RESUMO
BACKGROUND: This study aimed to explore the reasons adults in the general population, influenza risk groups (RGs) and health care workers (HCWs) in Norway give for their vaccination choices and whether these reasons vary between groups or over time in order to further improve influenza vaccination coverage. METHODS: Respondents of a nationally representative telephone survey conducted by Statistics Norway were asked "What was the most important reason why you did/did not get vaccinated?". The question on influenza non-vaccination was included in 2016 and in 2020 to 2023 and the question on influenza vaccination in 2021 to 2023. RESULTS: The study included 9 705 individuals aged 18-79 years. Influenza vaccination coverage in the RGs increased from 20.6% in 2016 to 63.1% in 2022, before a reduction to 58.3% in 2023. Common reasons for non-vaccination were similar in all groups. The most cited reasons were "no need" for the vaccine and "no specific reason", followed by "not recommended/offered the vaccine", "worry about side effects" and "vaccine refusal". The most frequent reasons for vaccination among the general population and RGs were protection against influenza and belonging to a RG, while the most frequent responses among HCWs were being offered the vaccine at work/work in health care, followed by a desire for protection against influenza. Receiving a vaccine recommendation from a health professional was mentioned in all groups. We also observed that the proportion reporting "no need" for the vaccine decreased over time, especially among HCWs, and that the proportions reporting vaccine refusal and worry about side effects as reasons for non-vaccination were temporarily reduced during the COVID-19 pandemic. CONCLUSIONS: The general population and RGs cite protection against influenza as their primary incentive for vaccination, while HCWs mainly refer to their professional role or workplace vaccination. For non-vaccination we see a similar pattern in all groups, with "no need" and "no specific reason" as the main reasons. Of note, worry about side effects and vaccine refusal is as frequent among HCWs as in other groups. Continued efforts to maintain and increase vaccine confidence are needed.
Assuntos
Vacinas contra Influenza , Influenza Humana , Humanos , Pessoa de Meia-Idade , Adulto , Noruega , Vacinas contra Influenza/administração & dosagem , Masculino , Adolescente , Feminino , Influenza Humana/prevenção & controle , Idoso , Adulto Jovem , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Vacinação/psicologia , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/psicologia , Estações do AnoRESUMO
Memory T cells play a key role in immune protection against cancer. Vaccine-induced tissue-resident memory T (TRM) cells in the lung have been shown to protect against lung metastasis. Identifying the source of lung TRM cells can help to improve strategies, preventing tumor metastasis. Here, we found that a prime-boost vaccination approach using intramuscular DNA vaccine priming, followed by intranasal live-attenuated influenza-vectored vaccine (LAIV) boosting induced higher frequencies of lung CD8+ TRM cells compared with other vaccination regimens. Vaccine-induced lung CD8+ TRM cells, but not circulating memory T cells, conferred significant protection against metastatic melanoma and mesothelioma. Central memory T (TCM) cells induced by the DNA vaccination were major precursors of lung TRM cells established after the intranasal LAIV boost. Single-cell RNA sequencing analysis indicated that transcriptional reprogramming of TCM cells for differentiation into TRM cells in the lungs started as early as day 2 post the LAIV boost. Intranasal LAIV altered the mucosal microenvironment to recruit TCM cells via CXCR3-dependent chemotaxis and induced CD8+ TRM-associated transcriptional programs. These results identified TCM cells as the source of vaccine-induced CD8+ TRM cells that protect against lung metastasis. Significance: Prime-boost vaccination shapes the mucosal microenvironment and reprograms central memory T cells to generate lung resident memory T cells that protect against lung metastasis, providing insights for the optimization of vaccine strategies.
Assuntos
Linfócitos T CD8-Positivos , Vacinas Anticâncer , Memória Imunológica , Neoplasias Pulmonares , Células T de Memória , Animais , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/patologia , Camundongos , Células T de Memória/imunologia , Linfócitos T CD8-Positivos/imunologia , Vacinas Anticâncer/imunologia , Vacinas Anticâncer/administração & dosagem , Camundongos Endogâmicos C57BL , Vacinas de DNA/imunologia , Vacinas de DNA/administração & dosagem , Imunização Secundária/métodos , Vacinação/métodos , Feminino , Humanos , Administração Intranasal , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Pulmão/imunologia , Pulmão/patologiaRESUMO
BACKGROUND: Hesitancy about vaccination during pregnancy posed challenges to SARS-CoV-2 vaccination efforts. We aimed to examine rates of SARS-CoV-2 vaccination among Ontario residents who gave birth in early 2022, and to compare rates of SARS-CoV-2 vaccine uptake with rates of tetanus, diphtheria, and pertussis (Tdap) and influenza vaccination during pregnancy in 2019, 2021, and 2022. METHODS: We conducted a population-based retrospective cohort study to describe vaccination rates among pregnant and comparable nonpregnant populations in Ontario using linked administrative data. Provincially insured females who had a live, in-hospital birth from Jan. 1 to Mar. 31 in 2019, 2021, or 2022 were our primary cohort. Using log-binomial regression, we tested associations between SARS-CoV-2 (2022) and Tdap and influenza (2019, 2021, 2022) vaccination status, with birth group and covariates. We compared SARS-CoV-2 vaccination status with the status of a matched cohort of nonpregnant females and conducted subgroup analyses by age and prenatal clinician type. RESULTS: Among birthing people, 78.7% received their first SARS-CoV-2 vaccine dose and 74.2% received a second dose. The rate was significantly higher among nonpregnant comparators (dose 1: relative risk [RR] 0.94, 95% confidence interval [CI] 0.93-0.94; dose 2: RR 0.91, 95% CI 0.90-0.91). However, the rate of SARS-CoV-2 vaccination uptake among birthing people was higher than uptake of Tdap or influenza vaccination. Tetanus, diphtheria, and pertussis vaccination increased over time from 22.2% in 2019 to 32.6% in 2022, and influenza vaccination rose to 35.3% in 2021 but returned to prepandemic levels in 2022 (27.7%). Vaccination rates were lower among pregnant people who were young, multiparous, or residents of rural or economically deprived areas for all 3 vaccines. INTERPRETATION: Rates of SARS-CoV-2 vaccination were lower among pregnant people than among nonpregnant comparators but were higher than rates of routinely recommended Tdap and influenza vaccinations. Pandemic urgency may have overcome a great deal of hesitancy about vaccinating against SARS-CoV-2 during pregnancy in 2022, but uptake of routinely recommended vaccines in pregnancy remains a challenge. TRIAL REGISTRATION: Clinicaltrials.gov, no. NCT05663762.
Assuntos
COVID-19 , Vacinas contra Difteria, Tétano e Coqueluche Acelular , Vacinas contra Influenza , Influenza Humana , Humanos , Feminino , Gravidez , Ontário/epidemiologia , Estudos Retrospectivos , Adulto , Vacinas contra Influenza/administração & dosagem , COVID-19/prevenção & controle , COVID-19/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinação/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , Adulto Jovem , SARS-CoV-2 , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologiaRESUMO
Surveys often estimate vaccination intentions using dichotomous ("Yes"/"No") or trichotomous ("Yes," "Unsure," "No") response options presented in different orders. Do survey results depend on these variations? This controlled experiment randomized participants to dichotomous or trichotomous measures of vaccine intentions (with "Yes" and "No" options presented in different orders). Intentions were measured separately for COVID-19, its booster, and influenza vaccines. Among a sample of U.S. adults (N = 4,764), estimates of vaccine intention varied as much as 37.5 ± 17.4 percentage points as a function of the dichotomous or trichotomous response set. Among participants who had not received the COVID-19 vaccine, the "Unsure" option was more likely to reduce the share of "No" (versus "Yes") responses, whereas among participants who had received the COVID-19 vaccine, the "Unsure" option was more likely to reduce the share of "Yes" (versus "No") responses. The "Unsure" category may increase doubt and decrease reliance on past vaccination behavior when forming intentions. The order of "Yes" and "No" responses had no significant effect. Future research is needed to further evaluate why the effects of including the "Unsure" option vary in direction and magnitude.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Vacinas contra Influenza , Intenção , Vacinação , Humanos , Masculino , Vacinação/estatística & dados numéricos , Feminino , Adulto , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , COVID-19/epidemiologia , Pessoa de Meia-Idade , Vacinas contra Influenza/administração & dosagem , Inquéritos e Questionários , SARS-CoV-2/imunologia , Adulto Jovem , Idoso , Adolescente , Influenza Humana/prevenção & controleRESUMO
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.
Assuntos
Injúria Renal Aguda , Vacinas contra Influenza , Influenza Humana , Humanos , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/administração & dosagem , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/etiologia , Idoso , Masculino , Feminino , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , República da Coreia/epidemiologia , Idoso de 80 Anos ou mais , Incidência , Vacinação/efeitos adversos , Vacinação/estatística & dados numéricos , Bases de Dados Factuais , Hospitalização/estatística & dados numéricos , Estações do Ano , Fatores de RiscoRESUMO
Importance: Although influenza vaccination has been found to be safe in pregnancy, few studies have assessed repeated influenza vaccination over successive pregnancies, including 2 vaccinations in a year, in terms of adverse perinatal outcomes. Objective: To examine the association of seasonal influenza vaccination across successive pregnancies with adverse perinatal outcomes and whether the association varies by interpregnancy interval (IPI) and vaccine type (quadrivalent or trivalent). Design, Setting, and Participants: This retrospective cohort study included individuals with at least 2 successive singleton live-birth pregnancies between January 1, 2004, and December 31, 2018. Data were collected from the Vaccine Safety Datalink, a collaboration between the Centers for Disease Control and Prevention and integrated health care organizations. Data analysis was performed between January 8, 2021, and July 17, 2024. Exposures: Influenza vaccination was identified using vaccine administration codes. The vaccinated cohort consisted of people who received influenza vaccines during the influenza season (August 1 through April 30) in 2 successive pregnancies. The comparator cohort consisted of people identified as unvaccinated during both pregnancies. Main Outcomes and Measures: Main outcomes were risk of preeclampsia or eclampsia, placental abruption, fever, preterm birth, preterm premature rupture of membranes, chorioamnionitis, and small for gestational age among individuals with and without vaccination in both pregnancies. Adjusted relative risks (RRs) from Poisson regression were used to assess the magnitude of associations. The associations with adverse outcomes by IPI and vaccine type were evaluated. Results: Of 82â¯055 people with 2 singleton pregnancies between 2004 and 2018, 44â¯879 (54.7%) had influenza vaccination in successive pregnancies. Mean (SD) age at the start of the second pregnancy was 32.2 (4.6) years for vaccinated individuals and 31.2 (5.0) years for unvaccinated individuals. Compared with individuals not vaccinated in both pregnancies, vaccination in successive pregnancies was not associated with increased risk of preeclampsia or eclampsia (adjusted RR, 1.10; 95% CI, 0.99-1.21), placental abruption (adjusted RR, 1.01; 95% CI, 0.84-1.21), fever (adjusted RR, 0.87; 95% CI, 0.47-1.59), preterm birth (adjusted RR, 0.83; 95% CI, 0.78-0.89), preterm premature rupture of membranes (RR, 1.00; 95% CI, 0.94-1.06), chorioamnionitis (adjusted RR, 1.03; 95% CI, 0.90-1.18), or small for gestational age birth (adjusted RR, 0.99; 95% CI, 0.93-1.05). IPI and vaccine type did not modify the observed associations. Conclusions and Relevance: In this large cohort study of successive pregnancies, influenza vaccination was not associated with increased risk of adverse perinatal outcomes, irrespective of IPI and vaccine type. Findings support recommendations to vaccinate pregnant people or those who might be pregnant during the influenza season.
Assuntos
Vacinas contra Influenza , Influenza Humana , Humanos , Feminino , Gravidez , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/administração & dosagem , Estudos Retrospectivos , Adulto , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Estações do Ano , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Vacinação/efeitos adversos , Vacinação/estatística & dados numéricos , Adulto Jovem , Recém-NascidoRESUMO
BACKGROUND: Healthcare workers (HCWs) are an important target group for influenza vaccination due to their increased risk of infection. However, their uptake remains a challenge. This study aimed to identify and measure influenza vaccine hesitancy among HCWs in Nakhon Phanom province, Thailand. METHODS: A representative cross-sectional survey was conducted during August-September 2020, among 350 HCWs at six hospitals in the province selected by a two-stage cluster sampling using a self-administered questionnaire. HCWs who either delayed getting influenza vaccines, accepted the vaccines but were unsure, or refused the vaccine with doubts were categorized as hesitant. HCWs who accepted the influenza vaccine without any doubts were classified as non-hesitant. Determinants of vaccine hesitancy were identified by a multivariable logistic regression analysis. RESULTS: A total of 338 participants (97%) filled the questionnaires. The mean age of the participants was 37.2 years. Most participants were female (280; 83%), nurses (136; 40%), working at district hospitals (238; 71%), with bachelor's degree (223; 66%), and without any pre-existing chronic medical conditions (264; 78%). Influenza vaccine hesitancy was evident among nearly 60% of the participants (197/338), who had varying patterns of hesitancy. Significant factors of influenza vaccine hesitancy were found to be age above 50 years (adjusted odds ratio [aOR] 3.2, 95% CI 1.3-8.5), fair knowledge of influenza and vaccination (aOR 0.4, 95% CI 0.2-0.8), and negative influence of other HCW (High level-aOR 2.3, 95% CI 1.1-4.8; Moderate level- aOR 2.1, 95% CI 1.1-4.4). CONCLUSION: Influenza vaccine hesitancy was highly prevalent among the Thai HCWs in Nakhon Phanom province. Imparting updated information to the HCW, in combination with positive guidance from influential HCWs in the hospital, may help reduce hesitancy. These data may be useful to the National Immunization Program to design appropriate approaches to target hesitant HCWs in Thailand to improve influenza vaccine coverage.
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Pessoal de Saúde , Vacinas contra Influenza , Influenza Humana , Hesitação Vacinal , Humanos , Feminino , Tailândia , Masculino , Adulto , Estudos Transversais , Vacinas contra Influenza/administração & dosagem , Pessoal de Saúde/psicologia , Influenza Humana/prevenção & controle , Pessoa de Meia-Idade , Inquéritos e Questionários , Hesitação Vacinal/psicologia , Hesitação Vacinal/estatística & dados numéricos , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adulto JovemRESUMO
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.
Assuntos
Linfócitos T CD4-Positivos , Centro Germinativo , Vacinas contra Influenza , Infecções por Orthomyxoviridae , Animais , Centro Germinativo/imunologia , Camundongos , Infecções por Orthomyxoviridae/imunologia , Infecções por Orthomyxoviridae/prevenção & controle , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Linfócitos T CD4-Positivos/imunologia , Anticorpos Antivirais/imunologia , Camundongos Endogâmicos C57BL , Linfócitos B/imunologia , Memória Imunológica , Células T de Memória/imunologia , Imunização/métodos , Feminino , Antígenos Virais/imunologiaRESUMO
BACKGROUND: Since May 7 2022, mpox has been endemic in many countries which has attracted the attention of health authorities in various countries and made control decisions, in which vaccination is the mainstream strategy. However, the shortage of vaccine doses and the reduction of protective efficacy have led to unresolved issues such as vaccine allocation decisions and evaluation of transmission scale. METHODS: We developed an epidemiological model to describe the prevalence of the mpox virus in New York City and calibrated the model to match surveillance data from May 19 to November 3, 2022. Finally, we adjusted the model to simulate and compare several scenarios of non-vaccination and pre-pandemic vaccination. RESULTS: Relative to the status quo, if vaccination is not carried out, the number of new infections increases to about 385%, and the transmission time will be extended to about 350%, while if vaccinated before the epidemic, the number of new infections decreases to 94.2-96%. CONCLUSIONS: The mpox outbreak in New York City may be linked to the Pride event. However, with current vaccine coverage, there will be no more large-scale outbreaks of mpox, even if there is another similar activity. For areas with limited vaccines, priority is given to high-risk groups in the age group [34-45] years as soon as possible.
Assuntos
Surtos de Doenças , Humanos , Cidade de Nova Iorque/epidemiologia , Surtos de Doenças/prevenção & controle , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Criança , Idoso , Vacinação/estatística & dados numéricos , Pré-Escolar , Mpox/epidemiologia , Mpox/prevenção & controle , Lactente , Masculino , Feminino , Modelos Epidemiológicos , Idoso de 80 Anos ou mais , Vacinas contra Influenza/administração & dosagem , Recém-Nascido , Fatores Etários , PrevalênciaRESUMO
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.
Assuntos
COVID-19 , Pessoal de Saúde , Vacinas contra Influenza , Influenza Humana , Cobertura Vacinal , Humanos , Vacinas contra Influenza/administração & dosagem , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , China , Influenza Humana/prevenção & controle , Masculino , Feminino , Adulto , Cobertura Vacinal/estatística & dados numéricos , Pessoa de Meia-Idade , COVID-19/prevenção & controle , COVID-19/epidemiologia , Vacinação/estatística & dados numéricos , Vacinação/psicologia , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Adulto JovemRESUMO
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.
Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Vacinas contra Influenza , Síncope , Vacinas Atenuadas , Humanos , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/administração & dosagem , Adolescente , Vacinas Atenuadas/efeitos adversos , Vacinas Atenuadas/administração & dosagem , Adulto Jovem , Adulto , Masculino , Feminino , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Criança , Síncope/etiologia , Síncope/epidemiologia , Pessoa de Meia-Idade , Influenza Humana/prevenção & controle , Influenza Humana/complicações , Estados Unidos/epidemiologia , Idoso , Vacinação/efeitos adversos , Administração IntranasalRESUMO
BACKGROUND: In 2022, publicly funded influenza vaccine was made available to all residents of Queensland, Australia. This study compared influenza epidemiology in 2022 with previous years (2017-2021) and estimated influenza vaccine effectiveness (VE) during 2022. METHODS: The study involved a descriptive analysis of influenza notifications and a case-control study to estimate VE. Cases were notifications of laboratory-confirmed influenza, and controls were individuals who were test negative for COVID-19. Cases and controls were matched on age, postcode and specimen collection date. VE against hospitalisation was investigated by matching hospitalised cases to controls. Conditional logistic regression models were adjusted for sex. RESULTS: In 2022, Queensland experienced an early influenza season onset (April-May) and high case numbers (n = 45,311), compared to the previous 5 years (annual average: 29,364) and 2020-2021 (2020:6047; 2021:301) during the COVID-19 pandemic. Adjusted VE (VEadj) against laboratory-confirmed influenza was 39% (95% confidence interval [CI]: 37-41), highest for children aged 30 months to < 5 years (61%, 95% CI: 49-70) and lowest for adults aged ≥ 65 years (24%, 95% CI: 17-30). VEadj against influenza-associated hospitalisation was 54% (95% CI: 48-59). Among children < 9 years of age, VEadj against laboratory-confirmed influenza (55%, 95% CI: 49-61) and hospitalisation (67%, 95% CI: 39-82) was higher in those who received a complete dose schedule. CONCLUSION: In Queensland, the 2022 influenza season started earlier than the previous 5 years. VE against influenza notifications varied across age groups. VE estimates against influenza-associated hospitalisation were higher than those against laboratory-confirmed influenza.
Assuntos
Hospitalização , Vacinas contra Influenza , Influenza Humana , Eficácia de Vacinas , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Queensland/epidemiologia , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/imunologia , Pessoa de Meia-Idade , Pré-Escolar , Masculino , Feminino , Criança , Adulto , Idoso , Lactente , Adolescente , Estudos de Casos e Controles , Adulto Jovem , Eficácia de Vacinas/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinação/estatística & dados numéricos , SARS-CoV-2/imunologia , Estações do Ano , Idoso de 80 Anos ou maisRESUMO
Infections caused by the influenza virus lead to both epidemic and pandemic outbreaks in humans and animals. Owing to their rapid production, safety, and stability, DNA vaccines represent a promising avenue for eliciting immunity and thwarting viral infections. While DNA vaccines have demonstrated substantial efficacy in murine models, their effectiveness in larger animals remains subdued. This limitation may be addressed by augmenting the immunogenicity of DNA-based vaccines. In the investigation here, protein expression was enhanced via codon optimization and then mouse cytotoxic T-lymphocyte antigen 4 (CTLA-4) was harnessed as a modulatory adjunct to bind directly to antigen-presenting cells. Further, the study evaluated the immunogenicity of two variants of the hemagglutinin (HA) antigen, i.e. the full-length and the C-terminal deletion versions. The study findings revealed that the codon-optimized HA gene (pcHA) led to increased protein synthesis, as evidenced by elevated mRNA levels. Codon optimization also significantly bolstered both cellular and humoral immune responses. In cytokine assays, all plasmid constructs, particularly pCTLA4-cHA, induced robust interferon (IFN)-γ production, while interleukin (IL)-4 levels remained uniformly non-significant. Mice immunized with pcHA displayed an augmented presence of IFNγ+ T-cells, underscoring the enhanced potency of the codon-optimized HA vaccine. Contrarily, CTLA-4-fused DNA vaccines did not significantly amplify the immune response.
Assuntos
Antígeno CTLA-4 , Códon , Glicoproteínas de Hemaglutininação de Vírus da Influenza , Vacinas contra Influenza , Infecções por Orthomyxoviridae , Vacinas de DNA , Animais , Vacinas de DNA/imunologia , Vacinas de DNA/genética , Camundongos , Antígeno CTLA-4/genética , Antígeno CTLA-4/imunologia , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Códon/genética , Infecções por Orthomyxoviridae/imunologia , Infecções por Orthomyxoviridae/prevenção & controle , Humanos , Feminino , Camundongos Endogâmicos BALB C , Modelos Animais de Doenças , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Vírus da Influenza A Subtipo H1N1/imunologiaRESUMO
Seasonal influenza poses significant health and economic challenges globally each year, particularly impacting the elderly population (aged ≥ 65 years) with increased rates of hospitalization, and mortality. The population of older adults is steadily increasing in the Gulf Cooperation Council (GCC) countries and is likely to increase even further. In addition, there is a high burden of chronic comorbidities in these countries like diabetes and obesity, which increases the likelihood of severe consequences of influenza infection. The GCC countries also host mass gathering events like Hajj, Umrah pilgrimage, Arba'een (nearby Iraq) pilgrimage, and international sports and business events, which further intensify the risk of outbreaks like influenza. These events facilitate the mixing of visitors from various countries. Thus, influenza activity in this North Hemisphere (NH) geography is usually present even before the availability of NH seasonal influenza vaccine. This is especially problematic for the elderly, whose protection from the previous year's immunization would have waned. Higher dosages of antigens or adjuvants have been used to improve immunogenicity in older people with superior vaccine effectiveness. Therefore, there is a compelling argument in favor of the implementation of high-dose seasonal influenza vaccines in the GCC countries to improve the protection of individuals aged 65 years and older against influenza infection and associated severe complications.
Assuntos
Vacinas contra Influenza , Influenza Humana , Humanos , Vacinas contra Influenza/administração & dosagem , Idoso , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Oriente Médio/epidemiologia , Idoso de 80 Anos ou maisRESUMO
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.
Assuntos
Algoritmos , Influenza Humana , Cobertura Vacinal , Humanos , Cobertura Vacinal/estatística & dados numéricos , Influenza Humana/prevenção & controle , Influenza Humana/epidemiologia , Vacinas contra Influenza/administração & dosagem , Política de Saúde , Suécia/epidemiologia , Adulto , Idoso , Vacinação/métodos , Masculino , Pessoa de Meia-Idade , FemininoRESUMO
BACKGROUND: Seasonal influenza outbreaks in France cause a surge in patients, exacerbating the overburdened healthcare system each winter. Older adults are particularly vulnerable to serious events related to influenza. Quadrivalent influenza high dose (QIV HD) vaccines have been developed to offer better clinical protection in older adults, who often exhibit suboptimal immune response to quadrivalent influenza standard dose vaccines (QIV SD). This study aims to evaluate the public health impact and cost-effectiveness of administering HD versus SD vaccines to individuals aged 65+ in France. METHODOLOGY: Using a static model and decision-tree approach, the study analyzed health outcomes such as influenza cases, GP (general practitioner) visits, hospitalizations, and mortality; relative vaccine efficacy (rVE) estimates were derived from a pivotal randomized-controlled trial and a meta-analysis comparing HD to SD vaccines. Two approaches were implemented to model hospitalizations (conditional on influenza or not), and analyses on bed occupancy were performed. RESULTS: Results showed that using QIV HD instead of QIV SD during an average influenza season in France led to the prevention of 57,209 additional cases of influenza, 13,704 GP visits, and 764 influenza-related deaths. Moreover, switching to QIV HD resulted in an additional 1,728-15,970 hospitalizations avoided and 15,124-138,367 reduced days of hospitalization depending on the hospitalization approach used. The cost-utility analysis showed a cost per quality-adjusted life year (QALY) gained ranging from 24,020 /QALY to 5,036 /QALY. CONCLUSIONS: Switching to QIV HD in older adults was shown to be cost-effective, with even greater public health benefits at a higher coverage rate, regardless of the season severity.
Assuntos
Análise Custo-Benefício , Hospitalização , Vacinas contra Influenza , Influenza Humana , Humanos , Idoso , França , Vacinas contra Influenza/economia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Influenza Humana/economia , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Feminino , Masculino , Anos de Vida Ajustados por Qualidade de Vida , Idoso de 80 Anos ou mais , Saúde Pública/economia , Árvores de Decisões , Modelos EconométricosRESUMO
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.
Assuntos
Índice de Massa Corporal , Vacinas contra Influenza , Influenza Humana , Humanos , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Masculino , Feminino , Influenza Humana/prevenção & controle , Influenza Humana/imunologia , Influenza Humana/epidemiologia , Adulto , Criança , Pessoa de Meia-Idade , Adolescente , Eficácia de Vacinas , Idoso , Vacinação , Adulto Jovem , Pré-Escolar , Obesidade , Vírus da Influenza A Subtipo H3N2/imunologiaRESUMO
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.