Expert review of vaccines
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Expert review of vaccines · Jan 2011
ReviewProgress in filovirus vaccine development: evaluating the potential for clinical use.
Marburg and Ebola viruses cause severe hemorrhagic fever in humans and nonhuman primates. Currently, there are no effective treatments and no licensed vaccines; although a number of vaccine platforms have proven successful in animal models. ⋯ In addition, a single platform, recombinant vesicular stomatitis virus, has demonstrated both prophylactic and postexposure protection in nonhuman primates. These results demonstrate that achieving a vaccine that is protective against filoviruses is possible; the challenge now is to prove its safety and efficacy in order to obtain a vaccine that is ready for human use.
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Expert review of vaccines · Oct 2010
ReviewGenetic shifts of Neisseria meningitidis serogroup B antigens and the quest for a broadly cross-protective vaccine.
Serogroup B Neisseria meningitidis is the leading cause of meningococcal disease in developed countries. There is currently no vaccine offering wide-ranging protection. Development of a serogroup B polysaccharide-based vaccine has been hindered by potential risks of autoantibodies that cross-react with glycosylated host antigens. ⋯ In this article, we describe the high degree of genomic variability in N. meningitidis and several of the mechanisms involved. An overview of the implications of antigenic variation of several surface-exposed proteins on their potential vaccine candidacy is provided. The outlook for the quest for broadly cross-protective meningococcal serogroup B vaccine components in the postgenomic era will be discussed.
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Expert review of vaccines · Sep 2010
ReviewMMR vaccination and disease elimination: the Finnish experience.
Measles, mumps and rubella (MMR) vaccinations have been included in Finland's national vaccination program as a two-dose schedule since 1982. Owing to the high (>95%) coverage of vaccinations, indigenous MMR diseases were eliminated from Finland by the mid-1990s. In 1982, the incidence of measles, mumps and rubella was 105, 43 and 64 per 100,000 population, respectively, but declined to 0.1 per 100,000 population for all MMR diseases in 1995. ⋯ Antibody follow-up has revealed that MMR vaccine-induced antibodies wane over time, and concerns have arisen about the continuation of this good situation. High vaccination coverage, enhanced surveillance and preparedness to administer additional doses when needed are key factors for future success. Here we present an overview of MMR vaccinations and the Finnish experience of the MMR disease elimination process, and we describe surveillance activities in the era following elimination in Finland.
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Expert review of vaccines · May 2010
ReviewPopulation impact of Vi capsular polysaccharide vaccine.
Development of a safe and efficacious vaccine against typhoid fever has been the mainstay of enteric vaccinology since production of the first parenteral whole-cell typhoid vaccine in 1896. The new-generation Vi polysaccharide single-dose injectable typhoid vaccine developed in the 1980s is widely used in countries where it is locally produced, such as China, and in travelers from industrialized countries to typhoid-endemic settings. ⋯ Recent evidence of herd protection conferred by the Vi vaccine has highlighted the significance of the vaccine's effects beyond the vaccinated population. The large-scale use of this vaccine can yield protective benefits to a larger population and can reduce the epidemiologic and economic burden of typhoid fever in endemic countries.
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Herpes zoster (HZ; shingles) results from reactivation of varicella-zoster virus that has been dormant in the spinal and cranial sensory ganglia following primary infection with varicella (chickenpox), usually during childhood. In developed countries more than 95% of the adult population are seropositive for varicella-zoster virus and are therefore at risk of developing HZ. Reactivation can occur at any age, but it is associated with an age-related decline in cell-mediated immunity and therefore occurs more frequently in older adults. ⋯ Management is challenging and often unsatisfactory (<50% of patients gain 50% relief of pain). With the older adult population steadily growing in size, the number of patients presenting with HZ is also likely to increase and this will place a greater burden on healthcare systems. Prevention strategies, such as vaccinating those at greatest risk, may offer the best option for the future.