Therapeutic Advances in Vaccines and Immunotherapy最新文献

Background: Needle pain due to routine vaccination is an important factor contributing to low vaccine adherence and immunization coverage. Prophylactic oral analgesics can address this important issue of needle pain related to vaccination. Paracetamol and mefenamic acid are commonly used nonsteroidal anti-inflammatory drugs for pain relief, but there is little published literature on whether the same can be used for needle pain related to vaccination.

Objectives: This study was planned to compare the efficacy of oral mefenamic acid and paracetamol over placebo as a prophylactic analgesic during vaccination and prophylactic antipyretic during the post-vaccination period.

Designs: Three-arm, triple-blind, randomized controlled trial.

Methods: This study was conducted at the outpatient department of a tertiary-level medical college in South India from January 2021 to June 2022. In this three-arm interventional trial, each arm had either a single dose of placebo or mefenamic acid (4 mg/kg/dose) or paracetamol (10 mg/kg/dose). These medicines were administered orally 30 min before vaccination to reduce needle pain.

Main outcome and measures: Outcome was measured with the change of FLACC (Face, Leg, Activity, Cry, Consolability) scoring at the time of vaccination, subsequently at 15 and 30 min of vaccination in all three groups. Appearance of fever, grade of fever, and need for antipyretics 24 h after vaccination were also noted.

Results: There was a significant difference in FLACC scores at the time of administration (p = 0.010) and at 15 min (p = 0.014) with mefenamic acid compared to placebo. Although the paracetamol group showed a difference when compared to the placebo, it was not significant at the time of administration (p = 0.401), at 15 min (p = 0.451), or 30 min (p = 0.892) post-vaccination. The appearance of fever, grade of fever, and use of antipyretic up to 24 h post-vaccination had no significant difference among any of the three groups.

Conclusion: Mefenamic acid was more potent than placebo for pre-vaccination pain prophylaxis in children. There was no difference in the appearance of fever and its grade among the three groups. The promising results from this trial warrant further large-scale studies to recommend a single oral dose of mefenamic acid to tackle needle pain related to vaccination in children to improve vaccine adherence and coverage.

Trial registration: CTRI (Clinical trials registry-India) (CTRI/2021/01/030239). [Date of Commencement: 13 Jan 2021, Date of last recruitment: 30 June 2022 (now closed for new participants)].

Diffusely infiltrating gliomas - including glioblastoma (GBM), isocitrate dehydrogenase (IDH) mutant gliomas, and histone 3 (H3) altered gliomas - are primary brain tumors with an invariably fatal outcome. Despite advances in the understanding of their biology, standard, targeted and immune checkpoint inhibitor immunotherapies have proven ineffective in arresting their inexorable progression and associated morbidity and mortality. Recognizing the unique aspects of the immunogenicity of cancer cells, the last decade has seen the development and evaluation of vaccine-based therapies for the treatment of solid tumors, including gliomas. Here we review the current vaccine strategies for the treatment of GBM, IDH-mutant gliomas and diffuse midline glioma H3 K27M-altered. We discuss potential benefits and challenges of vaccine therapies in these specific patient populations.

Background: Ghana was the first country to receive the coronavirus vaccination in West Africa from AstraZeneca or Oxford. Ghana plans to vaccinate 20 million out of the 32 million population and provide the necessary doses utilizing multilateral and bilateral agreements. As Ghana begins vaccinating its citizens, there is some skepticism about administering the coronavirus vaccine (CVV). This research aimed to analyze the socioeconomic and demographic characteristics influencing vaccine hesitancy (VH) and refusal among Ghanaians.

Methods: The multinomial logistics regression model was employed to investigate the relationship between respondents' socio-demographic characteristics and VH. The research data were gathered between March to June 2021 through an online survey.

Findings: The findings of this study indicated that approximately 92.75% of the 400 respondents have heard about CVV. The study suggests that less than 5% of the participants have so far received the CVV. Most of the respondents (36.8%) indicated rejecting the CVV. Interestingly, male participants [adjusted odds ratio (AOR) = 1.048; 95% confidence interval (CI): 0.532-2.063] with higher educational backgrounds (AOR = 2.11; 95% CI: 0.870-5.121) had higher odds of being CVV hesitant or refusers. Low economic class, rural settlers, unmarried individuals, and unemployed people also had higher odds of being VH or refusers. The survey also shows that most Ghanaians refused to receive the CVV because they did not trust the system to track the vaccine's side or adverse effects.

Conclusion: Government can use social media platforms and other media platforms to effectively provide relevant information regarding the full benefit and risks of taking the virus.

Background: Acceptance of vaccines has been on a decline in recent times, with vaccine hesitancy being listed as one of the top 10 global health threats. This study analysed vaccine hesitancy and belief towards vaccination among caregivers of children aged below 5 years.

Methods: In this cross-sectional study, 196 caregivers of children aged 6 months to below 5 years who had attended an immunization clinic at a tertiary care institute of Eastern India from March to May 2019 were surveyed. Consecutive sampling was used to recruit eligible study participants. The survey assessed the attitudes of parents towards childhood vaccination by using the Vaccine Hesitancy Scale and their beliefs towards vaccination. Univariate analysis was performed to assess the association of various sociodemographic factors with vaccine hesitancy.

Results: Among the caregivers, most (48%) mothers were aged 26-35 years, literate and homemakers. Vaccine hesitancy was observed in 9.18% of the participants. Only the age of the child was significantly associated with vaccine hesitancy. Nearly half (48.5%) of the participants were concerned about the serious adverse effects of vaccines, and a third (30.6%) agreed that newer vaccines are associated with higher risks than the older ones. Caregivers felt that vaccines are no longer required for uncommon diseases.

Conclusion: Concerns regarding vaccine hesitancy are prevalent even among caregivers attending a tertiary care institute. Thus, additional studies are required to assess hesitancy in urban, rural, remote and inaccessible areas. Policymakers ought to conduct periodic assessments and implement necessary remedial measures for the long-term sustenance of the benefits of the national immunization programme.

COVID-19-related vaccine demand and delivery volume challenged delivery organizations as few crises have. Imperatives to ensure security of patient information, defend against cybersecurity threats, and accurately identify/authenticate clinician identity for patients remained unchanged. Deployment of identity access and management (IAM) and single sign-on (SSO) can accelerate operationalization of a vaccine delivery center when urgently needed in a crisis. Innovative application of existing IAM/SSO technology, combined with an identity governance solution, greatly accelerated vaccine delivery. Secure access enabled by IAM technology facilitated a rapid expansion (25 minutes) where 500 new vaccine delivery personnel were identified and authenticated during a period of high pandemic incidence. Existing digital identity solutions enabled a vaccine delivery organization to accelerate secure IAM of clinical staff during the peak of the COVID-19 pandemic. Existing IAM investments and capabilities that are widely implemented in nations with mature health information technology systems can greatly accelerate standing up emergent vaccine delivery capabilities and sites in the midst of a public health crisis.