Vaccine
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Measles-mumps-rubella-varicella (MMRV) vaccine is associated with increased febrile seizure risk compared with measles-mumps-rubella and varicella vaccine given separately (MMR+V) in children 12-15-month old. We assessed knowledge regarding MMRV and febrile seizures, intended practices, and factors influencing the decision to recommend MMRV. ⋯ After receiving data regarding febrile seizure risk after MMRV, few physicians report they would recommend MMRV to a healthy 12-15-month-old child.
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Comparative Study
Revaccination with Fendrix® or HBVaxPro® results in better response rates than does revaccination with three doses of Engerix-B® in previous non-responders.
Because non-response (<10 IU/l anti-HBs) after revaccination for hepatitis B occurs frequently (50%), this study aimed to provide evidence for a more effective revaccination regimen by comparing four different revaccinations: (1) three revaccinations with Engerix-B(®) (n=201); (2) one revaccination with Engerix-B(®) (n=37); (3) one revaccination with HBVaxPro-40(®) (n=108); (4) one revaccination with Fendrix(®) (n=39). The level of anti-HBs antibodies was determined with the AXSYM-MEIA system (Abbott, Chicago, USA). Using linear and logistic regression, the efficacy (antibody response) after the four revaccinations was compared. ⋯ The height of the primary titre independently predicted antibody response. Compared to the revaccination scheme using three Engerix-B(®) doses, revaccination with a single dose of HBVaxPro-40(®) or Fendrix(®) performed significantly better. The use of these highly potent vaccines should be considered when revaccinating hepatitis B vaccine non-responders.
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In 2003 the existing 23-valent pneumococcal vaccine (PPV23) programme for high risk groups was extended to include all ≥ 65 year olds in England and Wales, starting with ≥ 80 year olds and moving to 75-79 and 65-74 year olds by 2005. We conducted an ecological study to assess the impact of the extended PPV23 programme on serotype-specific incidence of invasive pneumococcal disease (IPD) and a case-control study to assess vaccine effectiveness (VE) using the national IPD surveillance dataset. Between 1998 and 2006 IPD incidence caused by PPV23 serotypes in the targeted age-groups was unchanged. ⋯ In conclusion PPV23 was effective, particularly in healthy under 75 year olds, but protection waned after 5 years. There was no discernible impact of PPV23 on IPD incidence or PCV7-induced serotype replacement, consistent with the modest overall effectiveness, the 45% increased coverage over the former risk-based programme and lack of herd immunity from the PPV23 programme. Based on the VE estimates PPV23 was still considered a cost-effective intervention for the low risk elderly.
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Two rotavirus vaccines have been licensed globally since 2006. In China, only a lamb rotavirus vaccine is licensed and several new rotavirus vaccines are in development. Data regarding the projected health impact and cost-effectiveness of vaccination of children in China against rotavirus will assist policy makers in developing recommendations for vaccination. ⋯ A national rotavirus vaccination program could be a cost-effective measure to effectively reduce deaths, hospitalizations, and outpatient visits due to rotavirus disease in China.
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In order to meet the global demand for rapid production of pandemic influenza vaccines, we have developed a recombinant fusion vaccine platform in which the globular head of hemagglutinin (HA) antigen is genetically fused to bacterial flagellin (a TLR5 ligand). These flagellin-HA fusion vaccine candidates elicit highly protective immunity against a lethal challenge with 2009 pandemic H1N1 (Liu, et al. PLoS ONE 2011; 6:e20928) or H5N1 influenza A/Vietnam/1203/04 (A/VN) infections in mice (Song, et al. ⋯ Finally, we found that two vaccine candidates of A/AN induced significant HAI titers in mice. Taken together, our recombinant flagellin-HA platform has been successfully used to generate potent H5N1 HPAIV vaccine candidates. These promising preclinical results justify the advancement of these candidates into the clinic.