PMID: 

Vaccine. 2017 12 14 ;35(49 Pt B):6828-6841. Epub 2017 Nov 13. PMID: 29146380

Abstract Title: 

Inclusion of the value of herd immunity in economic evaluations of vaccines. A systematic review of methods used.

Abstract: 

OBJECTIVE: The objectives of this review were to identify vaccine economic evaluations that include herd immunity and describe the methodological approaches used.METHODS: We used Kim and Goldie's search strategy from a systematic review (1976-2007) of modelling approaches used in vaccine economic evaluations and additionally searched PubMed/MEDLINE and Embase for 2007-2015. Studies were classified according to modelling approach used. Methods for estimating herd immunity effects were described, in particular for the static models.RESULTS: We identified 625 economic evaluations of vaccines against human-transmissible diseases from 1976 to 2015. Of these, 172 (28%) included herd immunity. While 4% of studies included herd immunity in 2001, 53% of those published in 2015 did this. Pneumococcal, human papilloma and rotavirus vaccines represented the majority of studies (63%) considering herd immunity. Ninety-five of the 172 studies utilised a static model, 59 applied a dynamic model, eight a hybrid model and ten did not clearly state which method was used. Relatively crude methods and assumptions were used in the majority of the static model studies.CONCLUSION: The proportion of economic evaluations using a dynamic model has increased in recent years. However, 55% of the included studies used a static model for estimating herd immunity. Values from a static model can only be considered reliable if high quality surveillance data are incorporated into the analysis. Without this, the results are questionable and they should only be included in sensitivity analysis.

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PMID: 

J Pract Nurs. 1966 Dec ;16(11):25-9 passim. PMID: PMC5179050

Abstract Title: 

Working-play of the hospital child.

Abstract: 

[n/a]

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PMID: 

Vaccine. 2016 11 11 ;34(47):5815-5818. Epub 2016 Oct 13. PMID: 27745952

Abstract Title: 

An inflammatory response is essential for the development of adaptive immunity-immunogenicity and immunotoxicity.

Abstract: 

The humoral and cellular immune responses of adaptive immunity are induced following immunization with effective vaccines. They induce functional cytokines and chemokines through the binding of vaccine components or adjuvants to innate immune receptors. Alum-adjuvanted vaccines induce local inflammatory nodules at injection sites, and the systemic and local production of the inflammatory cytokines, IL-1β, IL-6, and TNF-α, has been reported to occur three hours after vaccinations. Furthermore, G-CSF levels increase at injection sites. Neutrophils initially migrate and neutrophil extracellular traps (NETs) then develop, which stimulate damage-associated molecular patterns (DAMPs), inducing inflammatory cytokines production. Approximately 10-15% of recipients of simultaneous immunizations with multiple vaccines develop febrile reactions, and have higher G-CSF levels. Innate immune responses following vaccinations are discussed herein.

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PMID: 

NPJ Vaccines. 2016 ;1:16009. Epub 2016 Jul 28. PMID: 29263852

Abstract Title: 

Vaccinology in the twenty-first century.

Abstract: 

[n/a]

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PMID: 

Pediatr Infect Dis J. 2016 06 ;35(6):662-72. PMID: 26928521

Abstract Title: 

Five-year Antibody Persistence and Booster Response After 1 or 2 Doses of Meningococcal A, C, W and Y Tetanus Toxoid Conjugate Vaccine in Healthy Children.

Abstract: 

BACKGROUND: We evaluated antibody persistence up to 5 years postvaccination with a quadrivalent meningococcal serogroups A, C, W and Y tetanus toxoid conjugate vaccine (MenACWY-TT), and subsequent booster responses to MenACWY-TT in healthy US children.METHODS: In the initial phase II, open, multicenter study (NCT00471081), 349 infants were randomized (1:1) to receive MenACWY-TT (1 or 2 doses). In the follow-up study (NCT00718666), we evaluated antibody persistence at years 1, 3 and 5 by serum bactericidal assay using human complement (hSBA). At year 5, children received a booster dose of MenACWY-TT. We compared their immune responses at 1 month postbooster with those from 100 age-matched, meningococcal naive children, who received a primary MenACWY-TT dose. We recorded solicited adverse events for 4 days and unsolicited adverse events for 31 days, followed by an additional 5-month extended safety follow-up.RESULTS: At year 5,≥64.0% of 1-dose and ≥74.6% of 2-dose recipients had hSBA titers ≥8 for MenC, MenW and MenY. For MenA, 31.7% of 1-dose and 38.0% of 2-dose recipients had hSBA titers ≥8. One month postvaccination, all booster dose recipients and ≥78.5% of primary dose recipients exhibited hSBA titers ≥8for all serogroups. Geometric mean titers were higher in primed than in naive children. MenACWY-TT had a clinically acceptable safety profile.CONCLUSIONS: With the exception of serogroup W, antibody persistence 5 years after MenACWY-TT vaccination did not differ substantially between children who received 1 or 2 doses in infancy. A booster dose of MenACWY-TT elicited robust anamnestic responses and was well tolerated.

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PMID: 

Lancet Infect Dis. 2015 Aug ;15(8):868-9. Epub 2015 May 14. PMID: 25981884

Abstract Title: 

Herd immunity and the herd severity effect.

Abstract: 

[n/a]

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PMID: 

Vaccine. 2014 Sep 29 ;32(43):5624-31. Epub 2014 Aug 17. PMID: 25140930

Abstract Title: 

Humoral responses to independent vaccinations are correlated in healthy boosted adults.

Abstract: 

BACKGROUND: Roughly half of U.S. adults do not receive recommended booster vaccinations, but protective antibody levels are rarely measured in adults. Demographic factors, vaccination history, and responses to other vaccinations could help identify at-risk individuals. We sought to characterize rates of seroconversion and determine associations of humoral responses to multiple vaccinations in healthy adults.METHODS: Humoral responses toward measles, mumps, tetanus toxoid, pertussis, hepatitis B surface antigen, and anthrax protective antigen were measured by ELISA in post-immunization samples from 1465 healthy U.S. military members. We examined the effects of demographic and clinical factors on immunization responses, as well as assessed correlations between vaccination responses.RESULTS: Subsets of boosted adults did not have seroprotective levels of antibodies toward measles (10.4%), mumps (9.4%), pertussis (4.7%), hepatitis B (8.6%) or protective antigen (14.4%) detected. Half-lives of antibody responses were generally long (>30 years). Measles and mumps antibody levels were correlated (r=0.31, p

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PMID: 

Front Immunol. 2015 ;6:18. Epub 2015 Feb 2. PMID: 25699041

Abstract Title: 

The genetic regulation of infant immune responses to vaccination.

Abstract: 

A number of factors are recognized to influence immune responses to vaccinations including age, gender, the dose, and quality of the antigen used, the number of doses given, the route of administration, and the nutritional status of the recipient. Additionally, several immunogenetic studies have identified associations between polymorphisms in genes encoding immune response proteins, both innate and adaptive, and variation in responses to vaccines. Variants in the genes encoding Toll-like receptors, HLA molecules, cytokines, and cytokine receptors have associated with heterogeneity of responses to a wide range of vaccines including measles, hepatitis B, influenza A, BCG, Haemophilus influenzae type b, and certain Neisseria meningitidis serotypes, amongst others. However, the vast majority of these studies have been conducted in older children and adults and there are very few data available from studies conducted in infants. This paper reviews the evidence to date that host genes influencing vaccines responses in these older population and identifies a large gap in our understanding of the genetic regulation of responses in early life. Given the high mortality from infection in early life and the challenges of developing vaccines that generate effective immune responses in the context of the developing immune system further research on infant populations is required.

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PMID: 

Vaccine. 2014 May 23 ;32(25):2948-57. Epub 2014 Apr 5. PMID: 24709587

Abstract Title: 

How advances in immunology provide insight into improving vaccine efficacy.

Abstract: 

Vaccines represent one of the most compelling examples of how biomedical research has improved society by saving lives and dramatically reducing the burden of infectious disease. Despite the importance of vaccinology, we are still in the early stages of understanding how the best vaccines work and how we can achieve better protective efficacy through improved vaccine design. Most successful vaccines have been developed empirically, but recent advances in immunology are beginning to shed new light on the mechanisms of vaccine-mediated protection and development of long-term immunity. Although natural infection will often elicit lifelong immunity, almost all current vaccines require booster vaccination in order to achieve durable protective humoral immune responses, regardless of whether the vaccine is based on infection with replicating live-attenuated vaccine strains of the specific pathogen or whether they are derived from immunization with inactivated, non-replicating vaccines or subunit vaccines. The form of the vaccine antigen (e.g., soluble or particulate/aggregate) appears to play an important role in determining immunogenicity and the interactions between dendritic cells, B cells and T cells in the germinal center are likely to dictate the magnitude and duration of protective immunity. By learning how to optimize these interactions, we may be able to elicit more effective and long-lived immunity with fewer vaccinations.

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PMID: 

Vaccine. 2014 Apr 7 ;32(17):1946-53. Epub 2014 Feb 13. PMID: 24530932

Abstract Title: 

Associations between race, sex and immune response variations to rubella vaccination in two independent cohorts.

Abstract: 

INTRODUCTION: Immune response variations after vaccination are influenced by host genetic factors and demographic variables, such as race, ethnicity and sex. The latter have not been systematically studied in regard to live rubella vaccine, but are of interest for developing next generation vaccines for diverse populations, for predicting immune responses after vaccination, and for better understanding the variables that impact immune response.METHODS: We assessed associations between demographic variables, including race, ethnicity and sex, and rubella-specific neutralizing antibody levels and secreted cytokines (IFNγ, IL-6) in two independent cohorts (1994 subjects), using linear and linear mixed models approaches, and genetically defined racial and ethnic categorizations.RESULTS: Our replicated findings in two independent, large, racially diverse cohorts indicate that individuals of African descent have significantly higher rubella-specific neutralizing antibody levels compared to individuals of European descent and/or Hispanic ethnicity (p

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