Vaccine
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This study aims to describe the frequency and quality of spontaneous narcolepsy case reports following administration of pandemic influenza vaccine as captured in the Eudravigilance database. ⋯ An increase in reporting of narcolepsy appeared in Eudravigilance only after awareness was raised by the national authorities. Most narcolepsy reports were received from countries where the signal initially occurred, and were related to Pandemrix® in children/adolescents. Basic information about the patient and the exposure was present in most of the ICSRs. The ICSRs captured by Eudravigilance however, do not collect enough information to assess the diagnostic certainty according to the Brighton Collaboration case definition.
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There is a need for pregnancy safety information overall and for each seasonal formulation of the influenza vaccine. ⋯ Combining the 2010-2014 influenza seasons, we found a moderately elevated RR for major birth defects overall, but no evidence of a specific pattern; 95% CIs included 1, and this finding could be due to chance. In the combined seasons, we found no meaningful evidence of an increased risk for spontaneous abortion or preterm delivery following exposure to the seasonal influenza vaccine.
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Multicenter Study Clinical Trial
Immunogenicity and persistence of immunity of a quadrivalent Human Papillomavirus (HPV) vaccine in immunocompromised children.
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Hepatitis B virus (HBV) is highly endemic in many of the Pacific Island countries. Four island countries-Cook Islands, Kiribati, Niue, and Tokelau-sought to evaluate the success of their hepatitis B vaccination programs by conducting nationally representative serosurveys among children born post-vaccine introduction. ⋯ The Cook Islands, Niue, and Tokelau have made remarkable progress in establishing strong vaccination programs and towards decreasing the burden of hepatitis B among children. Kiribati still needs to improve vaccination coverage to achieve the <1% HBsAg target established by the World Health Organization Western Pacific Region.
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Introduction of new vaccines in low- and lower middle-income countries has accelerated since Gavi, the Vaccine Alliance was established in 2000. This study sought to (i) estimate the costs of introducing pneumococcal conjugate vaccine, rotavirus vaccine and a second dose of measles vaccine in Zambia; and (ii) assess affordability of the new vaccines in relation to Gavi's co-financing and eligibility policies. ⋯ While the introduction of new vaccines is justified by expected positive health impacts, long-term affordability will be challenging in light of the current economic climate in Zambia. The government needs to both allocate more resources to the health sector and seek efficiency gains within service provision.