination is an effective vaccination strategy for enhancing herd immunity against

  16. Immune Responses of Bison and Efficacy after Booster Vaccination with Brucella abortus Strain RB51

    PubMed Central

    McGill, J. L.; Sacco, R. E.; Hennager, S. G.

    2015-01-01

    Thirty-one bison heifers were randomly assigned to receive saline or a single vaccination with 1010 CFU of Brucella abortus strain RB51. Some vaccinated bison were randomly selected for booster vaccination with RB51 at 11 months after the initial vaccination. Mean antibody responses to RB51 were greater (P < 0.05) in vaccinated bison after initial and booster vaccination than in nonvaccinated bison. The proliferative responses by peripheral blood mononuclear cells (PBMC) from the vaccinated bison were greater (P < 0.05) than those in the nonvaccinated bison at 16 and 24 weeks after the initial vaccination but not after the booster vaccination. The relative gene expression of gamma interferon (IFN-γ) was increased (P < 0.05) in the RB51-vaccinated bison at 8, 16, and 24 weeks after the initial vaccination and at 8 weeks after the booster vaccination. The vaccinated bison had greater (P < 0.05) in vitro production of IFN-γ at all sampling times, greater interleukin-1β (IL-1β) production in various samplings after the initial and booster vaccinations, and greater IL-6 production at one sampling time after the booster vaccination. Between 170 and 180 days of gestation, the bison were intraconjunctivally challenged with approximately 1 × 107 CFU of B. abortus strain 2308. The incidences of abortion and infection were greater (P < 0.05) in the nonvaccinated bison after experimental challenge than in the bison receiving either vaccination treatment. Booster-vaccinated, but not single-vaccinated bison, had a reduced (P < 0.05) incidence of infection in fetal tissues and maternal tissues compared to that in the controls. Compared to the nonvaccinated bison, both vaccination treatments lowered the colonization (measured as the CFU/g of tissue) of Brucella organisms in all tissues, except in retropharyngeal and supramammary lymph nodes. Our study suggests that RB51 booster vaccination is an effective vaccination strategy for enhancing herd immunity against brucellosis in

  17. Global prevention, funding, accountability debated in fight against HIV / AIDS.

    PubMed

    1999-10-18

    World leaders, physicians, economists, governmental health organizations, and pharmaceutical manufacturers attended the Third International Conference on Healthcare Resource Allocation for HIV/AIDS and Other Life-threatening Illnesses in Vienna, Austria. The conference participants discussed the economic, ethical, and human rights issues underlying health care resource allocation. Some highlights of the meeting included: the prevention strategies in fighting AIDS virus; the use of high medical ethical standards; the affordability and accessibility of essential therapies; the economic aspects affecting the medical assistance mechanisms; the need to improve the pharmaceutical industry; the need to improve HIV/AIDS care access in developing countries; promoting the development of HIV/AIDS vaccines; and developing rapid diagnosis of HIV.

  18. Vector-based genetically modified vaccines: Exploiting Jenner's legacy.

    PubMed

    Ramezanpour, Bahar; Haan, Ingrid; Osterhaus, Ab; Claassen, Eric

    2016-12-07

    The global vaccine market is diverse while facing a plethora of novel developments. Genetic modification (GM) techniques facilitate the design of 'smarter' vaccines. For many of the major infectious diseases of humans, like AIDS and malaria, but also for most human neoplastic disorders, still no vaccines are available. It may be speculated that novel GM technologies will significantly contribute to their development. While a promising number of studies is conducted on GM vaccines and GM vaccine technologies, the contribution of GM technology to newly introduced vaccines on the market is disappointingly limited. In this study, the field of vector-based GM vaccines is explored. Data on currently available, actually applied, and newly developed vectors is retrieved from various sources, synthesised and analysed, in order to provide an overview on the use of vector-based technology in the field of GM vaccine development. While still there are only two vector-based vaccines on the human vaccine market, there is ample activity in the fields of patenting, preclinical research, and different stages of clinical research. Results of this study revealed that vector-based vaccines comprise a significant part of all GM vaccines in the pipeline. This study further highlights that poxviruses and adenoviruses are among the most prominent vectors in GM vaccine development. After the approval of the first vectored human vaccine, based on a flavivirus vector, vaccine vector technology, especially based on poxviruses and adenoviruses, holds great promise for future vaccine development. It may lead to cheaper methods for the production of safe vaccines against diseases for which no or less perfect vaccines exist today, thus catering for an unmet medical need. After the introduction of Jenner's vaccinia virus as the first vaccine more than two centuries ago, which eventually led to the recent eradication of smallpox, this and other viruses may now be the basis for constructing vectors

  19. The Potential Impact of Preventive HIV Vaccines in China: Results and Benefits of a Multi-Province Modeling Collaboration

    PubMed Central

    Harmon, Thomas; Guo, Wei; Stover, John; Wu, Zunyou; Kaufman, Joan; Schneider, Kammerle; Liu, Li; Feng, Liao; Schwartländer, Bernard

    2015-01-01

    China’s commitment to implementing established and emerging HIV/AIDS prevention and control strategies has led to substantial gains in terms of access to antiretroviral treatment and prevention services, but the evolving and multifaceted HIV/AIDS epidemic in China highlights the challenges of maintaining that response. This study presents modeling results exploring the potential impact of HIV vaccines in the Chinese context at varying efficacy and coverage rates, while further exploring the potential implications of vaccination programs aimed at reaching populations at highest risk of HIV infection. A preventive HIV vaccine would add a powerful tool to China’s response, even if not 100% efficacious or available to the full population. PMID:26344945

  20. Rheumatoid arthritis vaccine therapies: perspectives and lessons from therapeutic ligand epitope antigen presentation system vaccines for models of rheumatoid arthritis

    PubMed Central

    Rosenthal, Kenneth S.; Mikecz, Katalin; Steiner, Harold L.; Glant, Tibor T.; Finnegan, Alison; Carambula, Roy E.; Zimmerman, Daniel H.

    2016-01-01

    The current status of therapeutic vaccines for autoimmune diseases is reviewed with rheumatoid arthritis as the focus. Therapeutic vaccines for autoimmune diseases must regulate or subdue responses to common self-antigens. Ideally, such a vaccine would initiate an antigen-specific modulation of the T-cell immune response that drives the inflammatory disease. Appropriate animal models and types of T helper cells and signature cytokine responses that drive autoimmune disease are also discussed. Interpretation of these animal models must be done cautiously because the means of initiation, autoantigens, and even the signature cytokine and T helper cell (Th1 or Th17) responses that are involved in the disease may differ significantly from those in humans. We describe ligand epitope antigen presentation system vaccine modulation of T-cell autoimmune responses as a strategy for the design of therapeutic vaccines for rheumatoid arthritis, which may also be effective in other autoimmune conditions. PMID:25787143

  1. New, More Authentic Model for AIDS Will Accelerate Studies | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer, and Jeff Lifson, Guest Writer Researchers are working to develop a more authentic animal model of human immunodeficiency virus (HIV) infection and AIDS that is expected to speed up studies of experimental treatments and vaccines.

  2. Harnessing case isolation and ring vaccination to control Ebola.

    PubMed

    Wells, Chad; Yamin, Dan; Ndeffo-Mbah, Martial L; Wenzel, Natasha; Gaffney, Stephen G; Townsend, Jeffrey P; Meyers, Lauren Ancel; Fallah, Mosoka; Nyenswah, Tolbert G; Altice, Frederick L; Atkins, Katherine E; Galvani, Alison P

    2015-05-01

    As a devastating Ebola outbreak in West Africa continues, non-pharmaceutical control measures including contact tracing, quarantine, and case isolation are being implemented. In addition, public health agencies are scaling up efforts to test and deploy candidate vaccines. Given the experimental nature and limited initial supplies of vaccines, a mass vaccination campaign might not be feasible. However, ring vaccination of likely case contacts could provide an effective alternative in distributing the vaccine. To evaluate ring vaccination as a strategy for eliminating Ebola, we developed a pair approximation model of Ebola transmission, parameterized by confirmed incidence data from June 2014 to January 2015 in Liberia and Sierra Leone. Our results suggest that if a combined intervention of case isolation and ring vaccination had been initiated in the early fall of 2014, up to an additional 126 cases in Liberia and 560 cases in Sierra Leone could have been averted beyond case isolation alone. The marginal benefit of ring vaccination is predicted to be greatest in settings where there are more contacts per individual, greater clustering among individuals, when contact tracing has low efficacy or vaccination confers post-exposure protection. In such settings, ring vaccination can avert up to an additional 8% of Ebola cases. Accordingly, ring vaccination is predicted to offer a moderately beneficial supplement to ongoing non-pharmaceutical Ebola control efforts.

  3. HIV-1 vaccine-specific responses induced by Listeria vector vaccines are maintained in mice subsequently infected with a model helminth parasite, Schistosoma mansoni.

    PubMed

    Shollenberger, Lisa M; Bui, Cac T; Paterson, Yvonne; Nyhoff, Lindsay; Harn, Donald A

    2013-11-19

    In areas co-endemic for helminth parasites and HIV/AIDS, infants are often administered vaccines prior to infection with immune modulatory helminth parasites. Systemic Th2 biasing and immune suppression caused by helminth infection reduces cell-mediated responses to vaccines such as tetanus toxoid and BCG. Therefore, we asked if infection with helminthes post-vaccination, alters already established vaccine induced immune responses. In our model, mice are vaccinated against HIV-1 Gag using a Listeria vaccine vector (Lm-Gag) in a prime-boost manner, then infected with the human helminth parasite Schistosoma mansoni. This allows us to determine if established vaccine responses are maintained or altered after helminth infection. Our second objective asked if helminth infection post-vaccination alters the recipient's ability to respond to a second boost. Here we compared responses between uninfected mice, schistosome infected mice, and infected mice that were given an anthelminthic, which occurred coincident with the boost or four weeks prior, as well as comparing to un-boosted mice. We report that HIV-1 vaccine-specific responses generated by Listeria vector HIV-1 vaccines are maintained following subsequent chronic schistosome infection, providing further evidence that Listeria vector vaccines induce potent vaccine-specific responses that can withstand helminth infection. We also were able to demonstrate that administration of a second Listeria boost, which markedly enhanced the immune response, was minimally impacted by schistosome infection, or anthelminthic therapy. Surprisingly, we also observed enhanced antibody responses to HIV Gag in vaccinated mice subsequently infected with schistosomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. German "National Cancer Aid Monitoring" 2015-2019 - study protocol and initial results.

    PubMed

    Schneider, Sven; Görig, Tatiana; Schilling, Laura; Breitbart, Eckhard W; Greinert, Rüdiger; Diehl, Katharina

    2017-09-01

    The National Cancer Aid Monitoring of Tanning Bed Use (NCAM) project is a major German study that aims to observe the most significant risk factors for skin cancer: natural sunlight and artificial UV radiation. NCAM is a nationwide cross-sectional survey that will initially involve four rounds of data collection (so-called waves) between 2015 and 2018. Every year, a representative nationwide sample consisting of 3,000 individuals aged between 14 and 45 years will be surveyed. The cross-sectional survey will be complemented by a panel of n  =  450 current tanning bed users. The initial wave in 2015 shows an overall prevalence of tanning bed use of 29.5 %. Eleven percent of all participants had used a tanning bed within the past twelve months. Determinants of current tanning bed use included younger age, female gender, and full-time/part-time employment. The main motivations for tanning bed use reported were relaxation and increased attractiveness. NCAM is the first study worldwide to monitor skin cancer risk factors at one-year intervals using a large, nationally representative sample. Initial results indicate that, despite WHO warnings, millions of Germans use tanning beds, and that many of these users are adolescents despite legal restrictions aimed at preventing minors from using tanning beds. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  5. Comparative cost effectiveness of varicella, hepatitis A, and pneumococcal conjugate vaccines.

    PubMed

    Jacobs, R J; Meyerhoff, A S

    2001-12-01

    Several state and local U.S. governments are considering making varicella, hepatitis A, and/or pneumococcal conjugate vaccination conditions of day care or school entry. These requirements will likely be issued sequentially, because simultaneous mandates exacerbate budget constraints and complicate communication with parents and providers. Cost-effectiveness assessments should aid the establishment of vaccination priorities, but comparing results of published studies is confounded by their dissimilar methods. We reviewed U.S. cost-effectiveness studies of childhood varicella, hepatitis A, and pneumococcal conjugate vaccines and identified four providing data required to standardize methods. Vaccination, disease treatment, and work-loss costs were estimated from original study results and current prices. Estimated life-years saved were derived from original study results, epidemiological evidence, and alternative procedures for discounting to present values. Hepatitis A vaccine would have the lowest health system costs per life-year saved. Varicella vaccine would provide the greatest reduction in societal costs, mainly through reduced parent work loss. Pneumococcal conjugate vaccine would cost twice the amount of varicella and hepatitis A vaccines combined and be less cost effective than the other vaccines. Hepatitis A and varicella vaccines, but not pneumococcal conjugate vaccine, meet or exceed conventional standards of cost effectiveness. Copyright 2001 American Health Foundation and Elsevier Science.

  6. Pathogenesis of primary foot-and-mouth disease virus infection in the nasopharynx of vaccinated and non-vaccinated cattle

    USDA-ARS?s Scientific Manuscript database

    A time-course pathogenesis study was performed to compare and contrast primary foot-and-mouth disease virus (FMDV) infection in vaccinated and non-vaccinated cattle following simulated-natural virus exposure. FMDV genome and infectious virus were detected during the initial phase of infection from b...

  7. Vaccine process technology.

    PubMed

    Josefsberg, Jessica O; Buckland, Barry

    2012-06-01

    perspective, Quality by Design (QbD) and Process Analytical Technology (PAT) are important initiatives that can be applied effectively to many types of vaccine processes. Universal demand for vaccines requires that a manufacturer plan to supply tens and sometimes hundreds of millions of doses per year at low cost. To enable broader use, there is intense interest in improving temperature stability to allow for excursions from a rigid cold chain supply, especially at the point of vaccination. Finally, there is progress in novel routes of delivery to move away from the traditional intramuscular injection by syringe approach. Copyright © 2012 Wiley Periodicals, Inc.

  8. Field evaluation of a canine parvovirus vaccination program, using feline origin modified live virus vaccine.

    PubMed

    Gordon, J C; Rogers, W A

    1982-06-15

    Antibody titers measured by hemagglutination inhibition testing were determined in previously vaccinated dogs at the time of booster vaccination and 2 weeks later. All vaccines consisted of modified live panleukopenia virus. The booster injection was administered approximately 6 months after the initial parvovirus vaccination series was given. Fecal and serum specimens were collected immediately before and 2 weeks after administration of the booster vaccine for hemagglutination and hemagglutination inhibition testing, respectively. All dogs were privately owned and were from the Columbus, Ohio, area but were from environments with various exposure potentials to canine parvovirus. Results of hemagglutination (HA) testing on feces were negative in all dogs before and after booster vaccination. Therefore, these vaccinations did not interfere with interpretation of HA testing of feces. Results of serum hemagglutination inhibition (HI) testing indicated that 50% of the dogs had serum titers less than 1:80 prior to vaccination and that, of these dogs, 65.2% still had serum titers less than 1:80 2 weeks after the booster vaccination. Only 10.9% of all dogs had a marked increase in serum HI titer after the booster vaccination, indicating that overall serologic response to vaccination was poor. High HI titers (greater than or equal to 1:640) were associated with exposure to other dogs and cats in the neighborhood or to dogs suspected of having had parvovirus infection.

  9. Exploring Audiologists' Language and Hearing Aid Uptake in Initial Rehabilitation Appointments.

    PubMed

    Sciacca, Anna; Meyer, Carly; Ekberg, Katie; Barr, Caitlin; Hickson, Louise

    2017-06-13

    The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon. A binomial, multivariate logistic regression analysis was conducted to investigate the associations between these language measures and hearing aid uptake. The logistic regression model revealed that the Flesch-Kincaid reading grade level of audiologists' language was significantly associated with hearing aid uptake. Patients were less likely to obtain hearing aids when audiologists' language was at a higher reading grade level. No associations were found between audiologists' use of jargon and hearing aid uptake. Audiologists' use of complex language may present a barrier for patients to understand hearing rehabilitation recommendations. Reduced understanding may limit patient participation in the decision-making process and result in patients being less willing to trial hearing aids. Clear, concise language is recommended to facilitate shared decision making.

  10. Pretreatment CD4 Cell Slope and Progression to AIDS or Death in HIV-Infected Patients Initiating Antiretroviral Therapy—The CASCADE Collaboration: A Collaboration of 23 Cohort Studies

    PubMed Central

    Wolbers, Marcel; Babiker, Abdel; Sabin, Caroline; Young, Jim; Dorrucci, Maria; Chêne, Geneviève; Mussini, Cristina; Porter, Kholoud; Bucher, Heiner C.

    2010-01-01

    Background CD4 cell count is a strong predictor of the subsequent risk of AIDS or death in HIV-infected patients initiating combination antiretroviral therapy (cART). It is not known whether the rate of CD4 cell decline prior to therapy is related to prognosis and should, therefore, influence the decision on when to initiate cART. Methods and Findings We carried out survival analyses of patients from the 23 cohorts of the CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe) collaboration with a known date of HIV seroconversion and with at least two CD4 measurements prior to initiating cART. For each patient, a pre-cART CD4 slope was estimated using a linear mixed effects model. Our primary outcome was time from initiating cART to a first new AIDS event or death. We included 2,820 treatment-naïve patients initiating cART with a median (interquartile range) pre-cART CD4 cell decline of 61 (46–81) cells/µl per year; 255 patients subsequently experienced a new AIDS event or death and 125 patients died. In an analysis adjusted for established risk factors, the hazard ratio for AIDS or death was 1.01 (95% confidence interval 0.97–1.04) for each 10 cells/µl per year reduction in pre-cART CD4 cell decline. There was also no association between pre-cART CD4 cell slope and survival. Alternative estimates of CD4 cell slope gave similar results. In 1,731 AIDS-free patients with >350 CD4 cells/µl from the pre-cART era, the rate of CD4 cell decline was also not significantly associated with progression to AIDS or death (hazard ratio 0.99, 95% confidence interval 0.94–1.03, for each 10 cells/µl per year reduction in CD4 cell decline). Conclusions The CD4 cell slope does not improve the prediction of clinical outcome in patients with a CD4 cell count above 350 cells/µl. Knowledge of the current CD4 cell count is sufficient when deciding whether to initiate cART in asymptomatic patients. Please see later in the article for the Editors' Summary PMID

  11. African American parents' HPV vaccination intent and concerns.

    PubMed

    Sanders Thompson, Vetta L; Arnold, Lauren D; Notaro, Sheri R

    2012-02-01

    This study describes attitudes and social and environmental factors that affect African American parents' intent to vaccinate their daughters against human papillomavirus (HPV). Thirty African American parents of daughters aged nine to 17 years and no history of HPV infection completed semi-structured interviews. Interviews addressed factors that influenced intent to vaccinate, perception of community norms related to vaccination, vaccination scenarios involving place of vaccination, and vaccination prior to or after the child's initiation of sexual activity. A recurring theme was the influence of physician recommendation on African American parents' intent to obtain HPV vaccination for their daughters. Most parents reported that they could overcome barriers to vaccination, except vaccine costs and lack of insurance. While religious beliefs were important to parents, they reported that they would not interfere with vaccination decisions; fears of early sexuality due to vaccination were limited. The implications of these findings are discussed.

  12. Understanding HIV infection for the design of a therapeutic vaccine. Part II: Vaccination strategies for HIV.

    PubMed

    de Goede, A L; Vulto, A G; Osterhaus, A D M E; Gruters, R A

    2015-05-01

    HIV infection leads to a gradual loss CD4(+) T lymphocytes comprising immune competence and progression to AIDS. Effective treatment with combined antiretroviral drugs (cART) decreases viral load below detectable levels but is not able to eliminate the virus from the body. The success of cART is frustrated by the requirement of expensive lifelong adherence, accumulating drug toxicities and chronic immune activation resulting in increased risk of several non-AIDS disorders, even when viral replication is suppressed. Therefore, there is a strong need for therapeutic strategies as an alternative to cART. Immunotherapy, or therapeutic vaccination, aims to increase existing immune responses against HIV or induce de novo immune responses. These immune responses should provide a functional cure by controlling viral replication and preventing disease progression in the absence of cART. The key difficulty in the development of an HIV vaccine is our ignorance of the immune responses that control of viral replication, and thus how these responses can be elicited and how they can be monitored. Part one of this review provides an extensive overview of the (patho-) physiology of HIV infection. It describes the structure and replication cycle of HIV, the epidemiology and pathogenesis of HIV infection and the innate and adaptive immune responses against HIV. Part two of this review discusses therapeutic options for HIV. Prevention modalities and antiretroviral therapy are briefly touched upon, after which an extensive overview on vaccination strategies for HIV is provided, including the choice of immunogens and delivery strategies. Copyright © 2014. Published by Elsevier Masson SAS.

  13. Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children.

    PubMed

    Finney Rutten, Lila J; St Sauver, Jennifer L; Beebe, Timothy J; Wilson, Patrick M; Jacobson, Debra J; Fan, Chun; Breitkopf, Carmen Radecki; Vadaparampil, Susan T; MacLaughlin, Kathy L; Jacobson, Robert M

    2017-10-27

    We tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates. From October 2015 through January 2016, we conducted a survey of primary care clinicians (n=227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11-12years (n=14,406) with site-level vaccination rates. The majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR)=1.05; 95% CI (1.01-1.09)] and completion (3 doses) [IRR=1.08; 95% CI (1.02-1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR=1.03; 95% CI (1.00-1.06)] and completion [IRR=1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR

  14. Provider-Verified HPV Vaccine Coverage among a National Sample of Hispanic Adolescent Females

    PubMed Central

    Reiter, Paul L.; Gupta, Kunal; Brewer, Noel T.; Gilkey, Melissa B.; Katz, Mira L.; Paskett, Electra D.; Smith, Jennifer S.

    2014-01-01

    Background Hispanic females have the highest cervical cancer incidence rate of any racial or ethnic group in the US, yet relatively little research has examined HPV vaccination among this fast-growing population. We examined HPV vaccination among a national sample of Hispanic adolescent females. Methods We analyzed provider-verified vaccination data from the 2010-2011 National Immunization Survey-Teen for Hispanic females ages 13-17 (n=2,786). We used weighted logistic regression to identify correlates of HPV vaccine initiation (receipt of one or more doses), completion (receipt of three doses), and follow-through (receipt of three doses among those who initiated the series). Results HPV vaccine initiation was 60.9%, completion was 36.0%, and follow-through was 59.1%. Initiation and completion were more common among older daughters and those whose parents had received a provider recommendation to vaccinate (all p<0.05). Completion was less common among daughters who had moved from their birth state (p<0.05). All vaccination outcomes were less common among daughters without health insurance (all p<0.05). Vaccination did not differ by parents’ preferred language (all p>0.05), although intent to vaccinate was higher among Spanish-speaking parents (p<0.01). Spanish-speaking parents were more likely to indicate lack of provider recommendation (20.2% vs. 5.3%) and cost (10.9% vs. 1.8%) as main reasons for not intending to vaccinate (both p<0.05). Conclusions Many Hispanic females have not received HPV vaccine. Several factors, including provider recommendation and health insurance, are key correlates of vaccination. Impact HPV vaccination programs targeting Hispanics are needed and should consider how potential barriers to vaccination may differ by preferred language. PMID:24633142

  15. Healthy competition drives success in results-based aid: Lessons from the Salud Mesoamérica Initiative.

    PubMed

    El Bcheraoui, Charbel; Palmisano, Erin B; Dansereau, Emily; Schaefer, Alexandra; Woldeab, Alexander; Moradi-Lakeh, Maziar; Salvatierra, Benito; Hernandez-Prado, Bernardo; Mokdad, Ali H

    2017-01-01

    The Salud Mesoamérica Initiative (SMI) is a three-operation strategy, and is a pioneer in the world of results-based aid (RBA) in terms of the success it has achieved in improving health system inputs following its initial operation. This success in meeting pre-defined targets is rare in the world of financial assistance for health. We investigated the influential aspects of SMI that could have contributed to its effectiveness in improving health systems, with the aim of providing international donors, bilateral organizations, philanthropies, and recipient countries with new perspectives that can help increase the effectiveness of future assistance for health, specifically in the arena of RBA. Qualitative methods based on the criteria of relevance and effectiveness proposed by the Development Assistance Committee of the Organization for Economic Co-operation and Development. Our methods included document review, key informant interviews, a focus group discussion, and a partnership analysis. A purposive sample of 113 key informants, comprising donors, representatives from the Inter-American Development Bank, ministries of health, technical assistance organizations, evaluation organizations, and health care providers. During May-October 2016, we interviewed regarding the relevance and effectiveness of SMI. Themes emerged relative to the topics we investigated, and covered the design and the drivers of success of the initiative. The success is due to 1) the initiative's regional approach, which pressured recipient countries to compete toward meeting targets, 2) a robust and flexible design that incorporated the richness of input from stakeholders at all levels, 3) the design-embedded evaluation component that created a culture of accountability among recipient countries, and 4) the reflective knowledge environment that created a culture of evidence-based decision-making. A regional approach involving all appropriate stakeholders, and based on knowledge sharing and

  16. A 2020 vision for vaccines against HIV, tuberculosis and malaria.

    PubMed

    Rappuoli, Rino; Aderem, Alan

    2011-05-26

    Acquired immune deficiency syndrome (AIDS), malaria and tuberculosis collectively cause more than five million deaths per year, but have nonetheless eluded conventional vaccine development; for this reason they represent one of the major global public health challenges as we enter the second decade of the twenty-first century. Recent trials have provided evidence that it is possible to develop vaccines that can prevent infection by human immunodeficiency virus (HIV) and malaria. Furthermore, advances in vaccinology, including novel adjuvants, prime-boost regimes and strategies for intracellular antigen presentation, have led to progress in developing a vaccine against tuberculosis. Here we discuss these advances and suggest that new tools such as systems biology and structure-based antigen design will lead to a deeper understanding of mechanisms of protection which, in turn, will lead to rational vaccine development. We also argue that new and innovative approaches to clinical trials will accelerate the availability of these vaccines.

  17. Case of mumps orchitis after vaccination.

    PubMed

    Kanda, Takayoshi; Mochida, Junichi; Takada, Shogo; Hori, Yutaro; Yamaguchi, Kenya; Takahashi, Satoru

    2014-04-01

    We present a case of mumps orchitis after vaccination. A 35-year-old man visited the emergency unit of our hospital for fever and right testicular pain on 7 January 2012. Two weeks before the visit, he underwent vaccination for mumps. After 7 days of hospitalization, the patient recovered from fever and testicular pain. Scrotal magnetic resonance imaging suggested right orchitis, and an increased level of serum mumps immunoglobulin M and immunoglobulin G indicated an initial infection of mumps virus. The peak value of immunoglobulin G showed 106 enzyme immunoassay unit 5 weeks after vaccination, which was 10-fold higher than the ordinary rise of a vaccinated individual. This fact leads to two possibilities. One is this happened as an adverse event of vaccination, and the other is that he actually had a wild-type infection at the same time as vaccination. There are some reports regarding adverse events of mumps vaccine; however, they might include wild-type infection. © 2013 The Japanese Urological Association.

  18. High Antigen Dose Is Detrimental to Post-Exposure Vaccine Protection against Tuberculosis.

    PubMed

    Billeskov, Rolf; Lindenstrøm, Thomas; Woodworth, Joshua; Vilaplana, Cristina; Cardona, Pere-Joan; Cassidy, Joseph P; Mortensen, Rasmus; Agger, Else Marie; Andersen, Peter

    2017-01-01

    Mycobacterium tuberculosis (Mtb), the etiologic agent of tuberculosis (TB), causes 1.8M deaths annually. The current vaccine, BCG, has failed to eradicate TB leaving 25% of the world's population with latent Mtb infection (LTBI), and 5-10% of these people will reactivate and develop active TB. An efficient therapeutic vaccine targeting LTBI could have an enormous impact on global TB incidence, and could be an important aid in fighting multidrug resistance, which is increasing globally. Here we show in a mouse model using the H56 (Ag85B-ESAT-6-Rv2660) TB vaccine candidate that post-exposure, but not preventive, vaccine protection requires low vaccine antigen doses for optimal protection. Loss of protection from high dose post-exposure vaccination was not associated with a loss of overall vaccine response magnitude, but rather with greater differentiation and lower functional avidity of vaccine-specific CD4 T cells. High vaccine antigen dose also led to a decreased ability of vaccine-specific CD4 T cells to home into the Mtb-infected lung parenchyma, a recently discovered important feature of T cell protection in mice. These results underscore the importance of T cell quality rather than magnitude in TB-vaccine protection, and the significant role that antigen dosing plays in vaccine-mediated protection.

  19. Evaluating a County-Sponsored Social Marketing Campaign to Increase Mothers' Initiation of HPV Vaccine for their Pre-teen Daughters in a Primarily Rural Area.

    PubMed

    Cates, Joan R; Shafer, Autumn; Diehl, Sandra J; Deal, Allison M

    2011-01-01

    Routine vaccination against human papillomavirus (HPV), the main cause of cervical cancer, is recommended for 11-12 year old girls, yet vaccine uptake is low. This study evaluates a social marketing campaign initiated by 13 North Carolina counties to raise awareness among parents and reduce barriers to accessing the vaccine in a primarily rural area. The 3-month campaign targeted mothers of girls ages 11-12 and healthcare practices serving pre-teen girls in four counties. Principles of social marketing were: product (recommended vaccine against HPV), price (cost, perception of safety and efficacy, and access), promotion (posters, brochures, website, news releases, doctor's recommendation), and place (doctors' offices, retail outlets). We analyzed (1) website traffic, hotline calls, and media placement; (2) cross-sectional surveys of mothers and providers; and (3) HPV immunization rates in intervention versus non-intervention counties. Of respondent mothers (n=225), 82% heard or saw campaign messages or materials. Of respondent providers (n=35), 94% used campaign brochures regularly or occasionally in conversations with parents. HPV vaccination rates within six months of campaign launch were 2% higher for 9-13 year old girls in two of the four intervention counties compared to 96 non-intervention counties. This evaluation supports campaign use in other primarily rural and underserved areas.

  20. Youth mental health first aid: a description of the program and an initial evaluation

    PubMed Central

    2011-01-01

    Background Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions. Methods The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries. Results The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were

  1. Potential targets for next generation antimicrobial glycoconjugate vaccines

    PubMed Central

    Micoli, Francesca; Costantino, Paolo; Adamo, Roberto

    2018-01-01

    Abstract Cell surface carbohydrates have been proven optimal targets for vaccine development. Conjugation of polysaccharides to a carrier protein triggers a T-cell-dependent immune response to the glycan moiety. Licensed glycoconjugate vaccines are produced by chemical conjugation of capsular polysaccharides to prevent meningitis caused by meningococcus, pneumococcus and Haemophilus influenzae type b. However, other classes of carbohydrates (O-antigens, exopolysaccharides, wall/teichoic acids) represent attractive targets for developing vaccines. Recent analysis from WHO/CHO underpins alarming concern toward antibiotic-resistant bacteria, such as the so called ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) and additional pathogens such as Clostridium difficile and Group A Streptococcus. Fungal infections are also becoming increasingly invasive for immunocompromised patients or hospitalized individuals. Other emergencies could derive from bacteria which spread during environmental calamities (Vibrio cholerae) or with potential as bioterrorism weapons (Burkholderia pseudomallei and mallei, Francisella tularensis). Vaccination could aid reducing the use of broad-spectrum antibiotics and provide protection by herd immunity also to individuals who are not vaccinated. This review analyzes structural and functional differences of the polysaccharides exposed on the surface of emerging pathogenic bacteria, combined with medical need and technological feasibility of corresponding glycoconjugate vaccines. PMID:29547971

  2. Emerging nanotechnology approaches for HIV/AIDS treatment and prevention

    PubMed Central

    Mamo, Tewodros; Moseman, E Ashley; Kolishetti, Nagesh; Salvador-Morales, Carolina; Shi, Jinjun; Kuritzkes, Daniel R; Langer, Robert; von Andrian, Ulrich

    2010-01-01

    Currently, there is no cure and no preventive vaccine for HIV/AIDS. Combination antiretroviral therapy has dramatically improved treatment, but it has to be taken for a lifetime, has major side effects and is ineffective in patients in whom the virus develops resistance. Nanotechnology is an emerging multidisciplinary field that is revolutionizing medicine in the 21st century. It has a vast potential to radically advance the treatment and prevention of HIV/AIDS. In this review, we discuss the challenges with the current treatment of the disease and shed light on the remarkable potential of nanotechnology to provide more effective treatment and prevention for HIV/AIDS by advancing antiretroviral therapy, gene therapy, immunotherapy, vaccinology and microbicides. PMID:20148638

  3. HPV Vaccination among Adolescent Males: Results from the National Immunization Survey-Teen

    PubMed Central

    Reiter, Paul L.; Gilkey, Melissa B.; Brewer, Noel T.

    2013-01-01

    US guidelines provided a permissive recommendation forHPV vaccine for males in 2009, with an updated recommendation for routine vaccination in 2011. Dataon vaccine uptake among males, however, remain sparse. We analyzed 2010–2011 data (collected mostlyprior to the recommendation for routine vaccination) from the National Immunization Survey-Teen for a nationally representative sample of adolescent males ages 13–17 (n=22,365). We examined HPV vaccine initiation( receipt of at least one doseba sed on healthcare provider records) as the primary outcome. Analyses used weighted logistic regression. HPV vaccine initiation increased from 1.4% in 2010 to 8.3% in 2011. Parents who reported receiving a healthcare provider recommendation to get their sons HPV vaccine were much more likely to have vaccinated sons (OR=19.02, 95% CI: 14.36–25.19). Initiation was also higher among sons who were Hispanic (OR=1.83, 95% CI: 1.24–2.71) or who were eligible for the Vaccines for Children program (OR=1.53, 95% CI: 1.01–2.31). Only31.0% of parents with unvaccinated sons indicatedtheir sons were “somewhat likely” or “very likely” to receive HPV vaccine in the next year. The most common main reasons for parents not intending to vaccinate were believing vaccination is not needed or not necessary (24.5%), not having received a provider recommendation (22.1%), and lack of knowledge (15.9%). HPV vaccination is low among adolescent males in the US, and provider recommendation for vaccination is likely keyto improv ingvaccine uptake. Given the updated recommendation for routine vaccination and the changes in health insurance coverage that are likely to follow, continued efforts are needed to monitor HPV vaccination among males. PMID:23602667

  4. Intra-Prostate Cancer Vaccine Inducer

    DTIC Science & Technology

    2006-02-01

    analyzed by flowcytometry for Ii and MHC class II expression. The active constructs were used for the Ii suppression in the experiments planned in...care guidelines under an approved protocol. Cell lines and antibodies Green monkey kidney COS cells (#CRL-1650), cultured in RPMI-1640 medium with...AIDS vaccine protection in rhesus monkeys . J Virol 2004;78(14):7490-7. 12. Letvin NL, Montefiori DC, Yasutomi Y, et al. Potent, protective anti-HIV

  5. Vaccine Adjuvants: from 1920 to 2015 and Beyond

    PubMed Central

    Di Pasquale, Alberta; Preiss, Scott; Tavares Da Silva, Fernanda; Garçon, Nathalie

    2015-01-01

    The concept of stimulating the body’s immune response is the basis underlying vaccination. Vaccines act by initiating the innate immune response and activating antigen presenting cells (APCs), thereby inducing a protective adaptive immune response to a pathogen antigen. Adjuvants are substances added to vaccines to enhance the immunogenicity of highly purified antigens that have insufficient immunostimulatory capabilities, and have been used in human vaccines for more than 90 years. While early adjuvants (aluminum, oil-in-water emulsions) were used empirically, rapidly increasing knowledge on how the immune system interacts with pathogens means that there is increased understanding of the role of adjuvants and how the formulation of modern vaccines can be better tailored towards the desired clinical benefit. Continuing safety evaluation of licensed vaccines containing adjuvants/adjuvant systems suggests that their individual benefit-risk profile remains favorable. Adjuvants contribute to the initiation of the innate immune response induced by antigens; exemplified by inflammatory responses at the injection site, with mostly localized and short-lived effects. Activated effectors (such as APCs) then move to draining lymph nodes where they direct the type, magnitude and quality of the adaptive immune response. Thus, the right match of antigens and adjuvants can potentiate downstream adaptive immune responses, enabling the development of new efficacious vaccines. Many infectious diseases of worldwide significance are not currently preventable by vaccination. Adjuvants are the most advanced new technology in the search for new vaccines against challenging pathogens and for vulnerable populations that respond poorly to traditional vaccines. PMID:26343190

  6. Rhabdoviruses as vaccine platforms for infectious disease and cancer.

    PubMed

    Zemp, Franz; Rajwani, Jahanara; Mahoney, Douglas J

    2018-05-21

    The family Rhabdoviridae (RV) comprises a large, genetically diverse collection of single-stranded, negative sense RNA viruses from the order Mononegavirales. Several RV members are being developed as live-attenuated vaccine vectors for the prevention or treatment of infectious disease and cancer. These include the prototype recombinant Vesicular Stomatitis Virus (rVSV) and the more recently developed recombinant Maraba Virus, both species within the genus Vesiculoviridae. A relatively strong safety profile in humans, robust immunogenicity and genetic malleability are key features that make the RV family attractive vaccine platforms. Currently, the rVSV vector is in preclinical development for vaccination against numerous high-priority infectious diseases, with clinical evaluation underway for HIV/AIDS and Ebola virus disease. Indeed, the success of the rVSV-ZEBOV vaccine during the 2014-15 Ebola virus outbreak in West Africa highlights the therapeutic potential of rVSV as a vaccine vector for acute, life-threatening viral illnesses. The rVSV and rMaraba platforms are also being tested as 'oncolytic' cancer vaccines in a series of phase 1-2 clinical trials, after being proven effective at eliciting immune-mediated tumour regression in preclinical mouse models. In this review, we discuss the biological and genetic features that make RVs attractive vaccine platforms and the development and ongoing testing of rVSV and rMaraba strains as vaccine vectors for infectious disease and cancer.

  7. Macromolecular Assemblage in the Design of a Synthetic AIDS Vaccine

    NASA Astrophysics Data System (ADS)

    Defoort, Jean-Philippe; Nardelli, Bernardetta; Huang, Wolin; Ho, David D.; Tam, James P.

    1992-05-01

    We describe a peptide vaccine model based on the mimicry of surface coat protein of a pathogen. This model used a macromolecular assemblage approach to amplify peptide antigens in liposomes or micelles. The key components of the model consisted of an oligomeric lysine scaffolding to amplify peptide antigens covalently 4-fold and a lipophilic membrane-anchoring group to further amplify noncovalently the antigens many-fold in liposomal or micellar form. A peptide antigen derived from the third variable domain of glycoprotein gp120 of human immunodeficiency virus type 1 (HIV-1), consisting of neutralizing, T-helper, and T-cytotoxic epitopes, was used in a macromolecular assemblage model (HIV-1 linear peptide amino acid sequence 308-331 in a tetravalent multiple antigen peptide system linked to tripalmitoyl-S-glycerylcysteine). The latter complex, in liposome or micelle, was used to immunize mice and guinea pigs without any adjuvant and found to induce gp120-specific antibodies that neutralize virus infectivity in vitro, elicit cytokine production, and prime CD8^+ cytotoxic T lymphocytes in vivo. Our results show that the macromolecular assemblage approach bears immunological mimicry of the gp120 of HIV virus and may lead to useful vaccines against HIV infection.

  8. Evaluation of responses to vaccination of Angus cattle for four viruses that contribute to bovine respiratory disease complex.

    PubMed

    Kramer, L M; Mayes, M S; Fritz-Waters, E; Williams, J L; Downey, E D; Tait, R G; Woolums, A; Chase, C; Reecy, J M

    2017-11-01

    Although vaccination is an effective measure in reducing the risk of bovine respiratory disease complex (BRDC) in cattle, BRDC losses remain significant. Increasing the efficacy of vaccination depends on elucidating the protective immune response to different antigens included in vaccines, determining the best timing for vaccination, and understanding the impact of the age of the calf on vaccination. This study measured the serum antibodies present in calves following vaccination against 4 viruses commonly associated with BRDC: bovine viral diarrhea virus type 1 and 2 (BVDV1 and BVDV2), bovine respiratory syncytial virus (BRSV), and bovine herpesvirus 1 (BHV1). Serum antibody titers were measured in more than 1,600 calves at 3-wk intervals starting at the time of the first vaccination. This first vaccination occurred at weaning for approximately half of the individuals and 3 wk before weaning for the other half. Dam age (years), time of weaning (initial vaccination or booster vaccination), and age of calf within year-season (days within year-season) classification all were found to have a significant effect on measured traits such as the initial titer and overall response. An increased initial titer was negatively correlated with each response trait (initial, booster, and overall response). Calves that were weaned at initial vaccination had greater overall antibody response to BVDV1 and BVDV2 compared with calves weaned 3 wk before initial vaccination. In contrast, calves given their initial vaccination 3 wk before weaning had greater overall antibody response to BRSV and BHV1 compared with calves that were vaccinated at weaning. Furthermore, the circulating antibody titer at which each virus needed to be below for an individual calf to positively respond to vaccination was determined (log titer of 0.38 for BVDV1, 1.5 for BVDV2, 3.88 for BRSV, and 1.5 for BHV1). This information can be used to improve vaccination protocols to allow for a greater response rate of

  9. ADVICE for a healthier life: Adult Vaccination Campaign in Europe.

    PubMed

    Ozisik, Lale; Tanriover, Mine Durusu; Rigby, Shirley; Unal, Serhat

    2016-09-01

    Immunization is one of the most effective public health measures to prevent disease. Despite relatively good vaccination rates in childhood in many parts of the world, vaccines to prevent diseases are underused in the adult population and adult vaccination rates are still far below the target. The European Federation of Internal Medicine (EFIM), declared that 'internal medicine must focus on better care for individuals, better health care for populations and lower costs'. Adult vaccination is a good example of a public health initiative aimed at reducing morbidity and mortality, but awareness of the need for adult vaccination and uptake of the programs across Europe is variable. The Adult Vaccination Campaign in Europe (ADVICE) was developed with an aim to raise awareness for adult vaccination and to understand the dynamics of the vaccination practices and the possible barriers against achieving targeted vaccination rates in Europe. In order to reach vaccination targets, we need evidence based, up to date guidelines; recommendations at national and international levels; surveillance for vaccination rates; and opportunities to provide vaccines more readily. Leadership at a European level and a firm research and action agenda are crucial. The European Federation of Internal Medicine can take the lead as it declared its interest on 'better care for individuals, better health care for populations'. Hence, we consider ADVICE a very timely and very valuable initiative to draw a roadmap to improve adult vaccination rates in Europe. Copyright © 2016. Published by Elsevier B.V.

  10. The Complexity of a Dengue Vaccine: A Review of the Human Antibody Response

    PubMed Central

    Flipse, Jacky; Smit, Jolanda M.

    2015-01-01

    Dengue is the most prevalent mosquito-borne viral disease worldwide. Yet, there are no vaccines or specific antivirals available to prevent or treat the disease. Several dengue vaccines are currently in clinical or preclinical stages. The most advanced vaccine is the chimeric tetravalent CYD-TDV vaccine of Sanofi Pasteur. This vaccine has recently cleared Phase III, and efficacy results have been published. Excellent tetravalent seroconversion was seen, yet the protective efficacy against infection was surprisingly low. Here, we will describe the complicating factors involved in the generation of a safe and efficacious dengue vaccine. Furthermore, we will discuss the human antibody responses during infection, including the epitopes targeted in humans. Also, we will discuss the current understanding of the assays used to evaluate antibody response. We hope this review will aid future dengue vaccine development as well as fundamental research related to the phenomenon of antibody-dependent enhancement of dengue virus infection. PMID:26065421

  11. Adverse Reactions to Vaccination: From Anaphylaxis to Autoimmunity.

    PubMed

    Gershwin, Laurel J

    2018-03-01

    Vaccines are important for providing protection from infectious diseases. Vaccination initiates a process that stimulates development of a robust and long-lived immune response to the disease agents in the vaccine. Side effects are sometimes associated with vaccination. These vary from development of acute hypersensitivity responses to vaccine components to local tissue reactions that are annoying but not significantly detrimental to the patient. The pathogenesis of these responses and the consequent clinical outcomes are discussed. Overstimulation of the immune response and the potential relationship to autoimmunity is evaluated in relation to genetic predisposition. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Prevalence and Predictors of Human Papillomavirus (HPV) Vaccination among Young Women Surviving Childhood Cancer

    PubMed Central

    Klosky, James L.; Favaro, Brianne; Peck, Kelly R.; Simmons, Jessica L.; Russell, Kathryn M.; Green, Daniel M.; Hudson, Melissa M.

    2015-01-01

    Purpose Human papillomavirus (HPV) is a sexually transmitted infection and the cause of cervical and other cancers. Vaccination is available to protect against genital HPV and is recommended for individuals aged 9-26 years. This study aimed to estimate the prevalence of HPV vaccination among childhood cancer survivors and to identify factors associated with vaccine outcomes. Methods Young adult females with (n = 114; M age =21.18 years, SD =2.48) and without (n = 98; M age = 20.65 years, SD = 2.29) a childhood cancer history completed surveys querying HPV vaccination initiation/completion, as well as sociodemographic, medical, and health belief factors. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for vaccine outcomes. Results Among survivors, 38.6% (44/114) and 26.3% (30/114) initiated or completed vaccination compared to 44.9% (44/98) and 28.6% (28/98) among controls, respectively. In the combined survivor/control group, physician recommendation (OR = 11.24, 95% CI, 3.15 – 40.14), and familial HPV communication (OR = 7.28, 95% CI, 1.89 – 28.05) associated with vaccine initiation. Perceptions of vaccine benefit associated with vaccine completion (OR = 10.55, 95% CI, 1.59 – 69.92), whereas perceptions of HPV-related severity associated with non-completion (OR = 0.14, 95% CI, 0.03 – 0.71). Conclusion Despite their increased risk for HPV-related complication, a minority of childhood cancer survivors have initiated or completed HPV vaccination. Modifiable factors associating with vaccine outcomes were identified. Implications HPV vaccination is a useful tool for cancer prevention in survivorship, and interventions to increase vaccine uptake are warranted. PMID:26572902

  13. Assessment of the Safety and Immunogenicity of 2 Novel Vaccine Platforms for HIV-1 Prevention: A Randomized Trial.

    PubMed

    Baden, Lindsey R; Karita, Etienne; Mutua, Gaudensia; Bekker, Linda-Gail; Gray, Glenda; Page-Shipp, Liesl; Walsh, Stephen R; Nyombayire, Julien; Anzala, Omu; Roux, Surita; Laher, Fatima; Innes, Craig; Seaman, Michael S; Cohen, Yehuda Z; Peter, Lauren; Frahm, Nicole; McElrath, M Juliana; Hayes, Peter; Swann, Edith; Grunenberg, Nicole; Grazia-Pau, Maria; Weijtens, Mo; Sadoff, Jerry; Dally, Len; Lombardo, Angela; Gilmour, Jill; Cox, Josephine; Dolin, Raphael; Fast, Patricia; Barouch, Dan H; Laufer, Dagna S

    2016-03-01

    . International AIDS Vaccine Initiative, National Institutes of Health, Ragon Institute, Crucell Holland.

  14. Protection Against Dengue Virus by Non-Replicating and Live Attenuated Vaccines Used Together in a Prime Boost Vaccination Strategy

    DTIC Science & Technology

    2010-01-01

    vaccines primed rhesus maca - ques for an immune response to a tetravalent live attenuated virus (TLAV) vaccine. An initial experiment was performed in 16...and 4 and no measurable increase for DENV 1. These two experiments clearly demonstrated that rhesus maca - ques could be successfully immunized and

  15. Associations between parents' satisfaction with provider communication and HPV vaccination behaviors.

    PubMed

    Kornides, Melanie L; Fontenot, Holly B; McRee, Annie-Laurie; Panozzo, Catherine A; Gilkey, Melissa B

    2018-05-03

    Despite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents' decision-making. Healthcare providers can influence parents' HPV vaccination decision-making, but little is known about parents' perspectives on the counseling they receive. We sought to assess U.S. parents' satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors. Parents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression. Most parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38-0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15-2.55) and continuation (aOR = 2.05, 95% CI: 1.24-3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29-0.70, initiation aOR = 3.59, 95% CI: 2.23-5.78, and continuation aOR = 4.08, 95% CI: 2.38-7.01). Our study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item

  16. Early Adoption of HPV Vaccine among Hispanic Adolescent Males in the United States

    PubMed Central

    Reiter, Paul L.; Brewer, Noel T.; Gilkey, Melissa B.; Katz, Mira L.; Paskett, Electra D.; Smith, Jennifer S.

    2015-01-01

    Background Human papillomavirus (HPV) infection is common among Hispanic males, but little is known about HPV vaccination in this population. We examined the early adoption of HPV vaccine among a national sample of Hispanic adolescent males. Methods We analyzed provider-verified HPV vaccination data from the 2010–2012 National Immunization Survey-Teen (NIS-Teen) for Hispanic males ages 13–17 (n=4,238). Weighted logistic regression identified correlates of HPV vaccine initiation (receipt of one or more doses). Results HPV vaccine initiation was 17.1% overall, increasing from 2.8% in 2010 to 31.7% in 2012 (p<0.0001). Initiation was higher among sons whose parents had received a provider recommendation to vaccinate compared to those whose parents had not (53.3% vs. 9.0%; OR=8.77, 95% CI: 6.05–12.70). Initiation was also higher among sons who had visited a healthcare provider in the previous year (OR=2.42, 95% CI: 1.39–4.23). Among parents with unvaccinated sons, Spanish-speaking parents reported much higher intent to vaccinate compared to English-speaking parents (means: 3.52 vs. 2.54, p<0.0001). Spanish-speaking parents were more likely to indicate lack of knowledge (32.9% vs. 19.9%) and not having received a provider recommendation (32.2% vs. 17.7%) as a main reason for not intending to vaccinate (both p<0.05). Conclusions HPV vaccination among Hispanic adolescent males has increased substantially in recent years. Ensuring healthcare visits and provider recommendation will be key for continuing this trend. Preferred language may also be important for increasing HPV vaccination and addressing potential barriers to vaccination. PMID:24948439

  17. DNA-launched live-attenuated vaccines for biodefense applications

    PubMed Central

    Pushko, Peter; Lukashevich, Igor S.; Weaver, Scott C.; Tretyakova, Irina

    2016-01-01

    Summary A novel vaccine platform uses DNA immunization to launch live-attenuated virus vaccines in vivo. This technology has been applied for vaccine development against positive-strand RNA viruses with global public health impact including alphaviruses and flaviviruses. The DNA-launched vaccine represents the recombinant plasmid that encodes the full-length genomic RNA of live-attenuated virus downstream from a eukaryotic promoter. When administered in vivo, the genomic RNA of live-attenuated virus is transcribed. The RNA initiates limited replication of a genetically defined, live-attenuated vaccine virus in the tissues of the vaccine recipient, thereby inducing a protective immune response. This platform combines the strengths of reverse genetics, DNA immunization and the advantages of live-attenuated vaccines, resulting in a reduced chance of genetic reversions, increased safety, and improved immunization. With this vaccine technology, the field of DNA vaccines is expanded from those that express subunit antigens to include a novel type of DNA vaccines that launch live-attenuated viruses. PMID:27055100

  18. Assessing university students' sexual risk behaviors as predictors of human papillomavirus (HPV) vaccine uptake behavior.

    PubMed

    Rohde, Rebecca L; Adjei Boakye, Eric; Christopher, Kara M; Geneus, Christian J; Walker, Ronald J; Varvares, Mark A; Osazuwa-Peters, Nosayaba

    2018-06-14

    There exists a significant gap in vaccine coverage of the human papillomavirus (HPV) among college-aged students. This study assessed sexual risk-taking behavior among university students and analyzed predictors of HPV vaccine initiation and completion in this population. Data (n = 746) were from an anonymous online, cross-sectional survey distributed to university students, between the ages of 19-26 years, at a private Midwestern university. Both chi-square and multivariable logistics regression models estimated the association between sociodemographic characteristics and sexual risk factors (including number of vaginal sexual partners, number of oral sexual partners, initiation of oral sex, and initiation of vaginal sex), with HPV vaccine initiation and completion. A significant number of participants (40%) had not received a single dose of the HPV vaccine series. Of those who initiated the series, more than half (51%) did not achieve completion. Additionally, a greater number of participants have had multiple (4 or more) oral sexual partners than vaginal sexual partners (25.7% vs. 20.3%). After adjusting for covariates, it was found that sexual risk factors were not significantly associated with HPV vaccine initiation or completion. HPV vaccine initiation and completion rates are suboptimal among university students. High levels of sexual-risk taking behaviors associated with HPV infection persist, yet are not significant predictors of HPV vaccine behaviors in this age group. To increase uptake among 18-26-year-old students, future public health interventions should focus on HPV vaccine education and uptake across the entire population, irrespective of sexual risk profile. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Vaccinations and multiple sclerosis.

    PubMed

    Gout, O

    2001-04-01

    Two problems must be considered in regard to the relationship between vaccinations and MS: Do vaccinations favour the first attack of MS? Do they increase the short- or long-term risk in patients with known disease? Answers to these questions are difficult due to the paucity of reported cases, our ignorance of the precise frequency of neurological adverse events in vaccines based on prospective studies, and finally by the lack of a well established pathophysiology. In most instances, the role of the vaccine is based on a temporal link between the injection and the onset of neurological disease, and more rarely to a positive reintroduction. Acute disseminated encephalomyelitis (ADEM), a monophasic and multifocal illness of the white and grey matter, has been observed following various viral or bacterial infections as well as vaccine injections for diseases such as pertussis, tetanus and yellow fever. The similarities between ADEM and experimental allergic encephalitis (EAE) are suggestive of an immunological process. In addition to the dramatic presentation of ADEM, more limited white matter involvement, such as optic neuritis or myelitis, has been reported following vaccine injections, and has occasionally been counted as the first attack of MS. In France, 25 million inhabitants, almost half of the population, were vaccinated against hepatitis B (HB) between 1991 and 1999. Several hundred cases of an acute central demyelinating event following HB vaccination were reported to the pharmacovigilance unit, leading to a modification of vaccination policy in the schools and the initiation of several studies designed to examine the possible relationship between the vaccine and the central demyelinating events. The results of these studies failed to establish the causality of the HB vaccine. Nevertheless, molecular mimicry between HB antigen(s) and one or more myelin proteins, or a non-specific activation of autoreactive lymphocytes, could constitute possible pathogenetic

  20. A chronicle of serologic response in commercial layer chickens to vaccination with commercial F strain Mycoplasma gallisepticum vaccine.

    PubMed

    Branton, S L; Leigh, S A; Purswell, J L; Evans, J D; Collier, S D; Olanrewaju, H A; Pharr, G T

    2010-09-01

    Vaccination of multi-age layer operations, wherein one million plus commercial layer chickens are housed, has been spurious until the development of a self-propelled, constant-speed spray vaccinator. Still, even with its use, live Mycoplasma gallisepticum (MG) vaccinations have been questionable in terms of seroconversion. Using the vaccinator as a research tool over the past 5 yr, factors have been elucidated which impact seroconversion to one live MG vaccine in particular, the F strain of MG (FMG). These factors include the type of nozzle used to spray the vaccine, the temperature of the water used to rehydrate and administer the vaccine, and the pH and osmolarity of the fluid used to apply the vaccine. In the present study, one farm was monitored for its seroconversion rates over 4 1/2 yr, during which time the FMG vaccination protocol was amended as factors were identified that enhanced seroconversion rates. The results of this study showed that implementation and inclusion of the optimized factors into the vaccination protocol for FMG enhanced seroconversion rates because they went from an initial 50%-55% positive seroconversion rate to a consistent 100% positive seroconversion rate over the 56-mo study period.

  1. Universal varicella vaccine immunization in Japan.

    PubMed

    Yoshikawa, Tetsushi; Kawamura, Yoshiki; Ohashi, Masahiro

    2016-04-07

    In 1974, Japanese scientists developed a live attenuated varicella vaccine based on the Oka strain. The efficacy of the vaccine for the prevention of varicella has been primarily demonstrated in studies conducted in the United States following the adoption of universal immunization using the Oka strain varicella vaccine in 1996. Although the vaccine was developed by Japanese scientists, until recently, the vaccine has been administered on a voluntary basis in Japan resulting in a vaccine coverage rate of approximately 40%. Therefore, Japan initiated universal immunization using the Oka strain varicella vaccine in November 2014. Given the transition from voluntary to universal immunization in Japan, it will also be important to monitor the epidemiology of varicella and herpes zoster. The efficacy and safety of co-administration of the varicella vaccine and measles, mumps, and rubella vaccine have been demonstrated in many countries; however, there was no data from Japan. In order to adopt the practice of universal immunization using the Oka strain varicella vaccine in Japan, data demonstrating the efficacy and safety of co-administration of varicella vaccine and measles and rubella (MR) vaccine were required. Additionally, we needed to elucidate the appropriate time interval between the first and second administrations of the vaccine. It is also important to differentiate between wild type and Oka vaccine type strains in herpes zoster patient with past history of varicella vaccine. Thus, there are many factors to consider regarding the adoption of universal immunization in Japan to control varicella zoster virus (VZV) infections. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Immunogenicity of sanofi pasteur tetravalent dengue vaccine.

    PubMed

    Guy, Bruno

    2009-10-01

    A candidate tetravalent (TV) dengue vaccine based on the yellow fever (YF) 17D vaccine has been developed by sanofi pasteur. This dengue TV vaccine induced a controlled dendritic cell stimulation in vitro. In clinical trials, Th1 and CD8 responses were induced with an IFN-gamma/TNF-alpha ratio favouring IFN-gamma in both cases, regardless of whether the vaccine recipients were flavivirus naive or not. There was an absence of Th2 response in all cases. The Th1 response was dominated by the D4 serotype in flavivirus naive individuals after initial vaccination but broadened to include all serotypes after second vaccination. This broadened response was also observed after primary dengue TV vaccination in subjects previously administered monovalent live-attenuated dengue 1 and dengue 2 vaccines. Notably, virtually no cross-reactivity between YF 17D and dengue NS3 antigens at the CD8 level was observed. Clinical and pre-clinical results support the favourable immunogenicity and short-term safety of the dengue TV. Future studies will establish the longevity of the vaccine-induced immunity and requirements for boosters.

  3. Medical and sociodemographic factors associated with human papillomavirus (HPV) vaccination adherence among female survivors of childhood cancer.

    PubMed

    Klosky, James L; Russell, Kathryn M; Simmons, Jessica L; Foster, Rebecca H; Peck, Kelly; Green, Daniel M; Hudson, Melissa M

    2015-09-01

    Among those 9-26 years of age, vaccination can prevent specific types of genital human papillomavirus (HPV), the most common sexually transmitted infection and cause of cervical and other cancers. The objective of this study was to estimate the prevalence of and factors associated with HPV vaccine initiation and completion among females surviving childhood cancer. One-hundred fourteen young adults and 230 mothers with daughters surviving childhood cancer completed surveys querying HPV vaccination history along with medical and sociodemographic factors potentially associated with vaccination outcomes. Vaccination rate differences by age necessitated analysis of outcomes by age group: 9-13 years (preadolescents), 14-17 years (adolescents), and 18-26 years (young adults). Multivariable logistic regression was utilized to identify factors associated with HPV vaccination outcomes. Overall, 34.6% (119/344) of survivors initiated and 20.9% (72/344) completed HPV vaccination. Preadolescents were least likely to have initiated vaccination (P < 0.001). Physician recommendation was associated with initiation across age groups (OR = 6.81-11.96, Ps < 0.001-.01), whereas older age at diagnosis (≥12 years of age) was associated with lower vaccination initiation among young adults only (OR = 0.28; 95%CI, 0.10-0.76, P = 0.012). Physician recommendation (OR = 7.54; 95%CI, 1.19-47.69, P = 0.032; adolescent group) and greater treatment intensity (OR = 5.25; 95%CI, 1.00-27.61, P = 0.050; young adult group) were associated with vaccine completion, whereas being non-White was associated with decreased vaccination completion (OR = 0.17; 95%CI, 0.05-0.66, P = 0.010; adolescent group). A minority of youths surviving childhood cancer have initiated or completed HPV vaccination. Strategies to increase vaccination among survivors are discussed. © 2015 Wiley Periodicals, Inc.

  4. The impact of new technologies on vaccines.

    PubMed

    Talwar, G P; Diwan, M; Razvi, F; Malhotra, R

    1999-01-01

    Vast changes are taking place in vaccinology consequent to the introduction of new technologies. Amongst the vaccines included in the Expanded Programme of Immunization (EPI), the pertussis vaccine has been replaced by acellular purified fractions devoid of side-effects. Non-pathogenic but immunogenic mutants of tetanus and diptheria toxins are likely to replace the toxoids. An effective vaccine against hepatitis B prepared by recombinant technology is in large-scale use. Conjugated vaccines against Haemophilus influenzae b, S. pneumococcus and meningococcus are now available, as also vaccines against mumps, rubella and measles. Combination vaccines have been devised to limit the number of injections. Vaccine delivery systems have been developed to deliver multiple doses of the vaccine at a single contact point. A genetically-engineered oral vaccine for typhoid imparts better and longer duration of immunity. Oral vaccines for cholera and other enteric infections are under clinical trials. The nose as a route for immunization is showing promise for mucosal immunity and for anti-inflammatory experimental vaccines against multiple sclerosis and insulin-dependent diabetes mellitus. The range of vaccines has expanded to include pathogens resident in the body such as Helicobacter pylori (duodenal ulcer), S. mutans (dental caries), and human papilloma virus (carcinoma of the cervix). An important progress is the recognition that DNA alone can constitute the vaccines, inducing both humoral and cell-mediated immune responses. A large number of DNA vaccines have been made and shown interesting results in experimental animals. Live recombinant vaccines against rabies and rinderpest have proven to be highly effective for controlling these infections in the field, and those for AIDS are under clinical trial. Potent adjuvants have added to the efficacy of the vaccines. New technologies have emerged to 'humanize' mouse monoclonals by genetic engineering and express these

  5. Anthrax Vaccine as a Component of the Strategic National Stockpile: A Dilemma for Homeland Security

    DTIC Science & Technology

    2009-12-01

    reviews . Finally, a gap analysis aids in explaining continued reliance on the old vaccine technology. To conclude... review of the writings on anthrax vaccine summarizes published sources and synthesizes a pattern, or shift, in the literature around the 1998 time...IOM, 2002, p. 208). A 2000 IOM report also determined, “there is a paucity of published peer- reviewed literature on the

  6. High Antigen Dose Is Detrimental to Post-Exposure Vaccine Protection against Tuberculosis

    PubMed Central

    Billeskov, Rolf; Lindenstrøm, Thomas; Woodworth, Joshua; Vilaplana, Cristina; Cardona, Pere-Joan; Cassidy, Joseph P.; Mortensen, Rasmus; Agger, Else Marie; Andersen, Peter

    2018-01-01

    Mycobacterium tuberculosis (Mtb), the etiologic agent of tuberculosis (TB), causes 1.8M deaths annually. The current vaccine, BCG, has failed to eradicate TB leaving 25% of the world’s population with latent Mtb infection (LTBI), and 5–10% of these people will reactivate and develop active TB. An efficient therapeutic vaccine targeting LTBI could have an enormous impact on global TB incidence, and could be an important aid in fighting multidrug resistance, which is increasing globally. Here we show in a mouse model using the H56 (Ag85B-ESAT-6-Rv2660) TB vaccine candidate that post-exposure, but not preventive, vaccine protection requires low vaccine antigen doses for optimal protection. Loss of protection from high dose post-exposure vaccination was not associated with a loss of overall vaccine response magnitude, but rather with greater differentiation and lower functional avidity of vaccine-specific CD4 T cells. High vaccine antigen dose also led to a decreased ability of vaccine-specific CD4 T cells to home into the Mtb-infected lung parenchyma, a recently discovered important feature of T cell protection in mice. These results underscore the importance of T cell quality rather than magnitude in TB-vaccine protection, and the significant role that antigen dosing plays in vaccine-mediated protection. PMID:29379507

  7. Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot

    PubMed Central

    Atkins, Katherine; van Hoek, Albert Jan; Watson, Conall; Baguelin, Marc; Choga, Lethiwe; Patel, Anika; Raj, Thara; Jit, Mark; Griffiths, Ulla

    2016-01-01

    Objective To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. Design We analysed 2013–2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011–2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. Setting All London boroughs. Participants London-based GPs, and pharmacies that currently offer seasonal flu vaccination. Interventions Not applicable. Main outcome measures Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. Results No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. Conclusions Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data. PMID:26883237

  8. Perceived Need for a Parental Decision Aid for the HPV Vaccine: Content and Format Preferences

    PubMed Central

    Lechuga, Julia; Swain, Geoffrey; Weinhardt, Lance S.

    2014-01-01

    The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process. PMID:21444922

  9. Perceived need of a parental decision aid for the HPV vaccine: content and format preferences.

    PubMed

    Lechuga, Julia; Swain, Geoffrey; Weinhardt, Lance S

    2012-03-01

    The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process.

  10. Achieving an HIV vaccine: the need for an accelerated national campaign.

    PubMed

    Marlink, R

    1997-11-01

    The development of an effective HIV vaccine has become a crucial national healthcare goal. To develop a worldwide AIDS vaccine, an international collaboration with developing countries is needed. The global approach rationale is threefold: millions of lives can be saved, a vaccine preparation can be tested more rapidly and economically among populations with high rates of infections; and the HIV epidemic comprises at least ten different subtypes. Although a number of barriers to the successful development of an HIV vaccine exist, the polio vaccine can be used as an example to show researchers how to overcome the obstacles. Jonas Salk, the polio vaccine developer, used killed whole virus in a technique that critics argued would not be fully effective. However, the Salk vaccine reduced polio-related paralysis by 72 percent, while the more effective Sabin oral vaccine did not become available until several years later. The lesson to be learned is that any percent of effectiveness is better than nothing, and researchers should not abandon uncertain HIV vaccine development efforts because they believe a better solution may develop in the future. The existence of traditional research should not preclude the development of new solutions that might prove more effective. For example, in the case of polio, the March of Dimes campaign pushed both the Salk and Sabin vaccines despite the skepticism of many academic research groups.

  11. Evaluating a County-Sponsored Social Marketing Campaign to Increase Mothers’ Initiation of HPV Vaccine for their Pre-teen Daughters in a Primarily Rural Area

    PubMed Central

    Cates, Joan R.; Shafer, Autumn; Diehl, Sandra J.; Deal, Allison M.

    2011-01-01

    Routine vaccination against human papillomavirus (HPV), the main cause of cervical cancer, is recommended for 11–12 year old girls, yet vaccine uptake is low. This study evaluates a social marketing campaign initiated by 13 North Carolina counties to raise awareness among parents and reduce barriers to accessing the vaccine in a primarily rural area. The 3-month campaign targeted mothers of girls ages 11–12 and healthcare practices serving pre-teen girls in four counties. Principles of social marketing were: product (recommended vaccine against HPV), price (cost, perception of safety and efficacy, and access), promotion (posters, brochures, website, news releases, doctor’s recommendation), and place (doctors’ offices, retail outlets). We analyzed (1) website traffic, hotline calls, and media placement; (2) cross-sectional surveys of mothers and providers; and (3) HPV immunization rates in intervention versus non-intervention counties. Of respondent mothers (n=225), 82% heard or saw campaign messages or materials. Of respondent providers (n=35), 94% used campaign brochures regularly or occasionally in conversations with parents. HPV vaccination rates within six months of campaign launch were 2% higher for 9–13 year old girls in two of the four intervention counties compared to 96 non-intervention counties. This evaluation supports campaign use in other primarily rural and underserved areas. PMID:21804767

  12. Mothers' screening histories influence daughters' vaccination uptake: an analysis of linked cervical screening and human papillomavirus vaccination records in the North West of England.

    PubMed

    Spencer Nee Pilkington, Angela M; Brabin, Loretta; Verma, Arpana; Roberts, Stephen A

    2013-04-01

    Achieving high human papillomavirus (HPV) vaccine coverage is important because cervical screening coverage is declining. As key decision makers, mothers' experiences of, and participation in, the cervical screening programme could affect vaccination consent. We investigate whether mother's screening history influences daughter's participation in the HPV vaccination programme. Mothers' cervical screening records from the National Health Authority Information System were linked to the daughters' HPV vaccination records from the Child Health System in North West England by address. Odds ratios for daughter's vaccination were computed using Logistic Regression, adjusting for age, Primary Care Trust and vaccine cohort (AOR). Daughters in both the routine and catch up programmes were more likely to have initiated vaccination and completed the course if their mothers had attended screening. The association was strongest when mothers had attended within the last 5 years (AOR in routine group: 3.5 (95% confidence interval (CI) 3.1-4.0) for initiation and 2.2 (1.6-2.9) for retention). Mothers who had personally decided to cease screening were less likely to have vaccinated daughters than those who had ceased for medical indications. Daughters were more likely to have been vaccinated if their mothers had received an abnormal smear result. Daughter's HPV vaccination uptake was associated with mother's cervical screening attendance. Daughters of mothers who are not engaged with preventive services are less likely to be vaccinated and may be less likely to engage with screening. This makes mothers central to health interventions to promote both cervical screening and HPV vaccination. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Resolving legal, ethical, and human rights challenges in HIV vaccine research.

    PubMed

    Patterson, D

    2000-01-01

    In the absence of a cure for AIDS, attention has turned to the possibility of developing a preventive vaccine for HIV infection. Yet many scientific, ethical, legal, and economic obstacles remain. At the current rate, the development and production of an effective vaccine could take 15 to 20 years or longer. If tens of millions more HIV infections and deaths are to be avoided in the coming decades, vaccine research needs to be greatly expedited. Furthermore, it must be undertaken ethically, and the products of this research must benefit people in developing countries. This article, an edited and updated version of a paper presented at "Putting Third First," addresses challenges arising in HIV preventive vaccine research in developing countries. It does not address clinical research in developing countries relating to treatments or therapeutic vaccines. Nor does it address legal and ethical issues relating to HIV vaccine research in industrialized countries, although similar issues arise in both contexts. The article concludes that while ethical codes are silent on the obligation to undertake research and development, international law provides strong legal obligations--particularly with regard to industrialized states--that should be invoked to accelerate HIV vaccine development, and distribution.

  14. Role of Global Alliance for Vaccines and Immunization (GAVI) in Accelerating Inactivated Polio Vaccine Introduction.

    PubMed

    Thacker, Naveen; Thacker, Deep; Pathak, Ashish

    2016-08-07

    Global Alliance for Vaccines and Immunization (GAVI, the Vaccine Alliance) is an international organization built through public-private partnership. GAVI has supported more than 200 vaccine introductions in the last 5 years by financing major proportion of costs of vaccine to 73 low-income countries using a co-financing model. GAVI has worked in close co-ordination with Global Polio Eradication Initiative (GPEI) since 2013, to strengthen health systems in countries so as to accelerate introduction of inactivated polio vaccine (IPV). GAVI is involved in many IPV related issues like demand generation, supply, market shaping, communications, country readiness etc. Most of the 73 GAVI eligible countries are also high priority countries for GPEI. GAVI support has helped India to accelerate introduction of IPV in all its states. However, GAVI faces challenges in IPV supply-related issues in the near future. It also needs to play a key role in global polio legacy planning and implementation.

  15. Seasonal influenza vaccines.

    PubMed

    Fiore, Anthony E; Bridges, Carolyn B; Cox, Nancy J

    2009-01-01

    Influenza vaccines are the mainstay of efforts to reduce the substantial health burden from seasonal influenza. Inactivated influenza vaccines have been available since the 1940s and are administered via intramuscular injection. Inactivated vaccines can be given to anyone six months of age or older. Live attenuated, cold-adapted influenza vaccines (LAIV) were developed in the 1960s but were not licensed in the United States until 2003, and are administered via nasal spray. Both vaccines are trivalent preparations grown in eggs and do not contain adjuvants. LAIV is licensed for use in the United States for healthy nonpregnant persons 2-49 years of age.Influenza vaccination induces antibodies primarily against the major surface glycoproteins hemagglutinin (HA) and neuraminidase (NA); antibodies directed against the HA are most important for protection against illness. The immune response peaks at 2-4 weeks after one dose in primed individuals. In previously unvaccinated children <9 years of age, two doses of influenza vaccine are recommended, as some children in this age group have limited or no prior infections from circulating types and subtypes of seasonal influenza. These children require both an initial priming dose and a subsequent booster dose of vaccine to mount a protective antibody response.The most common adverse events associated with inactivated vaccines are sore arm and redness at the injection site; systemic symptoms such as fever or malaise are less commonly reported. Guillian-Barré Syndrome (GBS) was identified among approximately 1 per 100,000 recipients of the 1976 swine influenza vaccine. The risk of influenza vaccine-associated GBS from seasonal influenza vaccine is thought to be at most approximately 1-2 cases per 1 million vaccinees, based on a few studies that have found an association; other studies have found no association.The most common adverse events associated with LAIV are nasal congestion, headache, myalgias or fever. Studies of the

  16. Casting off vaccine supply charity -- the pace quickens. CVI goal: quality vaccines for all children.

    PubMed

    1995-10-01

    Several proposals are offered for production of high-quality vaccines within developing countries. The World Health Organization's Vaccine Supply and Quality (VSQ) team from the Global Program for Vaccines and Immunization (GPV) visited 10 countries (Bangladesh, Brazil, Egypt, India, Indonesia, Iran, Mexico, Pakistan, Philippines, and South Africa) out of 14 priority countries (China, Russia, Thailand, and Vietnam were not visited) producing vaccines and found only two with a quality control system that was acceptable. Vaccine-producing countries are urged to consider the full costs of production that include necessary infrastructure, an independent national control authority and laboratory, manufacturers with managerial autonomy, and manufacturers with good management, a qualified staff, and adequate technology. UNICEF has urged both private and public sectors to combine forces in bringing down the price of new vaccines for distribution to a very large market. Some imaginative proposals were made by some manufacturers for vaccine production and supply for a range of less traditional vaccines. The Director of the Massachusetts Public Health Biologic Laboratories proposed the formation of a consortium of vaccine manufacturers who would support public health priorities for market-affordable, simple vaccines against the major childhood diseases. The aim would be international validation of high-quality local vaccine production in developing countries, ease of research collaboration, improvement in information exchange between countries, and structured assistance. Lack of political commitment has been blamed for poor quality local production. A small cooperative effort among some Latin American countries, the Pan American Association's Regional Vaccine System for Latin America (SIREVA), is backed by the Children's Vaccine Initiative. SIREVA is a consortium of manufacturers in Brazil, Chile, and Mexico that plans joint development of some vaccines. Donor assistance is

  17. Influenza vaccination program for elderly outpatients.

    PubMed

    Knoell, K R; Leeds, A L

    1991-02-01

    The effect of pharmacist interventions on the rate at which elderly outpatients were offered influenza vaccination was studied. Pharmacists at a university-based ambulatory-care facility reviewed the medical records of a random sample of control patients over the age of 65 who had been seen during the influenza vaccination months in 1987 or 1988 or both years. The purpose was to estimate the percentage of patients who had been documented as being offered influenza vaccination. In 1989 an intervention program was undertaken consisting of inservice presentations to the facility's nursing staff, dissemination of influenza information sheets to patients upon check-in, placement of wall posters, placement of reminders in patient charts, and institution and advertisement of a vaccination clinic. At the end of the 1989 vaccination season, the records of a random sample of intervention group patients were reviewed to determine the proportion of patients who had been offered influenza virus vaccine. Of the 280 control group patients, 47% were offered influenza vaccination during 1987 and 1988. A significantly higher proportion of the 153 intervention group patients, 71%, was offered influenza vaccine during 1989. A combination of pharmacist-initiated interventions significantly increased the number of elderly patients who were offered vaccinations during scheduled clinic visits.

  18. The role of complement in the success of vaccination with conjugated vs. unconjugated polysaccharide antigen.

    PubMed

    Salehen, Nur'ain; Stover, Cordula

    2008-01-24

    The complement system, a well-characterised arm of the innate immune system, significantly influences the adaptive immune response via direct cell-cell interaction and maintenance of lymphoid organ architecture. Development of vaccines is a major advance in modern health care. In this review, we highlight the importance of the marginal zone in response to both, polysaccharide and conjugated vaccines, and discuss the relevance of complement herein, based on findings obtained from animal models with specific deletions of certain complement components and from vaccination reports of complement-deficient individuals. We conclude that both, intactness of the complement system and maturity of expression of its components, are relatively more important to aid in the immune response to polysaccharide vaccine than to conjugated vaccines.

  19. Detection of Emerging Vaccine-Related Polioviruses by Deep Sequencing.

    PubMed

    Sahoo, Malaya K; Holubar, Marisa; Huang, ChunHong; Mohamed-Hadley, Alisha; Liu, Yuanyuan; Waggoner, Jesse J; Troy, Stephanie B; Garcia-Garcia, Lourdes; Ferreyra-Reyes, Leticia; Maldonado, Yvonne; Pinsky, Benjamin A

    2017-07-01

    Oral poliovirus vaccine can mutate to regain neurovirulence. To date, evaluation of these mutations has been performed primarily on culture-enriched isolates by using conventional Sanger sequencing. We therefore developed a culture-independent, deep-sequencing method targeting the 5' untranslated region (UTR) and P1 genomic region to characterize vaccine-related poliovirus variants. Error analysis of the deep-sequencing method demonstrated reliable detection of poliovirus mutations at levels of <1%, depending on read depth. Sequencing of viral nucleic acids from the stool of vaccinated, asymptomatic children and their close contacts collected during a prospective cohort study in Veracruz, Mexico, revealed no vaccine-derived polioviruses. This was expected given that the longest duration between sequenced sample collection and the end of the most recent national immunization week was 66 days. However, we identified many low-level variants (<5%) distributed across the 5' UTR and P1 genomic region in all three Sabin serotypes, as well as vaccine-related viruses with multiple canonical mutations associated with phenotypic reversion present at high levels (>90%). These results suggest that monitoring emerging vaccine-related poliovirus variants by deep sequencing may aid in the poliovirus endgame and efforts to ensure global polio eradication. Copyright © 2017 Sahoo et al.

  20. Desirability and feasibility of a vaccine against cytomegalovirus

    PubMed Central

    Griffiths, Paul; Plotkin, Stanley; Mocarski, Edward; Pass, Robert; Schleiss, Mark; Krause, Philip; Bialek, Stephanie

    2017-01-01

    Publication of a report from the Institute of Medicine in 2000 showing that a vaccine against cytomegalovirus (CMV) would likely be cost saving was very influential and encouraged the clinical evaluation of candidate vaccines. The major objective of a CMV vaccination program would be to reduce disease caused by congenital CMV infection, which is the leading viral cause of sensorineural hearing loss and neurodevelopmental delay. CMV has challenges as a vaccine target because it is a herpesvirus, it persists lifelong despite host immunity, infected individuals can be reinfected with new strains, overt disease occurs in those with immature or impaired immune systems and persons with this infection do not usually report symptoms. Nevertheless, natural immunity against CMV provides some protection against infection and disease, natural history studies have defined the serological and molecular biological techniques needed for endpoints in future clinical trials of vaccines and CMV is not highly communicable, suggesting that it may not be necessary to achieve very high levels of population immunity through vaccination in order to affect transmission. Three phase 2 CMV vaccine studies have been completed in the last 3 years and all report encouraging outcomes. A key international meeting was organized by the Food and Drug Administration in January 2012 at which interested parties from regulatory bodies, industry and academia discussed and prioritised designs for phase 2 and phase 3 clinical trials. Vaccines able to prevent primary infection with CMV and to boost the immune response of those already infected are desirable. The major target populations for a CMV vaccine include women of childbearing age and adolescents. Toddlers represent another potential population, since an effect of vaccine in this age group could potentially decrease transmission to adults. In addition, prospective recipients of transplants and patients with AIDS would be expected to benefit. PMID

  1. Use of Licensed Vaccines for Active Immunization of the Immunocompromised Host

    PubMed Central

    Pirofski, Liise-anne; Casadevall, Arturo

    1998-01-01

    The latter part of the 20th century has witnessed an unprecedented rise in the number of individuals with impaired immunity. This is primarily attributable to the increased development and use of antineoplastic therapy for malignancies, organ and bone marrow transplantation, and the AIDS epidemic. Individuals with impaired immunity are often at increased risk for infections, and they can experience more severe and complicated courses of infection. The lack of therapy for a variety of viruses and the rise in antimicrobial resistance of many pathogens have focused attention on vaccination to prevent infectious diseases. The efficacy of most licensed vaccines has been established in immunocompetent hosts. However, there is also considerable experience with most vaccines in those with impaired immunity. We reviewed the use of licensed live, inactivated, and polysaccharide vaccines in this group, and several themes emerged: (i) most vaccines are less immunogenic in those with impaired immunity than in normal individuals; (ii) live vaccines are generally contraindicated in this group; and (iii) the efficacy of many commonly used vaccines has not been established in people with impaired immunity. This review suggests that for most vaccines there are little or no efficacy data in those with impaired immunity but their use in this patient group is generally safe. PMID:9457426

  2. Vaccines against Ebola virus.

    PubMed

    Venkatraman, Navin; Silman, Daniel; Folegatti, Pedro M; Hill, Adrian V S

    2017-08-02

    We have just witnessed the largest and most devastating outbreak of Ebola virus disease, which highlighted the urgent need for development of an efficacious vaccine that could be used to curtail future outbreaks. Prior to 2014, there had been limited impetus worldwide to develop a vaccine since the virus was first discovered in 1976. Though too many lives were lost during this outbreak, it resulted in the significantly accelerated clinical development of a number of candidate vaccines through an extraordinary collaborative global effort coordinated by the World Health Organisation (WHO) and involving a number of companies, trial centres, funders, global stakeholders and agencies. We have acquired substantial safety and immunogenicity data on a number of vaccines in Caucasian and African populations. The rapid pace of events led to the initiation of the landmark efficacy trial testing the rVSV-vectored vaccine, which showed high level efficacy in an outbreak setting when deployed using an innovative ring vaccination strategy. Though the Public Health Emergency of International Concern (PHEIC) declared by the WHO has now been lifted, the global scientific community faces numerous challenges ahead to ensure that there is a licensed, deployable vaccine available for use in future outbreaks for at least the Zaire and Sudan strains of Ebola virus. There remain several unanswered questions on the durability of protection, mechanistic immunological correlates and preferred deployment strategies. This review outlines a brief history of the development of Ebola vaccines, the significant progress made since the scale of the outbreak became apparent, some lessons learnt and how they could shape future development of vaccines and the management of similar outbreaks. Copyright © 2017. Published by Elsevier Ltd.

  3. Benefits of pharmacist-led flu vaccination services in community pharmacy.

    PubMed

    Kirkdale, C L; Nebout, G; Megerlin, F; Thornley, T

    2017-01-01

    Seasonal influenza is a major cause of excess winter deaths and increased hospital admissions. There is a high level of economic burden associated with the infection. Although vaccination targets have been set to tackle this international issue, many countries struggle to reach these coverage targets for their at-risk populations using traditional delivery methods. Traditional providers include family doctors and nurses; however, pharmacist-led influenza vaccination has become a more commonly utilised aid to support vaccination targets. Community pharmacies are convenient and widely accessible and evaluations consistently demonstrate that patients are satisfied with pharmacist-led vaccinations. Allowing community pharmacists to administer influenza vaccination as an alternative option for delivery helps to increase the coverage rate of vaccination. In addition, commissioning community pharmacists to provide this service has been shown to contribute to achieving targets for those at-risk. Pharmacist-led influenza vaccination services can create value for payors and reduce pressure on health systems. This review aims to demonstrate the success of pharmacy-led influenza vaccinations, and the impact it has had in driving up immunisation rates within other countries. Experiences of countries such as England, Portugal and the United States provide evidence to demonstrate the benefit to both the patient and the health system. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  4. Active RNAP pre-initiation sites are highly mutated by cytidine deaminases in yeast, with AID targeting small RNA genes

    PubMed Central

    Taylor, Benjamin JM; Wu, Yee Ling; Rada, Cristina

    2014-01-01

    Cytidine deaminases are single stranded DNA mutators diversifying antibodies and restricting viral infection. Improper access to the genome leads to translocations and mutations in B cells and contributes to the mutation landscape in cancer, such as kataegis. It remains unclear how deaminases access double stranded genomes and whether off-target mutations favor certain loci, although transcription and opportunistic access during DNA repair are thought to play a role. In yeast, AID and the catalytic domain of APOBEC3G preferentially mutate transcriptionally active genes within narrow regions, 110 base pairs in width, fixed at RNA polymerase initiation sites. Unlike APOBEC3G, AID shows enhanced mutational preference for small RNA genes (tRNAs, snoRNAs and snRNAs) suggesting a putative role for RNA in its recruitment. We uncover the high affinity of the deaminases for the single stranded DNA exposed by initiating RNA polymerases (a DNA configuration reproduced at stalled polymerases) without a requirement for specific cofactors. DOI: http://dx.doi.org/10.7554/eLife.03553.001 PMID:25237741

  5. A potential disruptive technology in vaccine development: gene-based vaccines and their application to infectious diseases.

    PubMed

    Kaslow, David C

    2004-10-01

    Vaccine development requires an amalgamation of disparate disciplines and has unique economic and regulatory drivers. Non-viral gene-based delivery systems, such as formulated plasmid DNA, are new and potentially disruptive technologies capable of providing 'cheaper, simpler, and more convenient-to-use' vaccines. Typically and somewhat ironically, disruptive technologies have poorer product performance, at least in the near-term, compared with the existing conventional technologies. Because successful product development requires that the product's performance must meet or exceed the efficacy threshold for a desired application, the appropriate selection of the initial product applications for a disruptive technology is critical for its successful evolution. In this regard, the near-term successes of gene-based vaccines will likely be for protection against bacterial toxins and acute viral and bacterial infections. Recent breakthroughs, however, herald increasing rather than languishing performance improvements in the efficacy of gene-based vaccines. Whether gene-based vaccines ultimately succeed in eliciting protective immunity in humans to persistent intracellular pathogens, such as HIV, malaria and tuberculosis, for which the conventional vaccine technologies have failed, remains to be determined. A success against any one of the persistent intracellular pathogens would be sufficient proof that gene-based vaccines represent a disruptive technology against which future vaccine technologies will be measured.

  6. Missed Opportunities for Hepatitis A Vaccination, National Immunization Survey-Child, 2013.

    PubMed

    Casillas, Shannon M; Bednarczyk, Robert A

    2017-08-01

    To quantify the number of missed opportunities for vaccination with hepatitis A vaccine in children and assess the association of missed opportunities for hepatitis A vaccination with covariates of interest. Weighted data from the 2013 National Immunization Survey of US children aged 19-35 months were used. Analysis was restricted to children with provider-verified vaccination history (n = 13 460). Missed opportunities for vaccination were quantified by determining the number of medical visits a child made when another vaccine was administered during eligibility for hepatitis A vaccine, but hepatitis A vaccine was not administered. Cross-sectional bivariate and multivariate polytomous logistic regression were used to assess the association of missed opportunities for vaccination with child and maternal demographic, socioeconomic, and geographic covariates. In 2013, 85% of children in our study population had initiated the hepatitis A vaccine series, and 60% received 2 or more doses. Children who received zero doses of hepatitis A vaccine had an average of 1.77 missed opportunities for vaccination compared with 0.43 missed opportunities for vaccination in those receiving 2 doses. Children with 2 or more missed opportunities for vaccination initiated the vaccine series 6 months later than children without missed opportunities. In the fully adjusted multivariate model, children who were younger, had ever received WIC benefits, or lived in a state with childcare entry mandates were at a reduced odds for 2 or more missed opportunities for vaccination; children living in the Northeast census region were at an increased odds. Missed opportunities for vaccination likely contribute to the poor coverage for hepatitis A vaccination in children; it is important to understand why children are not receiving the vaccine when eligible. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Knowledge of mothers on poliomyelitis and other vaccine preventable diseases and vaccination status of children in pastoralist and semi-pastoralist areas of Ethiopia.

    PubMed

    Dinku, Bezunesh; Bisrat, Filimona; Kebede, Yetnayet; Asegidew, Bethelehem; Fantahun, Mesganaw

    2013-07-01

    Awareness and service utilization are key to polio eradication. Assess the knowledge of mothers on polio and other vaccine preventable diseases, and utilization of immunization services in pastoralist and semi-pastoralist areas in Ethiopia. A community-based cross sectional study using a multistage cluster sampling method involving women who delivered during the previous one year was conducted. A total of 600 women were interviewed. Three hundred-and-five (50.8%) women said they knew what polio was. The time to initiate polio vaccination was correctly indicated to be at birth or within 2 weeks of birth by 224 (37.4%) women. Four hundred forty five (74.2%) women said they did not know how polio is transmitted Polio birth dose (Polio 0) and Polio 3 vaccine coverage were estimated at 32% and 37% respectively. Adjusting for other factors, knowledge of when polio vaccination starts was significantly associated with having a child vaccinated for Polio 3 (OR 95% CI = 3.45 (2.33- 5.11). Knowledge of mothers about polio is low and a little more than one third were aware of when the initial vaccine dose should be administered. Providing detailed information on polio and the recommended vaccination schedule can contribute to improve immunization and hasten polio eradication.

  8. Vaccines: facing complex problems with the promise of immunology.

    PubMed

    Plotkin, Stanley A; Rees, Jenaid

    2014-08-01

    Highly renowned in the vaccines world, Stanley A. Plotkin has worked at many leading institutions throughout his career, and is Emeritus Professor of the University of Pennsylvania and Adjunct Professor of the Johns Hopkins University. In 1991, Plotkin joined Sanofi Pasteur and worked there from 1991 to 1997, and now works as principal of Vaxconsult, LLC as a consultant to vaccine manufacturers, biotechnology companies and non-profit research organizations. Plotkin has served as chairman of the Infectious Diseases Committee and the AIDS Task Force of the American Academy of Pediatrics, liaison member of the Advisory Committee on Immunization Practices, and Chairman of the Microbiology and Infectious Diseases Research Committee of the National Institutes of Health. He has been a recipient of numerous prestigious medals and awards throughout his career, and his bibliography includes over 700 articles and several books, including the standard textbook on vaccines. He has worked extensively on the development and application of many vaccines including anthrax, oral polio, rabies, varicella and cytomegalovirus. He is also codeveloper of the newly licensed pentavalent rotavirus and is well-known for developing the rubella vaccine, now in standard use throughout the world.

  9. Monodisperse, Uniformly-Shaped Particles for Controlled Respiratory Vaccine Delivery

    NASA Astrophysics Data System (ADS)

    Fromen, Catherine Ann

    The majority of the world's most infectious diseases occur at the air-tissue interface called the mucosa, including HIV/AIDS, tuberculosis, measles, and bacterial or viral gut and respiratory infections. Despite this, vaccines have generally been developed for the systemic immune system and fail to provide protection at the mucosal site. Vaccine delivery directly to the lung mucosa could provide superior lung protection for many infectious diseases, such as TB or influenza, as well as systemic and therapeutic vaccines for diseases such as Dengue fever, asthma, or cancer. Specifically, precision engineered biomaterials are believed to offer tremendous opportunities for a new generation of vaccines. The goal of this approach is to leverage naturally occurring processes of the immune system to produce memory responses capable of rapidly destroy virulent pathogens without harmful exposure. Considerable knowledge of biomaterial properties and their interaction with the immune system of the lung is required for successful translation. The overall goal of this work was to fabricate and characterize nano- and microparticles using the Particle Replication In Non-wetting Templates (PRINT) fabrication technique and optimize them as pulmonary vaccine carriers. (Abstract shortened by ProQuest.).

  10. Self-amplifying mRNA vaccines.

    PubMed

    Brito, Luis A; Kommareddy, Sushma; Maione, Domenico; Uematsu, Yasushi; Giovani, Cinzia; Berlanda Scorza, Francesco; Otten, Gillis R; Yu, Dong; Mandl, Christian W; Mason, Peter W; Dormitzer, Philip R; Ulmer, Jeffrey B; Geall, Andrew J

    2015-01-01

    This chapter provides a brief introduction to nucleic acid-based vaccines and recent research in developing self-amplifying mRNA vaccines. These vaccines promise the flexibility of plasmid DNA vaccines with enhanced immunogenicity and safety. The key to realizing the full potential of these vaccines is efficient delivery of nucleic acid to the cytoplasm of a cell, where it can amplify and express the encoded antigenic protein. The hydrophilicity and strong net negative charge of RNA impedes cellular uptake. To overcome this limitation, electrostatic complexation with cationic lipids or polymers and physical delivery using electroporation or ballistic particles to improve cellular uptake has been evaluated. This chapter highlights the rapid progress made in using nonviral delivery systems for RNA-based vaccines. Initial preclinical testing of self-amplifying mRNA vaccines has shown nonviral delivery to be capable of producing potent and robust innate and adaptive immune responses in small animals and nonhuman primates. Historically, the prospect of developing mRNA vaccines was uncertain due to concerns of mRNA instability and the feasibility of large-scale manufacturing. Today, these issues are no longer perceived as barriers in the widespread implementation of the technology. Currently, nonamplifying mRNA vaccines are under investigation in human clinical trials and can be produced at a sufficient quantity and quality to meet regulatory requirements. If the encouraging preclinical data with self-amplifying mRNA vaccines are matched by equivalently positive immunogenicity, potency, and tolerability in human trials, this platform could establish nucleic acid vaccines as a versatile new tool for human immunization. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Human Papillomavirus Vaccine Coverage and Prevalence of Missed Opportunities for Vaccination in an Integrated Healthcare System.

    PubMed

    Irving, Stephanie A; Groom, Holly C; Stokley, Shannon; McNeil, Michael M; Gee, Julianne; Smith, Ning; Naleway, Allison L

    2018-03-01

    Human papillomavirus (HPV) vaccination has been recommended in the United States for female and male adolescents since 2006 and 2011, respectively. Coverage rates are lower than those for other adolescent vaccines. The objective of this study was to evaluate an assessment and feedback intervention designed to increase HPV vaccination coverage and quantify missed opportunities for HPV vaccine initiation at preventive care visits. We examined changes in HPV vaccination coverage and missed opportunities within the adolescent (11-17 years) population at 9 Oregon-based Kaiser Permanente Northwest outpatient clinics after an assessment and feedback intervention. Quarterly coverage rates were calculated for the adolescent populations at the clinics, according to age group (11-12 and 13-17 years), sex, and department (Pediatrics and Family Medicine). Comparison coverage assessments were calculated at 3 nonintervention (control) clinics. Missed opportunities for HPV vaccine initiation, defined as preventive care visits in which a patient eligible for HPV dose 1 remained unvaccinated, were examined according to sex and age group. An average of 29,021 adolescents were included in coverage assessments. Before the intervention, 1-dose and 3-dose quarterly coverage rates were increasing at intervention as well as at control clinics in both age groups. Postimplementation quarterly trends in 1-dose or 3-dose coverage did not differ significantly between intervention and control clinics for either age group. One-dose coverage rates among adolescents with Pediatrics providers were significantly higher than those with Family Medicine providers (56% vs 41% for 11- to 12-year-old and 82% vs 69% for 13- to 17-year-old girls; 55% vs 40% for 11- to 12-year-old and 78% vs 62% for 13- to 17-year-old boys). No significant differences in HPV vaccine coverage were identified at intervention clinics. However, coverage rates were increasing before the start of the intervention and might have

  12. Improving Human Papillomavirus Vaccination Uptake in College Students: A Socioecological Perspective

    ERIC Educational Resources Information Center

    Lanning, Beth; Golman, Mandy; Crosslin, Katie

    2017-01-01

    Background: Human papillomavirus (HPV) vaccination rates remain relatively low, despite new recommendations found in "Healthy People 2020." Purpose: The purpose of this study was to determine vaccination rates, identify factors that influenced initiation/continuance of HPV vaccine series, and identify levels of influence for HPV health…

  13. Predictors of Human Papillomavirus Vaccine Follow-Through Among Privately Insured US Patients.

    PubMed

    Spencer, Jennifer C; Brewer, Noel T; Trogdon, Justin G; Wheeler, Stephanie B; Dusetzina, Stacie B

    2018-05-17

    To assess predictors of timely human papillomavirus (HPV) vaccine follow-through among privately insured individuals initiating the 3-dose series. Using MarketScan Commercial claims data, we identified 1 332 217 privately insured US individuals aged 9 to 26 years who initiated the bivalent or quadrivalent HPV vaccine series from 2006 to 2014, with follow-up data extending through 2015. The study outcome was receipt of third HPV dose within 12 months of the first, compared by year of initiation. Control variables were age, region, insurance plan type, provider type, and seasonal influenza vaccination. Timely HPV vaccine follow-through fell over time. The trend was especially pronounced for females (from 67% in 2006 to 38% in 2014), but was also present for males (from 36% in 2011 to 33% in 2014). Similar patterns were present when we controlled for patient and provider characteristics or used alternative definitions of follow-through. Other positive predictors of timely follow-through included receipt of flu vaccine in the prior year and receipt of first HPV vaccine dose from an obstetrician/gynecologist. HPV vaccine follow-through is low and has declined over time. (Am J Public Health. Published online ahead of print May 17, 2018: e1-e5. doi:10.2105/AJPH.2018.304408).

  14. Overview of Global, Regional, and National Routine Vaccination Coverage Trends and Growth Patterns From 1980 to 2009: Implications for Vaccine-Preventable Disease Eradication and Elimination Initiatives

    PubMed Central

    Wallace, Aaron S.; Ryman, Tove K.; Dietz, Vance

    2015-01-01

    Background Review of the historical growth in annual vaccination coverage across countries and regions can better inform decision makers’ development of future goals and strategies to improve routine vaccination services. Methods Using the World Health Organization (WHO) and the United Nations Children's Fund estimates of annual national third dose of diphtheria-tetanus-pertussis–containing vaccine (DTP3) and third dose of polio vaccine (POL3) coverage for 1980–2009, we calculated the mean absolute annual rate of change in national DTP3 coverage among all countries (globally) and among countries within each WHO region, as well as the number of years taken by each region to reach specific regional coverage levels. Last, we assessed differences in mean absolute annual rate of change in DTP3 coverage, stratified by baseline level of DTP3 coverage. Results During the 1980s, global DTP3 coverage increased a mean of 5.3 percentage points/year. Annual rate of change decreased to 0.5 percentage points/year in the 1990s and then increased to 0.9 percentage points/year during the 2000s. Mean annual rate of change in coverage across all countries was highest (9.2 percentage points) when national coverage levels were 26%–30% and lowest (−0.9 percentage points) when national coverage levels were 96%–100%. Regional differences existed as both WHO South-East Asia Region and WHO African Region countries experienced mean negative DTP3 coverage growth at lower coverage levels (81%–85%) than other regions. The regions that have achieved 95% DTP3 coverage (Americas, Western Pacific, and European) took 25–29 years to reach that level from a level of 50% DTP3 coverage. POL3 coverage change trends were similar to described DTP3 coverage change trends. Conclusions Mean national coverage growth patterns across all regions are nonlinear as coverage levels increase. Saturation points of mean 0 percentage-point growth in annual coverage varies by region and require further

  15. Plasmid DNA initiates replication of yellow fever vaccine in vitro and elicits virus-specific immune response in mice

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tretyakova, Irina; Nickols, Brian; Hidajat, Rachmat

    Yellow fever (YF) causes an acute hemorrhagic fever disease in tropical Africa and Latin America. To develop a novel experimental YF vaccine, we applied iDNA infectious clone technology. The iDNA represents plasmid that encodes the full-length RNA genome of 17D vaccine downstream from a cytomegalovirus (CMV) promoter. The vaccine was designed to transcribe the full-length viral RNA and to launch 17D vaccine virus in vitro and in vivo. Transfection with 10 ng of iDNA plasmid was sufficient to start replication of vaccine virus in vitro. Safety of the parental 17D and iDNA-derived 17D viruses was confirmed in AG129 mice deficientmore » in receptors for IFN-α/β/γ. Finally, direct vaccination of BALB/c mice with a single 20 μg dose of iDNA plasmid resulted in seroconversion and elicitation of virus-specific neutralizing antibodies in animals. We conclude that iDNA immunization approach combines characteristics of DNA and attenuated vaccines and represents a promising vaccination strategy for YF. - Highlights: • The iDNA{sup ®} platform combines advantages of DNA and live attenuated vaccines. • Yellow fever (YF) 17D vaccine was launched from iDNA plasmid in vitro and in vivo. • Safety of iDNA-generated 17D virus was confirmed in AG129 mice. • BALB/c mice seroconverted after a single-dose vaccination with iDNA. • YF virus-neutralizing response was elicited in iDNA-vaccinated mice.« less

  16. Reduction of racial/ethnic disparities in vaccination coverage, 1995-2011.

    PubMed

    Walker, Allison T; Smith, Philip J; Kolasa, Maureen

    2014-04-18

    The Presidential Childhood Immunization Initiative was developed in 1993 to address major gaps in childhood vaccination coverage in the United States. Eliminating the cost of vaccines as a barrier to vaccination was one strategy of the Childhood Immunization Initiative; it led to Congressional legislation that authorized creation of the Vaccines for Children program (VFC) in 1994. CDC analyzed National Immunization Survey data for 1995-2011 to evaluate trends in disparities in vaccination coverage rates between non-Hispanic white children and children of other racial/ethnic groups. VFC has been effective in ireducing disparities in vaccination coverage among U.S. children. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion that follows to provide an example of a program that has been effective in reducing childhood vaccination coverage-related disparities in the United States. At its inception in 1994, VFC was implemented in 78 Immunization Action Plan areas that covered the entire United States; within each area, concerted efforts were made to improve childhood vaccination coverage. The findings in this report demonstrate that there have been no racial/ethnic disparities in vaccine coverage for measles-mumps-rubella and poliovirus in the United States since 2005. Disparities in coverage for the diphtheria-tetanus-pertussis/diphtheria-tetanus-acellular pertussis vaccine were absent, declining, or inconsistent during this period, depending on the racial/ethnic group examined. The results in this report highlight the effectiveness of VFC.

  17. Trends in influenza vaccination coverage rates in South Korea from 2005 to 2014: Effect of public health policies on vaccination behavior.

    PubMed

    Seo, Jeongmin; Lim, Juwon

    2018-05-05

    Influenza is a major cause of morbidity and mortality worldwide. Annual vaccination is effective in its prevention and is recommended especially in susceptible populations such as the elderly over 65 years, children younger than 5, pregnant women, and people with chronic diseases. Overall, South Korea has a high vaccination rate owing to its National Immunization Program, although the method and extent of its coverage varies among the target subgroups. The aim of this study is to assess the trend of influenza vaccination coverage between 2005 and 2014 in South Korea to address the influence of sociodemographic and disease factors on vaccination behavior. Also, we aim to compare the vaccination coverage of target subgroups and evaluate the effect of relevant policies to provide suggestions for their improvement. A total of 61,036 respondents from the Korea National Health and Nutrition Examination Surveys III to VI were included. The total influenza vaccination coverage increased from 38.0% in 2005 to 44.1% in 2014. Vaccination coverage was higher among the elderly aged ≥65 years (range, 70.0-79.8%; p-for-trend <0.001) and children under 5 (range, 64.6-78.9%; p-for-trend < 0.001) than among pregnant women (range, 9.4-37.8%; p-for-trend = 0.122) and people with chronic diseases (range, 29.6-42.6%; p-for-trend = 0.068) from 2005 to 2014. High vaccination coverage was associated with female gender, rural residence, low education level, high income, and increasing number of chronic diseases. But the effect of high income on high vaccination coverage was absent in the elderly aged ≥65 years and children under 5. Influenza vaccination rates have steadily increased from 2005 to 2014 in South Korea. Disparities between target groups correspond to their financial coverage under the National Immunization Program, and financial aids remove the influence of high income on higher vaccination rates. Future vaccination policies should focus on pregnant women

  18. Seasonal vaccination against malaria: a potential use for an imperfect malaria vaccine.

    PubMed

    Greenwood, Brian; Dicko, Alassane; Sagara, Issaka; Zongo, Issaka; Tinto, Halidou; Cairns, Matthew; Kuepfer, Irene; Milligan, Paul; Ouedraogo, Jean-Bosco; Doumbo, Ogobara; Chandramohan, Daniel

    2017-05-02

    In many parts of the African Sahel and sub-Sahel, where malaria remains a major cause of mortality and morbidity, transmission of the infection is highly seasonal. Seasonal malaria chemoprevention (SMC), which involves administration of a full course of malaria treatment to young children at monthly intervals during the high transmission season, is proving to be an effective malaria control measure in these areas. However, SMC does not provide complete protection and it is demanding to deliver for both families and healthcare givers. Furthermore, there is a risk of the emergence in the future of resistance to the drugs, sulfadoxine-pyrimethamine and amodiaquine, that are currently being used for SMC. Substantial progress has been made in the development of malaria vaccines during the past decade and one malaria vaccine, RTS,S/AS01, has received a positive opinion from the European Medicines Authority and will soon be deployed in large-scale, pilot implementation projects in sub-Saharan Africa. A characteristic feature of this vaccine, and potentially of some of the other malaria vaccines under development, is that they provide a high level of efficacy during the period immediately after vaccination, but that this wanes rapidly, perhaps because it is difficult to develop effective immunological memory to malaria antigens in subjects exposed previously to malaria infection. A potentially effective way of using malaria vaccines with high initial efficacy but which provide only a short period of protection could be annual, mass vaccination campaigns shortly before each malaria transmission season in areas where malaria transmission is confined largely to a few months of the year.

  19. A Cost Effectiveness and Capacity Analysis for the Introduction of Universal Rotavirus Vaccination in Kenya: Comparison between Rotarix and RotaTeq Vaccines

    PubMed Central

    van Hoek, Albert Jan; Ngama, Mwanajuma; Ismail, Amina; Chuma, Jane; Cheburet, Samuel; Mutonga, David; Kamau, Tatu; Nokes, D. James

    2012-01-01

    Background Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination. Methods Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain. Results The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix. Conclusion Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability. PMID:23115650

  20. A cost effectiveness and capacity analysis for the introduction of universal rotavirus vaccination in Kenya: comparison between Rotarix and RotaTeq vaccines.

    PubMed

    van Hoek, Albert Jan; Ngama, Mwanajuma; Ismail, Amina; Chuma, Jane; Cheburet, Samuel; Mutonga, David; Kamau, Tatu; Nokes, D James

    2012-01-01

    Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination. Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain. The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix. Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability.

  1. [Vaccinations in psychiatry].

    PubMed

    Dols, A; van den Brink, W; Eikelenboom, P

    2009-01-01

    Vaccination is a well-known strategy for preventing and treating infections. The purpose of vaccinations is to render antigens harmless by the production of antibodies. In psychiatry there are also situations where antigens that have been introduced from outside or that have developed during an illness constitute a threat to the patient's health. To explore the possible applications of vaccination in psychiatry. In this article we discuss the applications of vaccination in psychiatry on the basis of two examples. In addiction research, trials are being conducted with antibodies against substances such as cocaine and nicotine in order to prevent such addictive substances from crossing the blood-brain barrier and thereby initiating their rewarding effect. The first clinical results are very promising, but vaccines have not yet been applied clinically. With regard to Alzheimer's disease it has been shown by means of animal models that specific antibodies can prevent AlphaBeta aggregation and dissolve existing aggregates. On the basis of these findings various large-scale clinical trials have begun in order to study immunotherapy for Alzheimer's disease. The first clinical results showed little neurocognitive effects. A wellknown study had to be terminated because of side-effects of the therapy, in the form of neuro-encephalitis. Our tentative conclusion is that the clinical application of immunotherapy in psychiatry still has its limitations, but is indeed promising.

  2. The Changing HIV/AIDS Landscape: Where Do Biologics Fit In?

    PubMed Central

    BUTCHER, LOLA

    2007-01-01

    The number of therapies available to improve and extend the lives of HIV/AIDS patients is increasing. So is the cost of providing them. Biotechs and others are working on HIV blockers, vaccines, and gene therapies that may one day benefit patients and keep the cost of staying healthy down. PMID:23372512

  3. Effects of a Presidential Candidate’s Comments on HPV Vaccine

    PubMed Central

    Zucker, Rachel A.; Reiter, Paul L.; Mayer, Melissa K.; Brewer, Noel T.

    2015-01-01

    Background During and after the 2011 Republican presidential debate, a candidate questioned the safety of HPV vaccine. We sought to determine what effect these comments had on parents. Methods A national sample of 327 parents with adolescent sons ages 11–17 completed online surveys in fall 2010 (baseline, about a year before the debate) and 2011 (follow-up, about a month after the debate). We used regression models to examine the association of parents’ awareness of the candidate’s comments with HPV vaccine initiation among their sons, their willingness to get sons free HPV vaccine, and their beliefs about potential harms of HPV vaccine. Results Overall, 17% of parents reported hearing about the Republican presidential candidate’s comments about HPV vaccine. Parents who were aware of the comments had a larger increase between baseline and follow-up in the belief that HPV vaccine might cause short-term health problems (mean change=0.47) compared to parents who were not aware (mean change=0.07, p<0.001). Awareness was not associated with HPV vaccine initiation among parents’ adolescent sons, changes in parents’ willingness to get their sons free HPV vaccine, or other outcomes (all p>0.05). Conclusions Although the candidate’s comments may have increased some parents’ beliefs about the short-term harms of HPV vaccine, the comments had no impact on other beliefs, willingness to vaccinate, or behavior. Having accurate information about HPV vaccine that is readily available to the public during such controversies may diminish their impact. PMID:25950109

  4. Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot.

    PubMed

    Atkins, Katherine; van Hoek, Albert Jan; Watson, Conall; Baguelin, Marc; Choga, Lethiwe; Patel, Anika; Raj, Thara; Jit, Mark; Griffiths, Ulla

    2016-02-16

    To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. We analysed 2013-2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011-2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. All London boroughs. London-based GPs, and pharmacies that currently offer seasonal flu vaccination. Not applicable. Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Vaccine-induced, simian immunodeficiency virus-specific CD8+ T cells reduce virus replication but do not protect from simian immunodeficiency virus disease progression.

    PubMed

    Engram, Jessica C; Dunham, Richard M; Makedonas, George; Vanderford, Thomas H; Sumpter, Beth; Klatt, Nichole R; Ratcliffe, Sarah J; Garg, Seema; Paiardini, Mirko; McQuoid, Monica; Altman, John D; Staprans, Silvija I; Betts, Michael R; Garber, David A; Feinberg, Mark B; Silvestri, Guido

    2009-07-01

    Our limited understanding of the interaction between primate lentiviruses and the host immune system complicates the design of an effective HIV/AIDS vaccine. To identify immunological correlates of protection from SIV disease progression, we immunized two groups of five rhesus macaques (RMs) with either modified vaccinia Ankara (MVA) or MVADeltaudg vectors that expressed SIVmac239 Gag and Tat. Both vectors raised a SIV-specific CD8(+) T cell response, with a magnitude that was greater in mucosal tissues than in peripheral blood. After challenge with SIVmac239, all vaccinated RMs showed mucosal and systemic CD8(+) T cell recall responses that appeared faster and were of greater magnitude than those in five unvaccinated control animals. All vaccinated RMs showed a approximately 1-log lower peak and early set-point SIV viral load than the unvaccinated animals, and then, by 8 wk postchallenge, exhibited levels of viremia similar to the controls. We observed a significant direct correlation between the magnitude of postchallenge SIV-specific CD8(+) T cell responses and SIV viral load. However, vaccinated RMs showed no protection from either systemic or mucosal CD4(+) T cell depletion and no improved survival. The observation that vaccine-induced, SIV-specific CD8(+) T cells that partially control SIVmac239 virus replication fail to protect from immunological or clinical progression of SIV infection underscores both the complexity of AIDS pathogenesis and the challenges of properly assessing the efficacy of candidate AIDS vaccines.

  6. Worldwide Report, Epidemiology

    DTIC Science & Technology

    1985-10-28

    California, Yucatan AIDS 36 AIDS Contracted in U.S. 36 MOZAMBIQUE Briefs NETHERLANDS I o7 Polio, Measles Vaccinations J/ Government on Spread of AIDS...CALIFORNIA, YUCATAN AIDS—It has been confirmed that three persons have died in Baja California and Yucatan as a result of acquired Immune deficiency...breeds and nutrition . Grazing schemes could be initiated. Fridges would hold vaccines for rabies, anthrax, quarter evil and fowl pox and the list

  7. What shapes vaccine policy? The case of hepatitis B in the UK.

    PubMed

    Stanton, J

    1994-12-01

    Comparison of hepatitis B vaccine policy with other cases in the past is complicated by the restricted modes of transmission of this disease, which affects relatively few people in the UK. Still, considerations of cost, fear of contamination, divisions of opinion within the medical profession, and regional dispersal of authority are all factors--analysed for other vaccines--which help to explain the limited UK central policy on hepatitis B immunization observed through the 1980s. An important issue, in previous debates on vaccine policies, has been the conflict between public health interests and the rights of individuals to eschew health interventions imposed by the state. It is argued here that this question fed into hepatitis B vaccine policy in an oblique manner, via policy on screening for hepatitis B in the 1970s; minimal screening mainly of selected groups of health workers was favoured, maximizing individual rights. Changes to hepatitis B vaccine policy can be traced, linked with international policy, pharmaceutical company pressure, advances in vaccine technology, and questions of legal liability. The most accurate predictor for vaccine policy appears to have been screening policy. Will this apply to AIDS, which is epidemiologically similar to hepatitis B?

  8. Delay and refusal of human papillomavirus vaccine for girls, national immunization survey-teen, 2010.

    PubMed

    Dorell, Christina; Yankey, David; Jeyarajah, Jenny; Stokley, Shannon; Fisher, Allison; Markowitz, Lauri; Smith, Philip J

    2014-03-01

    Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine's effectiveness, and believing the vaccine is not needed.

  9. Promotora outreach, education and navigation support for HPV vaccination to Hispanic women with unvaccinated daughters

    PubMed Central

    Parra-Medina, Deborah; Morales-Campos, Daisy Y.; Mojica, Cynthia; Ramirez, Amelie G.

    2015-01-01

    Background Cervical cancer disparities persist in the predominantly Hispanic population of South Texas, and Hispanic girls are less likely to initiate and complete the three-dose HPV vaccine series. Culturally relevant interventions are needed to eliminate these disparities and improve HPV vaccine initiation and completion. Subjects We enrolled 372 Hispanic women from South Texas’ Cameron and Hidalgo counties with a daughter aged 11–17 who had not received HPV vaccine. Intervention All participants received an HPV vaccine educational brochure in their preferred language (English or Spanish) and were invited to participate in the Entre Madre e Hija (EMH) program, a culturally relevant cervical cancer prevention program. EMH participants (n= 257) received group health education, referral and navigation support from a promotora (a trained, culturally competent community health worker). Those who declined participation in EMH received the brochure only (n=115). Results Eighty-four percent of enrolled participants initiated the HPV vaccine, and no differences were observed between EMH program and brochure-only participants. Compared to brochure-only participants, EMH participants were more likely to complete the vaccine series [Adj. OR=2.24, 95% CI (1.25, 4.02)]. In addition, participants who were employed and insured had lower odds of completing the vaccine series [Adj. OR=.45, 95% CI (.21 – .96); Adj. OR=.36, 95% CI (.13 – .98), respectively]. Conclusion All enrolled participants had high vaccine initiation rates (>80%); however, EMH program participants were more likely to complete the vaccine series. HPV vaccine promotion efforts that include referral and navigation support in addition to education show promise. PMID:24898942

  10. Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia

    PubMed Central

    Chinsembu, Kazhila C

    2009-01-01

    Many people with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in Namibia have access to antiretroviral drugs but some still use traditional medicines to treat opportunistic infections and offset side-effects from antiretroviral medication. Namibia has a rich biodiversity of indigenous plants that could contain novel anti-HIV agents. However, such medicinal plants have not been identified and properly documented. Various ethnomedicines used to treat HIV/AIDS opportunistic infections have not been scientifically validated for safety and efficacy. These limitations are mostly attributable to the lack of collaboration between biomedical scientists and traditional healers. This paper presents a five-step contextual model for initiating collaboration with Namibian traditional healers in order that candidate plants that may contain novel anti-HIV agents are identified, and traditional medicines used to treat HIV/AIDS opportunistic infections are subjected to scientific validation. The model includes key structures and processes used to initiate collaboration with traditional healers in Namibia; namely, the National Biosciences Forum, a steering committee with the University of Namibia (UNAM) as the focal point, a study tour to Zambia and South Africa where other collaborative frameworks were examined, commemorations of the African Traditional Medicine Day (ATMD), and consultations with stakeholders in north-eastern Namibia. Experiences from these structures and processes are discussed. All traditional healers in north-eastern Namibia were willing to collaborate with UNAM in order that their traditional medicines could be subjected to scientific validation. The current study provides a framework for future collaboration with traditional healers and the selection of candidate anti-HIV medicinal plants and ethnomedicines for scientific testing in Namibia. PMID:19852791

  11. Synergizing vaccinations with therapeutics for measles eradication.

    PubMed

    Plemper, Richard K; Hammond, Anthea L

    2014-02-01

    The measles virus is a major human pathogen responsible for approximately 150,000 deaths annually. The disease is vaccine preventable and eradication of the virus is considered feasible, in principle. However, a herd immunity exceeding 95% is required to prevent sporadic viral outbreaks in a population. Declining disease prevalence, combined with public anxiety over the vaccination's safety, has led to increased vaccine refusal, especially in Europe. This has led to the resurgence of measles in some areas. This article discusses whether synergizing effective measles therapeutics with the measles vaccination could contribute to finally eradicating measles. The authors identify key elements in a desirable drug profile and review current disease management strategies and the state of experimental inhibitor candidates. The authors also evaluate the risk associated with viral escape from inhibition, and consider the potential of measles therapeutics in the management of persistent central nervous system (CNS) viral infection. Finally, the authors contemplate the possible impact of therapeutics in controlling the threat imposed by closely related zoonotic pathogens of the same genus as measles. Efficacious therapeutics used for post-exposure prophylaxis of high-risk social contacts of confirmed index cases may aid measles eradication by closing herd immunity gaps; this is due to vaccine refusal or failure in populations with overall good vaccination coverage. The envisioned primarily prophylactic application of measles therapeutics to a predominantly pediatric and/or adolescent population, dictates the drug profile. It also has to be safe and efficacious, orally available, shelf-stable at ambient temperature and amenable to cost-effective manufacturing.

  12. Mechanisms of Cytotoxicity of the Aids Virus

    DTIC Science & Technology

    1994-08-01

    al., 1987; Luciw et al., 1989), sheep (visna virus) (Haas et al., 1985), goats (caprine-arthritis encepha- litis virus) (Narayan & Cork , 1985), and...into therapeutic maneuvers which may suppress virus replication and/or cytopathicity, and assist in the development of a vaccine for WIV prevention. 7...and AIDS. Narayan and Cork , 1985, Rev. Infect. Dis. 7:89. Niederran et al., 1989, Proc. Natl. Acad. Sci. 86:1128. Pederson et al., 1987, Science 235

  13. Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States.

    PubMed

    Henry, Kevin A; Swiecki-Sikora, Allison L; Stroup, Antoinette M; Warner, Echo L; Kepka, Deanna

    2017-07-14

    This study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.). Data from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately. In 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of  HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32)  than Hispanic boys in  low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas. Higher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with

  14. A vaccine composed of a hypothetical protein and the eukaryotic initiation factor 5a from Leishmania braziliensis cross-protection against Leishmania amazonensis infection.

    PubMed

    Duarte, Mariana Costa; Lage, Daniela Pagliara; Martins, Vívian Tamietti; Costa, Lourena Emanuele; Carvalho, Ana Maria Ravena Severino; Ludolf, Fernanda; Santos, Thaís Teodoro de Oliveira; Vale, Danniele Luciana; Roatt, Bruno Mendes; Menezes-Souza, Daniel; Fernandes, Ana Paula; Tavares, Carlos Alberto Pereira; Coelho, Eduardo Antonio Ferraz

    2017-02-01

    In the present study, two proteins cloned from Leishmania braziliensis species, a hypothetical protein (LbHyp) and the eukaryotic initiation factor 5a (EiF5a), were evaluated to protect BALB/c mice against L. amazonensis infection. The animals were immunized with the antigens, either separately or in combination, using saponin as an immune adjuvant in both cases. Spleen cells from vaccinated and later infected mice produced significantly higher levels of protein and parasite-specific IFN-γ, IL-12, and GM-CSF, in addition to low levels of IL-4 and IL-10. Evaluating the parasite load by means of a limiting dilution technique and quantitative Real-Time PCR, vaccinated animals presented significant reductions in the parasite load in both infected tissues and organs, as well as lower footpad swelling, when compared to the control (saline and saponin) groups. The best results regarding the protection of the animals were achieved when the combined vaccine was administered into the animals. Protection was associated with an IFN-γ production against parasite antigens, which was mediated by both CD4 + and CD8 + T cells and correlated with antileishmanial nitrite production. In conclusion, data from the present study show that this polyprotein vaccine, which combines two L. braziliensis proteins, can induce protection against L. amazonensis infection. Copyright © 2016 Elsevier GmbH. All rights reserved.

  15. Physician Attitudes toward the Herpes Zoster Vaccination in South Korea.

    PubMed

    Yang, Tae Un; Cheong, Hee Jin; Choi, Won Suk; Song, Joon Young; Noh, Ji Yun; Kim, Woo Joo

    2014-09-01

    This survey investigated Korean physician attitudes toward the herpes zoster (HZ) vaccine. A total of 400 physicians answered a self-reported questionnaire. Most physicians knew that HZ poses a significant socioeconomic burden and had good knowledge about HZ and its vaccine. Physicians who did not recommend HZ vaccine were concerned about costs (90.7%, 78/86) and doubted the effectiveness of the vaccine (58.1%, 50/86). Patient demand had a profound effect on physicians decisions; 84.9% (73/86) of them who said not recommending HZ vaccine reported that they would provide the vaccine upon patient request. In conclusion, educational initiatives should be targeted toward both physicians and patients.

  16. Sex of Sexual Partners and Human Papillomavirus Vaccination Among U.S. Girls and Women.

    PubMed

    Agénor, Madina; McCauley, Heather L; Peitzmeier, Sarah M; Haneuse, Sebastien; Gordon, Allegra R; Potter, Jennifer; Austin, S Bryn

    2016-03-01

    Girls and women are at risk of human papillomavirus (HPV) infection and cervical cancer from male and female sexual partners throughout the life course. However, no study has assessed how sex of sexual partners, a dimension of sexual orientation, may relate to HPV vaccination among girls and women. In 2014, data from the 2006-2010 National Survey of Family Growth were used to conduct logistic regression analyses estimating the relationship between sex of lifetime and past-year sexual partners and HPV vaccine awareness and initiation among U.S. girls and women aged 15-25 years (N=3,253). Among U.S. girls and women aged 15-25 years, the prevalence of HPV vaccine awareness and HPV vaccine initiation was 84.4% and 28.5%, respectively. Adjusting for sociodemographic factors, participants with only female past-year sexual partners had significantly lower odds of initiating HPV vaccination relative to those with only male past-year sexual partners (OR=0.16, 95% CI=0.05, 0.55). Similarly, respondents with no lifetime (OR=0.65, 95% CI=0.46, 0.92) or past-year (OR=0.69, 95% CI=0.50, 0.94) sexual partners had significantly lower adjusted odds of HPV vaccine initiation compared with those with only male sexual partners. No difference was apparent in the odds of initiating HPV vaccination between participants with male and female sexual partners and those with only male sexual partners. Medical and public health professionals should ensure that girls and women with only female or no sexual partners are included in HPV vaccine education and promotion efforts. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Epigenetic regulation of HIV, AIDS, and AIDS-related malignancies.

    PubMed

    Verma, Mukesh

    2015-01-01

    Although epigenetics is not a new field, its implications for acquired immunodeficiency syndrome (AIDS) research have not been explored fully. To develop therapeutic and preventive approaches against the human immunodeficiency virus (HIV) and AIDS, it is essential to understand the mechanisms of interaction between the virus and the host, involvement of genetic and epigenetic mechanisms, characterization of viral reservoirs, and factors influencing the latency of the virus. Both methylation of viral genes and histone modifications contribute to initiating and maintaining latency and, depending on the context, triggering viral gene repression or expression. This chapter discusses progress made at the National Institutes of Health (NIH), recommendations from the International AIDS Society Scientific Working Group on HIV Cure, and underlying epigenetic regulation. A number of epigenetic inhibitors have shown potential in treating AIDS-related malignancies. Epigenetic drugs approved by the US Food and Drug Administration and their implications for the eradication of HIV/AIDS and AIDS-related malignancies also are discussed.Past and current progress in developing treatments and understanding the molecular mechanisms of AIDS and HIV infection has greatly improved patient survival. However, increased survival has been coupled with the development of cancer at higher rates than those observed among the HIV/AIDS-negative population. During the early days of the AIDS epidemic, the most frequent AIDS-defining malignancies were Kaposi's sarcoma and non-Hodgkin lymphoma (NHL). Now, with increased survival as the result of widespread use in the developed world of highly active antiretroviral therapy (HAART), non-AIDS defining cancers (i.e., anal, skin, and lung cancers, and Hodgkin disease) are on the increase in HIV-infected populations. The current status of AIDS-related malignancies also is discussed.

  18. Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status.

    PubMed

    Moore, Michael C; Davis, Rolan D; Kang, Qing; Vahl, Christopher I; Wallace, Ryan M; Hanlon, Cathleen A; Mosier, Derek A

    2015-01-15

    To compare anamnestic antibody responses of dogs and cats with current versus out-of-date vaccination status. Cross-sectional study. 74 dogs and 33 cats. Serum samples were obtained from dogs and cats that had been exposed to rabies and brought to a veterinarian for proactive serologic monitoring or that had been brought to a veterinarian for booster rabies vaccination. Blood samples were collected on the day of initial evaluation (day 0) and then again 5 to 15 days later. On day 0, a rabies vaccine was administered according to label recommendations. Paired serum samples were analyzed for antirabies antibodies by means of a rapid fluorescent focus inhibition test. All animals had an antirabies antibody titer ≥ 0.5 IU/mL 5 to 15 days after booster vaccination. Dogs with an out-of-date vaccination status had a higher median increase in titer, higher median fold increase in titer, and higher median titer following booster vaccination, compared with dogs with current vaccination status. Most (26/33) cats, regardless of rabies vaccination status, had a titer ≥ 12 IU/mL 5 to 15 days after booster vaccination. Results indicated that dogs with out-of-date vaccination status were not inferior in their antibody response following booster rabies vaccination, compared with dogs with current vaccination status. Findings supported immediate booster vaccination followed by observation for 45 days of dogs and cats with an out-of-date vaccination status that are exposed to rabies, as is the current practice for dogs and cats with current vaccination status.

  19. From Epidemic Meningitis Vaccines for Africa to the Meningitis Vaccine Project.

    PubMed

    Aguado, M Teresa; Jodar, Luis; Granoff, Dan; Rabinovich, Regina; Ceccarini, Costante; Perkin, Gordon W

    2015-11-15

    Polysaccharide vaccines had been used to control African meningitis epidemics for >30 years but with little or modest success, largely because of logistical problems in the implementation of reactive vaccination campaigns that are begun after epidemics are under way. After the major group A meningococcal meningitis epidemics in 1996-1997 (250,000 cases and 25,000 deaths), African ministers of health declared the prevention of meningitis a high priority and asked the World Health Organization (WHO) for help in developing better immunization strategies to eliminate meningitis epidemics in Africa. WHO accepted the challenge and created a project called Epidemic Meningitis Vaccines for Africa (EVA) that served as an organizational framework for external consultants, PATH, the US Centers for Disease Control and Prevention (CDC), and the Bill & Melinda Gates Foundation (BMGF). Consultations were initiated with major vaccine manufacturers. EVA commissioned a costing study/business plan for the development of new group A or A/C conjugate vaccines and explored the feasibility of developing these products as a public-private partnership. Representatives from African countries were consulted. They confirmed that the development of conjugate vaccines was a priority and provided information on preferred product characteristics. In parallel, a strategy for successful introduction was also anticipated and discussed. The expert consultations recommended that a group A meningococcal conjugate vaccine be developed and introduced into the African meningitis belt. The results of the costing study indicated that the "cost of goods" to develop a group A - containing conjugate vaccine in the United States would be in the range of US$0.35-$1.35 per dose, depending on composition (A vs A/C), number of doses/vials, and presentation. Following an invitation from BMGF, a proposal was submitted in the spring of 2001. In June 2001, BMGF awarded a grant of US$70 million to create the Meningitis

  20. Plasmid DNA initiates replication of yellow fever vaccine in vitro and elicits virus-specific immune response in mice.

    PubMed

    Tretyakova, Irina; Nickols, Brian; Hidajat, Rachmat; Jokinen, Jenny; Lukashevich, Igor S; Pushko, Peter

    2014-11-01

    Yellow fever (YF) causes an acute hemorrhagic fever disease in tropical Africa and Latin America. To develop a novel experimental YF vaccine, we applied iDNA infectious clone technology. The iDNA represents plasmid that encodes the full-length RNA genome of 17D vaccine downstream from a cytomegalovirus (CMV) promoter. The vaccine was designed to transcribe the full-length viral RNA and to launch 17D vaccine virus in vitro and in vivo. Transfection with 10 ng of iDNA plasmid was sufficient to start replication of vaccine virus in vitro. Safety of the parental 17D and iDNA-derived 17D viruses was confirmed in AG129 mice deficient in receptors for IFN-α/β/γ. Finally, direct vaccination of BALB/c mice with a single 20 μg dose of iDNA plasmid resulted in seroconversion and elicitation of virus-specific neutralizing antibodies in animals. We conclude that iDNA immunization approach combines characteristics of DNA and attenuated vaccines and represents a promising vaccination strategy for YF. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. New Animal Model Could Boost Research on AIDS Drugs and Vaccines | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer, and Jeff Lifson, Guest Writer In a research milestone reported in the June 20 issue of the journal Science, scientists have developed a minimally modified version of HIV-1, the virus that causes AIDS in infected humans, that is capable of causing progressive infection and AIDS in monkeys. The advance should help create more authentic animal

  2. Vaccine Images on Twitter: Analysis of What Images are Shared

    PubMed Central

    Dredze, Mark

    2018-01-01

    Background Visual imagery plays a key role in health communication; however, there is little understanding of what aspects of vaccine-related images make them effective communication aids. Twitter, a popular venue for discussions related to vaccination, provides numerous images that are shared with tweets. Objective The objectives of this study were to understand how images are used in vaccine-related tweets and provide guidance with respect to the characteristics of vaccine-related images that correlate with the higher likelihood of being retweeted. Methods We collected more than one million vaccine image messages from Twitter and characterized various properties of these images using automated image analytics. We fit a logistic regression model to predict whether or not a vaccine image tweet was retweeted, thus identifying characteristics that correlate with a higher likelihood of being shared. For comparison, we built similar models for the sharing of vaccine news on Facebook and for general image tweets. Results Most vaccine-related images are duplicates (125,916/237,478; 53.02%) or taken from other sources, not necessarily created by the author of the tweet. Almost half of the images contain embedded text, and many include images of people and syringes. The visual content is highly correlated with a tweet’s textual topics. Vaccine image tweets are twice as likely to be shared as nonimage tweets. The sentiment of an image and the objects shown in the image were the predictive factors in determining whether an image was retweeted. Conclusions We are the first to study vaccine images on Twitter. Our findings suggest future directions for the study and use of vaccine imagery and may inform communication strategies around vaccination. Furthermore, our study demonstrates an effective study methodology for image analysis. PMID:29615386

  3. Vaccine safety evaluation: Practical aspects in assessing benefits and risks.

    PubMed

    Di Pasquale, Alberta; Bonanni, Paolo; Garçon, Nathalie; Stanberry, Lawrence R; El-Hodhod, Mostafa; Tavares Da Silva, Fernanda

    2016-12-20

    Vaccines are different from most medicines in that they are administered to large and mostly healthy populations including infants and children, so there is a low tolerance for potential risks or side-effects. In addition, the long-term benefits of immunisation in reducing or eliminating infectious diseases may induce complacency due to the absence of cases. However, as demonstrated in recent measles outbreaks in Europe and United States, reappearance of the disease occurs as soon as vaccine coverage falls. Unfounded vaccine scares such as those associating the combined measles-mumps-rubella vaccine with autism, and whole-cell pertussis vaccines with encephalopathy, can also have massive impacts, resulting in reduced vaccine uptake and disease resurgence. The safety assessment of vaccines is exhaustive and continuous; beginning with non-clinical evaluation of their individual components in terms of purity, stability and sterility, continuing throughout the clinical development phase and entire duration of use of the vaccine; including post-approval. The breadth and depth of safety assessments conducted at multiple levels by a range of independent organizations increases confidence in the rigour with which any potential risks or side-effects are investigated and managed. Industry, regulatory agencies, academia, the medical community and the general public all play a role in monitoring vaccine safety. Within these stakeholder groups, the healthcare professional and vaccine provider have key roles in the prevention, identification, investigation and management of adverse events following immunisation (AEFI). Guidelines and algorithms aid in determining whether AEFI may have been caused by the vaccine, or whether it is coincidental to it. Healthcare providers are encouraged to rigorously investigate AEFIs and to report them via local reporting processes. The ultimate objective for all parties is to ensure vaccines have a favourable benefit-risk profile. Copyright

  4. Vaccine Images on Twitter: Analysis of What Images are Shared.

    PubMed

    Chen, Tao; Dredze, Mark

    2018-04-03

    Visual imagery plays a key role in health communication; however, there is little understanding of what aspects of vaccine-related images make them effective communication aids. Twitter, a popular venue for discussions related to vaccination, provides numerous images that are shared with tweets. The objectives of this study were to understand how images are used in vaccine-related tweets and provide guidance with respect to the characteristics of vaccine-related images that correlate with the higher likelihood of being retweeted. We collected more than one million vaccine image messages from Twitter and characterized various properties of these images using automated image analytics. We fit a logistic regression model to predict whether or not a vaccine image tweet was retweeted, thus identifying characteristics that correlate with a higher likelihood of being shared. For comparison, we built similar models for the sharing of vaccine news on Facebook and for general image tweets. Most vaccine-related images are duplicates (125,916/237,478; 53.02%) or taken from other sources, not necessarily created by the author of the tweet. Almost half of the images contain embedded text, and many include images of people and syringes. The visual content is highly correlated with a tweet's textual topics. Vaccine image tweets are twice as likely to be shared as nonimage tweets. The sentiment of an image and the objects shown in the image were the predictive factors in determining whether an image was retweeted. We are the first to study vaccine images on Twitter. Our findings suggest future directions for the study and use of vaccine imagery and may inform communication strategies around vaccination. Furthermore, our study demonstrates an effective study methodology for image analysis. ©Tao Chen, Mark Dredze. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 03.04.2018.

  5. Vaccination and the politics of medical knowledge in nineteenth-century Japan.

    PubMed

    Trambaiolo, Daniel

    2014-01-01

    The adoption of the cowpox vaccine in nineteenth-century Japan has often been seen as a more straightforward development than its introduction to other non-Western countries. However, the research leading to this conclusion has been based primarily on sources written by Japanese practitioners of Westernstylemedicine (ranpoˉ), while the perspectives of Chinese-style (kanpoˉ) practitioners,who were more numerous than ranpoˉ practitioners but less likely to have shown immediate enthusiasm for vaccination, have been largely neglected. Kanpoˉdoctors typically learned about vaccination from Chinese rather than European sources and often held an ambivalent attitude toward the vaccine’s foreign origins.This article develops an analysis of kanpoˉ writings on vaccination and suggests that skepticism about the vaccine remained widespread for at least a decade after its initial arrival in Japan, providing new insights into both the initial opposition and the subsequent acceptance of the technique.

  6. Male Undergraduates' HPV Vaccination Behavior: Implications for Achieving HPV-Associated Cancer Equity.

    PubMed

    Lee, Hee Yun; Lust, Katherine; Vang, Suzanne; Desai, Jay

    2018-06-01

    Despite the availability of the human papillomavirus (HPV) vaccine for males, uptake of the vaccine has been low, particularly among young adult males. This study aimed to investigate the levels of HPV vaccination and predictors of HPV vaccine completion in college men ages 18-26. We analyzed data from the 2015 College Student Health Survey, which was administered at 17 post-secondary institutions in Midwest areas. We included only responses from male participants who were ages 18-26 years old, resulting in a sample size of 2516. We used Andersen's Behavioral Model of Health Services Utilization to guide our study design. Multivariate logistic regression was used to examine predictors of HPV vaccine receipt. College-aged males in our sample had a HPV vaccine completion rate of 50.0%. Male students who were younger, had at least one parent who held a graduate degree, had initiated sex, and were enrolled at a private 4-year institution were more likely to have been vaccinated. These findings suggest that HPV vaccination in college-aged men are low. Efforts are needed to increase HPV vaccination in male students who are older, from lower socioeconomic statuses, have not initiated sex, and enrolled at public institutions. Findings also indicate important gender disparities in vaccine uptake that must be addressed in order to achieve optimal vaccine uptake in college-aged males.

  7. Safety and effectiveness of MF-59 adjuvanted influenza vaccines in children and adults.

    PubMed

    Black, Steven

    2015-06-08

    The squalene oil-in-water emulsion MF-59 adjuvant was developed initially to enhance the immunogenicity of influenza vaccines in populations such as children and adults with known suboptimal response. Developed in the 1990s, it was initially licensed in Europe for use in seasonal influenza vaccine in the elderly. Since that time, both Avian and p2009H1N1 vaccines have also been developed. Overall, more than 30,000 individuals have participated in clinical trials of MF-59 adjuvanted vaccine and more than 160 million doses of licensed vaccine have been administered. Safety and effectiveness data from clinical trials and observation studies attest to the safety of MF-59 and to its ability to enhance the effectiveness of influenza vaccines in children and the elderly. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Succeeding in New Vaccine Introduction: Lessons Learned From the Introduction of Inactivated Poliovirus Vaccine in Cameroon, Kenya, and Nigeria

    PubMed Central

    Snidal, Sarah; Saidu, Yauba; Ojumu, Abiola; Ngatia, Antony; Bagana, Murtala; Mutuku, Faith; Sobngwi, Joelle; Efe-Aluta, Oniovo; Roper, Julia; LeTallec, Yann; Kang’ethe, Alice

    2017-01-01

    Abstract Introducing a new vaccine is a large-scale endeavor that can face many challenges, resulting in introduction delays and inefficiencies. The development of national task teams and tools, such as prelaunch trackers, for the introduction of new vaccines (hereafter, “new vaccine introductions” [NVIs]) can help countries implement robust project management systems, front-load critical preparatory activities, and ensure continuous communication around vaccine supply and financing. In addition, implementing postlaunch assessments to take rapid corrective action accelerates the uptake of the new vaccines. NVIs can provide an opportunity to strengthen routine immunization, through strengthening program management systems or by reinforcing local immunization managers’ abilities, among others. This article highlights key lessons learned during the introduction of inactivated poliovirus vaccine in 3 countries that would make future NVIs more successful. The article concludes by considering how the Immunization Systems Management Group of the Global Polio Eradication Initiative has been useful to the NVI process and how such global structures could be further enhanced. PMID:28838156

  9. Influenza and Pneumonia Vaccination Rates and Factors Affecting Vaccination among Patients with Chronic Obstructive Pulmonary Disease.

    PubMed

    Aka Aktürk, Ülkü; Görek Dilektaşlı, Aslı; Şengül, Aysun; Musaffa Salepçi, Banu; Oktay, Nuray; Düger, Mustafa; Arık Taşyıkan, Hale; Durmuş Koçak, Nagihan

    2017-05-05

    Influenza and pneumococcal vaccinations are recommended in chronic obstructive pulmonary disease patients to decrease associated risks at all stages. Although the prevalence of chronic obstructive pulmonary disease is high in our country, as previously reported, vaccination rates are low. To assess the vaccination rates of chronic obstructive pulmonary disease patients and factors that may affect these. Multi-centre cross-sectional study. Patients admitted to the chest diseases clinics of six different centres between 1 February 2013 and 1 January 2014 with a pre-diagnosis of Chronic obstructive pulmonary disease according to the Global initiative for chronic obstructive lung disease criteria, who were in a stable condition were included in the study. The survey, which included demographic characteristics, socio-economic status, severity of disease and vaccination information, was first tested on a small patient population before the study. The survey was completed by the investigators after obtaining written informed consent. The average age of the 296 included patients was 66.3±9.3 years and 91.9% were male. Of these, 36.5% had the influenza vaccination and 14.1% had the pneumococcal vaccination. The most common reason for not being vaccinated was 'no recommendation by doctors': 57.2% in the case of influenza vaccinations, and 46.8% in the case of pneumococcal vaccinations. Both vaccination rates were significantly higher in those patients with comorbidities (influenza vaccination p<0.001; pneumococcal vaccination p=0.06). There was no significant correlation with age, gender, smoking and severity of disease (p>0.05). Vaccination rates were significantly higher in those with a white-collar occupation and higher education level, and who presented to a university hospital (p<0.001). Medical professionals do not request vaccinations as often as the International Guidelines suggest for chronic obstructive pulmonary disease patients. Awareness of the importance of

  10. Induction of Cell Cycle and NK Cell Responses by Live-Attenuated Oral Vaccines against Typhoid Fever

    PubMed Central

    Blohmke, Christoph J.; Hill, Jennifer; Darton, Thomas C.; Carvalho-Burger, Matheus; Eustace, Andrew; Jones, Claire; Schreiber, Fernanda; Goodier, Martin R.; Dougan, Gordon; Nakaya, Helder I.; Pollard, Andrew J.

    2017-01-01

    The mechanisms by which oral, live-attenuated vaccines protect against typhoid fever are poorly understood. Here, we analyze transcriptional responses after vaccination with Ty21a or vaccine candidate, M01ZH09. Alterations in response profiles were related to vaccine-induced immune responses and subsequent outcome after wild-type Salmonella Typhi challenge. Despite broad genetic similarity, we detected differences in transcriptional responses to each vaccine. Seven days after M01ZH09 vaccination, marked cell cycle activation was identified and associated with humoral immunogenicity. By contrast, vaccination with Ty21a was associated with NK cell activity and validated in peripheral blood mononuclear cell stimulation assays confirming superior induction of an NK cell response. Moreover, transcriptional signatures of amino acid metabolism in Ty21a recipients were associated with protection against infection, including increased incubation time and decreased severity. Our data provide detailed insight into molecular immune responses to typhoid vaccines, which could aid the rational design of improved oral, live-attenuated vaccines against enteric pathogens. PMID:29075261

  11. HIV/AIDS, HPV and Anal Cancer

    PubMed Central

    Wang, Chia-ching J.; Sparano, Joseph; Palefsky, Joel M.

    2016-01-01

    SYNOPSIS Anal cancer is an increasingly common non-AIDS-defining cancer among HIV-infected individuals. It is associated with human papillomavirus (HPV), the most common sexually transmitted infectious agent. The 14 oncogenic types of HPV are causally associated with 5–10% of all cancers, notably anogenital cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The HPV types detected in anal cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing anal precancerous lesions in HIV-infected individuals. The standard treatment for anal cancer has been fluorouracil (5-FU) and mitomycin (or cisplatin) as chemotherapy agents plus radiation, which can also be effectively used for the HIV-infected patients. Continued studies will be needed to test new treatment strategies in HIV-infected patients with anal cancer to determine which treatment protocols provide the best therapeutic index. PMID:27889034

  12. The impact of non-financial and financial encouragements on participation in non school-based human papillomavirus vaccination: a retrospective cohort study.

    PubMed

    Lefevere, Eva; Hens, Niel; De Smet, Frank; Beutels, Philippe

    2016-04-01

    Adolescent vaccination coverage under a system of non school-based vaccination is likely to be suboptimal, but might be increased by targeted encouragement campaigns. We analysed the effect on human papillomavirus (HPV) vaccination initiation by girls aged 12-18 of two campaigns set up in Flanders (Belgium) in 2007 and 2009: a personal information campaign and a combined personal information and financial incentive campaign. We analysed (objective) data on HPV vaccination behaviour from the National Alliance of Christian Mutualities (NACM), Flanders' largest sickness fund. We used z-scores to compare the monthly proportion of girls initiating HPV vaccination over time between carefully selected intervention and control groups. Separate analyses were done for older and younger girls. Total sample sizes of the intervention (control) groups were 221 (243) for the personal information campaign and 629 (5,322) for the combined personal information and financial incentive campaign. The personal information campaign significantly increased vaccination initiation, with older girls reacting faster. One year after the campaign the percentages of vaccination initiation for the oldest girls were 64.6 and 42.8 % in the intervention and control group, respectively (z = 3.35, p = 0.0008); for the youngest girls the percentages were 78.4 and 68.1 % (z = 1.71, p = 0.09). The combined personal information and financial incentive campaign increased vaccination initiation among certain age groups. One year after the campaign the difference in percentage points for HPV vaccination initiation between intervention and control groups varied between 18.5 % (z = 3.65, p = 0.0002) and 5.1 % (z = 1.12, p = 0.26). Under a non school-based vaccination system, personal information and removing out-of-pocket costs had a significant positive effect on HPV vaccination initiation, although the effect substantially varied in magnitude. Overall, the obtained vaccination rates remained far below those

  13. Challenges and successes for the grantees and the Technical Advisory Group of WHO's influenza vaccine technology transfer initiative.

    PubMed

    Grohmann, Gary; Francis, Donald P; Sokhey, Jaspal; Robertson, James

    2016-10-26

    One of the aims of the WHO Global Action Plan for Influenza Vaccines (GAP) was to transfer influenza vaccine production technology to interested manufacturers and governments in developing countries, to enable greater influenza vaccine manufacturing capacity against any pandemic threat or pandemic. For this objective, the GAP was supported by an independent Technical Advisory Group (TAG) to assist WHO to select vaccine manufacturing proposals for funding and to provide programmatic support for successful grantees. While there were many challenges, for both the TAG and grantees, there were also notable successes with an additional capacity of 338-600 million pandemic vaccine doses being made possible by the programme between 2007 and 2015, and a potential capacity of more than 600 million by 2016/17 with up to one billion doses expected by 2018/19. Seasonal vaccine production was also developed in 4 countries with another 4-5 countries expected to be producing seasonal vaccine by 2018/19. The relatively small WHO investments - in time and funding - made in these companies to develop their own influenza vaccine production facilities have had quite dramatic results. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Drying a tuberculosis vaccine without freezing.

    PubMed

    Wong, Yun-Ling; Sampson, Samantha; Germishuizen, Willem Andreas; Goonesekera, Sunali; Caponetti, Giovanni; Sadoff, Jerry; Bloom, Barry R; Edwards, David

    2007-02-20

    With the increasing incidence of tuberculosis and drug resistant disease in developing countries due to HIV/AIDS, there is a need for vaccines that are more effective than the present bacillus Calmette-Guérin (BCG) vaccine. We demonstrate that BCG vaccine can be dried without traditional freezing and maintained with remarkable refrigerated and room-temperature stability for months through spray drying. Studies with a model Mycobacterium (Mycobacterium smegmatis) revealed that by removing salts and cryoprotectant (e.g., glycerol) from bacterial suspensions, the significant osmotic pressures that are normally produced on bacterial membranes through droplet drying can be reduced sufficiently to minimize loss of viability on drying by up to 2 orders of magnitude. By placing the bacteria in a matrix of leucine, high-yield, free-flowing, "vial-fillable" powders of bacteria (including M. smegmatis and M. bovis BCG) can be produced. These powders show relatively minor losses of activity after maintenance at 4 degrees C and 25 degrees C up to and beyond 4 months. Comparisons with lyophilized material prepared both with the same formulation and with a commercial formulation reveal that the spray-dried BCG has better overall viability on drying.

  15. [Present state of countermeasure to AIDS in the world today].

    PubMed

    Takakuwa, E

    1997-11-01

    infected persons are few in number. 3) This number will rapidly increase with greater active interchange with western countries following elimination of the Berlin Wall. 4) AIDS countermeasures such as blood and blood products examinations are inadequate due to insufficient funds. In Bulgaria, the government has conducted AIDS tests on more than half the population and in Romania, there is the tragic situation. (3) Guidelines for WHO-ILO countermeasures to AIDS at work places. 4. Present situation in research. The development of effective medicines and vaccines is the primary objective of AIDS research. Research programs may be enumerated as follows; 1) In the U.S.A., NIH and CDC are major organizations which lead research around the world. The major objective is synthetic medicine. 2) In U.K., the development of vaccines for monkey and cat is being sought. 3) In China, herb medicine is administrated to patients in Un-nan-sho where AIDS patients are quite numerous. 4) In Japan, a recombinant vaccine is being sought through use of BCG, vaccinia viruses and the like. 5. Topics related to AIDS include 1) informed consent to be treated by a AIDS-infected doctor, 2) suits against doctors who fail to make infected person known infection and 3) government control laws for AIDS in Russia.

  16. An Analysis of Computer Aided Design (CAD) Packages Used at MSFC for the Recent Initiative to Integrate Engineering Activities

    NASA Technical Reports Server (NTRS)

    Smith, Leigh M.; Parker, Nelson C. (Technical Monitor)

    2002-01-01

    This paper analyzes the use of Computer Aided Design (CAD) packages at NASA's Marshall Space Flight Center (MSFC). It examines the effectiveness of recent efforts to standardize CAD practices across MSFC engineering activities. An assessment of the roles played by management, designers, analysts, and manufacturers in this initiative will be explored. Finally, solutions are presented for better integration of CAD across MSFC in the future.

  17. Alaska Dental Health Aide Program.

    PubMed

    Shoffstall-Cone, Sarah; Williard, Mary

    2013-01-01

    In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  18. Alaska Dental Health Aide Program

    PubMed Central

    Shoffstall-Cone, Sarah; Williard, Mary

    2013-01-01

    Background In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities. PMID:23984306

  19. Cancer Vaccines: Moving Beyond Current Paradigms

    PubMed Central

    Schlom, Jeffrey; Arlen, Philip M.; Gulley, James L.

    2008-01-01

    The field of cancer vaccines is currently in an active state of preclinical and clinical investigations. While no therapeutic cancer vaccine has to date been approved by the FDA, several new paradigms are emerging from recent clinical findings in both the use of combination therapy approaches and, perhaps more importantly, in clinical trial design and endpoint analyses. This paper will review recent clinical trials involving several different cancer vaccines from which data are emerging contrasting classical “tumor response” (RECIST) criteria with “patient response” in the manifestation of increased patient survival post-vaccine therapy. Also described are several strategies in which cancer vaccines can be exploited in combination with other agents and therapeutic modalities that are quite unique when compared with “conventional” combination therapies. This is most likely due to the phenomena that (a) cancer vaccines initiate a dynamic immune process that can be exploited in subsequent therapies, and (b) both radiation and certain chemotherapeutic agents have been shown to alter the phenotype of tumor cells as to render them more susceptible to T-cell–mediated killing. Consequently, evidence is emerging from several studies in which patient cohorts who first receive a cancer vaccine (as contrasted with control cohorts) benefit clinically from subsequent therapies. PMID:17606707

  20. The RTS,S/AS01 malaria vaccine in children 5 to 17 months of age at first vaccination.

    PubMed

    Vandoolaeghe, Pascale; Schuerman, Lode

    2016-12-01

    The RTS,S/AS01 malaria vaccine received a positive scientific opinion from the European Medicines Agency in July 2015. The World Health Organization recommended pilot implementation of the vaccine in children at least 5 months of age according to an initial 3-dose schedule given at least 1 month apart, and a 4th dose 15-18 months post-dose 3. Clinical trials and mathematical modeling demonstrated that the partial protection provided by RTS,S/AS01 against malaria has the potential to provide substantial public health benefit when used in parallel with other malaria interventions, especially in highly endemic regions. The highest impact was seen with 4 vaccine doses in children aged 5 months or older. The vaccine will be evaluated in real-life settings to further assess its impact on mortality, vaccine safety in the context of routine immunization, and programmatic feasibility of delivering a 4-dose vaccination schedule requiring new immunization contacts. If successful, this will pave the way for larger-scale implementation.

  1. The multi-epitope polypeptide approach in HIV-1 vaccine development.

    PubMed

    Cano, C A

    1999-11-01

    The application of a preventive HIV vaccine is the only hope for most developing countries to halt the AIDS pandemic. A project aimed to develop a preventive AIDS vaccine is being carried out since 1992 by three Cuban research institutions: Centro de Ingeniería Genética y Biotecnologia de La Habana, Instituto de Medicina Tropical 'Pedro Kouri' and Laboratorio de Investigaciones de SIDA de La Habana. The project includes two main strategies: (a) generation of recombinant multi-epitope polypeptides (MEPs) bearing several copies of the V3 loop from different HIV-1 isolates; and (b) development of immunogens capable of inducing a cytotoxic T cell response (CTL) specific for human immunodeficiency virus type 1 (HIV-1) antigens. This article summarizes the work in the first of these strategies. Based on the sequence of the V3 loop of HIV-1 we constructed a series of MEPs and evaluated their immunogenicity in mice, rabbits and macaques. The MEP TAB9, containing six V3 epitopes from isolates LR10, JY1, RF, MN, BRVA and IIIB, was selected together with the oil adjuvant Montanide ISA720 (SEPPIC, France) to perform a Phase I clinical trial in HIV seronegative Cuban volunteers. The trial was double blinded, randomized, and fulfilled all ethical and regulatory requirements. All TAB9 vaccinated volunteers developed a strong immune response and neutralizing antibodies were observed in the 50% of the subjects. However the second and third inoculations of the vaccine were not well tolerated because transient severe local reactions appeared in some individuals. A new formulation of TAB9 is currently in pre-clinical studies and is expected to enter clinical trials in 1999.

  2. Development of Sanofi Pasteur tetravalent dengue vaccine.

    PubMed

    Guy, Bruno; Saville, Melanie; Lang, Jean

    2010-09-16

    The Sanofi Pasteur tetravalent dengue vaccine candidate is composed of 4 recombinant live attenuated vaccines based on a yellow fever vaccine 17D (YFV 17D) backbone, each expressing the prM and envelope genes of one of the four dengue virus serotypes. Pre-clinical studies have demonstrated that the TV dengue vaccine is genetically and phenotypically stable, non-hepatotropic, less neurovirulent than YFV 17D and does not infect mosquitoes by the oral route. In vitro and in vivo preclinical studies also showed that the TV dengue vaccine induced controlled stimulation in human dendritic cells and significant immune responses in monkeys. TV dengue vaccine reactogenicity, viraemia induction and antibody responses were investigated in three Phase I trials in the USA, the Philippines and Mexico, in a two or three-dose regimen over a 12 month period. Results showed that the majority of adverse events were mild to moderate and transient in nature. Viraemia was transient and low, and was not increased after initial dengue TV administration, even in the case of incomplete responses. ϕSeropositivity [≥10 in a PRNT 50 assay] was 100% for all four serotypes in flavivirus-naive adults injected with 3 doses of TV dengue vaccine in the USA. Similarly, seropositivity was 88-100% following three administrations in flavivirus-naive Mexican children aged 2-5 years. Furthermore, the proportion of seropositive subjects increased with each dengue TV injection in the Philippines where baseline flavivirus immunity was high. Responses were also monitored at the cellular level in humans, and their level and nature were in good agreement with the observed safety and the immunogenicity of the vaccine. Finally, the challenges inherent to the development of such TV dengue vaccines will also be discussed in the last part of this review. In conclusion, preclinical and clinical results support the favorable immunogenicity and short-term safety of the dengue TV vaccine. An extensive clinical

  3. Off-label use of vaccines.

    PubMed

    Neels, Pieter; Southern, James; Abramson, Jon; Duclos, Philippe; Hombach, Joachim; Marti, Melanie; Fitzgerald-Husek, Alanna; Fournier-Caruana, Jacqueline; Hanquet, Germaine

    2017-04-25

    This article reviews the off-label recommendations and use of vaccines, and focuses on the differences between the labelled instructions on how to use the vaccine as approved by the regulatory authorities (or "label" 1 ), and the recommendations for use issued by public health advisory bodies at national and international levels. Differences between public health recommendations and the product label regarding the vaccine use can lead to confusion at the level of vaccinators and vaccinees and possibly result in lower compliance with national vaccination schedules. In particular, in many countries, the label may contain regulatory restrictions and warnings against vaccination of specific population groups (e.g. pregnant women) due to a lack of evidence of safety from controlled trials at the time of initial licensure of the vaccine, while public health authorities may recommend the same vaccine for that group, based on additional post-marketing data and benefit risk analyses. We provide an overview of the different responsibilities between regulatory authorities and public health advisory bodies, and the rationale for off-label use 2 of vaccines, the challenges involved based on the impact of off-label use in real-life. We propose to reduce off-label use of vaccines by requiring the manufacturer to regularly adapt the label as much as possible to the public health needs as supported by new evidence. This would require manufacturers to collect and report post-marketing data, communicate them to all stakeholders and regulators to extrapolate existing evidence (when acceptable) to other groups or to other brands of a vaccine (class effect 3 ). Regulatory authorities have a key role to play by requesting additional post-marketing data, e.g. in specific target groups. When public health recommendations for vaccine use that are outside labelled indications are considered necessary, good communication between regulatory bodies, public health authorities, companies and

  4. A Learning Collaborative Model to Improve Human Papillomavirus Vaccination Rates in Primary Care.

    PubMed

    Rand, Cynthia M; Tyrrell, Hollyce; Wallace-Brodeur, Rachel; Goldstein, Nicolas P N; Darden, Paul M; Humiston, Sharon G; Albertin, Christina S; Stratbucker, William; Schaffer, Stanley J; Davis, Wendy; Szilagyi, Peter G

    2018-03-01

    Human papillomavirus (HPV) vaccination rates remain low, in part because of missed opportunities (MOs) for vaccination. We used a learning collaborative quality improvement (QI) model to assess the effect of a multicomponent intervention on reducing MOs. Study design: pre-post using a QI intervention in 33 community practices and 14 pediatric continuity clinics over 9 months to reduce MOs for HPV vaccination at all visit types. outcome measures comprised baseline and postproject measures of 1) MOs (primary outcome), and 2) HPV vaccine initiation and completion. Process measures comprised monthly chart audits of MOs for HPV vaccination for performance feedback, monthly Plan-Do-Study-Act surveys and pre-post surveys about office systems. providers were trained at the start of the project on offering a strong recommendation for HPV vaccination. Practices implemented provider prompts and/or standing orders and/or reminder/recall if desired, and were provided monthly feedback on MOs to assess their progress. chi-square tests were used to assess changes in office practices, and logistic regression used to assess changes in MOs according to visit type and overall, as well as HPV vaccine initiation and completion. MOs overall decreased (from 73% to 53% in community practices and 62% to 55% in continuity clinics; P < .01, and P = .03, respectively). HPV vaccine initiation increased for both genders in community practices (from 66% to 74% for female, 57% to 65% for male; P < .01), and for male patients in continuity clinics (from 68% to 75%; P = .05). Series completion increased overall in community practices (39% to 43%; P = .04) and for male patients in continuity clinics (from 36% to 44%; P = .03). Office systems changes using a QI model and multicomponent interventions decreased rates of MO for HPV vaccination and increased initiation and completion rates among some gender subgroups. A learning collaborative model provides an effective forum for practices to

  5. Two consecutive randomized controlled pertussis booster trials in children initially vaccinated in infancy with an acellular vaccine: The first with a five-component Tdap vaccine to 5-year olds and the second with five- or monocomponent Tdap vaccines at age 14-15 years.

    PubMed

    Carlsson, R M; Gustafsson, L; Hallander, H O; Ljungman, M; Olin, P; Gothefors, L; Nilsson, L; Netterlid, E

    2015-07-17

    Prior study children from a DTaP efficacy trial were recruited at ages 5 and 15 years to randomized booster trials addressing immunogenicity and reactogenicity; 475 preschool children received mixed or separate injections of a reduced antigen vaccine (Tdap5, Sanofi Pasteur MSD) and an inactivated polio vaccine, and 230 adolescents received the same or another booster vaccine (Tdap1, SSI, Denmark). Pre-vaccination antibody concentrations against pertussis antigens were significantly higher at 15 than 5 years of age, probably due to natural boosting between the studies. Tdap5 induced comparable anti-PT concentrations at both ages, but antibody responses were significantly higher to filamentous haemagglutinin, pertactin and fimbriae 2/3 in adolescents. As expected, a higher amount of PT (Tdap1, 20μg) induced a stronger anti-PT response than a lower amount (Tdap5, 2.5μg). The frequency of adverse events was low and there were no serious adverse reactions. All local reactions had an early onset and a short duration. A large swelling or redness of more than half of the upper arm circumference was reported in 8/475 5-year-olds and in 6/230 15-year-olds. Children vaccinated with Tdap5 reported more moderate pain in adolescence than at preschool age, whereas itching was only reported in preschool children. Sweden introduced DTaP vaccines in 1996 after a 17-year hiatus with no general pertussis vaccination and pertussis was still endemic at the time of the studies. The frequency of adverse events was nevertheless low in both preschool children and adolescents and antibody responses were adequate. These studies document immunogenicity and reactogenicity in a trial cohort consecutively vaccinated with acellular pertussis vaccines from infancy to adolescence. The adolescent study was registered at ClinicalTrials.gov on 26 March 2009 (NCT00870350). Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. The Thermal Stabilization of Vaccines Against Agents of Bioterrorism

    DTIC Science & Technology

    2005-09-01

    to determine (1) whether rPA in the formulation buffer in the absence of excipients binds to Alhydrogel®and (2) the binding capacity . The aluminum...botulinum toxin (Allergan), A ricin vaccine (DOR Biopharma ) and a vaccine against Norwalk virus (Ligocyte) were also initiated and are in various

  7. Evaluating a Web-Based MMR Decision Aid to Support Informed Decision-Making by UK Parents: A Before-and-After Feasibility Study

    ERIC Educational Resources Information Center

    Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal

    2010-01-01

    Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…

  8. Comparative analysis of the Parent Attitudes about Childhood Vaccines (PACV) short scale and the five categories of vaccine acceptance identified by Gust et al.

    PubMed

    Oladejo, Omolade; Allen, Kristen; Amin, Avnika; Frew, Paula M; Bednarczyk, Robert A; Omer, Saad B

    2016-09-22

    There is a need to develop a standardized tool to aid in identifying, measuring and classifying the unique needs of vaccine-hesitant parents (VHPs). This will also assist in designing tailored interventions to address these needs. The Parental Attitude about Childhood Vaccines (PACV) short scale developed by Opel et al., and the Gust et al. vaccine acceptance categories have been acknowledged as potentially useful tools to measure parental vaccine hesitancy. The PACV short scale requires further validation. In our study, we evaluated how the Gust et al. vaccine acceptance categories correspond with the PACV short scale. As part of a larger study on vaccine attitudes, using the PACV short scale and Gust et al. vaccine acceptance categories, we assessed the correlation between the two measures using Spearman correlation coefficient, and the association between the two measures using the Cochran-Mantel-Haentszel test of association. We used logistic regression modelling to compare the association between a child's up-to-date immunization status and (a) PACV short scale and (b) Gust et al. vaccine acceptance categories. The PACV short scale and Gust et al. vaccine acceptance categories were positively correlated (r=0.6, df=198, p<0.05), and the Cochran-Mantel-Haentszel test of association yielded a statistically significant association (p<0.05). The two scales similarly predicted children's up-to-date immunization status for all recommended childhood vaccines. The ability of the PACV short scale to identify and classify parental vaccine hesitancy is similar to classification using Gust et al. vaccine acceptance categories, and both measure linear entities. The PACV short scale is recommended for screening parents at their first pediatric visit because it is easier to administer. A clearer understanding of how to classify parental vaccine hesitancy can be used to design tailored interventions based on these classifications, to address their specific needs. Copyright

  9. 48 CFR 352.270-8 - Prostitution and related activities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... not apply to any “exempt organizations” (i.e., the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Health Organization; the International AIDS Vaccine Initiative; and any United Nations...

  10. 48 CFR 352.270-8 - Prostitution and related activities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... not apply to any “exempt organizations” (i.e., the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Health Organization; the International AIDS Vaccine Initiative; and any United Nations...

  11. 48 CFR 352.270-8 - Prostitution and related activities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... not apply to any “exempt organizations” (i.e., the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Health Organization; the International AIDS Vaccine Initiative; and any United Nations...

  12. Beyond empiricism: Informing vaccine development through innate immunity research

    PubMed Central

    Levitz, Stuart M.; Golenbock, Douglas T.

    2012-01-01

    Summary While a great public heath success, vaccines provide suboptimal protection in some patient populations and are not available to protect against many infectious diseases. Insights from innate immunity research have led to a better understanding of how existing vaccines work and informed vaccine development. New adjuvants and delivery systems are being designed based upon their capacity to stimulate innate immune sensors and target antigens to dendritic cells, the cells responsible for initiating adaptive immune responses. Incorporating these adjuvants and delivery systems in vaccines can beneficially alter the quantitative and qualitative nature of the adaptive immune response resulting in enhanced protection. PMID:22424235

  13. Uptake and timeliness of rotavirus vaccination in Norway: The first year post-introduction.

    PubMed

    Valcarcel Salamanca, Beatriz; Hagerup-Jenssen, Maria Elisabeth; Flem, Elmira

    2016-09-07

    To minimise vaccine-associated risk of intussusception following rotavirus vaccination, Norway adopted very strict age limits for initiating and completing the vaccine series at the time rotavirus vaccination was included in the national immunisation programme, October 2014. Although Norway has a high coverage for routine childhood vaccines, these stringent age limits could negatively affect rotavirus coverage. We documented the status and impact of rotavirus vaccination on other infant vaccines during the first year after its introduction. We used individual vaccination data from the national immunisation register to calculate coverage for rotavirus and other vaccines and examine adherence with the recommended schedules. We identified factors associated with completing the full rotavirus series by performing multiple logistic regression analyses. We also evaluated potential changes in uptake and timeliness of other routine vaccines after the introduction of rotavirus vaccine using the Kaplan-Meier method. The national coverage for rotavirus vaccine achieved a year after the introduction was 89% for one dose and 82% for two doses, respectively. Among fully rotavirus-vaccinated children, 98% received both doses within the upper age limit and 90% received both doses according to the recommended schedule. The child's age at the initiation of rotavirus series and being vaccinated with diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (DTaP/IPV/Hib) and pneumococcal vaccines were the strongest predictors of completing the full rotavirus series. No major changes in uptake and timeliness of other paediatric vaccines were observed after introduction of rotavirus vaccine. Norway achieved a high national coverage and excellent adherence with the strict age limits for rotavirus vaccine administration during the first year of introduction, indicating robustness of the national immunisation programme. Rotavirus vaccination did not impact coverage or

  14. Impact of Sylvatic Plague Vaccine on Non-target Small Rodents in Grassland Ecosystems.

    PubMed

    Bron, Gebbiena M; Richgels, Katherine L D; Samuel, Michael D; Poje, Julia E; Lorenzsonn, Faye; Matteson, Jonathan P; Boulerice, Jesse T; Osorio, Jorge E; Rocke, Tonie E

    2018-05-09

    Oral vaccination is an emerging management strategy to reduce the prevalence of high impact infectious diseases within wild animal populations. Plague is a flea-borne zoonosis of rodents that often decimates prairie dog (Cynomys spp.) colonies in the western USA. Recently, an oral sylvatic plague vaccine (SPV) was developed to protect prairie dogs from plague and aid recovery of the endangered black-footed ferret (Mustela nigripes). Although oral vaccination programs are targeted toward specific species, field distribution of vaccine-laden baits can result in vaccine uptake by non-target animals and unintended indirect effects. We assessed the impact of SPV on non-target rodents at paired vaccine and placebo-treated prairie dog colonies in four US states from 2013 to 2015. Bait consumption by non-target rodents was high (70.8%, n = 3113), but anti-plague antibody development on vaccine plots was low (23.7%, n = 266). In addition, no significant differences were noted in combined deer mice (Peromyscus maniculatus) and western harvest mouse (Reithrodontomys megalotis) abundance or community evenness and richness of non-target rodents between vaccine-treated and placebo plots. In our 3-year field study, we could not detect a significant positive or negative effect of SPV application on non-target rodents.

  15. Differential uptake of recent Papanicolaou testing by HPV vaccination status among young women in the United States, 2008-2013.

    PubMed

    Sauer, Ann Goding; Jemal, Ahmedin; Simard, Edgar P; Fedewa, Stacey A

    2015-08-01

    A positive association between recent Papanicolaou (Pap) test uptake and initiation of HPV vaccination among U.S. women has been reported. However, it is unknown whether recent Pap testing by HPV vaccination status varies by race/ethnicity. Discerning racial/ethnic variations is important given the higher prevalence of HPV types other than 16 and 18 in some racial/ethnic groups. We assessed whether uptake of recent Pap testing differed among women aged 21-30 years who had not initiated the HPV vaccination series versus those who had and whether this pattern differed by sociodemographic factors. 2008, 2010, and 2013 National Health Interview Survey data were used to generate weighted prevalence estimates and 95% confidence intervals (CIs) (n=7095). Adjusted predicted marginal models were used to generate adjusted prevalence ratios (aPRs) to assess the relationship between recent Pap test uptake and HPV vaccination series initiation by race/ethnicity. The uptake of recent Pap testing among those who had not initiated the HPV vaccination series was significantly lower (81.0%) compared to those who had initiated vaccination (90.5%) (aPR=0.93, 95% CI: 0.90-0.96). This finding was consistent across most sociodemographic factors, though not statistically significant for Blacks, Hispanics, those with lower levels of education, or those with higher levels of income. Young women who had not initiated HPV vaccination were less likely to have had a recent Pap test compared to women who had initiated vaccination. Concerted efforts are needed to increase uptake of recommended cervical cancer screening and HPV vaccination among young women. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Enhanced immunity in intradermal vaccination by novel hollow microneedles.

    PubMed

    Ogai, N; Nonaka, I; Toda, Y; Ono, T; Minegishi, S; Inou, A; Hachiya, M; Fukamizu, H

    2018-04-29

    The intradermal (ID) route for vaccination represents an effective alternative to subcutaneous (SC)/intramuscular administration to induce protective immunity. However, a critical issue associated with ID vaccination is the precise delivery of solution in the upper dermis, which ensures enhanced immunity. We fabricated a hollow microneedle unit made of poly-glycolic acid by injection molding and bonding, and created a dedicated prototype injector. To ensure ID delivery of solution, the injected site was macroscopically and microscopically examined. Serum immunoglobulin G antibody production was measured by enzyme immunoassay and compared in groups of rats following either ID delivery with microneedles or SC administration with a 27-G stainless needle of graded vaccine doses. The unit used a tandem array of six microneedles, each with a side delivery hole, and a conduit inside for solution. Microneedles installed in the injector punctured the skin with the aid of a spring. Injection of solution formed a wheal due to ID distribution. Histologically, a wedge-shaped skin defect in the upper skin corresponded to each puncture site. Antibody titers following vaccinations on days 1 and 8 were significantly higher with ID injection than with SC delivery on day 15 and every 7 days thereafter until day 36 with mumps vaccination, and until day 36 with varicella vaccination. The microneedle unit presented here delivered solution intradermally without any difficulty and evoked antibody responses against viruses even with the reduced vaccine volume. Our findings confirm promising results of ID delivery as an immunogenic option to enhance vaccination efficacy. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. The influence of delivery vectors on HIV vaccine efficacy

    PubMed Central

    Ondondo, Beatrice O.

    2014-01-01

    Development of an effective HIV/AIDS vaccine remains a big challenge, largely due to the enormous HIV diversity which propels immune escape. Thus novel vaccine strategies are targeting multiple variants of conserved antibody and T cell epitopic regions which would incur a huge fitness cost to the virus in the event of mutational escape. Besides immunogen design, the delivery modality is critical for vaccine potency and efficacy, and should be carefully selected in order to not only maximize transgene expression, but to also enhance the immuno-stimulatory potential to activate innate and adaptive immune systems. To date, five HIV vaccine candidates have been evaluated for efficacy and protection from acquisition was only achieved in a small proportion of vaccinees in the RV144 study which used a canarypox vector for delivery. Conversely, in the STEP study (HVTN 502) where human adenovirus serotype 5 (Ad5) was used, strong immune responses were induced but vaccination was more associated with increased risk of HIV acquisition than protection in vaccinees with pre-existing Ad5 immunity. The possibility that pre-existing immunity to a highly promising delivery vector may alter the natural course of HIV to increase acquisition risk is quite worrisome and a huge setback for HIV vaccine development. Thus, HIV vaccine development efforts are now geared toward delivery platforms which attain superior immunogenicity while concurrently limiting potential catastrophic effects likely to arise from pre-existing immunity or vector-related immuno-modulation. However, it still remains unclear whether it is poor immunogenicity of HIV antigens or substandard immunological potency of the safer delivery vectors that has limited the success of HIV vaccines. This article discusses some of the promising delivery vectors to be harnessed for improved HIV vaccine efficacy. PMID:25202303

  18. Human papillomavirus vaccination in Auckland: reducing ethnic and socioeconomic inequities.

    PubMed

    Poole, Tracey; Goodyear-Smith, Felicity; Petousis-Harris, Helen; Desmond, Natalie; Exeter, Daniel; Pointon, Leah; Jayasinha, Ranmalie

    2012-12-17

    The New Zealand HPV publicly funded immunisation programme commenced in September 2008. Delivery through a school based programme was anticipated to result in higher coverage rates and reduced inequalities compared to vaccination delivered through other settings. The programme provided for on-going vaccination of girls in year 8 with an initial catch-up programme through general practices for young women born after 1 January 1990 until the end of 2010. To assess the uptake of the funded HPV vaccine through school based vaccination programmes in secondary schools and general practices in 2009, and the factors associated with coverage by database matching. Retrospective quantitative analysis of secondary anonymised data School-Based Vaccination Service and National Immunisation Register databases of female students from secondary schools in Auckland District Health Board catchment area. Data included student and school demographic and other variables. Binary logistic regression was used to estimate odds ratios and significance for univariables. Multivariable logistic regression estimated strength of association between individual factors and initiation and completion, adjusted for all other factors. The programme achieved overall coverage of 71.5%, with Pacific girls highest at 88% and Maori at 78%. Girls higher socioeconomic status were more likely be vaccinated in general practice. School-based vaccination service targeted at ethic sub-populations provided equity for the Maori and Pacific student who achieved high levels of vaccination. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Bio-ethical and legal issues in relation to HIV/AIDS: the Uganda experience.

    PubMed

    Yusuf, N K

    1998-01-01

    In Uganda, as in many other countries, there is a vacuum regarding an appropriate legal and ethical response to the HIV/AIDS pandemic. Whereas much has been done to address the HIV/AIDS pandemic in a multidisciplinary way, very little has been done regarding legal and ethical issues. Hence, cases of claimants to have cures for AIDS, spiritual healers and sale of fake drugs plus unauthorized vaccine and drug trials are on the increase. The rights and needs of people infected with HIV/AIDS are not adequately addressed. The property rights of those affected by the pandemic continue to be abused. Therefore there is need to mobilize doctors, lawyers and human rights activists who should advocate and address these issues. This paper therefore highlights the critical bio-ethical and legal issues in relation to HIV/AIDS.

  20. Review of the Persistence of Herpes Zoster Vaccine Efficacy in Clinical Trials.

    PubMed

    Cook, Stephen J; Flaherty, Dennis K

    2015-11-01

    The live attenuated herpes zoster vaccine(*) was approved for the prevention of shingles in 2006. Initial Phase III clinical trials proved vaccine efficacy persisted during the study duration; however, assessment of long-term efficacy required additional studies. This article reviews efficacy data for the zoster vaccine that have been published since 2004. It focuses on studies assessing declining vaccine efficacy. MEDLINE, EMBASE, CENTRAL, and CINAHL databases were searched for zoster vaccine efficacy trials. Randomized controlled trials published from 2004 to 2015 were included in the review. Six studies were included in the review. The zoster vaccine reduced the risk of herpes zoster by 51.3% to 72.4% in 2 Phase III trials. Primary and other analyses showed the vaccine was effective at reducing the burden of illness (61.1%), postherpetic neuralgia (66.5%), disease interference on functional status (66.2%), and disease impact on health-related quality of life (55%) compared with placebo. Surveillance studies showed a decrease in vaccine efficacy for reducing the incidence of herpes zoster during follow-up years 3.3 to 7.8 (39.6% relative reduction) and 4.7 to 11.6 (21.1% relative reduction). Initial zoster vaccine efficacy is significant, but declines in post-vaccination years 3 to 11. This raises the question about the need for possible revaccination with the zoster vaccine. Clinicians should consider the declining efficacy when administering the zoster vaccine to patients. Future studies will need to address the impact of the varicella vaccine on the incidence of shingles and whether this impacts the efficacy of the zoster vaccine. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  1. Hepatitis A and B vaccination--the rate of uptake and course completion in patients with hepatitis C.

    PubMed

    Fredericks, Trinity; Kwan, Kellie; Mak, Donna

    2010-10-01

    Western Australian general practitioners may order Department of Health funded hepatitis A and B vaccines for patients newly notified with hepatitis C to prevent complications associated with co-infections. The aim of this study was to determine vaccination uptake of hepatitis C patients through this program. We reviewed hepatitis C notifications and hepatitis A and B vaccine orders received in 2007 and 2008 to determine the rate of vaccine uptake and course completion. Vaccination orders for initial doses were received for 37% (448/1209) of patients. Vaccination uptake was positively associated with age and non- Aboriginality. Final vaccination doses were ordered for 30% of patients for whom an initial order had been received. Uptake of hepatitis A and B vaccination was higher than that of similar populations. However, vaccination course completion was low. General practitioners need to emphasise to their patients the importance of completing a vaccine course.

  2. AIDSCAP initiative. Innovation in NGO capacity building: Tanzania AIDS project.

    PubMed

    Dadian, M J

    1998-01-01

    Tanzania has since the mid-1980s experienced some of the highest rates of HIV infection in the world, with data now showing the mean levels of HIV seroprevalence nationwide to be greater than 13%, and even higher than 30% in some districts. By 2000, as many as 2.4 million Tanzanians will be infected with HIV and more than 850,000 Tanzanian children will be orphaned by the epidemic. The Tanzania AIDS Project (TAP), funded by the US Agency for International Development (USAID), was implemented through the AIDS Control and Prevention (AIDSCAP) Project by Family Health International (FHI) during 1993-97. TAP will receive support throughout 1998 through a cooperative agreement between USAID and FHI. Nongovernmental organization (NGO) representatives meet on a regular basis in Dar es Salaam and in 8 other regions of the country to plan and coordinate the major aspects of TAP's HIV/AIDS prevention activities in each area. The author describes the evolution of the idea to bring NGOs together into geographic clusters, the diversity of talents enjoyed from using the cluster concept, building institutional capacity, the challenges facing TAP's 9 clusters, and working with traditional communities.

  3. Human papillomavirus vaccine use among adolescent girls and young adult women: an analysis of the 2007 California Health Interview Survey.

    PubMed

    Tiro, Jasmin A; Tsui, Jennifer; Bauer, Heidi M; Yamada, Eileen; Kobrin, Sarah; Breen, Nancy

    2012-06-01

    Administration of the human papillomavirus (HPV) vaccine is recommended for adolescent girls and young adult women. Little is known about the factors associated with vaccination. This study examined prevalence and correlates of HPV vaccine initiation (≥1 dose) among a statewide representative sample of adolescent and young adult females living in California. HPV vaccination data on 3615 parents of adolescent girls aged 12-17 and 2068 young adult women aged 18-27 from the 2007 California Health Interview Survey (CHIS) were examined by sociodemographic, healthcare access, and health behavior factors using chi-square and multivariable logistic regression models. Nineteen percent of adolescent girls and 11% of young adult women had initiated the HPV vaccine series. In both groups, lower educational attainment (parental/own) was associated with lack of vaccine initiation. For adolescents, vaccine initiation was also significantly lower among those whose parents had low incomes or no usual source of care. For young adults, initiation was lower among the older group and those who spent less time in the United States, had public insurance, had no recent provider visit, or had fewer sexual partners. In a statewide representative sample, different correlates of early initiation of HPV vaccination emerged for Californian adolescent girls and young adult women. These different patterns may be due to differential access to programs that provide free or low-cost HPV vaccines. Because several of these factors are associated with disparities in use of Pap tests, disparities will persist or even worsen unless greater effort is placed on vaccinating populations at highest risk for cervical cancer.

  4. Initial preclinical safety of non-replicating human endogenous retrovirus envelope protein-coated baculovirus vector-based vaccines against human papillomavirus.

    PubMed

    Han, Su-Eun; Kim, Mi-Gyeong; Lee, Soondong; Cho, Hee-Jeong; Byun, Youngro; Kim, Sujeong; Kim, Young Bong; Choi, Yongseok; Oh, Yu-Kyoung

    2013-12-01

    Human endogenous retrovirus (HERV) envelope protein-coated, baculovirus vector-based HPV 16 L1 (AcHERV-HPV16L1) is a non-replicating recombinant baculoviral vaccine. Here, we report an initial evaluation of the preclinical safety of AcHERV-HPV16L1 vaccine. In an acute toxicity study, a single administration of AcHERV-HPV16L1 DNA vaccine given intramuscularly (i.m.) to mice at a dose of 1 × 10(8) plaque-forming units (PFU) did not cause significant changes in body weight compared with vehicle-treated controls. It did cause a brief increase in the weights of some organs on day 15 post-treatment, but by day 30, all organ weights were not significantly different from those in the vehicle-treated control group. No hematological changes were observed on day 30 post-treatment. In a range-finding toxicity study with three doses of 1 × 10(7) , 2 × 10(7) and 5 × 10(7) PFU once daily for 5 days, the group treated with 5 × 10(7) PFU showed a transient decrease in the body weights from day 5 to day 15 post-treatment, but recovery to the levels similar to those in the vehicle-treated control group by post-treatment day 20. Organ weights were slightly higher for lymph nodes, spleen, thymus and liver after repeated dosing with 5 × 10(7) PFU on day 15, but had normalized by day 30. Moreover, repeated administration of AcHERV-HPV16L1 did not induce myosin-specific autoantibody in serum, and did not cause immune complex deposition or tissue damage at injection sites. Taken together, these results provide preliminary evidence of the preclinical safety of AcHERV-based HPV16L1 DNA vaccines in mice. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Polio vaccination: past, present and future.

    PubMed

    Bandyopadhyay, Ananda S; Garon, Julie; Seib, Katherine; Orenstein, Walter A

    2015-01-01

    Live attenuated oral polio vaccine (OPV) and inactivated polio vaccine (IPV) are the tools being used to achieve eradication of wild polio virus. Because OPV can rarely cause paralysis and generate revertant polio strains, IPV will have to replace OPV after eradication of wild polio virus is certified to sustain eradication of all polioviruses. However, uncertainties remain related to IPV's ability to induce intestinal immunity in populations where fecal-oral transmission is predominant. Although substantial effectiveness and safety data exist on the use and delivery of OPV and IPV, several new research initiatives are currently underway to fill specific knowledge gaps to inform future vaccination policies that would assure polio is eradicated and eradication is maintained.

  6. Comparing the quality of pro- and anti-vaccination online information: a content analysis of vaccination-related webpages.

    PubMed

    Sak, Gabriele; Diviani, Nicola; Allam, Ahmed; Schulz, Peter J

    2016-01-15

    The exponential increase in health-related online platforms has made the Internet one of the main sources of health information globally. The quality of health contents disseminated on the Internet has been a central focus for many researchers. To date, however, few comparative content analyses of pro- and anti-vaccination websites have been conducted, and none of them compared the quality of information. The main objective of this study was therefore to bring new evidence on this aspect by comparing the quality of pro- and anti-vaccination online sources. Based on past literature and health information quality evaluation initiatives, a 40-categories assessment tool (Online Vaccination Information Quality Codebook) was developed and used to code a sample of 1093 webpages retrieved via Google and two filtered versions of the same search engine. The categories investigated were grouped into four main quality dimensions: web-related design quality criteria (10 categories), health-specific design quality criteria (3 categories), health related content attributes (12 categories) and vaccination-specific content attributes (15 categories). Data analysis comprised frequency counts, cross tabulations, Pearson's chi-square, and other inferential indicators. The final sample included 514 webpages in favor of vaccination, 471 against, and 108 neutral. Generally, webpages holding a favorable view toward vaccination presented more quality indicators compared to both neutral and anti-vaccination pages. However, some notable exceptions to this rule were observed. In particular, no differences were found between pro- and anti-vaccination webpages as regards vaccination-specific content attributes. Our analyses showed that the overall quality of pro-vaccination webpages is superior to anti-vaccination online sources. The developed coding scheme was proven to be a helpful and reliable tool to judge the quality of vaccination-related webpages. Based on the results, we advance

  7. Melioidosis Vaccines: A Systematic Review and Appraisal of the Potential to Exploit Biodefense Vaccines for Public Health Purposes

    PubMed Central

    Lubell, Yoel; Koh, Gavin C. K. W.; White, Lisa J.; Day, Nicholas P. J.; Titball, Richard W.

    2012-01-01

    Background Burkholderia pseudomallei is a Category B select agent and the cause of melioidosis. Research funding for vaccine development has largely considered protection within the biothreat context, but the resulting vaccines could be applicable to populations who are at risk of naturally acquired melioidosis. Here, we discuss target populations for vaccination, consider the cost-benefit of different vaccination strategies and review potential vaccine candidates. Methods and Findings Melioidosis is highly endemic in Thailand and northern Australia, where a biodefense vaccine might be adopted for public health purposes. A cost-effectiveness analysis model was developed, which showed that a vaccine could be a cost-effective intervention in Thailand, particularly if used in high-risk populations such as diabetics. Cost-effectiveness was observed in a model in which only partial immunity was assumed. The review systematically summarized all melioidosis vaccine candidates and studies in animal models that had evaluated their protectiveness. Possible candidates included live attenuated, whole cell killed, sub-unit, plasmid DNA and dendritic cell vaccines. Live attenuated vaccines were not considered favorably because of possible reversion to virulence and hypothetical risk of latent infection, while the other candidates need further development and evaluation. Melioidosis is acquired by skin inoculation, inhalation and ingestion, but routes of animal inoculation in most published studies to date do not reflect all of this. We found a lack of studies using diabetic models, which will be central to any evaluation of a melioidosis vaccine for natural infection since diabetes is the most important risk factor. Conclusion Vaccines could represent one strand of a public health initiative to reduce the global incidence of melioidosis. PMID:22303489

  8. Optimized dosing of a CCR2 antagonist for amplification of vaccine immunity.

    PubMed

    Mitchell, Leah A; Hansen, Ryan J; Beaupre, Adam J; Gustafson, Daniel L; Dow, Steven W

    2013-02-01

    We have recently discovered that inflammatory monocytes recruited to lymph nodes in response to vaccine-induced inflammation can function as potent negative regulators of both humoral and cell-mediated immune responses to vaccination. Monocyte depletion or migration blockade can significantly amplify both antibody titers and cellular immune responses to vaccination with several different antigens in mouse models. Thus, we hypothesized that the use of small molecule CCR2 inhibitors to block monocyte migration into lymph nodes may represent a broadly effective means of amplifying vaccine immunity. To address this question, the role of CCR2 in monocyte recruitment to vaccine draining lymph nodes was initially explored in CCR2-/- mice. Next, a small molecule antagonist of CCR2 (RS102895) was evaluated in mouse vaccination models. Initial studies revealed that a single intraperitoneal dose of RS102895 failed to effectively block monocyte recruitment following vaccination. Pharmacokinetic analysis of RS102895 revealed a short half-life (approximately 1h), and suggested that a multi-dose treatment regimen would be more effective. We found that administration of RS102895 every 6 h resulted in consistent plasma levels of 20 ng/ml or greater, which effectively blocked monocyte migration to lymph nodes following vaccination. Moreover, administration of RS102895 with concurrent vaccination markedly enhanced vaccine responses following immunization against the influenza antigen HA1. We concluded that administration of small molecule CCR2 antagonists such as RS102895 in the immediate post-vaccine period could be used as a novel means of significantly enhancing vaccine immunity. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. AIDS and its effects on the advancement of women.

    PubMed

    1989-01-01

    This document gives an overview of the worldwide spread of acquired immune deficiency syndrome (AIDS), the means of its prevention, and its effects on women who are not infected. It also explains how the AIDS virus is not spread, and why it is important not to be afraid of those infected with the AIDS virus. It stresses the need for information at a time when a vaccine or cure are not yet available, and education is the only means of prevention. The global mobilization being conducted to fight the AIDS crisis is discussed. Different ways in which women are at risk to infection by the HIV virus are reviewed, especially the subordination of women. This denies them the same education, legal rights, training, health, and independent incomes, all of which reduces their chance for access to information about AIDS. It considers risk of being infected by a partner, from a blood transfusion, increased susceptibility in someone who already has a sexually transmitted disease, increased susceptibility in a woman who has been circumcised, risk of infection from rape, and how women are coerced into prostitution, putting them at risk for AIDS. It also covers HIV infection and contraception, the danger to professional health-care workers, transmission of HIV infection from mother-to-infant, and discrimination that is AIDS-related. Women who are not infected are impacted by AIDS because they suffer stress as caretakers. The document also discusses the social and economic consequences of AIDS.

  10. A Statewide System for Improving Influenza Vaccination Rates in Hospital Employees

    PubMed Central

    Polgreen, Philip M.; Polgreen, Linnea A.; Evans, Thomas; Helms, Charles

    2010-01-01

    OBJECTIVE To describe and report the progress of a provider-initiated approach to increase influenza immunization rates for healthcare workers. DESIGN Observational study. SETTING The State of Iowa. SUBJECTS Acute care hospitals in Iowa. METHODS Hospitals reported rates of employee influenza vaccination to a provider-based collaborative during 2 influenza seasons (2006–2007 and 2007–2008). Hospital characteristics related to higher vaccination rates were examined. RESULTS One hundred (87.0%) of 115 Iowa hospitals and/or health systems participated in season 1; individual hospital vaccination rates ranged from 43.5% to 99.2% (mean, 72.4%; median, 73.1%). In season 2, 115 (100%) of 115 Iowa hospitals and/or health systems participated. Individual hospital vaccination rates ranged from 53.6% to 100% (mean, 79.5%; median, 82.0%). In both seasons, urban and large hospitals had vaccination rates that were 6.3% to 7.6% lower than those of hospitals in other locations. Hospitals that used declination statements had influenza vaccination rates 12.6% higher than hospitals that did not use declination statements in season 2. CONCLUSION The initial vaccination rates were high for healthcare workers in Iowa, especially in smaller rural hospitals, and rates increased during season 2. The successful voluntary approach for reporting influenza vaccination rates that we describe provides an efficient platform for collecting and disseminating other statewide measures of healthcare quality. PMID:19327039

  11. A statewide system for improving influenza vaccination rates in hospital employees.

    PubMed

    Polgreen, Philip M; Polgreen, Linnea A; Evans, Thomas; Helms, Charles

    2009-05-01

    To describe and report the progress of a provider-initiated approach to increase influenza immunization rates for healthcare workers. Observational study. The State of Iowa. Acute care hospitals in Iowa. Hospitals reported rates of employee influenza vaccination to a provider-based collaborative during 2 influenza seasons (2006-2007 and 2007-2008). Hospital characteristics related to higher vaccination rates were examined. One hundred (87.0%) of 115 Iowa hospitals and/or health systems participated in season 1; individual hospital vaccination rates ranged from 43.5% to 99.2% (mean, 72.4%; median, 73.1%). In season 2, 115 (100%) of 115 Iowa hospitals and/or health systems participated. Individual hospital vaccination rates ranged from 53.6% to 100% (mean, 79.5%; median, 82.0%). In both seasons, urban and large hospitals had vaccination rates that were 6.3% to 7.6% lower than those of hospitals in other locations. Hospitals that used declination statements had influenza vaccination rates 12.6% higher than hospitals that did not use declination statements in season 2. The initial vaccination rates were high for healthcare workers in Iowa, especially in smaller rural hospitals, and rates increased during season 2. The successful voluntary approach for reporting influenza vaccination rates that we describe provides an efficient platform for collecting and disseminating other statewide measures of healthcare quality.

  12. 22 CFR 224.39 - Appeal to A.I.D. Administrator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., whichever applies. (3) The A.I.D. Administrator may extend the initial 30 day period for an additional 30 days if the defendant files with the A.I.D. Administrator a request for an extension within the initial... within 60 days after the date on which the A.I.D. Administrator serves the defendant with a copy of his...

  13. HIV Vaccine for Prevention and Cure, A Mission Possible.

    PubMed

    Lu, Da-Yong; Wu, Hong-Ying; Ding, Jian; Sastry, Nagendra; Lu, Ting-Ren

    2016-01-01

    HIV/AIDS was once a highly deadly infective disease that killed the global people of a million annually two decades ago. While we are enjoying the HIV therapeutic advances (mostly important from HAART invention), one obvious drawback is still unresolved-unable to clearance all HIV from infected human bodies. As a result, a series of different therapeutic attempts have been proposed based on present knowledge of different features of HIV-induced pathogenesis and human mortalities. Facing this shortcoming, innovative designs and update of HIV vaccines and other types of HIV therapeutic inventions can be a final solution for completely HIV clearance and infection managements in human beings. Owing to these scientific and medical significances, several experimental and clinical attempts have to be made. Among these attempts, part of them (updating HIV vaccine developments and clinical routines) are quite promising and noteworthy. In this article, we offer the general information of this attempt and discuss it separately, especially on the respects of HIV vaccine strategic innovations.

  14. Assessment of BCG vaccination in India

    PubMed Central

    1957-01-01

    A second assessment of the mass BCG-vaccination campaign in India is described in this report. Data were collected to corroborate the findings of the first assessment and to study certain aspects of the problems they posed. Sample retesting of children vaccinated in the mass campaign reveals a higher and less variable allergy than that reported from the preliminary assessment work. The results indicate that a uniform and reasonably high level of allergy has been induced in Indian schoolchildren vaccinated in the campaign period assessed and that deficiencies in the tuberculin test by which the allergy was measured rather than defects of vaccine or vaccination technique were responsible for the disappointing variability initially reported. Testing of unvaccinated village populations in Madras and Mysore confirms previous observations that low-grade, non-specific tuberculin sensitivity is widely prevalent in South India, making it virtually impossible to separate the infected from the uninfected with the tuberculin tests in use today. The development of new techniques for use in areas where the low-grade, non-specific sensitivity is widespread is discussed. PMID:13489464

  15. [Pneumococcal vaccines in children: an update].

    PubMed

    Potin, Marcela

    2014-08-01

    Conjugated pneumococal vaccines had a notable impact on prevention of invasive pneumococcal disease (IPD) in vacccinated and non vaccinated (herd immunity) populations. In Chile a 10 valent conjugated vaccine (PCV10) was introduced in the Nacional Immunization Program (NIP) in 2011, initially in a 3+1 schedule at 2, 4, 6 and 12 months of age, and since 2012 in a 2+1 schedule (2, 4 and 12 months). In prematures schedule 3+1 was maintained. No catch up or high risk groups vaccination strategies were used. The inclusion of PCV10 has reduced the rates of IPD; 66% in infants less than 12 months old and a 60% in 12-24 months old. After 3 years of the introduction of PCV10, no herd immunity has been seen. Serotype replacement shows an increase of ST 3 but not ST19A. Surveillance shows that another vaccine with 13 serotypes (PCV13) would cover an additional 5 to 10% of cases. The nule herd immunity and more extense coverage of PCV13, suggests that NIP should switch from PCV10 to PCV13.

  16. Investigating the origin of AIDS: some ethical dimensions

    PubMed Central

    Martin, B

    2003-01-01

    The theory that AIDS originated from contaminated polio vaccines raises a number of challenging issues with ethical dimensions. The Journal of Medical Ethics dealt with a submission about the theory a decade ago; subsequent developments have raised further issues. Four areas of contention are addressed: whether the theory should be investigated; whether anyone should be blamed; whether defamation actions are appropriate, and whether the scientific community has a responsibility to examine unorthodox theories. PMID:12930866

  17. The Potential Value of Clostridium difficile Vaccine: An Economic Computer Simulation Model

    PubMed Central

    Lee, Bruce Y.; Popovich, Michael J.; Tian, Ye; Bailey, Rachel R.; Ufberg, Paul J.; Wiringa, Ann E.; Muder, Robert R.

    2010-01-01

    Efforts are currently underway to develop a vaccine against Clostridium difficile infection (CDI). We developed two decision analytic Monte Carlo computer simulation models: (1) an Initial Prevention Model depicting the decision whether to administer C. difficile vaccine to patients at-risk for CDI and (2) a Recurrence Prevention Model depicting the decision whether to administer C. difficile vaccine to prevent CDI recurrence. Our results suggest that a C. difficile vaccine could be cost-effective over a wide range of C. difficile risk, vaccine costs, and vaccine efficacies especially when being used post-CDI treatment to prevent recurrent disease. PMID:20541582

  18. Development and clinical testing of multivalent vaccines based on a diphtheria-tetanus-acellular pertussis vaccine: difficulties encountered and lessons learned.

    PubMed

    Capiau, Carine; Poolman, Jan; Hoet, Bernard; Bogaerts, Hugues; Andre, Francis

    2003-06-02

    The widespread use of whole-cell pertussis vaccines in the second half of the 20th century have reduced the incidence of the disease significantly. However, in some countries, concerns about the reactogenicity and potential neurological damage associated with whole-cell vaccines led to a decrease in vaccine acceptance and an increase in morbidity and mortality of pertussis in several countries. This prompted the development of less reactogenic acellular pertussis vaccines combined with diphtheria and tetanus toxoids, initially in Japan and later in other countries. In Europe, the improved diphtheria, tetanus and acellular pertussis (DTPa) vaccine was first introduced in March 1994. The pertussis component of this DTPa vaccine, developed by Glaxo SmithKline, consists of pertussis toxoid, filamentous haemagglutinin and pertactin. The vaccine is well tolerated, with a lower incidence of adverse reactions than after administration of whole-cell vaccines. The long-lasting efficacy and effectiveness of DTPa vaccines have been extensively documented and these are now the cornerstone of a large range of combined vaccines including DTPa-hepatitis B (HBV), DTPa-inactivated polio (IPV) and DTPa-HBV-IPV. A lyophilised Haemophilus influenzae type b (Hib) vaccine can be reconstituted with all of these liquid combinations. The introduction of well-tolerated and efficacious DTPa vaccines and their more polyvalent combinations has improved the acceptance and simplified the implementation of childhood immunisation. This paper is a review of the technical and scientific difficulties encountered and the lessons learned over the 10-year period that it took to develop and introduce six multivalent vaccines using the Glaxo SmithKline DTPa as a building block.

  19. Successful respiratory immunization with dry powder live-attenuated measles virus vaccine in rhesus macaques.

    PubMed

    Lin, Wen-Hsuan; Griffin, Diane E; Rota, Paul A; Papania, Mark; Cape, Stephen P; Bennett, David; Quinn, Brian; Sievers, Robert E; Shermer, Charles; Powell, Kenneth; Adams, Robert J; Godin, Steven; Winston, Scott

    2011-02-15

    Measles remains an important cause of childhood mortality worldwide. Sustained high vaccination coverage is the key to preventing measles deaths. Because measles vaccine is delivered by injection, hurdles to high coverage include the need for trained medical personnel and a cold chain, waste of vaccine in multidose vials and risks associated with needle use and disposal. Respiratory vaccine delivery could lower these barriers and facilitate sustained high coverage. We developed a novel single unit dose, dry powder live-attenuated measles vaccine (MVDP) for respiratory delivery without reconstitution. We tested the immunogenicity and protective efficacy in rhesus macaques of one dose of MVDP delivered either with a mask or directly intranasal with two dry powder inhalers, PuffHaler and BD Solovent. MVDP induced robust measles virus (MeV)-specific humoral and T-cell responses, without adverse effects, which completely protected the macaques from infection with wild-type MeV more than one year later. Respiratory delivery of MVDP was safe and effective and could aid in measles control.

  20. Approaches to Vaccination Among Populations in Areas of Conflict

    PubMed Central

    Nnadi, Chimeremma; Etsano, Andrew; Uba, Belinda; Ohuabunwo, Chima; Melton, Musa; Nganda, Gatei wa; Esapa, Lisa; Bolu, Omotayo; Mahoney, Frank; Vertefeuille, John; Wiesen, Eric; Durry, Elias

    2017-01-01

    Vaccination is an important and cost-effective disease prevention and control strategy. Despite progress in vaccine development and immunization delivery systems worldwide, populations in areas of conflict (hereafter, “conflict settings”) often have limited or no access to lifesaving vaccines, leaving them at increased risk for morbidity and mortality related to vaccine-preventable disease. Without developing and refining approaches to reach and vaccinate children and other vulnerable populations in conflict settings, outbreaks of vaccine-preventable disease in these settings may persist and spread across subnational and international borders. Understanding and refining current approaches to vaccinating populations in conflict and humanitarian emergency settings may save lives. Despite major setbacks, the Global Polio Eradication Initiative has made substantial progress in vaccinating millions of children worldwide, including those living in communities affected by conflicts and other humanitarian emergencies. In this article, we examine key strategic and operational tactics that have led to increased polio vaccination coverage among populations living in diverse conflict settings, including Nigeria, Somalia, and Pakistan, and how these could be applied to reach and vaccinate populations in other settings across the world. PMID:28838202

  1. A policy framework for accelerating adoption of new vaccines

    PubMed Central

    Hajjeh, Rana; Wecker, John; Cherian, Thomas; O'Brien, Katherine L; Knoll, Maria Deloria; Privor-Dumm, Lois; Kvist, Hans; Nanni, Angeline; Bear, Allyson P; Santosham, Mathuram

    2010-01-01

    Rapid uptake of new vaccines can improve health and wealth and contribute to meeting Millennium Development Goals. In the past, however, the introduction and use of new vaccines has been characterized by delayed uptake in the countries where the need is greatest. Based on experience with accelerating the adoption of Hib, pneumococcal and rotavirus vaccines, we propose here a framework for new vaccine adoption that may be useful for future efforts. The framework organizes the major steps in the process into a continuum from evidence to policy, implementation and finally access. It highlights the important roles of different actors at various times in the process and may allow new vaccine initiatives to save time and improve their efficiency by anticipating key steps and actions. PMID:21150269

  2. A policy framework for accelerating adoption of new vaccines.

    PubMed

    Levine, Orin S; Hajjeh, Rana; Wecker, John; Cherian, Thomas; O'Brien, Katherine L; Knoll, Maria Deloria; Privor-Dumm, Lois; Kvist, Hans; Nanni, Angeline; Bear, Allyson P; Santosham, Mathuram

    2010-12-01

    Rapid uptake of new vaccines can improve health and wealth and contribute to meeting Millennium Development Goals. In the past, however, the introduction and use of new vaccines has been characterized by delayed uptake in the countries where the need is greatest. Based on experience with accelerating the adoption of Hib, pneumococcal and rotavirus vaccines, we propose here a framework for new vaccine adoption that may be useful for future efforts. The framework organizes the major steps in the process into a continuum from evidence to policy, implementation and finally access. It highlights the important roles of different actors at various times in the process and may allow new vaccine initiatives to save time and improve their efficiency by anticipating key steps and actions.

  3. Computer-aided detection of initial polyp candidates with level set-based adaptive convolution

    NASA Astrophysics Data System (ADS)

    Zhu, Hongbin; Duan, Chaijie; Liang, Zhengrong

    2009-02-01

    In order to eliminate or weaken the interference between different topological structures on the colon wall, adaptive and normalized convolution methods were used to compute the first and second order spatial derivatives of computed tomographic colonography images, which is the beginning of various geometric analyses. However, the performance of such methods greatly depends on the single-layer representation of the colon wall, which is called the starting layer (SL) in the following text. In this paper, we introduce a level set-based adaptive convolution (LSAC) method to compute the spatial derivatives, in which the level set method is employed to determine a more reasonable SL. The LSAC was applied to a computer-aided detection (CAD) scheme to detect the initial polyp candidates, and experiments showed that it benefits the CAD scheme in both the detection sensitivity and specificity as compared to our previous work.

  4. mRNA Cancer Vaccines-Messages that Prevail.

    PubMed

    Grunwitz, Christian; Kranz, Lena M

    2017-01-01

    During the last decade, mRNA became increasingly recognized as a versatile tool for the development of new innovative therapeutics. Especially for vaccine development, mRNA is of outstanding interest and numerous clinical trials have been initiated. Strikingly, all of these studies have proven that large-scale GMP production of mRNA is feasible and concordantly report a favorable safety profile of mRNA vaccines. Induction of T-cell immunity is a multi-faceted process comprising antigen acquisition, antigen processing and presentation, as well as immune stimulation. The effectiveness of mRNA vaccines is critically dependent on making the antigen(s) of interest available to professional antigen-presenting cells, especially DCs. Efficient delivery of mRNA into DCs in vivo remains a major challenge in the mRNA vaccine field. This review summarizes the principles of mRNA vaccines and highlights the importance of in vivo mRNA delivery and recent advances in harnessing their therapeutic potential.

  5. Helicobacter pylori vaccine: from past to future.

    PubMed

    Agarwal, Kanishtha; Agarwal, Shvetank

    2008-02-01

    Helicobacter pylori infection is highly prevalent worldwide and is an important cause of gastritis, peptic ulcer disease, gastric mucosa-associated lymphoid tissue lymphoma (MALToma), and gastric adenocarcinoma. Infection is usually acquired during childhood and tends to persist unless treated. Because eradication requires treatment with multidrug regimens, prevention of initial infection by a suitable vaccine is attractive. Although immunization with H pylori protein subunits has been encouraging in animals, similar vaccine trials in humans have shown adjuvant-related adverse effects and only moderate effectiveness. Newer immunization approaches (use of DNA, live vectors, bacterial ghosts, and microspheres) are being developed. Several questions about when and whom to vaccinate will need to be appropriately answered, and a cost-effective vaccine production and delivery strategy will have to be useful for developing countries. For this review, we searched MEDLINE using the Medical Subject Heading (MeSH) terms Helicobacter pylori and vaccines for articles in English from 1990 to 2007.

  6. Cost-effectiveness of novel vaccines for tuberculosis control: a decision analysis study

    PubMed Central

    2011-01-01

    Background The development of a successful new tuberculosis (TB) vaccine would circumvent many limitations of current diagnostic and treatment practices. However, vaccine development is complex and costly. We aimed to assess the potential cost effectiveness of novel vaccines for TB control in a sub-Saharan African country - Zambia - relative to the existing strategy of directly observed treatment, short course (DOTS) and current level of bacille Calmette-Guérin (BCG) vaccination coverage. Methods We conducted a decision analysis model-based simulation from the societal perspective, with a 3% discount rate and all costs expressed in 2007 US dollars. Health outcomes and costs were projected over a 30-year period, for persons born in Zambia (population 11,478,000 in 2005) in year 1. Initial development costs for single vaccination and prime-boost strategies were prorated to the Zambian share (0.398%) of global BCG vaccine coverage for newborns. Main outcome measures were TB-related morbidity, mortality, and costs over a range of potential scenarios for vaccine efficacy. Results Relative to the status quo strategy, a BCG replacement vaccine administered at birth, with 70% efficacy in preventing rapid progression to TB disease after initial infection, is estimated to avert 932 TB cases and 422 TB-related deaths (prevention of 199 cases/100,000 vaccinated, and 90 deaths/100,000 vaccinated). This would result in estimated net savings of $3.6 million over 30 years for 468,073 Zambians born in year 1 of the simulation. The addition of a booster at age 10 results in estimated savings of $5.6 million compared to the status quo, averting 1,863 TB cases and 1,011 TB-related deaths (prevention of 398 cases/100,000 vaccinated, and of 216 deaths/100,000 vaccinated). With vaccination at birth alone, net savings would be realized within 1 year, whereas the prime-boost strategy would require an additional 5 years to realize savings, reflecting a greater initial development cost

  7. Clinical experience with respiratory syncytial virus vaccines.

    PubMed

    Piedra, Pedro A

    2003-02-01

    Respiratory syncytial virus (RSV) infection is at times associated with life-threatening lower respiratory tract illness in infancy. Severe infection during the first year of life may be an important risk factor or indicator for the development of asthma in early childhood. Severe infections primarily occur in healthy infants, and young infants and children with specific risk factors. However, RSV causes respiratory infections in all age groups. Indeed it is now recognized that RSV disease is responsible for significant morbidity and mortality in the geriatric population. RSV infection remains difficult to treat, and prevention is a worldwide goal. For this reason there has been an intensive effort to develop an effective and safe RSV vaccine. Initial infection with RSV affords limited protection to reinfection, yet repeated episodes decrease the risk for lower respiratory tract illness. In the 20 years from 1960 to 1980, trials of several candidate RSV vaccines failed to attain the desired safety and protection against natural infection. Some vaccine types either failed to elicit immunogenicity, as with the live subcutaneous vaccine, or resulted in exaggerated disease on natural exposure to the virus, as with the formalin-inactivated (FI) type. Currently vaccine candidates are being developed based on the molecular virology of RSV. Recent formulations of candidate RSV vaccines have focused on subunit vaccines [such as purified fusion protein (PFP)], subunit vaccines combined with nonspecific immune activating adjuvants, live attenuated vaccines (including cold passaged, temperature-sensitive or cpts mutants), genetically engineered live attenuated vaccines and polypeptide vaccines.

  8. Using Behavioral Risk Factor Data as a surveillance tool to monitor the prevalence of initiation, continuation and completion of Human Papilloma Virus vaccination in children.

    PubMed

    Barboza, Gia Elise; Dominguez, Silvia

    2016-06-01

    The Human Papilloma Virus ("HPV") is a common sexually transmitted disease that has infected approximately 79 million men and women in the United States alone. A vaccination is available but in order to be effective it must be received prior to becoming sexually active and recipients must complete a three-dose sequence. In this article we explore the predisposing, enabling and need-based factors associated with parents' or guardians' decision to have their child initiate, continue and complete the Human Papilloma Virus (HPV) vaccine. The data file includes 5531 parents and guardians with presumptive knowledge regarding the number of HPV vaccination their child received. Data includes information on the child (e.g. child׳s age) as well as the adult respondent (e.g. health insurance status). A smaller subset of the dataset along with the code to run the model are supplied with this article. The interpretation of these data can be found in the research article published by the authors in the Journal of Preventive Medicine in 2015 http://dx.doi.org/10.1016/j.ypmed.2016.01.010[1].

  9. Media coverage of anthrax vaccination refusal by Australian Defence Force personnel.

    PubMed

    Ackermann, Deonna; Chapman, Simon; Leask, Julie

    2004-12-02

    During February 2003 a number of Australian sailors were returned home from their deployment to the Persian Gulf after refusing anthrax vaccination. This paper examines the media coverage of this episode as a case study in how controversies about vaccine safety escalate. Frame analysis of articles from major Australian newspapers (n=83) and transcripts of radio and television news and current affairs programs (n=22) to identify the main supportive and oppositional themes used in reportage and media debate. Initially, the major news frames were supportive of the vaccine refusing soldiers, and conveyed a sense of distrust of the government's actions. These initial themes were rapidly re-framed and new dominant discourses appeared. First, sailors went from brave whistleblowers to being portrayed as deserters and cowards. Second, proponents shifted from their portrayal as faceless regulators to personal risk takers embodied in a well-respected Major General having the vaccine. Third, the voluntary nature of the vaccine was emphasised, thus dousing the flames of implied coercion. Marked shifts in the representation of vaccine opponents and proponents possibly contributed to the rapid diminishment of media interest in the story.

  10. Impact of introduction of the 9-valent human papillomavirus vaccine on vaccination coverage of youth in North Carolina.

    PubMed

    Trogdon, Justin G; Shafer, Paul; Lindsay, Brianna; Coyne-Beasley, Tamera

    2018-02-28

    The objective of this study was to evaluate the impact of introduction of 9vHPV vaccine on HPV vaccination uptake (doses per capita) and initiation (≥1 doses), completion (≥3 doses) and compliance (≥3 doses within 12 months) by adolescents. We used a retrospective cohort analysis using North Carolina Immunization Registry (NCIR) data from January 2008 through October 2016. The sample included Vaccines for Children eligible adolescents aged 9 to 17 years in 2016, for whom the NCIR contains complete vaccination history. We applied an interrupted time series design to measure associations between ZIP Code Tabulation Area (ZCTA)-level HPV vaccination outcomes over time with the introduction of 9vHPV in North Carolina (NC) in July 2015. Each outcome displayed a linear upward trend over time with large seasonal spikes near August of each year, corresponding to the time when adolescents often receive other vaccines required for school entry. After accounting for these underlying trends, introduction of 9vHPV was not associated with a change in publicly funded HPV vaccination rates in NC. Our results indicate that 9vHPV substituted for 4vHPV in the first year after release in NC, but the release of 9vHPV was not associated with an overall change in HPV vaccination. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Considerations for sustainable influenza vaccine production in developing countries.

    PubMed

    Nannei, Claudia; Chadwick, Christopher; Fatima, Hiba; Goldin, Shoshanna; Grubo, Myriam; Ganim, Alexandra

    2016-10-26

    Through its Global Action Plan for Influenza Vaccines (GAP), the World Health Organization (WHO) in collaboration with the United States Department of Health and Human Services has produced a checklist to support policy-makers and influenza vaccine manufacturers in identifying key technological, political, financial, and logistical issues affecting the sustainability of influenza vaccine production. This checklist highlights actions in five key areas that are beneficial for establishing successful local vaccine manufacturing. These five areas comprise: (1) the policy environment and health-care systems; (2) surveillance systems and influenza evidence; (3) product development and manufacturing; (4) product approval and regulation; and (5) communication to support influenza vaccination. Incorporating the checklist into national vaccine production programmes has identified the policy gaps and next steps for countries involved in GAP's Technology Transfer Initiative. Lessons learnt from country experiences provide context and insight that complement the checklist's goal of simplifying the complexities of influenza prevention, preparedness, and vaccine manufacturing. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Vaccinating parents experience vaccine anxiety too.

    PubMed

    Luthy, Karlen E; Beckstrand, Renea L; Asay, Whitney; Hewett, Carly

    2013-12-01

    To identify common causes of parental anxiety regarding childhood vaccinations among parents who vaccinate. Another purpose was to seek recommendations for healthcare providers to help parents overcome their anxiety when their children are immunized. Four 1-h focus groups were conducted, each consisting of 8-10 parents. Each focus group discussion was conducted by a moderator and an assistant moderator. The moderator facilitated discussion while the assistant moderator took notes. Each session was recorded on video. The data were transcribed and analyzed for themes. Parents identifying themselves as being compliant with childhood vaccination requirements reported anxiety that can be divided into five major themes: parental anxiety prior to vaccination, parental anxiety during the vaccination, parental anxiety after the vaccination, parental suggestions for healthcare providers, and informational issues. Making minor changes in office policies may help alleviate some parental anxiety regarding vaccinations. Providers should also create lists of credible sources about vaccination information. Because the cause of vaccine-related parental anxiety varies, targeted education is necessary to relieve common causes of vaccine anxiety, even among parents who vaccinate. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  13. Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

    PubMed Central

    Mugambi, Melissa L.; Palamountain, Kara M.; Gallarda, Jim; Drain, Paul K.

    2017-01-01

    In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs). Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI). Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping) might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI). PMID:28134750

  14. Vaccine decision-making begins in pregnancy: Correlation between vaccine concerns, intentions and maternal vaccination with subsequent childhood vaccine uptake.

    PubMed

    Danchin, M H; Costa-Pinto, J; Attwell, K; Willaby, H; Wiley, K; Hoq, M; Leask, J; Perrett, K P; O'Keefe, Jacinta; Giles, M L; Marshall, H

    2017-08-12

    Maternal and childhood vaccine decision-making begins prenatally. Amongst pregnant Australian women we aimed to ascertain vaccine information received, maternal immunisation uptake and attitudes and concerns regarding childhood vaccination. We also aimed to determine any correlation between a) intentions and concerns regarding childhood vaccination, (b) concerns about pregnancy vaccination, (c) socioeconomic status (SES) and (d) uptake of influenza and pertussis vaccines during pregnancy and routine vaccines during childhood. Women attending public antenatal clinics were recruited in three Australian states. Surveys were completed on iPads. Follow-up phone surveys were done three to six months post delivery, and infant vaccination status obtained via the Australian Childhood Immunisation Register (ACIR). Between October 2015 and March 2016, 975 (82%) of 1184 mothers consented and 406 (42%) agreed to a follow up survey, post delivery. First-time mothers (445; 49%) had significantly more vaccine concerns in pregnancy and only 73% had made a decision about childhood vaccination compared to 89% of mothers with existing children (p-value<0.001). 66% of mothers reported receiving enough information during pregnancy on childhood vaccination. In the post delivery survey, 46% and 82% of mothers reported receiving pregnancy influenza and pertussis vaccines respectively. The mother's degree of vaccine hesitancy and two attitudinal factors were correlated with vaccine uptake post delivery. There was no association between reported maternal vaccine uptake or SES and childhood vaccine uptake. First time mothers are more vaccine hesitant and undecided about childhood vaccination, and only two thirds of all mothers believed they received enough information during pregnancy. New interventions to improve both education and communication on childhood and maternal vaccines, delivered by midwives and obstetricians in the Australian public hospital system, may reduce vaccine hesitancy

  15. A brief history of the global effort to develop a preventive HIV vaccine.

    PubMed

    Esparza, José

    2013-08-02

    Soon after HIV was discovered as the cause of AIDS in 1983-1984, there was an expectation that a preventive vaccine would be rapidly developed. In trying to achieve that goal, three successive scientific paradigms have been explored: induction of neutralizing antibodies, induction of cell mediated immunity, and exploration of combination approaches and novel concepts. Although major progress has been made in understanding the scientific basis for HIV vaccine development, efficacy trials have been critical in moving the field forward. In 2009, the field was reinvigorated with the modest results obtained from the RV144 trial conducted in Thailand. Here, we review those vaccine development efforts, with an emphasis on events that occurred during the earlier years. The goal is to provide younger generations of scientists with information and inspiration to continue the search for an HIV vaccine. Copyright © 2013 The Author. Published by Elsevier Ltd.. All rights reserved.

  16. Beyond empiricism: informing vaccine development through innate immunity research.

    PubMed

    Levitz, Stuart M; Golenbock, Douglas T

    2012-03-16

    Although a great public heath success, vaccines provide suboptimal protection in some patient populations and are not available to protect against many infectious diseases. Insights from innate immunity research have led to a better understanding of how existing vaccines work and have informed vaccine development. New adjuvants and delivery systems are being designed based upon their capacity to stimulate innate immune sensors and target antigens to dendritic cells, the cells responsible for initiating adaptive immune responses. Incorporating these adjuvants and delivery systems in vaccines can beneficially alter the quantitative and qualitative nature of the adaptive immune response, resulting in enhanced protection. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Development of a multicomponent Staphylococcus aureus vaccine designed to counter multiple bacterial virulence factors

    PubMed Central

    Anderson, Annaliesa S.; Miller, Alita A.; Donald, Robert G.K.; Scully, Ingrid L.; Nanra, Jasdeep S.; Cooper, David; Jansen, Kathrin U.

    2012-01-01

    Staphylococcus aureus is a major cause of healthcare-associated infections and is responsible for a substantial burden of disease in hospitalized patients. Despite increasingly rigorous infection control guidelines, the prevalence and corresponding negative impact of S. aureus infections remain considerable. Difficulties in controlling S. aureus infections as well as the associated treatment costs are exacerbated by increasing rates of resistance to available antibiotics. Despite ongoing efforts over the past 20 years, no licensed S. aureus vaccine is currently available. However, learnings from past clinical failures of vaccine candidates and a better understanding of the immunopathology of S. aureus colonization and infection have aided in the design of new vaccine candidates based on multiple important bacterial pathogenesis mechanisms. This review outlines important considerations in designing a vaccine for the prevention of S. aureus disease in healthcare settings. PMID:22922765

  18. Barriers for Hispanic women in receiving the human papillomavirus vaccine: a nursing challenge.

    PubMed

    Wagner, Janelle

    2009-12-01

    Cervical cancer affects more Hispanic women than non-Hispanic women in the United States. A vaccination exists to aid in the prevention of cervical cancer; an estimated 70% of cases could be avoided with the human papillomavirus (HPV) vaccine. However, women of Hispanic descent have many access barriers. By identifying and addressing such barriers, nurses can play a significant role in educating Hispanic women about the benefits of vaccination before HPV exposure occurs. Theoretical integration with Leininger's Culture Care Theory of Diversity and Universality provides a framework to address cultural differences and awareness when educating Hispanic women about this health issue. Additional nursing research into effective communication and educational programs to help reach the Hispanic population continues to be a priority in this vulnerable community.

  19. Refining the approach to vaccines against influenza A viruses with pandemic potential

    PubMed Central

    Czako, Rita; Subbarao, Kanta

    2015-01-01

    Vaccination is the most effective strategy for prevention and control of influenza. Timely production and deployment of seasonal influenza vaccines is based on an understanding of the epidemiology of influenza and on global disease and virologic surveillance. Experience with seasonal influenza vaccines guided the initial development of pandemic influenza vaccines. A large investment in pandemic influenza vaccines in the last decade has resulted in much progress and a body of information that can now be applied to refine the established paradigm. Critical and complementary considerations for pandemic influenza vaccines include improved assessment of the pandemic potential of animal influenza viruses, proactive development and deployment of pandemic influenza vaccines, and application of novel platforms and strategies for vaccine production and administration. PMID:26587050

  20. Immune memory in children previously vaccinated with an experimental quadrivalent meningococcal polysaccharide diphtheria toxoid conjugate vaccine.

    PubMed

    Pichichero, Michael; Papa, Thomas; Blatter, Mark; Mitchell, Douglas; Kratz, Richard; Sneed, Jane; Bassily, Ehab; Casey, Janet; Gilmet, Gregory

    2006-11-01

    In a previous study, a meningococcal diphtheria toxoid conjugate vaccine (MCV-4) triggered robust bactericidal antibody responses against serogroups A, C, Y, and W-135 in 2- to 10-year-old children. A subset of participants, 2 to 3 years of age at the initial vaccination, was evaluated for persistence of antibody, immune memory, and antibody avidity. Participants were healthy children vaccinated 23 to 36 months earlier with MCV-4 (primed) or newly recruited meningococcal vaccine-naive 4-year-olds. Participants in both groups were alternately allocated to provide sera 8 or 28 days after administration of one tenth of the recommended dose of a meningococcal polysaccharide vaccine (PSV-4). Immune responses were assessed in sera obtained at baseline and either 8 or 28 days after reduced-dose PSV-4 administration. Safety was monitored. Before PSV-4 challenge, serum bactericidal antibody geometric mean titers (SBA GMTs) were higher for all 4 serogroups in the MCV-4-primed group than in the vaccine-naive group. SBA GMTs, geometric mean concentrations of immunoglobulin G (IgG) and geometric mean avidity indices for all 4 serogroups were significantly higher among MCV-4-primed versus vaccine-naive participants in the cohorts evaluated at 8 or 28 days after PSV-4 challenge. Adverse events were generally mild, self-limited, and comparable in all groups of children. Persistence of bactericidal antibody was seen for 23 to 36 months after a primary dose of MCV-4 in young children. Booster responses and avidity maturation were evident after a challenge with reduced-dose polysaccharide vaccine.

  1. Workshop report: Malaria vaccine development in Europe--preparing for the future.

    PubMed

    Viebig, Nicola K; D'Alessio, Flavia; Draper, Simon J; Sim, B Kim Lee; Mordmüller, Benjamin; Bowyer, Paul W; Luty, Adrian J F; Jungbluth, Stefan; Chitnis, Chetan E; Hill, Adrian V S; Kremsner, Peter; Craig, Alister G; Kocken, Clemens H M; Leroy, Odile

    2015-11-17

    The deployment of a safe and effective malaria vaccine will be an important tool for the control of malaria and the reduction in malaria deaths. With the launch of the 2030 Malaria Vaccine Technology Roadmap, the malaria community has updated the goals and priorities for the development of such a vaccine and is now paving the way for a second phase of malaria vaccine development. During a workshop in Brussels in November 2014, hosted by the European Vaccine Initiative, key players from the European, North American and African malaria vaccine community discussed European strategies for future malaria vaccine development in the global context. The recommendations of the European malaria community should guide researchers, policy makers and funders of global health research and development in fulfilling the ambitious goals set in the updated Malaria Vaccine Technology Roadmap. Copyright © 2015.

  2. [Private companies: an opportunity for hepatitis B virus (HBV) prevention and care in Ivory Coast in the wake of HIV/AIDS?].

    PubMed

    Bekelynck, A

    2015-02-01

    In the 1990s, defenders of "aids exceptionnalism" have promised that the inequities caused by HIV/AIDS could provide leverage in the care of other health issues later. Fifteen years later, this argument can be rethought at the light of the current context of hepatitis B virus (HBV) in Ivory Coast. In fact, in this country, the challenges caused by HBVecho those of HIV/AIDS fifteen years ago: high prevalence (8-10%), ignorance of the disease, and high cost of care. To this end, this article compares the role of private companies in the fights against HIV/AIDS in the 2000s and its role in the fight against HBV today. Although some private firms played a critical role in the promotion of universal access to ART, today, they are one of the few places where HBV screening, vaccination and treatment are offered in the country. HIV/AIDS opened the door for private companies to address other diseases through their health care systems. However, many challenges still need to be met: the absence of qualitative ongoing training for health professionals, illness representations and the costs of treatments, which are all related to the lack of international and national collective action. In Ivory Coast, at the early stage of the HIV/AIDS epidemic, national authorities took up the leadership in the fight against AIDS in West Africa, by developing extraverted strategies (Xth ICASA's organization, Unaids initiative hosting). The exceptional international mobilization and the creation of innovative funding mechanisms [International Therapeutic Solidarity Fund (ITSF), Global Fund (GM), and President's Emergency Plan for AIDS Relief (PEPFAR)] have facilitated easy access to ARV. Although 380 million people are infected by chronic HBV in the world, even so, international and national collective actions are fledgling and remained weak. Moreover, private firms have represented leverage for testing, treatment, and the provision of universal access to medication in the context of the HIV/AIDS

  3. Cost-Effectiveness of Norovirus Vaccination in Children in Peru

    PubMed Central

    Mirelman, Andrew; Ballard, Sarah-Blythe; Saito, Mayuko; Kosek, Margaret; Gilman, Robert H.

    2015-01-01

    Background With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. Methods We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru’s routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Results Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. Conclusions The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence

  4. Cost-effectiveness of norovirus vaccination in children in Peru.

    PubMed

    Mirelman, Andrew J; Ballard, Sarah Blythe; Saito, Mayuko; Kosek, Margaret N; Gilman, Robert H

    2015-06-17

    With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru's routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence rates are expected to be higher. Published

  5. Bad Blood: The Tuskegee Syphilis Study and Legacy Recruitment for Experimental AIDS Vaccines

    ERIC Educational Resources Information Center

    Hagen, Kimberly Sessions

    2005-01-01

    For African Americans, medical research often connotes exploitation and cruelty, making recruiting African Americans to participate in HIV vaccine trials particularly daunting. But infusing adult education principles into such efforts is both increasing African American participation and helping heal the legacy of the Tuskegee experiment.

  6. Human papillomavirus vaccines and vaccine implementation.

    PubMed

    de Sanjosé, Silvia; Alemany, Laia; Castellsagué, Xavier; Bosch, F Xavier

    2008-11-01

    Countries are now challenged by the rapid development of vaccines aimed at the primary prevention of infections. In the years to come, several vaccines will need to be considered as potential candidates in routine immunization programs. Recently, two new vaccines against two/four types of human papillomavirus (HPV) have been commercialized. Bivalent HPV 16 and 18 (Cervarix) and quadrivalent HPV 6, 11, 16 and 18 (Gardasil) vaccines are now extensively used in some countries. These vaccines will prevent infection and long-running complications, such as cervical cancer, other HPV-related cancers and genital warts (for the quadrivalent vaccine). The beneficial effect of these vaccines will be largely observed in women. This article summarizes the burden of HPV preventable disease worldwide and briefly describes the impact of secondary prevention and the most relevant aspects of the current available vaccines, their efficacy and safety. Finally, some major aspects that are likely to impact the introduction of these vaccines around the world are outlined, with particular emphasis on developing countries.

  7. New drugs, new vaccines, new diseases. An interview with Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID).

    PubMed

    Fuller, J

    1996-11-01

    This document presents an interview with Dr. Anthony Fauci on the development of a new generation of vaccines to prevent and possibly eradicate a legion of deadly diseases ranging from tuberculosis to AIDS. Infections that have caused major devastations in the world today include tuberculosis, malaria, schistosomiasis, filariasis, pneumococcal pneumonia, influenza, AIDS, and Ebola. Agencies should be making sure that the basic research base in microbiology, immunology, antimicrobials, and vaccinology is at the very highest level. The integration of research efforts between countries depends on collaboration between the investigators of home countries with foreign investigators. Among new developments in vaccinology are an acellular pertussis vaccine for pertussis/whooping cough (an extremely contagious disease that causes death), DNA immunization (a new technique applicable to all types of diseases), and transgenic plants for immunization against hepatitis, pertussis, and polio. As of now, AIDS in Western countries has declined, while in Africa and Asia its spread has accelerated. Combination therapy for AIDS has had a profound impact on the level of the virus in the body; however, the treatment is still vague. The good news with regard to AIDS is that education is having an impact; this is exemplified by the situation in Thailand, where the government together with nongovernmental organizations and the military has begun a crash education campaign regarding prostitutes and the use of condoms. Progress is being made in the search for better vaccine candidates. AIDS-like epidemics involving new diseases are bound to emerge at some future point, though, given the long-term historical trend.

  8. Facilitators and barriers to implementation of the AIDES initiative, a social innovation for participative assessment of children in need and for coordination of services.

    PubMed

    Dufour, Sarah; Lessard, Danielle; Chamberland, Claire

    2014-12-01

    As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. The potential value of Clostridium difficile vaccine: an economic computer simulation model.

    PubMed

    Lee, Bruce Y; Popovich, Michael J; Tian, Ye; Bailey, Rachel R; Ufberg, Paul J; Wiringa, Ann E; Muder, Robert R

    2010-07-19

    Efforts are currently underway to develop a vaccine against Clostridium difficile infection (CDI). We developed two decision analytic Monte Carlo computer simulation models: (1) an Initial Prevention Model depicting the decision whether to administer C. difficile vaccine to patients at-risk for CDI and (2) a Recurrence Prevention Model depicting the decision whether to administer C. difficile vaccine to prevent CDI recurrence. Our results suggest that a C. difficile vaccine could be cost-effective over a wide range of C. difficile risk, vaccine costs, and vaccine efficacies especially, when being used post-CDI treatment to prevent recurrent disease. (c) 2010 Elsevier Ltd. All rights reserved.

  10. Technology transfer of oil-in-water emulsion adjuvant manufacturing for pandemic influenza vaccine production in Romania: Preclinical evaluation of split virion inactivated H5N1 vaccine with adjuvant.

    PubMed

    Stavaru, Crina; Onu, Adrian; Lupulescu, Emilia; Tucureanu, Catalin; Rasid, Orhan; Vlase, Ene; Coman, Cristin; Caras, Iuliana; Ghiorghisor, Alina; Berbecila, Laurentiu; Tofan, Vlad; Bowen, Richard A; Marlenee, Nicole; Hartwig, Airn; Bielefeldt-Ohmann, Helle; Baldwin, Susan L; Van Hoeven, Neal; Vedvick, Thomas S; Huynh, Chuong; O'Hara, Michael K; Noah, Diana L; Fox, Christopher B

    2016-04-02

    Millions of seasonal and pandemic influenza vaccine doses containing oil-in-water emulsion adjuvant have been administered in order to enhance and broaden immune responses and to facilitate antigen sparing. Despite the enactment of a Global Action Plan for Influenza Vaccines and a multi-fold increase in production capabilities over the past 10 years, worldwide capacity for pandemic influenza vaccine production is still limited. In developing countries, where routine influenza vaccination is not fully established, additional measures are needed to ensure adequate supply of pandemic influenza vaccines without dependence on the shipment of aid from other, potentially impacted first-world countries. Adaptation of influenza vaccine and adjuvant technologies by developing country influenza vaccine manufacturers may enable antigen sparing and corresponding increases in global influenza vaccine coverage capacity. Following on previously described work involving the technology transfer of oil-in-water emulsion adjuvant manufacturing to a Romanian vaccine manufacturing institute, we herein describe the preclinical evaluation of inactivated split virion H5N1 influenza vaccine with emulsion adjuvant, including immunogenicity, protection from virus challenge, antigen sparing capacity, and safety. In parallel with the evaluation of the bioactivity of the tech-transferred adjuvant, we also describe the impact of concurrent antigen manufacturing optimization activities. Depending on the vaccine antigen source and manufacturing process, inclusion of adjuvant was shown to enhance and broaden functional antibody titers in mouse and rabbit models, promote protection from homologous virus challenge in ferrets, and facilitate antigen sparing. Besides scientific findings, the operational lessons learned are delineated in order to facilitate adaptation of adjuvant technologies by other developing country institutes to enhance global pandemic influenza preparedness.

  11. Status of arenavirus vaccines and their application

    PubMed Central

    Johnson, Karl M.

    1975-01-01

    A limited but definite need exists for vaccines against Lassa, Junin, and Machupo viruses. Medical and laboratory personnel, as well as defined high-risk population groups, require protection from these highly virulent agents. To date little work has been done on inactivated vaccines for these viruses. A live attenuated Junin vaccine has been tested successfully in more than 600 persons, and a high-passage Machupo virus strain has protected rhesus monkeys against lethal infection produced by a homologous field strain. Work has been initiated on possible heterologous protection induced by infection or antigenic stimulation with arenaviruses not pathogenic for man. Crucial for the eventual development of effective vaccines are the construction of more maximum security laboratories and the further elucidation of the experimental and natural biology of the agents in lower animals and man. PMID:182407

  12. Immune responses of bison and efficacy after booster vaccination with Brucella abortus strain RB51

    USDA-ARS?s Scientific Manuscript database

    Thirty-one bison heifers were randomly assigned to saline (control; n=7) or single vaccination (n=24) with 1010 CFU of B. abortus strain RB51 (RB51). Some vaccinated bison were randomly selected for booster vaccination with 10**10 CFU of RB51 at 11 months after initial vaccination (n=16). When comp...

  13. Vaccinations in sickle cell disease: An audit of vaccination uptake in sickle cell patients attending Newham University Hospital.

    PubMed

    Gorham, M W; Smith, C R; Smith, S K; Wong, L; Kreze, O

    2015-09-11

    To assess the level of adherence of patients with sickle cell disease to the advised vaccination schedule with respect to the Sickle Cell Society guidelines on vaccination [1,2]. A retrospective audit of patients' vaccination records was carried out between July 2012 and June 2013 on a sample of 80 patients over the age of 16, who attended Newham University Hospital accident and emergency (A&E) department with a presenting complaint coded as "sickle cell". A re-audit was conducted from January 2014 to December 2014 to close the audit loop. Chi-squared and Fisher's exact tests were used to compare the results. The initial audit and re-audit identified 80 and 86 patients, respectively. Only 2 (2012-2013) and 7 (2014) patients had a complete up-to-date vaccination profile. 24 (30%) patients had up-to-date influenza vaccination, increasing to 43 (50%, P=0.0062) when re-audited. 33 (41%) had current pneumococcal vaccinations, increasing to 38 (44%, P=0.7874). Uptake rates for vaccinations against Meningococcal group C (MenC), Haemophilus influenzae B (HiB) and Hepatitis B virus (HBV) were under 31% in both audits. A significant improvement in vaccination rate was observed for all vaccinations except pneumococcal and HBV. Although significant improvements have been demonstrated, this audit shows a low level of adherence to the advised vaccination schedule. The study also highlighted a shortfall in appropriate record keeping, reducing the potential for detailed conclusions being drawn in relation to the childhood vaccinations against MenC, HiB and HBV. Implementation of a new database of vaccination history, raising GP awareness and patient education seminars has lead to a significant improvement in vaccination rates locally and the authors hope that this may be replicated in other centres. There may be potential to increase rates further by administering vaccinations to inpatients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Setting government priorities in preventing HIV / AIDS.

    PubMed

    Ainsworth, M

    1998-03-01

    Since no cure has yet been found for AIDS and an effective vaccine is far off, preventing HIV infection by changing individual behavior is the key to stopping the AIDS epidemic in developing countries. People who have many sex partners and do not use condoms, and people who inject drugs and share unsterilized injecting equipment have the greatest risk of contracting HIV and infecting others. How quickly and extensively an HIV/AIDS epidemic spreads in a given population depends largely upon the extent to which people with many sex partners mix with people with fewer partners. A World Bank research report has, however, found that people who engage in high-risk behavior act to reduce their risk of contracting and spreading HIV when they have the knowledge and means to do so and a supportive community. The report highlights the following strategies to reduce risky behavior: providing information, lowering the costs of safer behavior, and raising the costs of risky behavior. Governments' main responsibilities in preventing the spread of HIV/AIDS are reducing the negative externalities of high-risk behavior and producing public goods. Without government action, individuals and firms will not have the incentives to do what is necessary. The need to act now and mobilizing political support are discussed.

  15. Application of “Systems Vaccinology” to Evaluate Inflammation and Reactogenicity of Adjuvanted Preventative Vaccines

    PubMed Central

    Lewis, David J. M.; Lythgoe, Mark P.

    2015-01-01

    Advances in “omics” technology (transcriptomics, proteomics, metabolomics, genomics/epigenomics, etc.) allied with statistical and bioinformatics tools are providing insights into basic mechanisms of vaccine and adjuvant efficacy or inflammation/reactogenicity. Predictive biomarkers of relatively frequent inflammatory reactogenicity may be identified in systems vaccinology studies involving tens or hundreds of participants and used to screen new vaccines and adjuvants in in vitro, ex vivo, animal, or human models. The identification of rare events (such as those observed with initial rotavirus vaccine or suspected autoimmune complications) will require interrogation of large data sets and population-based research before application of systems vaccinology. The Innovative Medicine Initiative funded public-private project BIOVACSAFE is an initial attempt to systematically identify biomarkers of relatively common inflammatory events after adjuvanted immunization using human, animal, and population-based models. Discriminatory profiles or biomarkers are being identified, which require validation in large trials involving thousands of participants before they can be generalized. Ultimately, it is to be hoped that the knowledge gained from such initiatives will provide tools to the industry, academia, and regulators to select optimal noninflammatory but immunogenic and effective vaccine adjuvant combinations, thereby shortening product development cycles and identifying unsuitable vaccine candidates that would fail in expensive late stage development or postmarketing. PMID:26380327

  16. Dual purpose recovered coagulant from drinking water treatment residuals for adjustment of initial pH and coagulation aid in electrocoagulation process.

    PubMed

    Jung, Kyung-Won; Ahn, Kyu-Hong

    2016-01-01

    The present study is focused on the application of recovered coagulant (RC) by acidification from drinking water treatment residuals for both adjusting the initial pH and aiding coagulant in electrocoagulation. To do this, real cotton textile wastewater was used as a target pollutant, and decolorization and chemical oxygen demand (COD) removal efficiency were monitored. A preliminary test indicated that a stainless steel electrode combined with RC significantly accelerated decolorization and COD removal efficiencies, by about 52% and 56%, respectively, even at an operating time of 5 min. A single electrocoagulation system meanwhile requires at least 40 min to attain the similar removal performances. Subsequently, the interactive effect of three independent variables (applied voltage, initial pH, and reaction time) on the response variables (decolorization and COD removal) was evaluated, and these parameters were statistically optimized using the response surface methodology. Analysis of variance showed a high coefficient of determination values (decolorization, R(2) = 0.9925 and COD removal, R(2) = 0.9973) and satisfactory prediction second-order polynomial quadratic regression models. Average decolorization and COD removal of 89.52% and 94.14%, respectively, were achieved, corresponding to 97.8% and 98.1% of the predicted values under statistically optimized conditions. The results suggest that the RC effectively played a dual role of both adjusting the initial pH and aiding coagulant in the electrocoagulation process.

  17. Attenuating homologous recombination stimulates an AID-induced antileukemic effect

    PubMed Central

    Lamont, Kristin R.; Hasham, Muneer G.; Donghia, Nina M.; Branca, Jane; Chavaree, Margaret; Chase, Betsy; Breggia, Anne; Hedlund, Jacquelyn; Emery, Ivette; Cavallo, Francesca; Jasin, Maria; Rüter, Jens

    2013-01-01

    Activation-induced cytidine deaminase (AID) is critical in normal B cells to initiate somatic hypermutation and immunoglobulin class switch recombination. Accumulating evidence suggests that AID is also prooncogenic, inducing cancer-promoting mutations or chromosome rearrangements. In this context, we find that AID is expressed in >40% of primary human chronic lymphocytic leukemia (CLL) cases, consistent with other reports. Using a combination of human B lymphoid leukemia cells and mouse models, we now show that AID expression can be harnessed for antileukemic effect, after inhibition of the RAD51 homologous recombination (HR) factor with 4,4′-diisothiocyanatostilbene-2-2′-disulfonic acid (DIDS). As a proof of principle, we show that DIDS treatment inhibits repair of AID-initiated DNA breaks, induces apoptosis, and promotes cytotoxicity preferentially in AID-expressing human CLL. This reveals a novel antineoplastic role of AID that can be triggered by inhibition of HR, suggesting a potential new paradigm to treat AID-expressing tumors. Given the growing list of tumor types with aberrant AID expression, this novel therapeutic approach has potential to impact a significant patient population. PMID:23589568

  18. The future of HIV vaccine research and the role of the Global HIV Vaccine Enterprise.

    PubMed

    Voronin, Yegor; Manrique, Amapola; Bernstein, Alan

    2010-09-01

    This review covers the role of the Global HIV Vaccine Enterprise (the Enterprise), an alliance of independent organizations committed to development of a safe and effective HIV vaccine. It discusses the history, impact on the field, and future directions and initiatives of the alliance in the context of recent progress in HIV vaccine research and development. Significant progress has been made in the field since the release of the 2005 Scientific Strategic Plan (the Plan) of the Enterprise. Over the last year, the Enterprise embarked on an impact assessment of the 2005 Plan and the development of the 2010 Plan. Enterprise Working Groups identified key priorities in the field, several of which are discussed in this review, including changing the nature, purpose and process of clinical trials, increasing and facilitating data sharing, and optimizing existing and mobilizing new resources. This time is an important moment in HIV vaccine research. New clinical trial and laboratory results have created new opportunities to advance the search for an HIV vaccine and reinvigorated the field. The Enterprise will publish its 2010 Plan this year, providing a framework for setting new priorities and directions and encouraging new and existing partners to embark on a shared scientific agenda.

  19. Increasing the demand for childhood vaccination in developing countries: a systematic review

    PubMed Central

    2009-01-01

    Background Attempts to maintain or increase vaccination coverage almost all focus on supply side interventions: improving availability and delivery of vaccines. The effectiveness and cost-effectiveness of efforts to increase demand is uncertain. Methods We performed a systematic review of studies that provided quantitative estimates of the impact of demand side interventions on uptake of routine childhood vaccination. We retrieved studies published up to Sept 2008. Results The initial search retrieved 468 potentially eligible studies, including four systematic reviews and eight original studies of the impact of interventions to increase demand for vaccination. We identified only two randomised controlled trials. Interventions with an impact on vaccination uptake included knowledge translation (KT) (mass media, village resource rooms and community discussions) and non-KT initiatives (incentives, economic empowerment, household visits by extension workers). Most claimed to increase vaccine coverage by 20 to 30%. Estimates of the cost per vaccinated child varied considerably with several in the range of $10-20 per vaccinated child. Conclusion Most studies reviewed here represented a low level of evidence. Mass media campaigns may be effective, but the impact depends on access to media and may be costly if run at a local level. The persistence of positive effects has not been investigated. The economics of demand side interventions have not been adequately assessed, but available data suggest that some may be very cost-effective. PMID:19828063

  20. Foreign Aid to Education: Recent U.S. Initiatives--Background, Risks, and Prospects

    ERIC Educational Resources Information Center

    Heyneman, Stephen P.

    2005-01-01

    The Millennium Challenge Account (MCA) is a commitment of the United States to raise its grant aid by a factor of 50% over the next 3 years and will result in a $5 billion annual increase over current foreign aid levels. Many other countries and multinational development assistance agencies will be asked to help co-finance this new account, and…

  1. Immunization against Genital Herpes with a Vaccine Virus That has Defects in Productive and Latent Infection

    NASA Astrophysics Data System (ADS)

    da Costa, Xavier J.; Jones, Cheryl A.; Knipe, David M.

    1999-06-01

    An effective vaccine for genital herpes has been difficult to achieve because of the limited efficacy of subunit vaccines and the safety concerns about live viruses. As an alternative approach, mutant herpes simplex virus strains that are replication-defective can induce protective immunity. To increase the level of safety and to prove that replication was not needed for immunization, we constructed a mutant herpes simplex virus 2 strain containing two deletion mutations, each of which eliminated viral replication. The double-mutant virus induces protective immunity that can reduce acute viral shedding and latent infection in a mouse genital model, but importantly, the double-mutant virus shows a phenotypic defect in latent infection. This herpes vaccine strain, which is immunogenic but has defects in both productive and latent infection, provides a paradigm for the design of vaccines and vaccine vectors for other sexually transmitted diseases, such as AIDS.

  2. Adolescent human papillomavirus vaccination in the United States: Opportunities for integrating pharmacies into the immunization neighborhood.

    PubMed

    Fava, Joseph P; Colleran, Jacob; Bignasci, Francesca; Cha, Raymond; Kilgore, Paul E

    2017-08-03

    Human Papillomavirus (HPV) vaccination faces several barriers, including a social stigma which carries religious and philosophical implications among parents of adolescents as well as young adults. Hundreds of immunization interventions and programs have been developed to address these factors and boost HPV vaccination rates in the United States. We sought to review the existing literature highlighting barriers to HPV immunization, as well as programs targeting increased HPV vaccine uptake in effort to develop novel vaccination initiatives. The most impactful barriers identified were parental stigma and low quality of provider recommendations for the vaccine. Despite the implementation of many HPV initiatives, outcomes of these programs are largely limited to modest improvements in vaccine uptake in small, homogeneous populations. We describe pharmacies as distinctly advantageous but underutilized resources within the immunization neighborhood and propose a novel concept to improve vaccination rates as well as reduce HPV-related disease burden in all demographics.

  3. Estimated public health impact of nationwide vaccination of infants with 7-valent pneumococcal conjugate vaccine (PCV7) in China.

    PubMed

    Hu, ShanLian; Shi, Qiang; Chen, Chieh-I; Caldwell, Ronald; Wang, Bruce; Du, LiXia; He, JiangJiang; Roberts, Craig S

    2014-09-01

    The goal of this study was to provide a comprehensive analysis of the potential health impact of universal vaccination of infants with the 7-valent pneumococcal conjugate vaccine (PCV7) in China. A decision-analytic model designed for pneumococcal disease and outcomes of pneumococcal infection was populated with local age-specific incidence and mortality data to estimate the expected health benefits of vaccinating birth cohorts of approximately 16 million infants per year over a 10-year time horizon in China. The model incorporates both the direct impact on vaccinated children and the indirect effect of herd protection on unvaccinated children and adults. The model predicts that more than 16.2 million cases of pneumococcal disease and 709 411 deaths could be prevented in China over the initial 10-year period following the introduction of the PCV7 vaccine. The majority of these health benefits are due to the indirect effectiveness of the vaccine on the unvaccinated population, resulting in approximately 10.8 million cases prevented and 636 371 lives saved over 10 years. The results suggest that a policy of universal PCV7 vaccination among infants in China would have a substantial positive public health impact on the population of China. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Clinical Development of a Cytomegalovirus DNA Vaccine: From Product Concept to Pivotal Phase 3 Trial.

    PubMed

    Smith, Larry R; Wloch, Mary K; Chaplin, Jennifer A; Gerber, Michele; Rolland, Alain P

    2013-09-25

    2013 marks a milestone year for plasmid DNA vaccine development as a first-in-class cytomegalovirus (CMV) DNA vaccine enters pivotal phase 3 testing. This vaccine consists of two plasmids expressing CMV antigens glycoprotein B (gB) and phosphoprotein 65 (pp65) formulated with a CRL1005 poloxamer and benzalkonium chloride (BAK) delivery system designed to enhance plasmid expression. The vaccine's planned initial indication under investigation is for prevention of CMV reactivation in CMV-seropositive (CMV⁺) recipients of an allogeneic hematopoietic stem cell transplant (HCT). A randomized, double-blind placebo-controlled phase 2 proof-of-concept study provided initial evidence of the safety of this product in CMV⁺ HCT recipients who underwent immune ablation conditioning regimens. This study revealed a significant reduction in viral load endpoints and increased frequencies of pp65-specific interferon-γ-producing T cells in vaccine recipients compared to placebo recipients. The results of this endpoint-defining trial provided the basis for defining the primary and secondary endpoints of a global phase 3 trial in HCT recipients. A case study is presented here describing the development history of this vaccine from product concept to initiation of the phase 3 trial.

  5. Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes.

    PubMed

    Sullivan, Shannon M; Pierrynowski-Gallant, Donna; Chambers, Larry; O'Connor, Annette; Bowman, Sherry; McNeil, Shelly; Strang, Robert; Knoefel, Frank

    2008-02-01

    The purpose of this study was to determine whether direct nursing care providers have decisional conflict about receiving influenza vaccinations and characteristics associated with decisional conflict. The researchers used a self-administered questionnaire mailed to direct nursing care providers in two long-term-care organizations. Most direct nursing care providers in both organizations (80% and 93%, respectively) intended to get the influenza vaccine. Unregulated direct nursing care providers had more decisional conflict than regulated providers, especially related to feeling uninformed about the pros and cons of influenza vaccination. Unclear valuing of the pros and cons of influenza vaccination was related to the age of the direct care providers in both organizations. Decisional conflict and influenza vaccination practices may be determined, in part, by age and by the culture of a health care organization. A decision aid to improve knowledge and clarify values may improve decision quality and increase influenza vaccination rates.

  6. Psychiatric considerations in the diagnosis, treatment, and prevention of HIV/AIDS.

    PubMed

    Ruiz, P; Guynn, R W; Matorin, A A

    2000-05-01

    HIV/AIDS has the unfortunate distinction of being one of the most devastating epidemics of the twentieth century. By the end of June, 1999, 420,201 deaths in persons with AIDS had been reported in the United States. While HIV/AIDS patients are currently living longer as a result of more effective and complex treatments, no vaccination or cure has yet been discovered. Over the years, the HIV/AIDS epidemic has become multifactorial and currently affects several different special population groups. Individuals who are at high risk for becoming infected with HIV or who already suffer from HIV/AIDS can benefit greatly from the interventions of psychiatrists or other mental health professionals. It is important that psychiatrists collaborate very closely with infectious disease specialists in the management of HIV/AIDS and its psychological sequelae. The authors describe the psychiatric conditions that most often occur in association with HIV/AIDS: mood disorders, anxiety disorders, substance-related disorders, psychotic disorders, insomnia and sleep disorders, delirium, dementia, and pain syndromes. We present guidelines for diagnosis and psychopharmacological and psychotherapeutic treatment of these disorders in patients with HIV/AIDS. The article concludes with a discussion of prevention strategies that can be used in a mental health treatment setting and special issues related to treating HIV/AIDS in certain special population groups.

  7. Enhancing HIV Vaccine Trial Consent Preparedness Among Street Drug Users

    PubMed Central

    Fisher, Celia B.

    2011-01-01

    This research used open-ended and true-false questions to assess the preparedness of 96 ethnically diverse, economically and socially marginalized adult street drug users to consent to participate in HIV vaccine trials (HVT). Specific areas of consent vulnerability included misconceptions about: (1) the recuperative value and risk of vaccines in general; (2) the presence of the HIV virus within the vaccine and the possibility of contracting or transmitting HIV as a consequence of participation; (3) inclusion criteria and experimental blinds; and (4) distrust in the medical and research establishments. A brief HVT lesson administered to 30 participants was effective in correcting specific HVT knowledge misperceptions and increasing certain, but not all areas of HVT trust. Assessment of post-lesson responses to ethics-relevant questions provides information on respondents' attitudes toward AIDS safe behavior, research risks and benefits, monetary compensation, and willingness to participate. Implications for enhancing informed consent for HVT involving active drug users are discussed. PMID:20569151

  8. Transiently increased IgE responses in infants and pre-schoolers receiving only acellular Diphtheria-Pertussis-Tetanus (DTaP) vaccines compared to those initially receiving at least one dose of cellular vaccine (DTwP) - Immunological curiosity or canary in the mine?

    PubMed

    Holt, Patrick G; Snelling, Tom; White, Olivia J; Sly, Peter D; DeKlerk, Nicholas; Carapetis, Jonathan; Biggelaar, Anita Van Den; Wood, Nicholas; McIntyre, Peter; Gold, Michael

    2016-07-29

    Several previous studies have highlighted the strong Th2-polarising and IgE-promoting activity of the DTaP vaccine, but there is no evidence that this has pathological consequences and accordingly there is no current interest amongst vaccine developers in reformulating DTaP to attenuate these properties. In light of an apparent resurgence in pertussis in many countries, and emerging evidence from other areas of paediatric immunology of IgE-mediated interference with host defence mechanisms, this issue requires more detailed clarification. We have re-evaluated the impact of DTaP-only versus mixed DTwP/DTaP vaccination on Th2-dependent "bystander" IgE responses in three cohorts of children under different priming conditions, encompassing both vaccine-targeted and unrelated antigens including food allergens. We confirm the generalised IgE-trophic activity of the DTaP vaccine in pre-schoolers and demonstrate similar (albeit transient) effects in infants. We additionally demonstrate that use of an alternative mixed infant priming schedule encompassing an initial dose of DTwP significantly attenuates this property. Central to our interpretation of these findings are studies demonstrating: (i) mixed DTwP/DTaP priming improves resistance to pertussis disease and attenuates the IgE-stimulatory component of long term vaccine-specific memory; (ii) IgE-mediated mechanisms can interfere with innate antiviral immunity and accordingly exacerbate airway symptoms in infected children. These observations, taken together with the data presented here, suggest a plausible mechanistic link between baseline pertussis-specific IgE titres in DTaP vaccinees and susceptibility to pertussis disease, which merits testing. Retrospective IgE analyses on sera collected from children at the time of presentation with pertussis could resolve this issue. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Serologic response of pups to the low-passage, modified-live canine parvovirus-2 component in a combination vaccine.

    PubMed

    O'Brien, S E

    1994-04-15

    Thirty pups from a general pet population were vaccinated for canine parvovirus-2 (CPV-2), using a low-passage, modified-live CPV-2 in a combination vaccine, every 3 weeks until the pups were between 11 and 18 weeks old. Canine parvovirus-2 antibody titers were measured by means of serum neutralization (SN) immediately before each vaccination and > or = 2 weeks after final vaccination. Thirteen pups that were initially seronegative (SN titer < 2 for CPV-2) developed protective titers (SN titer > or = 16) after 1 to 3 doses of the vaccine, administered when the pups were between 8 and 17 weeks old; 11 of the 13 developed protective titers after the first dose. Seventeen pups were initially seropositive for CPV-2 (SN titer > or = 2). Of these, 8 initially had titers < 16 and 3 others had titers that fell to < 16 during the study. Nine (82%) of these 11 pups developed protective titers. Results indicated that pups at high risk for CPV-2 disease should be vaccinated until 18 to 20 weeks old, even when the low-passage vaccine is used. Pups at lower risk of CPV-2 disease should be vaccinated periodically until 16 weeks old.

  10. Etoposide Induces Nuclear Re-Localisation of AID

    PubMed Central

    Lambert, Laurens J.; Walker, Simon; Feltham, Jack; Lee, Heather J.; Reik, Wolf; Houseley, Jonathan

    2013-01-01

    During B cell activation, the DNA lesions that initiate somatic hypermutation and class switch recombination are introduced by activation-induced cytidine deaminase (AID). AID is a highly mutagenic protein that is maintained in the cytoplasm at steady state, however AID is shuttled across the nuclear membrane and the protein transiently present in the nucleus appears sufficient for targeted alteration of immunoglobulin loci. AID has been implicated in epigenetic reprogramming in primordial germ cells and cell fusions and in induced pluripotent stem cells (iPS cells), however AID expression in non-B cells is very low. We hypothesised that epigenetic reprogramming would require a pathway that instigates prolonged nuclear residence of AID. Here we show that AID is completely re-localised to the nucleus during drug withdrawal following etoposide treatment, in the period in which double strand breaks (DSBs) are repaired. Re-localisation occurs 2-6 hours after etoposide treatment, and AID remains in the nucleus for 10 or more hours, during which time cells remain live and motile. Re-localisation is cell-cycle dependent and is only observed in G2. Analysis of DSB dynamics shows that AID is re-localised in response to etoposide treatment, however re-localisation occurs substantially after DSB formation and the levels of re-localisation do not correlate with γH2AX levels. We conclude that DSB formation initiates a slow-acting pathway which allows stable long-term nuclear localisation of AID, and that such a pathway may enable AID-induced DNA demethylation during epigenetic reprogramming. PMID:24324754

  11. Student Aid Research. A Manual for Financial Aid Administrators.

    ERIC Educational Resources Information Center

    Davis, Jerry Sheehan, Ed.

    This manual contains nine articles intended to assist student financial aid professionals in conducting research. Initial chapters provide basic information for those starting to do such research while later chapters deal with more complex issues. Some chapters include appendices that provide examples of the techniques under consideration. from…

  12. Ada protein-RNA polymerase sigma subunit interaction and alpha subunit-promoter DNA interaction are necessary at different steps in transcription initiation at the Escherichia coli Ada and aidB promoters.

    PubMed

    Landini, P; Bown, J A; Volkert, M R; Busby, S J

    1998-05-22

    The methylated form of the Ada protein (meAda) binds the ada and aidB promoters between 60 and 40 base pairs upstream from the transcription start and activates transcription of the Escherichia coli ada and aidB genes. This region is also a binding site for the alpha subunit of RNA polymerase and resembles the rrnB P1 UP element in A/T content and location relative to the core promoter. In this report, we show that deletion of the C-terminal domain of the alpha subunit severely decreases meAda-independent binding of RNA polymerase to ada and aidB, affecting transcription initiation at these promoters. We provide evidence that meAda activates transcription by direct interaction with the C-terminal domain of RNA polymerase sigma70 subunit (amino acids 574-613). Several negatively charged residues in the sigma70 C-terminal domain are important for transcription activation by meAda; in particular, a glutamic acid to valine substitution at position 575 has a dramatic effect on meAda-dependent transcription. Based on these observations, we propose that the role of the alpha subunit at ada and aidB is to allow initial binding of RNA polymerase to the promoters. However, transcription initiation is dependent on meAda-sigma70 interaction.

  13. Summer Peaks in Uptake of Human Papillomavirus and Other Adolescent Vaccines in the United States.

    PubMed

    Moss, Jennifer L; Reiter, Paul L; Rimer, Barbara K; Ribisl, Kurt M; Brewer, Noel T

    2016-02-01

    Seasonality in human papillomavirus (HPV) vaccination could have a large impact on national cancer prevention efforts. We hypothesized that uptake of HPV vaccine and other adolescent vaccines in the United States would be highest in the summer. Data came from health care provider-verified vaccination records for 70,144 adolescents (ages 13-17 years) from the 2008 to 2012 versions of the National Immunization Survey-Teen. Using the Edwards method for testing annual trends, we examined seasonal patterns in the uptake of HPV and other recommended adolescent vaccines [tetanus, diphtheria, and pertussis (Tdap) booster and meningococcal vaccine]. HPV vaccine initiation (receipt of the first of the three-dose series) data were for female adolescents. Uptake for HPV and other adolescent vaccines peaked in the summer across years and states (all P < 0.001). Uptake was five times as frequent at the peak as at the trough for HPV vaccine, and HPV vaccine initiation was highest in June, July, and August (percent of doses delivered in these months: 38.7%). The same pattern existed for Tdap booster and meningococcal vaccine. Concomitant (same-day) vaccination of HPV vaccine with other adolescent vaccines also demonstrated summer peaks each year nationally (all P < 0.001). Uptake of adolescent vaccines increased dramatically in summer months. These summer peaks are an important opportunity for interventions focused on concomitant vaccination. The potential cancer prevention impact of HPV vaccination programs could be increased, for example, by delivering messages about concomitant vaccination during the summer, when adolescents and their parents might be most open to them. ©2015 American Association for Cancer Research.

  14. Acellular pertussis vaccines effectiveness over time: A systematic review, meta-analysis and modeling study

    PubMed Central

    Chit, Ayman; Zivaripiran, Hossein; Shin, Thomas; Lee, Jason K. H.; Tomovici, Antigona; Macina, Denis; Johnson, David R.; Decker, Michael D.; Wu, Jianhong

    2018-01-01

    Background Acellular pertussis vaccine studies postulate that waning protection, particularly after the adolescent booster, is a major contributor to the increasing US pertussis incidence. However, these studies reported relative (ie, vs a population given prior doses of pertussis vaccine), not absolute (ie, vs a pertussis vaccine naïve population) efficacy following the adolescent booster. We aim to estimate the absolute protection offered by acellular pertussis vaccines. Methods We conducted a systematic review of acellular pertussis vaccine effectiveness (VE) publications. Studies had to comply with the US schedule, evaluate clinical outcomes, and report VE over discrete time points. VE after the 5-dose childhood series and after the adolescent sixth-dose booster were extracted separately and pooled. All relative VE estimates were transformed to absolute estimates. VE waning was estimated using meta-regression modeling. Findings Three studies reported VE after the childhood series and four after the adolescent booster. All booster studies reported relative VE (vs acellular pertussis vaccine-primed population). We estimate initial childhood series absolute VE is 91% (95% CI: 87% to 95%) and declines at 9.6% annually. Initial relative VE after adolescent boosting is 70% (95% CI: 54% to 86%) and declines at 45.3% annually. Initial absolute VE after adolescent boosting is 85% (95% CI: 84% to 86%) and declines at 11.7% (95% CI: 11.1% to 12.3%) annually. Interpretation Acellular pertussis vaccine efficacy is initially high and wanes over time. Observational VE studies of boosting failed to recognize that they were measuring relative, not absolute, VE and the absolute VE in the boosted population is better than appreciated. PMID:29912887

  15. Hepatitis B vaccine booster dose: low-dose recombinant hepatitis B vaccines as a booster dose.

    PubMed

    Bryan, J P; MacArthy, P; Rudock, A; Fogarty, J P; Dowd, H; Legters, L J; Perine, P L

    1997-06-01

    The timing and best regimen for a booster dose of hepatitis B vaccine have not been determined. Two studies were conducted to determine the response to a booster dose of 5 micrograms recombinant hepatitis B vaccine. In the first study, a 5 micrograms (0.5 ml) dose of Recombivax HB was administered intramuscularly 38 months after the initial dose to 71 volunteers. In a second study, we offered a 5 micrograms dose recombinant hepatitis B vaccine, either Recombivax HB (0.5 ml) or Engerix B (0.25 ml), to students who had previously been immunized with three doses of vaccine. In the first study, among the 44 persons for whom postbooster sera were available, the geometric mean concentration of anti-hepatitis B surface antigens increased from 42 to 2090 mIU/ml after the 5 micrograms (0.5 ml) dose of Recombivax. In the second study, after a 5 micrograms (0.5 ml) dose of Recombivax, the geometric mean concentration increased from 43 to 990 mIU/ml (n = 48), and in the group that received a 5 micrograms (0.25 ml) dose of Engerix B, the concentration increased from 83 to 2337 mIU/ml (n = 45) (p = 0.18 for postdose concentrations). A 5 micrograms dose of recombinant vaccine results in an excellent booster response at a cost one fourth to one half that of a full 1 ml dose of vaccine.

  16. Adverse events following immunisation with bacille Calmette-Guérin vaccination: baseline data to inform monitoring in Australia following introduction of new unregistered BCG vaccine.

    PubMed

    Hendry, Alexandra J; Dey, Aditi; Beard, Frank H; Khandaker, Gulam; Hill, Richard; Macartney, Kristine K

    2016-12-24

    In recent years there has been a global shortage of bacille Calmette-Guérin (BCG) vaccine and, from September 2012, unregistered vaccines have needed to be used in Australia (a Danish product initially until the end of 2015, and a Polish product used in some jurisdictions from early 2016). We examined rates and types of adverse events following immunisation (AEFI) with BCG vaccine reported to the Therapeutic Goods Administration between 2009 and 2014 in children aged less than 7 years. Reporting rates of AEFI with BCG vaccine increased from 87 per 100,000 doses (registered Sanofi Pasteur product) in 2009 to 201 per 100,000 doses (unregistered Danish Statens Serum Institute product) in 2014, with Victoria having the highest rate each year. Substantial variation between jurisdictions exists, suggesting differential reporting of BCG vaccine doses administered and/or BCG vaccine-related AEFI. The most commonly reported reactions were abscess (31%), injection site reaction (27%) and lymphadenopathy/lymphadenitis (17%). This study provides baseline data on BCG vaccine safety to inform surveillance. Given the current use of unregistered vaccines in the context of vaccine supply issues, improved recording of both administered BCG vaccine doses and the reporting of BCG vaccine-related AEFI are required to facilitate close monitoring of vaccine safety.

  17. Determinants of apparent rural-urban differentials in measles vaccination uptake in Indonesia.

    PubMed

    Fernandez, Renae C; Awofeso, Niyi; Rammohan, Anu

    2011-01-01

    Regional differences in vaccination uptake are common in both developed and developing countries, and are often linked to the availability of healthcare services and socioeconomic factors. In 2007, 0.9 million eligible Indonesian children missed measles vaccination, and 19 456 cases of measles were documented among Indonesian children. The authors investigated rural-urban differentials in measles vaccination coverage among young Indonesian children, and sought to identify key factors influencing the probability of a child receiving the first dose of measles vaccination in Indonesia. Data used in the analyses were sourced from the nationally representative Indonesia Demographic and Health Survey 2007. The influence of location of residence, household wealth, maternal and paternal education, total children ever born and use of skilled birth attendants on measles vaccination coverage was investigated using bivariate analysis and chi-square tests. The independent effects of these variables were established using binomial logistic regression analysis. Indonesia's 2007 first-dose measles national vaccination coverage was, at 72.8%, lower than the 2008 global first-dose measles vaccination average coverage of 82%. Bivariate analysis revealed that the first-dose measles vaccination coverage in rural areas of Indonesia was 68.5%, compared with 80.1% in urban regions (p < 0.001). The apparent significance of rural residence in impairing vaccination coverage was marginal after controlling for the sex of the child, maternal age, maternal and paternal education, wealth, and access to skilled health workers. Apart from sustainable initiatives to increase measles vaccination coverage globally, it is important to close the rural-urban gap in Indonesia's measles vaccination uptake. Addressing critical determinants of inferior measles vaccination coverage in Indonesia's rural regions will facilitate major improvements in Indonesia's child health trends. This article suggests

  18. Long-term immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in 10- to 14-year-old girls: open 6-year follow-up of an initial observer-blinded, randomized trial.

    PubMed

    Schwarz, Tino F; Huang, Li-Min; Lin, Tzou-Yien; Wittermann, Christoph; Panzer, Falko; Valencia, Alejandra; Suryakiran, Pemmaraju V; Lin, Lan; Descamps, Dominique

    2014-12-01

    Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine were evaluated up to 6 years postvaccination (month 72) in preteen/adolescent girls. Participants, who had received 3 HPV-16/18 AS04-adjuvanted vaccine doses at 10-14 years of age in an initial controlled, observer-blinded, randomized study (NCT00196924) and participated in the open 3-year follow-up (NCT00316706), were invited to continue the follow-up for up to 10 years postvaccination (NCT00877877). Anti-HPV-16 and -18 antibody titers were measured by enzyme-linked immunosorbent assays at yearly visits and were used to fit the modified power-law and piecewise models, predicting long-term immunogenicity. Serious adverse events (SAEs) and pregnancy information were recorded. In the according-to-protocol immunogenicity cohort, all participants (N = 505) with data available remained seropositive for anti-HPV-16 and -18 antibodies at month 72. In initially seronegative participants, anti-HPV-16 and -18 antibody geometric mean titers were 65.8- and 33.0-fold higher than those associated with natural infection (NCT00122681) and 5.0- and 2.5-fold higher than those measured at month 69-74 in a study demonstrating vaccine efficacy in women aged 15-25 years (NCT00120848). Exploratory antibody modeling, based on the 6-year data, predicted that vaccine-induced population anti-HPV-16 and -18 antibody geometric mean titers would remain above those associated with natural infection for at least 20 years postvaccination. The HPV-16/18 AS04-adjuvanted vaccine safety profile was clinically acceptable. In preteen/adolescent girls, the HPV-16/18 AS04-adjuvanted vaccine induced high anti-HPV-16 and -18 antibody levels up to 6 years postvaccination, which were predicted to remain above those induced by natural infection for at least 20 years.

  19. Strengthening routine immunization systems to improve global vaccination coverage.

    PubMed

    Sodha, S V; Dietz, V

    2015-03-01

    Global coverage with the third dose of diphtheria-tetanus-pertussis vaccine among children under 1 year of age stagnated at ∼ 83-84% during 2008-13. Annual World Health Organization and UNICEF-derived national vaccination coverage estimates. Incomplete vaccination is associated with poor socioeconomic status, lower education, non-use of maternal-child health services, living in conflict-affected areas, missed immunization opportunities and cancelled vaccination sessions. Vaccination platforms must expand to include older ages including the second year of life. Immunization programmes, including eradication and elimination initiatives such as those for polio and measles, must integrate within the broader health system. The Global Vaccine Action Plan (GVAP) 2011-20 is a framework for strengthening immunization systems, emphasizing country ownership, shared responsibility, equity, integration, sustainability and innovation. Immunization programmes should identify, monitor and evaluate gaps and interventions within the GVAP framework. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  20. Scientific approaches to AIDS prevention and control in China.

    PubMed

    Teng, T; Shao, Y

    2011-04-01

    The HIV epidemic in China started among intravenous drug users in the late 1980s. The second wave of the epidemic was caused by an outbreak in the paid plasma donors in central China in the mid-1990s. Sexually transmitted HIV cases have steadily increased and comprised more than half the reported HIV/AIDS infections since 2007. In the last 5 years, there has been a sharp increase of HIV infection in men who have sex with men. The HIV epidemic in China has expanded from high-risk groups to the general population and from rural regions to urban areas. This brief article discusses the history of HIV epidemics in China and the challenges facing the current AIDS control efforts in the country. It explains that only scientific approaches can sustain the national AIDS control programs and introduce the type of research needed to address those challenges. The selected research areas include molecular epidemiology, drug resistance surveillance, and the Chinese HIV vaccine research.