Vaccines最新文献

The burden of herpes zoster (HZ) is recognized worldwide; however, there is seemingly limited information on incidence and vaccination practices in Southeast Asia (SEA). A scientific workshop was held by the Zoster Experts' Network to exchange and consolidate insights on the burden of HZ and the patient pathway in SEA. The workshop included practicing clinical experts and public health specialists/epidemiologists from Indonesia, Malaysia, the Philippines, Thailand, and Vietnam. It aimed to identify gaps in the literature, outline patient pathways, and evaluate HZ vaccine recommendations among these countries. Consensus was identified on the substantial lack of epidemiological data on HZ in SEA and the need to investigate the impact of age, immunocompromising conditions, and comorbidities on the incidence and severity of HZ in the region. However, available data in SEA did indicate a rising disease and socioeconomic burden of HZ, with concerns that current treatment strategies for HZ are suboptimal. The HZ patient pathways generated by the experts highlighted common themes and differences between the five countries. Furthermore, the experts highlighted the lack of awareness of HZ and its impact on patients' quality of life, among patients and healthcare professionals. Evaluation of the current local HZ vaccine recommendations further showed differences in age and the inclusion of at-risk populations between countries. The workshop outcomes emphasize the need for further HZ surveillance in SEA. Efforts to align and address leakage within the patient pathway and raise awareness on the impact of HZ should be prioritized. Awareness initiatives and alignment on vaccine recommendations are also needed.

Background/objectives: A "people-centered" approach is one of the core principles of the Immunization Agenda (IA) 2030 and emphasizes the need for services to be organized around the needs and expectations of individuals and the community. A better understanding of the immunization experience from the client's perspective is key to guiding the design of policies and interventions aimed at improving immunization delivery and coverage. This study provides a synthesis of the immunization experiences of children's caregivers in Cameroon, highlighting potential barriers for timely and complete immunization.

Methods: A descriptive cross-sectional study was conducted, targeting caregivers of children brought to selected health facilities for immunization in all ten regions of Cameroon. Using structured questionnaires, data were collected from caregivers and analyzed using STATA version 13.

Results: In total, 1230 caregivers were interviewed in 265 health facilities. The median age of participants was 27 years and the median number of children per caregiver was two children. Most (87%) of the study participants reported to be satisfied with immunization service delivery. The median waiting time for vaccination was 1 h 48 min, with regional median waiting times ranging from 18 min in the South region to 4 h 6 min in the North region. About a quarter (24%) of surveyed participants reported to have presented to a health facility for immunization services and were turned away without achieving the purpose for which they came at least once. About half (48%) of the caregivers had never heard about planned vaccination activities in their communities.

Conclusion: While most caregivers appeared to be satisfied with immunization service delivery in Cameroon, our study highlights some notable caregiver concerns (long waiting times, unproductive immunization visits and inadequate information about outreach activities) which, if addressed, may go a long way to enhance the immunization experience of caregivers in Cameroon, build trust in immunization services and thus improve vaccination uptake.

Introduction: A limited number of studies focus on estimating the costs of interventions to increase childhood immunization coverage in low- and middle-income countries (LMICs). Existing reviews often compare estimated costs but lack information on the methods used. The objective of this review is to summarize the methods used in costing studies that assessed interventions to reach zero-dose (ZD) children. Methods: We conducted a review of existing studies that estimate the costs of increasing childhood vaccination and reducing prevalence of ZD children in LMICs. We conducted searches of PubMed using terms including "immunization", "cost", "coverage increase", "zero-dose", and "LMIC", and further extended our search to bibliographies and gray literature from organizations working to reach ZD children. We only included articles that estimated the cost of interventions to increase childhood vaccination and/or reach ZD children and not articles about introducing new vaccines or other age groups. We categorized each article according to their costing methods, cost components, types of costs calculated, and presence of uncertainty analysis. Results: Eleven articles met our inclusion criteria. Interventions costs varied from USD 0.08 per additional dose for SMS reminders in Kenya to USD 67 per dose for cash transfers in Nicaragua. Most of the studies were from South Asia: India (4), Pakistan (2), and Bangladesh (1). The rest were from Africa (3) and Latin America (1). Most articles did not include a description of their costing methods. Only three described their methods in detail. Conclusions: Few studies have estimated the costs of increasing childhood vaccination coverage and reducing the number of ZD children in LMICs. The wide variation in intervention costs underscores the need for standardized costing methodologies to enhance comparability across studies. Only three studies detailed their costing methods, making comparisons challenging. Establishing research principles for costing ZD interventions could strengthen future evidence for policymaking.

Introduction: COVID-19 vaccinations reduce the severity and number of symptoms for acute SARS-CoV-2 infections and may reduce the risk of developing Long COVID, also known as post-acute sequelae of SARS-CoV-2 (PASC). Limited and heterogenous data exist on how these vaccinations received after COVID-19 infection might impact the symptoms and trajectory of PASC, once persistent symptoms have developed.

Methods: We investigated the association of post-COVID-19 vaccination with any SARS-CoV-2 vaccine(s) on PASC symptoms in two independent cohorts: a retrospective chart review of self-reported data from patients (n = 128) with PASC seen in the Stanford PASC Clinic between May 2021 and May 2022 and a 2023 multinational survey assessment of individuals with PASC (n = 484).

Findings: Within the PASC Clinic patient cohort (n = 128), 58.6% (n = 75) were female, and 41.4% (n = 53) were male; 50% (n = 64) were white, and 38.3% (n = 49) were non-white. A total of 60.2% (n = 77) of PASC Clinic patients reported no change in their PASC symptoms after vaccination, 17.2% (n = 22) reported improved symptoms, and 22.7% (n = 29) reported worsened symptoms. In the multinational survey cohort (n = 484), 380 were from the U.S., and 104 were from outside the U.S.; 88.4% (n = 428) were female, and 11.6% (n = 56) were male; and 88.8% (n = 430) were white, and 11.2% (n = 54) were non-white. The distribution of survey self-reported vaccine effects on PASC symptoms was 20.2% worsened (n = 98), 60.5% no effect (n = 293), and 19.2% improved (n = 93). In both cohorts, demographic features, including age, sex, and race/ethnicity, were not significantly associated with post-vaccination PASC symptom changes. There was also a non-significant difference in the median dates of COVID-19 infection among the different outcomes. BMI was significant for symptom improvement (p = 0.026) in the PASC Clinic cohort, while a history of booster doses was significant for symptom improvement (p < 0.001) in the survey cohort.

Conclusions: Most individuals with PASC did not report significant changes in their overall PASC symptoms following COVID-19 vaccinations received after PASC onset. Further research is needed to better understand the relationship between COVID-19 vaccinations and PASC.

During the COVID-19 pandemic, over 13 [...].

Background/Objectives: Elephant endotheliotropic herpesvirus (EEHV) causes lethal hemorrhagic disease (HD) in Asian and African elephants in human care and the wild. It is the leading cause of death for young Asian elephants in North American and European zoos despite sensitive diagnostic tests and improved treatments. Thus, there is a critical need to develop an effective vaccine to prevent severe illness and reduce mortality from EEHV-HD. We generated a multi-antigenic EEHV mRNA vaccine to address this need that encodes the EEHV1A-subtype glycoproteins gB, gH, gL, and gO. These conserved proteins are the entry machinery for several herpesviruses in the betaherpesvirus subfamily and elicit humoral and cellular immunity in naturally infected elephants. Methods: Outbred CD-1 mice were vaccinated with two doses of an mRNA vaccine comprising modified EEHV1A gB, gH, gL, and gO mRNAs encapsulated into lipid nanoparticles. Humoral and T-cell immunity was assessed three weeks after the first dose or three weeks after the booster dose using luciferase immunoprecipitation system assays and flow cytometry, respectively. Results: The CD-1 mice vaccinated once had detectable antibody titers against gB, gH, and gL that increased significantly three weeks after a booster dose. Activated CD4⁺ and CD8⁺ T cells secreting cytokines associated with a T_H1 response were induced against all four glycoproteins. No adverse effects were observed following one or two doses of the vaccine. Conclusions: We found that gB, gH, gL, and gO as a multivalent vaccine stimulated robust humoral and cell-mediated immunity. This is a critical step for moving this candidate EEHV1A mRNA vaccine into clinical trials in Asian elephants.

Background/objectives: DNA vaccines are rapidly produced and adaptable to different pathogens, but they face considerable challenges regarding stability and delivery to the cellular target. Thus, effective delivery methods are essential for the success of these vaccines. Here, we evaluated the efficacy of capsules derived from the cell wall of the yeast Pichia pastoris as a delivery system for DNA vaccines.

Methods: The capsules were extracted from the yeast Pichia pastoris strain GS115, previously grown in a YPD medium. pVAX1 expression vector was adopted to evaluate the DNA vaccine insertion and delivery. Three encapsulation protocols were tested to identify the most effective in internalizing the plasmid. The presence of plasmids inside the capsules was confirmed by fluorescence microscopy, and the encapsulation efficiency was calculated by the difference between the initial concentration of DNA used for insertion and the concentration of unencapsulated DNA contained in the supernatant. The capsules were subjected to different temperatures to evaluate their thermostability and were co-cultured with macrophages for phagocytosis analysis. HEK-293T cells were adopted to assess the cytotoxicity levels by MTT assay.

Results: The microscopy results indicated that the macrophages successfully phagocytosed the capsules. Among the protocols tested for encapsulation, the one with 2% polyethylenimine for internalization showed the highest efficiency, with an encapsulation rate above 80%. However, the vaccine capsules obtained with the protocol that used 5% NaCl showed better thermal stability and encapsulation efficiency above 63% without induction of cell viability loss in HEK 293T.

Conclusions: We successfully described a vaccine delivery system using yeast capsules derived from Pichia pastoris, demonstrating its potential for DNA vaccine delivery for the first time. Additional studies will be needed to characterize and improve this delivery strategy.

Background/objectives: Urinary tract infections (UTI) represent a highly frequent and debilitating disease. Immunoactive prophylaxis, such as the polyvalent bacterial whole-cell-based sublingual vaccine MV140, have been developed to avoid antibiotic use. However, the effectiveness of this tool in the Portuguese population is still unknown. This study aims at assessing the effectiveness of treatment with MV140 in a cohort of Portuguese patients presenting with recurrent UTIs.

Methods: Prospective observational real-life study of 125 patients with complicated and uncomplicated recurrent UTIs treated with MV140. The primary outcome was a reduction in frequency and severity of UTIs after a follow-up of 12 months. Overall satisfaction, adverse events, and assessment of the effectiveness of MV140 in subgroups of patients with specific risk factors for UTIs were secondary outcomes.

Results: In the 12 months after treatment outset, 38% of patients were UTI-free, 34% reported 1 or 2 UTI episodes, and the remaining 28% presented 3 or more UTIs, corresponding to a mean reduction of 3.20 (2.87-3.53, 95% C.I.; p < 0.001) UTI episodes per year per patient. The effectiveness of MV140 was the same regardless of sex, BMI, regular sexual activity, hypertension, diabetes mellitus, depression, paraplegia, performance of intermittent self-catheterization, indwelling bladder catheter, or previous use of other UTI-preventing vaccines. We observed a higher effectiveness in post-menopausal women compared to pre-menopausal (74.7% vs. 59.4%, respectively, p = 0.029). A total of 73% of patients reported a reduction in symptom severity or days of disease, and the mean global satisfaction was 7.52/10.

Conclusions: MV140 demonstrated to be effective in the reduction rate of recurrent UTIs in a cohort of adult Portuguese patients.

Background/objectives: Anguillid herpesvirus 1 (AngHV-1) (recently renamed Cyvirus anguillidallo 1) is the etiologic agent of a lethal disease that affects several eel species. It is thought to be one of the main infectious agents causing a population decline in wild eels and economic loss within the eel aquaculture sector. To date, no vaccines are available against AngHV-1. Recently, we developed a safe and efficacious live attenuated recombinant vaccine against Cyprinid herpesvirus 3 (CyHV-3). This CyHV-3 recombinant vaccine encodes a deletion of ORF57. Orthologues of CyHV-3 ORF57 exist in Cyprinid herpesvirus 2 (CyHV-2, ORF57) and AngHV-1 (ORF35).

Methods: In the present study, using recombinant strains and bioluminescent in vivo imaging, we investigated the effect of AngHV-1 ORF35 deletion on virus replication in vitro, virulence in vivo, and the potential of an AngHV-1 ORF35-deleted recombinant as a vaccine candidate for the mass vaccination of eels by immersion. With this goal in mind, we produced ORF35-deleted recombinants using two parental strains: a UK strain and a recombinant derived from the former strain by insertion of a Luciferase-GFP reporter cassette into a non-coding intergenic region.

Results: Analyses of ORF35-deleted recombinants led to the following observations: (i) AngHV-1 ORF35 is not essential for viral growth in cell culture, and its deletion does not affect the production of extracellular virions despite reducing the size of viral plaque. (ii) In contrast to what has been observed for CyHV-3 ORF57 and CyHV-2 ORF57, in vivo bioluminescent analyses revealed that AngHV-1 ORF35 is an essential virulence factor and that its deletion led to abortive infection in vivo. (iii) Inoculation of the AngHV-1 ORF35-deleted recombinant by immersion induced a protective immune response against a wild-type challenge. This protection was shown to be dose-dependent and to rely on the infectivity of AngHV-1 ORF35-deleted virions.

Conclusions: This study suggests that the AngHV-1 ORF35 protein has singular properties compared to its orthologues encoded by CyHV-2 and CyHV-3. It also supports the potential of AngHV-1 ORF35-deleted recombinants for the mass vaccination of eels by immersion.

Background/Objectives: Yellow fever (YF) outbreaks continue to affect populations that are not reached by routine immunization services, such as workers at a high risk of occupational exposure to YF. In the Central African Republic (CAR), YF cases were detected in districts characterized by the presence of workers in forest areas. We developed an innovative approach based on a local partnership with private companies of the extractive industry to administer YF vaccine to workers in remote areas during the response to an outbreak. Methods: The planning stage of the campaign included the mapping of forestry and mining companies through the involvement of national and/or local representatives of companies from both the formal and informal sectors. Information sessions and mobilization targeted the heads of operating companies. Advanced and mobile strategies were used to target workers on their work site. Companies provided logistical support including transportation and communication and set up temporary vaccination posts. Results: Using this local partnership, it was possible to vaccinate over 70,000 workers (5.8% of the entire vaccinated population) in hard-to-reach areas, protecting them from YF. This represented around 47% of the estimated number of workers and dependents. The partnership with the private sector also contributed to increasing knowledge on the risk of YF and means of protection among a high-risk community. Conclusions: Private companies represent potentially useful actors that can contribute to the protection of high-risk workers and to the prevention and control YF outbreaks. The experience in the CAR has demonstrated that it is possible to obtain support from private companies, including informal ones, for a vaccination campaign.