Vaccine
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Transcutaneous immunisation (TCI) using a skin patch is a non-invasive vaccination route relevant to mass vaccination against infectious diseases. This phase I/II clinical study, documents that TCI of human adult volunteers with the live-attenuated measles vaccine ROUVAX((R)) is safe and poorly reactogenic. ⋯ However, in contrast to the subcutaneous route, TCI failed to evoke neutralising MV-specific serum antibodies. Thus, alternative delivery methods and/or devices providing optimal uptake by skin DC should be considered for live-attenuated virus vaccines, such as the measles vaccine.
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In a population-based study, we use ICD-9-CM codes to estimate the hospitalization rates for pneumococcal disease among young children in Hong Kong, 2000-2005 and the preventable burden using several outcome indicators. For children aged =2 years, the average admission rates (per 100,000 person-years) were 23.7 for invasive pneumococcal disease (IPD), 1047.5 for clinical pneumonia and 213 for radiological pneumonia. For this group of children, the disease burden potentially preventable by vaccination, per 100,000 person-years, were estimated to be 19.3 (95% CI, 16.7-21.9) for IPD, 58.5 (95% CI, 57.3-59.6) for clinical pneumonia and 40.6 (95% CI, 59-82.2) for radiological pneumonia.
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Using WHO-CHOICE methodology, we calculated cost-utility ratios for various interventions (PAP smear, HPV-DNA testing, VIA and vaccination against HPV) at various frequencies to reduce the burden of cervical cancer and condyloma (in the case of the HPV vaccination) in Israel, which has a low prevalence of cervical cancer. Assuming non-waning efficacy, HPV vaccinations will become cost-effective, very cost-effective and cost saving when the cost per dose falls below $96.85, $50.42 and $27.20, respectively. Attempts should be made to raise compliancy with PAP smears from the current opportunistic 12.2-20.0% per annum either before and/or after the vaccination is introduced.
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During a mass campaign with a newly licensed meningococcal polysaccharide ACW135 vaccine in Burkina Faso, adverse events following immunization (AEFI) were monitored up to 4 weeks after the campaign. Eighty-six AEFI cases (5.9 cases per 100,000 vaccine doses distributed) were reported. ⋯ In a setting with no prior surveillance system, adverse events were reported at rates comparable to documented rates for meningococcal polysaccharide vaccines in other settings. The findings confirm the benefits of the vaccine in the control of meningococcal meningitis.
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In the African meningitis belt, reported case-fatality ratio (CFR) for meningitis are usually calculated on the basis of presumed cases. We reviewed 3509 presumed cases of bacterial meningitis reported in Niger for which a cerebrospinal fluid (CSF) sample had been tested later at the reference laboratory. The main aetiologies were Neisseria meningitidis (1496 cases), Streptococcus pneumoniae (303 cases) and Haemophilus influenzae (105 cases). ⋯ The disease burden of pneumococcal meningitis must be better taken into consideration in the future. As most treatments are presumptive, there is a urgent need for an easy-to-administer, cheap first-line treatment effective on N. meningitidis as well as on S. pneumoniae and H. influenzae that would replace the single-dose oily chloramphenicol treatment which is the most frequent treatment administered today, independent of microbial aetiology and season. The development of diagnostic tools really suitable for remote health facilities also is an urgent challenge.