Vaccine
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Randomized Controlled Trial Clinical Trial
A phase I study of the safety and immunogenicity of recombinant hepatitis B surface antigen co-administered with an immunostimulatory phosphorothioate oligonucleotide adjuvant.
Certain oligodeoxynuclotides with CpG motifs provide enhanced immune response to co-delivered antigens. We performed a phase I, observer-blinded, randomized study in healthy anti-hepatitis B surface antigen (anti-HBsAg) antibody negative adults to explore safety and immunogenicity of co-injection of recombinant HBsAg combined with an immunostimulatory DNA sequence (ISS) 1018 ISS. Four ISS dosage groups (N=12 per group) were used: 300, 650, 1000 or 3000 microg. ⋯ Four weeks after the first dose, a seroprotective titer (>or=10 mIU/ml) was noted for 0, 25, 75, and 87.5% of subjects by increasing ISS dose group (P<0.05) for those who received ISS+HBsAg; 1 month after the second dose this increased to 62.5, 100, 100, and 100%, respectively. Geometric mean anti-HBsAg antibody levels by increasing ISS+HBsAg dose were 1.22, 5.78, 24.75, and 206.5 mIU/ml after the first dose and 65.37, 877.6, 1545, and 3045 mIU/ml after the second dose. We conclude that 1018 ISS+HBsAg was well tolerated and immunogenic in this phase I study in healthy adults and may offer the potential for enhancement of hepatitis B virus (HBV) immunization and protection after one or two doses or in individuals who fail to respond to the standard vaccine regimen.
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Review
Pentraxin 3, a non-redundant soluble pattern recognition receptor involved in innate immunity.
Pentraxin 3 (PTX3) is the first long pentraxin identified. Long pentraxins consist of a C-terminal pentraxin domain, which has sequence similarity to C-reactive protein (CRP) and serum amyloid P (SAP) component (the classic short pentraxins), and of an unrelated N-terminal portion. ⋯ It binds diverse ligands, including microbial moieties, C1q and apoptotic cells. Evidence suggests that PTX3 plays a role in the regulation of innate resistance to pathogens, inflammatory reactions, possibly clearance of self-components and female fertility.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the reactogenicity and immunogenicity of a split and a subunit-adjuvanted influenza vaccine in elderly subjects.
A randomised, open study was carried out among an elderly population in order to compare the reactogenicity and immunogenicity of an inactivated, split virion influenza vaccine (Vaxigrip, Aventis Pasteur MSD, Lyon, France) with that of an MF59-adjuvanted, subunit vaccine (Fluad, Chiron Vaccines, Siena, Italy). Both vaccines contained the three strains: A/Sydney/5/97 (H3N2), A/Beijing/262/95 (H1N1) and B/Beijing/184/93, recommended by the WHO for the 1998-1999 influenza season. A total of 2150 subjects were vaccinated and included in the reactogenicity analysis. ⋯ For both vaccines a lower percentage of subjects achieved a seroprotective titre > or =40 against the B/Beijing/184/93. A lower antibody response against the influenza B strain was also observed in other studies conducted during the same season. In subjects 75 years of age or older, Fluad was more immunogenic than Vaxigrip for all three virus strains.
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In this paper, we examine the phenomenon of 'clustering of exemptions' to childhood vaccination, and the dangers this poses both to those exempted as well as the general population. We examine how clusters of exemptions might form through collective action as described by Thomas Schelling, and how religious groups who live in close proximity to one another can "self-select" in a way that exacerbates this phenomenon. Given the growing number of exemptions and the increasing visibility of the anti-vaccine movement, policy makers must be vigilant for dangerous clustering in order to avoid loss of herd immunity.
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It is now accepted that investment in health is an important contributor to poverty reduction; however failure to immunise the world's children with readily available life-saving vaccines results in more than 3 million premature deaths annually. The Vaccine Fund-a new structural tool with a clear mission "every child every where" and the Global Alliance for Vaccines and Immunization (GAVI)-a true alliance of all global stakeholders, are working together to build sustainability of immunisation and immunisation capacity in the world's poorest countries. Substantial funding for immunisation has been raised but more is needed to complete the task of fully immunising the world's poorest children.