RESUMEN
Surprisingly, the 1977 "Russian flu" H1N1 pandemic influenza virus was genetically indistinguishable from strains that had circulated decades earlier but had gone extinct in 1957. This essay puts forward the most plausible chronology to explain the reemergence of the 1977 H1N1 pandemic virus: (1) in January-February 1976, a self-limited small outbreak of a swine H1N1 influenza virus occurred among Army personnel at Fort Dix, New Jersey; (2) in March 1976, the US launched a nationwide H1N1 swine influenza vaccine program; (3) other countries then also launched their own H1N1 R&D efforts; (4) a new H1N1 outbreak, genetically unrelated to the Fort Dix swine virus but indistinguishable from previously extinct H1N1 viruses, was detected early in 1977 in China; (5) the leading Chinese influenza virologist later disclosed that the Chinese military had conducted large H1N1 vaccine R&D studies in 1976. It is likely that the resurrected H1N1 influenza viruses were laboratory-stored strains that were unfrozen and studied as part of the emergency response to a perceived epidemic threat, and that accidentally escaped. The fear of a possible H1N1 pandemic was the critical factor that gave rise to the actual H1N1 pandemic, resulting in an avoidable "self-fulfilling prophecy pandemic."
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Vacunas contra la Influenza , Gripe Humana , Pandemias , Humanos , Gripe Humana/epidemiología , Gripe Humana/historia , Gripe Humana/virología , Historia del Siglo XX , Estados Unidos/epidemiología , China/epidemiología , Personal Militar , New Jersey/epidemiología , AnimalesRESUMEN
BACKGROUND: Several cases of renal complications, including acute kidney injury (AKI), after influenza vaccination have been reported, but the association remains unproven. We evaluated the association between influenza vaccination and AKI occurrence among the Korean elderly in the 2018-2019 and 2019-2020 seasons. METHODS: We used a large database combining vaccination registration data from the Korea Disease Control and Prevention Agency and claims data from the National Health Insurance Service. The study subjects were patients hospitalized with AKI for the first-time following vaccination among those who received one influenza vaccine in the 2018-2019 or 2019-2020 season. Only those aged 65 or older at the date of vaccination were included. We performed a self-controlled case series study, designating the risk period as 1 to 28 days post-vaccination and the observation period as each influenza season. The adjusted incidence rate ratio (aIRR) was calculated by adjusting for nephrotoxic drug use and influenza infection that may influence AKI occurrence using a conditional Poisson regression model. RESULTS: A total of 16 713 and 16 272 AKI events were identified during the 2018-2019 and 2019-2020 seasons, respectively. The aIRR for AKI was 0.83 (95% confidence interval [CI] = 0.79-0.87) in the 2018-2019 season. The aIRR for the 2019-2020 influenza season was similar to the 2018-2019 season (aIRR = 0.86; 95% CI = 0.82-0.90). CONCLUSIONS: Influenza vaccination is associated with a lower risk of AKI in the elderly over 65. This evidence supports the recommendation of annual influenza vaccination for the elderly. Further studies are needed to determine the biological mechanisms linking the influenza vaccine and AKI.
Asunto(s)
Lesión Renal Aguda , Vacunas contra la Influenza , Gripe Humana , Humanos , Vacunas contra la Influenza/efectos adversos , Vacunas contra la Influenza/administración & dosificación , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/etiología , Anciano , Masculino , Femenino , Gripe Humana/prevención & control , Gripe Humana/epidemiología , República de Corea/epidemiología , Anciano de 80 o más Años , Incidencia , Vacunación/efectos adversos , Vacunación/estadística & datos numéricos , Bases de Datos Factuales , Hospitalización/estadística & datos numéricos , Estaciones del Año , Factores de RiesgoAsunto(s)
Influenza Pandémica, 1918-1919 , Gripe Humana , Neumonía Viral , Humanos , Masculino , Adulto Joven , Dolor en el Pecho/diagnóstico , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Disnea/diagnóstico , Disnea/etiología , Pulmón/diagnóstico por imagen , Pulmón/patología , Radiografía Torácica , Fiebre/diagnóstico , Fiebre/etiología , Tos/diagnóstico , Tos/etiología , Gripe Humana/complicaciones , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Influenza Pandémica, 1918-1919/historia , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Historia del Siglo XX , Historia del Siglo XXI , Monitoreo Epidemiológico , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Preparación para una Pandemia , Vacunas contra la Influenza/administración & dosificaciónRESUMEN
Current influenza vaccine strategies have yet to overcome significant obstacles, including rapid antigenic drift of seasonal influenza viruses, in generating efficacious long-term humoral immunity. Due to the necessity of germinal center formation in generating long-lived high affinity antibodies, the germinal center has increasingly become a target for the development of novel or improvement of less-efficacious vaccines. However, there remains a major gap in current influenza research to effectively target T follicular helper cells during vaccination to alter the germinal center reaction. In this study, we used a heterologous infection or immunization priming strategy to seed an antigen-specific memory CD4+ T cell pool prior to influenza infection in mice to evaluate the effect of recalled memory T follicular helper cells in increased help to influenza-specific primary B cells and enhanced generation of neutralizing antibodies. We found that heterologous priming with intranasal infection with acute lymphocytic choriomeningitis virus (LCMV) or intramuscular immunization with adjuvanted recombinant LCMV glycoprotein induced increased antigen-specific effector CD4+ T and B cellular responses following infection with a recombinant influenza strain that expresses LCMV glycoprotein. Heterologously primed mice had increased expansion of secondary Th1 and Tfh cell subsets, including increased CD4+ TRM cells in the lung. However, the early enhancement of the germinal center cellular response following influenza infection did not impact influenza-specific antibody generation or B cell repertoires compared to primary influenza infection. Overall, our study suggests that while heterologous infection or immunization priming of CD4+ T cells is able to enhance the early germinal center reaction, further studies to understand how to target the germinal center and CD4+ T cells specifically to increase long-lived antiviral humoral immunity are needed.
Asunto(s)
Linfocitos T CD4-Positivos , Centro Germinal , Vacunas contra la Influenza , Infecciones por Orthomyxoviridae , Animales , Centro Germinal/inmunología , Ratones , Infecciones por Orthomyxoviridae/inmunología , Infecciones por Orthomyxoviridae/prevención & control , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/administración & dosificación , Linfocitos T CD4-Positivos/inmunología , Anticuerpos Antivirales/inmunología , Ratones Endogámicos C57BL , Linfocitos B/inmunología , Memoria Inmunológica , Células T de Memoria/inmunología , Inmunización/métodos , Femenino , Antígenos Virales/inmunologíaRESUMEN
Background: The factors influencing vaccination decision-making for newly developed vaccines may be similar to and different from those for established vaccines. Understanding these underlying differences and similarities is crucial for designing targeted measures to promote new vaccines against potential novel viruses. Objective: This study aims to compare public vaccination decisions for newly developed and established vaccines and to identify the differences and similarities in the influencing factors. Method: A discrete choice experiment (DCE) was conducted on 1,509 representatives of the general population in China to collect data on preferences for the coronavirus disease 2019 (COVID-19) and influenza vaccines, representing the newly developed and established vaccines, respectively. The latent class logit model was used to identify latent classes within the sample, allowing for an analysis of the factors distinctly influencing choices for both types of vaccines. Result: Participants valued similar attributes for both vaccines. However, concerns about sequelae were more significant for the newly developed vaccine, while effectiveness was prioritized for the established vaccine. Class membership analysis revealed these differences and similarities were significantly correlated with age, health, yearly household income, acquaintances' vaccination status, and risk perception. Conclusion: The study highlights the need for tailored communication strategies and targeted vaccination interventions. For the newly developed vaccines, addressing concerns about side effects is more crucial. For long-standing vaccines, emphasizing their effectiveness can enhance uptake more significantly. Engaging healthcare providers and community influencers is essential for both vaccines to increase public confidence and vaccination rates. Clear communication and community engagement are critical strategies for addressing public concerns and misinformation, particularly during periods of heightened concern.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Toma de Decisiones , Vacunas contra la Influenza , Vacunación , Humanos , China , Adulto , Masculino , Femenino , Persona de Mediana Edad , Vacunas contra la Influenza/administración & dosificación , Vacunas contra la COVID-19/administración & dosificación , Vacunación/estadística & datos numéricos , Vacunación/psicología , COVID-19/prevención & control , Adulto Joven , Modelos Logísticos , SARS-CoV-2 , Gripe Humana/prevención & control , Encuestas y Cuestionarios , Anciano , Adolescente , Análisis de Clases Latentes , Conducta de ElecciónRESUMEN
Background: Vitamin E from palm oil, known as the tocotrienol-rich fraction (TRF), has been shown to have immune-enhancing activity. To date, only one dose of TRF (400 mg daily) has been tested in a clinical trial. The proposed study will evaluate the immune-enhancing activity effects of lower doses (200, 100 and 50 mg) in a clinical trial using an influenza vaccine as the immunological challenge. Methods: A single-centre, randomised, parallel, double-blinded, placebo-controlled clinical trial with balance allocation involving five arms will be conducted. The healthy volunteers recruited will be randomly assigned to one of the arms, and they will be asked to take the respective supplements (400 mg, 200 mg, 100 mg, 50 mg of TRF or placebo) daily with their dinner. The volunteers will receive the influenza vaccine after four weeks. They will be asked to return to the study site four weeks later. A blood sample will be taken for the study at baseline, four and eight weeks. Primary outcome measures will be antibody levels to influenza, blood leucocyte profile and cytokine production. Secondary outcomes will be correlating plasma vitamin E levels with immune responses, plasma proteins and gene expression patterns. The findings from this study will be published in relevant peer-reviewed journals and presented at relevant national and international scientific meetings. Conclusions: The recent world events have created the awareness of having a healthy and functional immune system. Nutrition plays an important role in helping the immune system to function optimally. This study will show the effects of lower doses of TRF in boosting the immune response of healthy individuals and also elucidate the mechanisms through which TRF exerts its immune-enhancing effects. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) [ ACTRN12622000844741] dated 15 June 2022. Protocol version: 2.
Asunto(s)
Suplementos Dietéticos , Voluntarios Sanos , Vacunas contra la Influenza , Aceite de Palma , Tocotrienoles , Humanos , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/administración & dosificación , Tocotrienoles/administración & dosificación , Aceite de Palma/administración & dosificación , Gripe Humana/prevención & control , Gripe Humana/inmunología , Método Doble Ciego , Vacunación , Adulto , Masculino , Vitamina E , Femenino , Agentes Inmunomoduladores , Citocinas/sangreRESUMEN
Elevated body mass index (BMI) has been linked to severe influenza illness and impaired vaccine immunogenicity, but the relationship between BMI and clinical vaccine effectiveness (VE) is less well described. This secondary analysis of data from a test-negative study of outpatients with acute respiratory illness assessed BMI and VE against medically attended, PCR-confirmed influenza over seven seasons (2011-12 through 2017-18). Vaccination status was determined from electronic medical records (EMR) and self-report; BMI was estimated from EMR-documented height and weight categorized for adults as obesity (≥ 30 kg/m2), overweight (25-29 kg/m2), or normal and for children based on standardized z-scales. Current season VE by virus type/subtype was estimated separately for adults and children. Pooled VE for all seasons was calculated as 1-adjusted odds ratios from logistic regression with an interaction term for BMI and vaccination. Among 28,089 adults and 12,380 children, BMI category was not significantly associated with VE against outpatient influenza for any type/subtype. Adjusted VE against A/H3N2, A/H1N1pdm09, and B in adults ranged from 16-31, 46-54, and 44-57%, and in children from 29-34, 57-65, and 50-55%, respectively, across the BMI categories. Elevated BMI was not associated with reduced VE against laboratory confirmed, outpatient influenza illness.
Asunto(s)
Índice de Masa Corporal , Vacunas contra la Influenza , Gripe Humana , Humanos , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/administración & dosificación , Masculino , Femenino , Gripe Humana/prevención & control , Gripe Humana/inmunología , Gripe Humana/epidemiología , Adulto , Niño , Persona de Mediana Edad , Adolescente , Eficacia de las Vacunas , Anciano , Vacunación , Adulto Joven , Preescolar , Obesidad , Subtipo H3N2 del Virus de la Influenza A/inmunologíaRESUMEN
Healthcare workers (HCWs) are at increased risk of exposure to the influenza virus in their daily clinical and disease prevention activities, making them a high-risk group for influenza infection. However, the vaccination rate among HCWs has always been low. This study investigated influenza vaccination uptake and willingness among HCWs in the context of the COVID-19 pandemic. The analysis revealed that the influenza vaccination uptake among HCWs was 67.5%, with 79.6% willing to receive the influenza vaccine in 2022/2023 A significant majority (92.7%) agreed that the COVID-19 pandemic increased their willingness to receive the influenza vaccine, and 94.8% agreed with the necessity of receiving the influenza vaccine even after COVID-19 vaccination. Binary logistic regression model identified key factors that influence vaccination intentions. HCWs who perceived a high risk of influenza and its threat to health, found vaccination convenient, and believed in the safety of the influenza vaccine were more likely to be vaccinated. Conversely, the high price of the influenza vaccine was a barrier, whereas those who considered the vaccine affordable were more likely to be vaccinated. Although Changchun Changsheng vaccine incident (The Changchun Changsheng Biotechnology Company was found to have violated good manufacturing practices in 2018, leading to widespread distribution of subpotent vaccines in China.) may not significantly impact the vaccination uptake among healthcare workers, some HCWs still harbor doubts about vaccine safety, which remains a key reason for vaccine hesitancy. This study emphasizes the importance of the strict monitoring and management of vaccines, conducting clinical studies to support vaccine safety, and implementing free influenza vaccine policies, workplace vaccination requirements, and organized mass vaccinations. Educational efforts to increase HCWs' understanding of influenza and influenza vaccines are crucial to increasing vaccination uptake. Furthermore, implementing comprehensive intervention measures is essential to effectively improve the influenza vaccination uptake.
Asunto(s)
COVID-19 , Personal de Salud , Vacunas contra la Influenza , Gripe Humana , Cobertura de Vacunación , Humanos , Vacunas contra la Influenza/administración & dosificación , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , China , Gripe Humana/prevención & control , Masculino , Femenino , Adulto , Cobertura de Vacunación/estadística & datos numéricos , Persona de Mediana Edad , COVID-19/prevención & control , COVID-19/epidemiología , Vacunación/estadística & datos numéricos , Vacunación/psicología , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Adulto JovenRESUMEN
BACKGROUND The purpose of the study was to determine the level of antihemagglutinin antibodies in the serum of patients in the geriatric population in Doctor's Surgery NZOZ Nucleus Warsaw, Poland, during the epidemic season 2021/2022 using the hemagglutination inhibition assay (HAI), according to anti-influenza and anti-COVID-19 vaccination, age, and sex. MATERIAL AND METHODS Serum samples taken from 256 patients aged 65 to 99 years were examined for anti-hemagglutinin antibodies and protective levels of antibodies against antigens: A/Victoria/2570/2019 (H1N1)pdm09, A/Cambodia/e0826360/2020(H3N2), B/Washington/02/2019 (B/Victoria lineage), and B/Phuket/3073/2013 (B/Yamagata lineage) of the quadrivalent influenza vaccine for epidemic season 2021/2022. RESULTS The highest protective level, ie, the percentage of people with antibody titers ≥40 was 87.5% and was recorded for subtype A/Cambodia/e0826360/2020(H3N2), the dominant type causing infections in the epidemic season 2021/2022 confirmed by molecular biology methods. Geometric mean titer (GMT) values and protective levels for B/Washington/02/2019 (B/Victoria lineage) antigen were higher for men than women (respectively 38.4 vs 67.6; P<0.001 and 58.0% vs 74.6%; P<0.001). The protective levels of antibodies among patients vaccinated vs unvaccinated against COVID-19 were higher for B/Washington/02/2019 (B/Victoria lineage) and B/Phuket/3073/2013 (B/Yamagata lineage) antigens (64.2% vs 44.4%; P=0.023 and 78.6% vs 55.6%; P=0.004). GMT values for vaccinated against COVID-19 were also higher. There were no significant differences between younger (65-79 years) and older (≥80 years) seniors. CONCLUSIONS The analysis shows differences in the level of individual antibodies, GMT and the protective level depending on subtypes of influenza A or B virus, B/Victoria or B/Yamagata lineage, sex, and previous vaccination history against influenza and COVID-19.
Asunto(s)
Anticuerpos Antivirales , COVID-19 , Vacunas contra la Influenza , Gripe Humana , SARS-CoV-2 , Humanos , Anciano , Polonia/epidemiología , Masculino , Femenino , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , Gripe Humana/prevención & control , Gripe Humana/inmunología , Gripe Humana/epidemiología , Vacunas contra la Influenza/inmunología , Anciano de 80 o más Años , COVID-19/prevención & control , COVID-19/inmunología , COVID-19/epidemiología , SARS-CoV-2/inmunología , Vacunas contra la COVID-19/inmunología , Factores Sexuales , Vacunación , Subtipo H3N2 del Virus de la Influenza A/inmunología , Glicoproteínas Hemaglutininas del Virus de la Influenza/inmunología , Factores de Edad , Subtipo H1N1 del Virus de la Influenza A/inmunología , Pruebas de Inhibición de Hemaglutinación/métodos , Estaciones del AñoRESUMEN
Introduction: Influenza vaccination is one of the most important strategies for preventing influenza. However, the influenza vaccination rate in China remains low. During the COVID-19 pandemic, people held different attitudes toward the COVID-19 vaccine. In the post-pandemic era, do the varying attitudes toward the COVID-19 vaccine affect the intention to receive influenza vaccination? Methods: Based on the influence of presumed influence (IPI) model and spillover effects, this study employed structural equation modeling for multi-group comparison to analyze questionnaires from 613 participants, using instruments such as the Perceived Media Influence on Others Scale (PMIO), the Susceptibility to Influenza Scale (SI), and the Attitude toward Influenza Vaccine Scale (AIV). Results: The key findings are as follows: (1) Information exposure to the influenza vaccine significantly influences perceived media influence on others. (2) Perceived media influence on others does not directly impact the intention to receive influenza vaccination but rather affects it through attitude toward the influenza vaccine. (3) Moreover, multi-group analyses revealed differences in the IPI model among audiences with different attitudes toward the COVID-19 vaccine. These differences demonstrated that prior attitudes toward the COVID-19 vaccine can influence attitudes toward similar influenza vaccines, thus demonstrating the existence of spillover effects. Conclusion: Attitude toward the COVID-19 vaccine can influence the intention to receive the influenza vaccination. Those with a negative attitude toward the COVID-19 vaccine are significantly influenced by susceptibility to influenza. Perceived media influence affects the intention to receive the influenza vaccination among those with a positive attitude toward the COVID-19 vaccine.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Vacunas contra la Influenza , Gripe Humana , Intención , Humanos , Vacunas contra la Influenza/administración & dosificación , Femenino , Masculino , Adulto , COVID-19/prevención & control , Gripe Humana/prevención & control , China , Vacunas contra la COVID-19/administración & dosificación , Encuestas y Cuestionarios , Persona de Mediana Edad , Vacunación/psicología , Vacunación/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , SARS-CoV-2 , Adulto Joven , AncianoRESUMEN
Background: Concomitant administration of COVID-19, influenza, and pneumococcal vaccines could reduce the burden on healthcare systems. However, the immunogenicity and safety of various combinations of a third booster dose of SARS-CoV-2 inactivated vaccine (CoronaVac), inactivated quadrivalent influenza vaccine (IIV4), and 23-valent pneumococcal polysaccharide vaccine (PPV23), particularly in different age groups, is still unknown. Methods: A phase 4, randomized, open-label, controlled trial was conducted in Beijing, China. 636 healthy adults were divided into two age groups (18-59 and ≥60 years) and randomized equally into three groups: CoronaVac and IIV4 followed by PPV23; CoronaVac and PPV23 followed by IIV4; or CoronaVac followed by IIV4 and PPV23, with a 28-day interval between vaccinations. Immunogenicity was evaluated by measuring antibody titers, and safety was monitored. ClinicalTrials.gov Identifier: NCT05298800. Results: Co-administration of a third dose of CoronaVac, IIV4, and PPV23 in any combination was safe. Among adults aged 18-59, co-administration with PPV23 maintained non-inferiority of antibody levels for CoronaVac and IIV4, despite a slight reduction in antibody responses. This reduction was not observed in participants ≥60 years. Furthermore, co-administration of IIV4 and PPV23 affected seroconversion rates for both vaccines. Conclusions: Co-administration of the third dose of SARS-CoV-2 inactivated vaccine with the influenza vaccine, followed by PPV23, may be optimal for adults aged 18-59. In adults ≥60, all vaccine combinations were immunogenic, suggesting a flexible vaccination approach. Since antibody measurements were taken 28 days post-vaccination, ongoing surveillance is essential to assess the longevity of the immune responses.
Asunto(s)
Anticuerpos Antivirales , Vacunas contra la COVID-19 , COVID-19 , Inmunización Secundaria , Inmunogenicidad Vacunal , Vacunas contra la Influenza , Vacunas Neumococicas , SARS-CoV-2 , Humanos , Persona de Mediana Edad , Vacunas Neumococicas/inmunología , Vacunas Neumococicas/administración & dosificación , Vacunas Neumococicas/efectos adversos , Masculino , Femenino , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Vacunas contra la COVID-19/efectos adversos , Adulto , COVID-19/prevención & control , COVID-19/inmunología , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/efectos adversos , Vacunas contra la Influenza/administración & dosificación , Anciano , SARS-CoV-2/inmunología , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , Adulto Joven , Vacunas de Productos Inactivados/inmunología , Vacunas de Productos Inactivados/administración & dosificación , Vacunas de Productos Inactivados/efectos adversos , Adolescente , China , Gripe Humana/prevención & control , Gripe Humana/inmunologíaRESUMEN
Recombinant influenza virus neuraminidase (NA) is a promising broadly protective influenza vaccine candidate. However, the recombinant protein alone is not sufficient to induce durable and protective immune responses and requires the coadministration of immunostimulatory molecules. Here, we evaluated the immunogenicity and cross-protective potential of a recombinant influenza virus N2 neuraminidase vaccine construct, adjuvanted with a toll-like receptor 9 (TLR9) agonist (CpG 1018® adjuvant), and alum. The combination of CpG 1018 adjuvant and alum induced a balanced and robust humoral and T-cellular immune response against the NA, which provided protection and reduced morbidity against homologous and heterologous viral challenges in mouse and hamster models. This study supports Syrian hamsters as a useful complementary animal model to mice for pre-clinical evaluation of influenza virus vaccines.
Asunto(s)
Adyuvantes Inmunológicos , Anticuerpos Antivirales , Vacunas contra la Influenza , Neuraminidasa , Infecciones por Orthomyxoviridae , Animales , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/administración & dosificación , Neuraminidasa/inmunología , Neuraminidasa/genética , Infecciones por Orthomyxoviridae/prevención & control , Infecciones por Orthomyxoviridae/inmunología , Ratones , Adyuvantes Inmunológicos/administración & dosificación , Femenino , Cricetinae , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/sangre , Vacunas Sintéticas/inmunología , Vacunas Sintéticas/administración & dosificación , Adyuvantes de Vacunas , Ratones Endogámicos BALB C , Protección Cruzada/inmunología , Mesocricetus , Oligodesoxirribonucleótidos/administración & dosificación , Oligodesoxirribonucleótidos/inmunología , Compuestos de Alumbre/administración & dosificación , Modelos Animales de Enfermedad , Inmunidad CelularRESUMEN
BACKGROUND: Influenza B/Yamagata viruses exhibited weak antigenic selection in recent years, reducing their prevalence over time and requiring no update of the vaccine component since 2015. To date, no B/Yamagata viruses have been isolated or sequenced since March 2020. METHODS: The antibody prevalence against the current B/Yamagata vaccine strain in Italy was investigated: For each influenza season from 2012/2013 to 2021/2022, 100 human serum samples were tested by haemagglutination inhibition (HAI) assay against the vaccine strain B/Phuket/3073/2013. In addition, the sequences of 156 B/Yamagata strains isolated during the influenza surveillance activities were selected for analysis of the haemagglutinin genome segment. RESULTS: About 61.9% of the human samples showed HAI antibodies, and 21.7% had protective antibody levels. The prevalence of antibodies at protective levels in the seasons between the isolation of the strain and its inclusion in the vaccine was between 11% and 25%, with no significant changes observed in subsequent years. A significant increase was observed in the 2020/2021 season, in line with the increase in influenza vaccine uptake during the pandemic. Sequence analysis showed that from 2014/2015 season onward, all B/Yamagata strains circulating in Italy were closely related to the B/Phuket/2013 vaccine strain, showing only limited amino acid variation. CONCLUSIONS: A consistent prevalence of antibodies to the current B/Yamagata vaccine strain in the general population was observed. The prolonged use of a well-matched influenza vaccine and a low antigenic diversity of B/Yamagata viruses may have facilitated a strong reduction in B/Yamagata circulation, potentially contributing to the disappearance of this lineage.
Asunto(s)
Anticuerpos Antivirales , Pruebas de Inhibición de Hemaglutinación , Virus de la Influenza B , Vacunas contra la Influenza , Gripe Humana , Italia/epidemiología , Humanos , Virus de la Influenza B/genética , Virus de la Influenza B/clasificación , Virus de la Influenza B/aislamiento & purificación , Virus de la Influenza B/inmunología , Gripe Humana/epidemiología , Gripe Humana/virología , Anticuerpos Antivirales/sangre , Prevalencia , Vacunas contra la Influenza/inmunología , Estaciones del Año , Filogenia , Persona de Mediana Edad , Femenino , Adulto , Masculino , Adolescente , Adulto Joven , Niño , Anciano , PreescolarRESUMEN
Vaccination is crucial for the prevention and mitigation of avian influenza infections in China. The inactivated H7N9 vaccine, when administered to poultry, significantly lowers the risk of infection among both poultry and humans, while also markedly decreasing the prevalence of H7N9 detections. Highly pathogenic (HP) H7N9 viruses occasionally appear, whereas their low pathogenicity (LP) counterparts have been scarcely detected since 2018. However, these contributing factors remain poorly understood. We conducted an exploratory investigation of the mechanics via the application of comprehensive bioinformatic approaches. We delineated the Yangtze River Delta (YRD) H7N9 lineage into 5 clades (YRD-A to E). Our findings highlight the emergence and peak occurrence of the LP H7N9-containing YRD-E clade during the 5th epidemic wave in China's primary poultry farming areas. A more effective control of LP H7N9 through vaccination was observed compared to that of its HP H7N9 counterpart. YRD-E exhibited a tardy evolutionary trajectory, denoted by the conservation of its genetic and antigenic variation. Our analysis of YRD-E revealed only minimal amino acid substitutions along its phylogenetic tree and a few selective sweep mutations since 2016. In terms of epidemic fitness, the YRD-E was measured to be lower than that of the HP variants. Collectively, these findings underscore the conserved evolutionary patterns distinguishing the YRD-E. Given the conservation presented in its evolutionary patterns, the YRD-E LP H7N9 is hypothesized to be associated with a reduction following the mass vaccination in a relatively short period owing to its lower probability of antigenic variation that might affect vaccine efficiency.
Asunto(s)
Evolución Molecular , Subtipo H7N9 del Virus de la Influenza A , Vacunas contra la Influenza , Gripe Aviar , Filogenia , Aves de Corral , Subtipo H7N9 del Virus de la Influenza A/genética , Subtipo H7N9 del Virus de la Influenza A/inmunología , Subtipo H7N9 del Virus de la Influenza A/clasificación , Subtipo H7N9 del Virus de la Influenza A/patogenicidad , Animales , Gripe Aviar/virología , Gripe Aviar/prevención & control , China/epidemiología , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/genética , Aves de Corral/virología , Vacunación Masiva , Gripe Humana/prevención & control , Gripe Humana/virología , Gripe Humana/epidemiología , Enfermedades de las Aves de Corral/virología , Enfermedades de las Aves de Corral/prevención & control , Humanos , Pollos/virología , Variación Antigénica/genéticaRESUMEN
BACKGROUND: Influenza represents a critical public health challenge, disproportionately affecting at-risk populations, including older adults and those with chronic conditions, often compounded by socioeconomic factors. Innovative strategies, such as gamification, are essential for augmenting risk communication and community engagement efforts to address this threat. OBJECTIVE: This study aims to introduce the "Let's Control Flu" (LCF) tool, a gamified, interactive platform aimed at simulating the impact of various public health policies (PHPs) on influenza vaccination coverage rates and health outcomes. The tool aligns with the World Health Organization's goal of achieving a 75% influenza vaccination rate by 2030, facilitating strategic decision-making to enhance vaccination uptake. METHODS: The LCF tool integrates a selection of 13 PHPs from an initial set proposed in another study, targeting specific population groups to evaluate 7 key health outcomes. A prioritization mechanism accounts for societal resistance and the synergistic effects of PHPs, projecting the potential policy impacts from 2022 to 2031. This methodology enables users to assess how PHPs could influence public health strategies within distinct target groups. RESULTS: The LCF project began in February 2021 and is scheduled to end in December 2024. The model creation phase and its application to the pilot country, Sweden, took place between May 2021 and May 2023, with subsequent application to other European countries. The pilot phase demonstrated the tool's potential, indicating a promising increase in the national influenza vaccination coverage rate, with uniform improvements across all targeted demographic groups. These initial findings highlight the tool's capacity to model the effects of PHPs on improving vaccination rates and mitigating the health impact of influenza. CONCLUSIONS: By incorporating gamification into the analysis of PHPs, the LCF tool offers an innovative and accessible approach to supporting health decision makers and patient advocacy groups. It enhances the comprehension of policy impacts, promoting more effective influenza prevention and control strategies. This paper underscores the critical need for adaptable and engaging tools in PHP planning and implementation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/55613.
Asunto(s)
Algoritmos , Gripe Humana , Cobertura de Vacunación , Humanos , Cobertura de Vacunación/estadística & datos numéricos , Gripe Humana/prevención & control , Gripe Humana/epidemiología , Vacunas contra la Influenza/administración & dosificación , Política de Salud , Suecia/epidemiología , Adulto , Anciano , Vacunación/métodos , Masculino , Persona de Mediana Edad , FemeninoRESUMEN
Vasovagal syncope, or fainting, can be triggered by various stimuli, including medical procedures. Syncope after vaccination has been reported, most commonly among adolescents, and can result in injuries. Using the Vaccine Adverse Event Reporting System (VAERS), we reviewed and summarized reports of syncope after live attenuated influenza vaccine, intranasal (LAIV) administered as the sole vaccine (i.e., no concomitant injections). From June 17, 2003 (date of LAIV licensure in the US) through May 31, 2024, VAERS received 50 reports of syncope after LAIV. Nearly half (23; 46 %) pertained to individuals 10-19 years of age. While the vast majority of reports (35; 70 %) did not describe any injuries, 15 people (30 %) were injured, most commonly by falling and hitting their head or face. Twenty-two people (44 %) required evaluation in the emergency department or doctor's office, including an individual who lost consciousness while he was driving home from the vaccination appointment. He did not report any injuries, but the car was severely damaged. Nearly three-quarters of people (37; 74 %) developed syncope within 15 min after vaccination, but fewer than half of reports (24; 48 %) stated that the patient had waited in the observation area for at 15 min. Based on approximately 111.9 million doses of LAIV distributed in the US during the same time period, the reporting rate is approximately 0.4 per million doses, suggesting that syncope following LAIV is rare. The information summarized here may enable clinicians, patients, and caregivers to make a more informed decision regarding preventing injuries that may occur following LAIV-related syncope.
Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos , Vacunas contra la Influenza , Síncope , Vacunas Atenuadas , Humanos , Vacunas contra la Influenza/efectos adversos , Vacunas contra la Influenza/administración & dosificación , Adolescente , Vacunas Atenuadas/efectos adversos , Vacunas Atenuadas/administración & dosificación , Adulto Joven , Adulto , Masculino , Femenino , Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Niño , Síncope/etiología , Síncope/epidemiología , Persona de Mediana Edad , Gripe Humana/prevención & control , Gripe Humana/complicaciones , Estados Unidos/epidemiología , Anciano , Vacunación/efectos adversos , Administración IntranasalRESUMEN
Early-life nutrition significantly impacts vaccination efficacy in infants, whose immune response to vaccines is weaker compared to adults. This study investigated vaccination efficacy in female C57Bl/6JOlaHsd mice (6 weeks old) fed diets with 0.7% galacto-oligosaccharides (GOS)/long-chain fructo-oligosaccharides (lcFOS) (9:1), 0.3% human milk oligosaccharides (HMOS), or a combination (GFH) for 14 days prior to and during vaccination. Delayed-type hypersensitivity (DTH) was measured by assessing ear swelling following an intradermal challenge. Influvac-specific IgG1 and IgG2a levels were assessed using ELISAs, while splenic T and B lymphocytes were analyzed for frequency and activation via flow cytometry. Additionally, cytokine production was evaluated using murine splenocytes co-cultured with influenza-loaded dendritic cells. Mice on the GFH diet showed a significantly enhanced DTH response (p < 0.05), increased serological IgG1 levels, and a significant rise in memory B lymphocytes (CD27+ B220+ CD19+). GFH-fed mice also exhibited more activated splenic Th1 cells (CD69+ CXCR3+ CD4+) and higher IFN-γ production after ex vivo restimulation (p < 0.05). These findings suggest that GOS/lcFOS and HMOS, particularly in combination, enhance vaccine responses by improving memory B cells, IgG production, and Th1 cell activation, supporting the potential use of these prebiotics in infant formula for better early-life immune development.
Asunto(s)
Vacunas contra la Influenza , Ratones Endogámicos C57BL , Leche Humana , Oligosacáridos , Animales , Oligosacáridos/farmacología , Leche Humana/inmunología , Leche Humana/química , Femenino , Vacunas contra la Influenza/inmunología , Humanos , Ratones , Vacunación , Inmunoglobulina G/sangre , Galactosa , Linfocitos B/inmunología , Bazo/inmunología , Citocinas/metabolismo , Modelos Animales de Enfermedad , Anticuerpos Antivirales/sangreRESUMEN
BACKGROUND: Pregnant women, fetuses, and neonates are particularly vulnerable to vaccine-preventable diseases (VPDs). These VPDs are associated with high morbidity and mortality among expectant mothers and their fetuses and neonates. Vaccination during pregnancy can protect the expectant mother from VPDs to which she may be especially vulnerable while pregnant. In addition, the passive transfer of maternal neutralizing immunoglobulin G (IgG) and secretory immunoglobulin A (IgA) also protects the fetus against congenital infections and may further protect the neonate from infection during the first few months of life. Despite this, coverage of recommended maternal vaccines remains suboptimal globally, especially in resource-constrained settings. Determinants of vaccine acceptance and uptake are frequently understudied in low- and middle-income countries (LMICs) and among specific groups such as pregnant and postpartum women. This proposed systematic review will assess the acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in LMICs. METHODS: A Boolean search strategy employing common and medical subject heading (MeSH) terms for tetanus, influenza, pertussis, and COVID-19 vaccines, as well as vaccine acceptance, hesitancy, together with uptake, pregnancy, and postpartum, will be used to search electronic databases for relevant literature published between 2009 and 2024. Only studies conducted in LMICs that investigated determinants of acceptance, hesitancy, and uptake of tetanus, influenza, pertussis, and COVID-19 vaccines among pregnant and postpartum women will be eligible for inclusion in the review. The quality and the risk of bias of all eligible full-text articles will be assessed using the Joanna Briggs Institute's (JBI) critical appraisal tools. DISCUSSION: This protocol proposes a systematic review and meta-analysis that aims to assess the uptake of maternal vaccines and to systematically appraise and quantify determinants of the acceptance and uptake of recommended vaccines during pregnancy and postpartum in LMICs. A better understanding of these factors and how they influence maternal vaccine decision-making will enable public health practitioners as well as global and national policymakers to design more effective interventions as we look towards expanding the scope and reach of maternal immunization programs.
Asunto(s)
COVID-19 , Países en Desarrollo , Gripe Humana , Metaanálisis como Asunto , SARS-CoV-2 , Revisiones Sistemáticas como Asunto , Tétanos , Tos Ferina , Humanos , Femenino , Embarazo , COVID-19/prevención & control , Gripe Humana/prevención & control , Tétanos/prevención & control , SARS-CoV-2/inmunología , Tos Ferina/prevención & control , Periodo Posparto , Complicaciones Infecciosas del Embarazo/prevención & control , Vacunación/psicología , Vacunas contra la COVID-19 , Aceptación de la Atención de Salud , Vacunas contra la InfluenzaRESUMEN
Seasonal influenza is a severe disease that significantly impacts public health, causing millions of infections and hundreds of thousands of deaths each year. Seasonal influenza viruses, particularly the H3N2 subtype, exhibit high antigenic variability, often leading to mismatch between vaccine strains and circulating strains. Therefore, rapidly assessing the alignment between existing seasonal influenza vaccine and circulating strains is crucial for enhancing vaccine efficacy. This study, based on a pseudovirus platform, evaluated the match between current influenza H3N2 vaccine strains and circulating strains through cross-neutralization assays using clinical human immune sera against globally circulating influenza virus strains. The research results show that although mutations are present in the circulating strains, the current H3N2 vaccine strain still imparting effective protection, providing a scientific basis for encouraging influenza vaccination. This research methodology can be sustainably applied for the neutralization potency assessment of subsequent circulating strains, establishing a persistent methodological framework.