Expert Review of Vaccines最新文献

Background: We analyzed the impact of non-pharmacological interventions (NPIs) and PCV13 inoculation on nasopharyngeal (NP) carriage of Staphylococcus aureus (Sa), Streptococcus pneumoniae (Sp), Moraxella catarrhalis (Mc), and Haemophilus influenzae (Hi) in healthy children under 5-years-old in Beijing, China.

Research design and methods: NP swabs were taken from healthy children seeking routine well-child care at the pediatric preventive health clinic. NP swabs were frozen in Tryptic Soy Broth (TSB) medium and stored at -80°C, and bacterial was detected by culture.

Results: From December 2019 to November 2021, 1939 children were enrolled, among whom 278 (14.3%) were found to carry Sa isolates, 115 (5.9%) Sp, 39 (2.0%) Mc, and 6 (0.3%) Hi. The carriage of Sa was highest in infants under 6 months, negatively correlated with Sp and Mc. The Sa carriage rate in infants below 6 months of age rose from 26.7% in pre-NPIs to 32.7% in post-NPIs early. The 13-valent pneumococcal conjugate vaccine (PCV13) uptake rose from 42.3% in December 2019 to 62.3% by October 2021.

Conclusions: The broad application of NPIs caused a decline in Sp and Mc carriage among children under 5-years-old,  accompanied by an elevation in the Sa carriage rate among infants.

Background: This study evaluated the impact of various vaccination strategies using an adapted vaccine in Peru.

Research design and methods: Using a previously published combined Markov-decision-tree model adapted for Peru, this study estimated the outcomes of different vaccination strategies targeting various age and risk groups. The model used age-specific epidemiology, clinical, cost, and quality-of-life inputs derived from the published literature and national surveillance data. Sensitivity analyses were conducted to assess uncertainty.

Results: The vaccination strategy targeting older adults aged ≥ 60 years and the high-risk population between 12 and 59 years old with a 24% vaccine uptake was estimated to prevent 78,483 symptomatic cases, 2,962 hospitalizations, 103 deaths, and 2,913 lost QALYs compared with no vaccination, translating to an incremental decrease of $12,856,654 in total direct costs and an incremental decrease of $35,090,748 in total societal costs. These gains were further increased by expanding vaccination to additional age groups and increasing vaccine uptake.

Conclusions: Vaccination in the population aged ≥ 60 years and the high-risk population between 12 and 59 years old in Peru was projected to yield substantial health and economic benefits. The impact could be substantially increased by expanding eligibility to younger age groups and increasing vaccine uptake.

Background: Vaccine safety surveillance is one of the important elements of immunization program. Causality assessment of adverse events and dissemination of their results are equally important to ensure quality of vaccines and confidence in immunization program.

Research design and methods: All types of AEFIs are reported through national AEFI surveillance program that is a passive surveillance system. An analysis of causally assessed serious and severe adverse events following COVID-19 vaccines from January 2021 to September 2022 was conducted. These AEFIs are classified according to WHO's AEFI causality assessment protocol. A descriptive statistic across each category is being presented.

Results: Overall, causality assessment data of 2713 serious/severe AEFIs following COVID-19 vaccines was available for the study. Half of the serious/severe AEFIs were found to be coincidental and 15% were classified as vaccine-product-related reactions. There were 42 cases of thrombosis and thrombocytopenia syndrome and 12 cases of deep vein thrombosis. The proportion of COVID-19 infection among the total serious/severe AEFIs was 7%.

Conclusion: Causality assessment of AEFIs played key role in ensuring quality of the vaccination program. The proportion of the key serious events including TTS and GBS were rare and immunization program-related errors were negligible.

Background: The adjuvanted RSV prefusion F protein vaccine (adjuvanted RSVPreF3) can protect older adults against respiratory syncytial virus (RSV) infection and RSV-related lower respiratory tract disease (LRTD). We modeled the burden of RSV and the potential public health impact of RSV vaccination in adults ≥60 years in nine countries of the Middle East and North Africa (MENA) region.

Research design and methods: A Markov model was adapted to the settings of Bahrain, Egypt, Saudi Arabia, Kuwait, Morocco, Oman, Qatar, Turkey, and the United Arab Emirates. RSV acute respiratory infection (ARI) cases, LRTD-related pneumonia, hospitalizations, and deaths were computed over a five-year time horizon assuming no vaccination, and assuming adjuvanted RSVPreF3 vaccination coverage rates of 30% and 70%. Sensitivity of key inputs was explored using one-way sensitivity analyses.

Results: Across the considered countries, 9.1 million RSV ARI cases, including 4.6 million LRTD, were projected in adults ≥60 years over 5 years. A 30% coverage with a single dose of adjuvanted RSVPreF3 would prevent 1,052,191 RSV ARI cases (including 677,794 LRTD), 56,642 hospitalizations 52,138 pneumonia cases, and 5,377 deaths.

Conclusions: An important part of the substantial RSV burden in adults ≥60 years in the selected MENA countries could be prevented through vaccination with adjuvanted RSVPreF3.

Background: Rotavirus vaccination plays a key role in reducing rotavirus gastroenteritis (RVGE) related deaths. This analysis estimated the number of children under 5 years of age fully vaccinated with GSK rotavirus vaccine (RV1) since launch (2004) and its impact on RVGE-related deaths worldwide.

Research design and methods: To estimate the number of children under 5 years fully vaccinated with RV1 since launch, we used unpublished RV1 market supply data from GSK. The data were extrapolated until the time point when 1 billion doses will have been supplied. The number of RVGE-related deaths avoided was calculated using previously published data on the number of children needed to be fully vaccinated to avoid one fatal RVGE.

Results: Approximately 431 million children under 5 years received a complete RV1 course from 2004 to 2023, avoiding over 220,000 RVGE-related deaths globally. The forecasted analysis estimated that by January 2025, 1 billion RV1 doses will have been supplied worldwide, representing 239,000 RVGE-related deaths avoided. By December 2025, 0.5 billion babies will be protected with RV1, resulting in 259,000 RVGE-related deaths avoided since 2004.

Conclusion: RV1 has contributed to reducing the number of RVGE cases and related deaths and is anticipated to continue reducing this disease burden.

Background: A 20-valent pneumococcal conjugate vaccine (PCV20) was recently licensed for use in children by the United States Food and Drug Administration. The objective of this study was to assess healthcare providers' (HCPs') preferences for the use of PCV20 in the pediatric population and opinions about possible changes to pediatric pneumococcal vaccination recommendations.

Research design and methods: Pediatricians (N = 268), family medicine physicians/general practitioners (N = 184), physician assistants (N = 77), and nurse practitioners (N = 74) who prescribed, recommended, or administered a pneumococcal vaccine to a child aged ≤18 years in the past 3 months completed an online survey. A series of direct-elicitation questions was used to assess preferences for the potential use of PCV20 in the pediatric population.

Results: HCPs preferred options that provided protection against more serotypes: 76% of HCPs in this study favored transitioning children who started vaccination with PCV13/15 to PCV20, and most (≥60%) favored a supplemental dose of PCV20 for all children aged <5 years fully vaccinated with PCV13/15. 93% of HCPs preferred PCV20 over PCV15 for children aged ≤18 years.

Conclusions: HCPs' choices indicated a preference for the use of PCV20 in both a clinical setting and in pediatric pneumococcal vaccination recommendations, due to the higher number of serotypes covered by PCV20.

Background: This study assessed short-term stroke risk following COVID-19 vaccination using Qatar's national stroke registry and health platform.

Research design and methods: A self-controlled risk-interval study was conducted among individuals with stroke post-COVID-19 vaccination between 1 December 2020, and 11 April 2023. Stroke incidence during risk windows (0-21 and 22-42 days post-vaccination) was compared to a control window (43-180 days).

Results: Among 3,070 stroke cases, 685 met inclusion criteria. Stroke incidence was elevated in the 0-21-day window (IRR: 1.32; 95% CI: 1.07-1.63), but not in the 22-42-day window (IRR: 1.03; 95% CI: 0.82-1.30). Excess risk was estimated at 0.55 (95% CI: -0.04 to 1.01) strokes per 100,000 vaccine doses. IRRs for the 0-21-day window were 1.39 (95% CI: 1.08-1.80) for BNT162b2 and 1.15 (95% CI: 0.78-1.69) for mRNA-1273. By subtype, IRRs were 1.34 (95% CI: 1.07-1.68) for ischemic stroke, 1.11 (95% CI: 0.58-2.11) for hemorrhagic stroke, and 1.46 (95% CI: 0.38-5.56) for cerebral venous sinus thrombosis.

Conclusion: A small, transient increase in stroke incidence was observed within 21 days of vaccination; however, such events remain exceedingly rare, with an estimated excess risk substantially lower than that typically associated with infection.

Background: Dentists and other dental healthcare professionals (DHCP) are at increased risk for several vaccine-preventable diseases (VPDs). We studied vaccination policies for DHCP in Europe.

Methods: The national dental associations and chambers of 31 European countries were invited to complete a structured form. The survey was conducted in 2023.

Results: Vaccination policies for DHCP existed in all (21) participating countries. Vaccination policies against hepatitis B, COVID-19 and influenza existed in 20, 18, and 17 countries, respectively. Vaccination policies against measles, mumps, rubella, and varicella existed in 8, 7, 7, and 7 countries, respectively, and against diphtheria, tetanus, poliomyelitis, and pertussis in 5, 5, 4, and 2 countries, respectively. Vaccination policies against hepatitis A existed in 5 countries, against meningococcus C, meningococcus A, C, W, Y, and meningococcus B in 1, 2, and 2 countries, respectively, and against tuberculosis and pneumococcus in 4 countries each. Thirteen countries had mandatory vaccination policies.

Conclusions: All participating countries had vaccination policies targeting DHCP, however there were significant differences in the number of vaccinations and the implementation frame (mandatory or voluntary vaccinations). Considering the recent outbreaks of VPDs in Europe, vaccination programs for DHCP should be evaluated and strengthened to promote safety in dental facilities.