Vaccine
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Randomized Controlled Trial
Long-lasting immunogenicity of a virosomal vaccine in older children and young adults with type I diabetes mellitus.
To evaluate the long-lasting immunogenicity and reactogenicity of a virosomal influenza vaccine in subjects with type I diabetes, a trial was conducted during the 2007-2008 influenza season in Milan, Northern Italy. One hundred five subjects aged 9-30 years were randomized to receive by intramuscular injection vaccination by a single dose (0.5 ml) of either a virosomal (Inflexal V) (n=52) or a standard subunit (Influvac) (n=53) vaccine. Serum hemagglutinin inhibition antibody titres were determined against the three recommended influenza-like strains, A/H1N1, A/H3N2 and B, at pre-vaccination, and 1 and 6 months post-vaccination. ⋯ All reactions were transient and not severe. The results indicate that in older children and young adults with type I diabetes influenza vaccination with a virosomal or a standard subunit vaccine is safe and adequately immunogenic against the three influenza vaccine strains. In addition, the virosomal vaccine may show better long-lasting immune response than the standard subunit vaccine, especially in subjects without pre-existing antibodies to influenza strains.
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Streptococcus pneumoniae is an important cause of otitis media, sinusitis, pneumonia, and invasive pneumococcal diseases (IPDs) such as meningitis, bacteremia, and bacteremic pneumonia. Globally, pneumonia is the leading cause of death in children aged <5 years. After the implementation of routine immunisation with a seven-valent pneumococcal conjugate vaccine (PCV7) in the United States in 2000, a substantial decline in pneumonia-related hospitalisations among children aged <2 years was observed. In this age group, there was a 39% and 65% reduction in rates of all-cause and pneumococcal pneumonia hospitalisations, respectively, indicating a direct effect of routine immunisation with PCV7.
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Significant morbidity due to pneumococcal co-infection is associated with viral respiratory infections. Pneumonia is the leading cause of death in children worldwide. ⋯ The majority of the mortality associated with the influenza pandemic of 1918 was attributable to bacterial infections, especially the pneumococcus. Vaccination with PCV for children and pneumococcal polysaccharide vaccine for adults should be considered essential to pandemic influenza preparedness.
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The first influenza pandemic of the 21st century, due to a new strain of A(H1N1) virus, was declared on 11 June 2009 by the Director-General of the World Health Organization. Fortunately, the international community, including influenza vaccine manufacturers, has been increasing its preparedness for such an event, triggered by the need to stem the spread of the highly pathogenic avian influenza A(H5N1) virus over recent years. ⋯ However, two major issues need to be taken into consideration: how long will it take to produce sufficient pandemic vaccine doses to immunize the global population at risk, including poor populations that have no resources to purchase the vaccine; and how will pandemic vaccine production affect availability of trivalent vaccine for the forthcoming 2009-2010 influenza season. To address these questions, WHO carried out a survey in May 2009 among influenza vaccine manufacturers on their planned seasonal and pandemic production with a view to developing recommendations on the distribution and use of pandemic influenza vaccine.
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The Australian Childhood Immunisation Register (ACIR) was established in 1996 as an opt-out register built on the platform of Medicare, the universal national health insurance scheme. Introduction of financial incentives for providers and parents, linked to the ACIR, followed from 1998. ⋯ The ACIR has been important in implementation of a range of measures to improve childhood immunisation coverage in Australia. Linkage of a universal childhood immunisation register to national health insurance schemes has potential applicability in a variety of settings internationally.