Vaccine最新文献

Background Mental illnesses have been overlooked as a potential factor influencing antibody responses to COVID-19 vaccine. Associations between mental disorders and antibody response might vary by specific disorders, depend on the long-term course of the illness and relate to psychotropic treatment.

Methods: The association between mental illness diagnoses (mood affective disorders, anxiety disorders, other) over ten years and psychotropic drug prescription based on electronic health records with antibody levels (IgG and IgA) post COVID-19 vaccination was assessed in 939 vaccinated adults from Catalonia, Spain. We employed linear regression models to assess associations between specific mental illnesses and psychotropic drugs with antibody levels, correcting for demographics, comorbidities and lifestyle factors. In a genotyped subset (n = 247) we assessed the effect of polygenic risk scores (PRS) for mental illnesses and performed a two-sample mendelian randomization (MR) analysis to examine causality between mental illness and antibody responses.

Results: Mood affective disorders were associated with lower IgG to receptor binding domain (RBD) [percentage change = -26.37 (95 % CI, -42.00, -6.54)]. Diagnosis of anxiety disorders was not associated with the outcome. The group of other diagnoses (mainly including insomnia and nicotine dependence) were associated with lower IgG RBD levels [percentage change: -21.53 (95 % CI, -35.38, -4.71)] and recent onset cases (≤5 years ago) showed greater decline in antibody levels. Participants on second-generation antipsychotics and multiple classes of psychotropic drugs in the last 6 months exhibited lower antibody levels. In the genotyped population, higher genetic liability (higher PRS) to schizophrenia was associated with lower IgG RBD levels [percentage change = -35.49 (95 % CI, -56.55, -4.23)]. MR analysis revealed a causal relationship between major depression genetic instrumental variables and lower IgG RBD and S levels.

Conclusions: These findings raise concerns about the efficacy of COVID-19 vaccines and potentially of other vaccines as well, in individuals with mood affective disorders, current/recent insomnia and nicotine dependence and people on multiple psychotropic drugs. Whether these associations are translated into increased risk for breakthrough infections and immune mediated long-term sequels of the SARS-CoV-2 infection warrants further investigation.

The rapid development of coronavirus disease 2019 (COVID-19) vaccines has helped mitigate the initial impact of the pandemic. However, in order to reduce transmission rates and protect more vulnerable and immunocompromised individuals unable to mount an effective immune response, development of a next-generation of mucosal vaccines is necessary. Here, we developed an intranasal Newcastle disease virus (NDV)-based vaccine expressing the spike of the XBB.1.5 variant stabilized in its pre-fusion conformation (NDV-HXP-S). We demonstrated that one or two intranasal immunizations with live NDV-HXP-S expressing the XBB.1.5 spike induces systemic and mucosal antibody responses in mice and protects them from a challenge with the XBB.1.5 variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, one or two intranasal vaccinations with NDV-HXP-S XBB.1.5 protected hamsters from variant matched infection and reduced virus emission, thereby providing complete protection to naïve animals in a direct contact transmission study. The data shown in this study supports the notion that intranasal vaccination with variant-adapted NDV-HXP-S induces protective mucosal immunity and reduces transmission rates, highlighting the robust protective efficacy of a single mucosal vaccination in mice and hamsters.

Objective: To evaluate whether children with type 1 diabetes mellitus (T1DM) have optimal humoral immune response to pneumococcal polysaccharide vaccination (PPSV23) and to study factors affecting that response.

Methods: In this prospective pilot study, we recruited 29 children with T1DM who were vaccine naïve to PPSV23 and assessed serum-serotype specific IgG at baseline and 4-6 weeks post-immunization. We tested association between independent variables (age, gender, body mass index (BMI), hemoglobin A1c (HbA1c), glucose variability, and time in range assessed by continuous glucose monitors (CGM), insulin dose and outcome (log-2-fold change of immunoassay response between pre- and post-immunization testing) using linear regression.

Results: Eighty-eight percent of children (22/25) who completed the study had overall appropriate response with a median 4.2-fold change following immunization. When assessing PPSV23-exclusive serotypes, there was a statistically significant correlation between increasing age and greater response (0.16 log2-fold change per year, 95 % CI (0.014 to 0.3), p = 0.033). Higher BMI for age (p = 0.085) and a lower coefficient of glucose variation from CGM following immunization (p = 0.067) also coincided with greater vaccine response, with correlation statistically significant for certain pneumococcal serotypes for both.

Conclusions: Response to pneumococcal vaccination has not previously been assessed in children with T1DM, and our study demonstrates robust humoral immune response to PPSV23 vaccination in these children. Larger studies with a diverse representation and longer follow up to assess how humoral seroconversion correlates with clinical response to PPSV23 in this vulnerable population are warranted.

Social media is used to promote the HPV vaccine through various strategies, including the use of stories and narratives. Understanding the ethical concerns related to the use of social media in this capacity are important. The purpose of this study is to identify ethical concerns of using fictional stories to share information and emotions about the HPV vaccine on social media, ultimately to influence parents on their decision to vaccinate their child.

Methods: We conducted a cross-sectional survey with researchers in the fields of health communication, cancer prevention, social media, and public health ethics from October to December 2021. Respondents were presented with a fictional story that consisted of seven connected vignettes about the HPV vaccine. For each vignette, respondents were asked to rate the potential benefits and risk, as well as the potential for ethical concerns of using the fictional narrative style to share information about the HPV vaccine. Descriptive statistics summarized responses, and qualitative data were analyzed thematically.

Results: On average, respondents (n = 41) perceived more benefits than risks when it comes to 1) using social media for health education generally and 2) using a story with connected vignettes for vaccine communication. The vignettes prioritizing vaccine hesitancy, positive emotion, and health equity were seen as having the most potential benefit, while the vignettes highlighting vaccine confidence and skepticism were seen as having the most potential risk. Overall, respondents felt there were several ethical concerns of note - persuasion was the most common (15 % of respondents) followed by deception (9 %) and manipulation (8 %). Qualitative data highlighted the importance of transparency and trust to avoid ethical violations and negative outcomes.

Conclusions: Ethical concerns exist when using fictional stories to share health information on social media, particularly as new online technologies make it harder to tell fact from fiction. Practical and actionable recommendations for researchers must be developed, defining a range of ethical responsibilities.

Background: Vaccinations are a critical component of pediatric care, protecting children, including those with cancer, from infectious complications - and significantly improving patient outcomes and survival. However, the practice and perception of vaccinating children with cancer in Latin America and the Caribbean has not been well described.

Methods: A cross-sectional survey was conducted with a convenience sample of healthcare providers involved in caring for children with cancer in Latin America and the Caribbean to establish their knowledge, attitude, and practice regarding vaccinating this special population. The electronic, self-administered survey comprised primarily close-ended questions, such as multiple-choice, Likert scale, and true/false questions, with a few open-ended questions to enable respondents to provide information not otherwise captured.

Findings: Of 384 responses received (an 11.9 % response rate), we included 378 for analysis. These respondents represented 20 countries and were, on average, aged 44.3 years with just over 14 years of practice after completing their highest level of training. Of the 378 respondents analyzed, 321 (84.9 %) recommend vaccines to their pediatric patients with cancer, with 247 (65.3 %) referring to a vaccination guideline or clinical decision tool to help plan such vaccinations and 122 (49.6 %) referring to more than one guide.

Interpretation: Our findings show general agreement with and support for vaccinating children with cancer, especially against influenza. Respondents reported high levels of knowledge, mostly positive attitudes, and support for recommending vaccines to patients. However, their vaccine recommendations were inconsistent. It is important to explore influential contextual factors at the institutional and governmental levels to identify strategies to increase vaccination coverage of children with cancer in the region.

In 2019 the National Department of Health (NDoH) conducted a national immunisation coverage survey of caregivers of children aged 24-35 months in all 52 districts of South Africa, and reported a national fully immunised under one year-old coverage of 83.9 %, and 76.8 % coverage for all vaccines scheduled up to 18 months of age. This retrospective, descriptive study was a secondary data analysis of 3576 validated Microsoft Excel® records containing the reasons for missed vaccinations collected by field workers during the 2019 national survey. The reason "vaccine out of stock" had been captured by field workers from children's vaccination cards, while other reasons given by caregivers had been captured either as pre-defined codes or free text. Free text reasons were analysed and additional codes created, and all reasons were categorised. In total, 3576 caregivers gave 8116 reasons for 8056 doses that had been missed by their children. Reasons related to health facility obstacles (HFOs) (67.9 %; 2429/3576) and personal obstacles (34.6 %; 1237/3576) constituted the major categories of reasons for missed vaccinations. Of all vaccines missed because of HFO-related reasons, 57.8 % (1403/2429) were missed because of vaccine stock-outs, affecting 39.2 % (1403/3576) of children. Other important HFOs included lack of access to vaccination services (24.5 %; 595/2429); and information about missed vaccinations and the need to return for catch-up not being shared with caregivers (17.1 %; 416/2429). These results were stratified by district and shared with the NDoH, who have initiated several projects in collaboration with other stakeholders, focusing mainly on building capacity for effective vaccine management to prevent vaccine stock-outs, and ensuring that all children are able to access vaccination services. The results of this study can be used as a baseline against which the success of future interventions emanating from these projects can be measured.

Background: Under-vaccination is undoubtedly driving recent worldwide measles outbreaks, but undernutrition may also be playing a role in low- and middle-income countries. Studies have shown reduced immune response to vaccines in undernourished children but few have followed children beyond infancy, when they are more likely to be exposed to infectious diseases.

Methods: In the Venda Health Examination of Mothers, Babies and the Environment (VHEMBE) South African birth cohort study, we examined the relationship between undernutrition, as measured by stunting and other growth measures, and vaccine-specific serum antibody level to three different vaccine types: measles, tetanus and Haemophilus influenzae type b (Hib). We included 621 fully-vaccinated children with anthropometric measurements at ages 1, 2, and 3.5 years and antibody levels at 3.5 and 5 years.

Results: At 5 years of age, 90.4% of fully-vaccinated children were protected against measles, 66.7% against tetanus, and 56.1% against Hib. Children who were stunted or had any indicator of diminished growth at 3.5 years averaged a 24.1% (95% CI = -44.2, 0.6) or a 27.2% (95% CI = -45.1, -1.3) lower antibody titer for measles, respectively, relative to those with normal growth. In addition, girls, but not boys, with any indicator of diminished growth at 3.5 years averaged a 36.8% (-59.3, -7.0) lower antibody titer for tetanus. We found no association between undernutrition and Hib antibody titers.

Conclusions: Early life undernutrition may be associated with lower induction or persistence of antibody responses to certain vaccines. Addressing child undernutrition may improve vaccine efficacy and reduce the burden of vaccine-preventable diseases.

Background: The COVID-19 pandemic has significantly impacted people with cancer. Initial vaccine studies excluded patients with malignancy. Immunocompromised individuals remain vulnerable to SARS-CoV-2, necessitating detailed understanding of vaccine response. The epidemiology of COVID-19 in Australia offered unique opportunities to study cancer populations with minimal community exposure to SARS-CoV-2.

Methods: SerOzNET prospectively examined previously unvaccinated patients with solid and haematological malignancies receiving up to five COVID-19 vaccine doses. Antibody response was measured by live virus neutralisation assay (neutralising antibody (NAb); positive titre ≥1:20; study primary endpoint) and commercial assay. T cell response was measured by cytometric bead array; positive defined as interferon gamma (IFN-γ) ≥10 pg/mL in response to Spike antigen. Patient and physician-reported adverse events were secondary endpoints.

Outcomes: 395 adults were enrolled prior to receiving mRNA vaccine (BNT162b2 = 347; mRNA-1273 = 1) or viral vector vaccine (ChadOx1-S = 43) for initial two-dose course, plus up to three additional doses. Median age was 58 years (range: 20-85); 60 % were female; 35 % had haematological malignancy, 2/395 (0.5 %) had baseline positive nucleocapsid antibody indicating prior SARS-CoV-2 exposure. NAb response post dose three was demonstrated in 84 % overall; 96 % of patients with solid cancers and 64 % with haematological cancer (p < 0·001). Risk factors for non-response were haematological cancer and anti B-cell therapies. Some patients with haematological cancer seroconverted for the first time after the fourth or fifth dose. IFN-γ response was seen in many patients with haematological cancer who lacked NAb response. Serious adverse events were rare. COVID-19 infection occurred in 29 % with no deaths.

Interpretation: COVID-19 vaccination elicits B and T cell responses in patients with solid and haematological cancers, with an acceptable safety profile. A significant proportion of haematological cancer patients require >3 doses to elicit NAb, with many demonstrating T cell response, which may be an alternative pathway of immune protection.

Geographical disparities exist in human papillomavirus (HPV) vaccination rates with Southern states having the lowest rates. Parental attitudes remain understudied in different Southern locations. We assessed factors related to HPV vaccination receipt among children aged 9-17 years in Tennessee, and if those factors differed by child's age and gender. A cross-sectional survey of 506 parents was performed via random digit dial from May to August 2022. A multivariable logistic regression model was used to estimate adjusted odds ratios and 95 % confidence intervals to predict sociodemographic and overall vaccine-related factors associated with HPV vaccine receipt or non-receipt (referent) for their child, and exploratory analyses to determine if those factors differed by child's age and gender. In adjusted logistic regression models, HPV vaccine receipt was significantly positively associated with the child's age (13-17 years) and the parent and child having had the influenza vaccine this season and the COVID-19 vaccine, and negatively associated with children who were male and had a parent employed part-time/unemployed/retired/student/disabled. Significant associations for HPV vaccine receipt were with increased levels of agreement of the parent having enough information for decision-making, belief the vaccine was beneficial, and increased levels of trust and perceived effectiveness of the vaccine. Increased levels of hesitancy and increased levels of agreement that the vaccine might cause infertility issues in the child, was unsafe, and natural immunity is better than vaccine immunity had negative associations with HPV vaccine receipt. All associations were more pronounced among older than younger children, and all but one association (overall vaccine trust) was more pronounced among males compared with females. Strategies to improve HPV vaccine uptake should be targeted to and/or include males and parents with children aged 9-12 years, and include education on the importance and process of protecting the body through HPV vaccination and vaccines in general.

The continually high disease burden of influenza and the relatively low effectiveness of current influenza vaccines call for enhanced vaccine strategies. We previously generated unique S-HA1 pseudovirus nanoparticles (PVNPs) displaying the receptor binding HA1 antigens of the H7N9 subtype as an influenza vaccine candidate and characterized their features in biochemistry, biophysics, structure, and immune response. In this follow up study, we created new S-HA1 PVNPs displaying the HA1 antigens of other common influenza viruses, including two H1N1 strains, one H3N2 strain, and an influenza B virus, respectively. The recombinant PVNPs react well with antibodies against hemagglutinins (HAs) or mouse sera obtained after influenza virus challenge. 3D structural models were constructed to comprehend the structural features and size variations of the S-HA1 PVNPs. The PVNPs are immunogenic, eliciting high titers of HA1-specific serum antibodies that recognized commercial HA1 proteins. Importantly, the S-HA1 PVNP representing the H1N1 PR8 strain provided mice with 100 % protection against mortality caused by challenge with the mouse-adapted influenza virus of the same PR8 strain. The S-HA1 PVNP representing the H1N1 2009 pandemic strain conferred mice with 50 % protection against mortality caused by challenge with the 1934 PR8 strain, despite the two strains circulating 75 years apart. Our data demonstrated the feasibility of generating S-HA1 PVNPs to display HA1 antigens of diverse influenza A and B viruses. The readily available S-HA1 PVNPs hold promise as influenza vaccines, presenting a novel approach to combat the deadly influenza disease.