Vaccine
-
Australian Aboriginal children experience early, persistent and severe middle ear infections. We conducted a review of the medical literature that addressed acute otitis media (AOM) in Australian Aboriginal children. ⋯ Otitis media in Aboriginal children living in remote communities begins in the first 3 months of life following early bacterial colonisation. Young children with persistent signs of suppurative disease (bulging of the tympanic membrane or middle ear discharge) are probably most at risk of developing chronic suppurative otitis media.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Safety and immunogenicity of a zoster vaccine in varicella-zoster virus seronegative and low-seropositive healthy adults.
To evaluate immunogenicity and tolerability of a live attenuated zoster vaccine in varicella-zoster virus (VZV) seronegative or low-seropositive adults > or = 30 years of age. ⋯ The zoster vaccine appears to be immunogenic and generally well tolerated in healthy adults > or = 30 years of age, regardless of initial VZV antibody serostatus.
-
Rationing of scarce vaccine supplies will likely be required when the next pandemic occurs, raising the questions about how to ration and upon what principles. Because influenza pandemics have differing mortality patterns, such as the 1918 pandemic's "W" shaped curve that effected healthy young adults, the particular pattern should inform rationing. Competing ethical principles for vaccine rationing are utilitarianism and egalitarianism. ⋯ Utilitarian principles of choosing based on social worth or those in whom vaccination is most likely to medically succeed raise substantial justice issues. Egalitarian principles of medical neediness and random chance avoid justice concerns and are proposed. A framework that uses multiple principles to address influenza vaccine rationing in light of a shortage is recommended.
-
Randomized Controlled Trial Multicenter Study
Safety and tolerability of a high-potency zoster vaccine in adults >/= 50 or years of age.
Herpes zoster (HZ) incidence rises with age, especially after 50 years of age, probably due to waning varicella-zoster virus (VZV)-specific immunity. The Shingles Prevention Study [Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults, N Engl J Med 2005;352:2271-84], enrolled people >/= 60 or years of age and showed that zoster vaccine prevents HZ and postherpetic neuralgia (PHN), presumably through boosting VZV-specific immunity. This study of people >/= 50 or years of age compared the safety and tolerability of two zoster vaccine potencies. ⋯ Both vaccine potencies were generally well tolerated in this study of people > or years of age. Although rates of some moderate or severe injection-site AEs were greater in the higher potency group, all rates met the prespecified criteria for clinically acceptable tolerability.
-
Comparative Study
Assessment of the potency and potential immunomodulatory effects of the measles mumps rubella and varicella vaccine in infants.
This study compared the potency and immunomodulatory effects of measles mumps rubella (MMR) vaccine given to infants alone or in combination with varicella (MMR and V). In an additional group, MMR vaccination was delayed 42 days to permit analysis of potential effects on underlying maturation of systemic immune functions. Assessment of immunity to the vaccines indicated consistent antibody production coupled with mixed Th1/Th2 memory, and no significant differences between vaccine groups or to the group who had their MMR vaccination delayed. Parallel analyses of cytokine responses to phytohaemagglutinin and tetanus toxoid did not detect any "bystander" effects of the vaccines on systemic immunity.