scholarly journals Heterologous vaccination interventions to reduce pandemic morbidity and mortality: Modeling the US winter 2020 COVID-19 wave

2022 ◽  
Vol 119 (3) ◽  
pp. e2025448119
Author(s):  
Nathaniel Hupert ◽  
Daniela Marín-Hernández ◽  
Bo Gao ◽  
Ricardo Águas ◽  
Douglas F. Nixon
Keyword(s):  
Oral Polio Vaccine ◽  
The United States ◽  
Protective Effects ◽  
Policy Makers ◽  
Polio Vaccine ◽  
Nonspecific Effects ◽  
The Us ◽  
Age Cohort ◽  
Nonpharmaceutical Interventions ◽  
Optimal Implementation

COVID-19 remains a stark health threat worldwide, in part because of minimal levels of targeted vaccination outside high-income countries and highly transmissible variants causing infection in vaccinated individuals. Decades of theoretical and experimental data suggest that nonspecific effects of non–COVID-19 vaccines may help bolster population immunological resilience to new pathogens. These routine vaccinations can stimulate heterologous cross-protective effects, which modulate nontargeted infections. For example, immunization with Bacillus Calmette–Guérin, inactivated influenza vaccine, oral polio vaccine, and other vaccines have been associated with some protection from SARS-CoV-2 infection and amelioration of COVID-19 disease. If heterologous vaccine interventions (HVIs) are to be seriously considered by policy makers as bridging or boosting interventions in pandemic settings to augment nonpharmaceutical interventions and specific vaccination efforts, evidence is needed to determine their optimal implementation. Using the COVID-19 International Modeling Consortium mathematical model, we show that logistically realistic HVIs with low (5 to 15%) effectiveness could have reduced COVID-19 cases, hospitalization, and mortality in the United States fall/winter 2020 wave. Similar to other mass drug administration campaigns (e.g., for malaria), HVI impact is highly dependent on both age targeting and intervention timing in relation to incidence, with maximal benefit accruing from implementation across the widest age cohort when the pandemic reproduction number is >1.0. Optimal HVI logistics therefore differ from optimal rollout parameters for specific COVID-19 immunizations. These results may be generalizable beyond COVID-19 and the US to indicate how even minimally effective heterologous immunization campaigns could reduce the burden of future viral pandemics.

scholarly journals Failure to detect infection by oral polio vaccine virus following natural exposure among inactivated polio vaccine recipients

2007 ◽  
Vol 136 (2) ◽  
pp. 180-183 ◽  
Author(s):  
H. E. GARY ◽  
B. SMITH ◽  
J. JENKS ◽  
J. RUIZ ◽  
W. SESSIONS ◽  
...  
Keyword(s):  
Oral Polio Vaccine ◽  
Developed Countries ◽  
The United States ◽  
Vaccine Virus ◽  
Susceptible Population ◽  
Inactivated Polio Vaccine ◽  
Polio Vaccine ◽  
Natural Exposure ◽  
The Us ◽  
Protection Against Infection

SUMMARYWhile oral polio vaccine (OPV) has been shown to be safe and effective, it has been observed that it can circulate within a susceptible population and revert to a virulent form. Inactivated polio vaccine (IPV) confers protection from paralytic disease, but provides limited protection against infection. It is possible, then, that an IPV-immunized population, when exposed to OPV, could sustain undetected circulation of vaccine-derived poliovirus. This study examines the possibility of polio vaccine virus circulating within the United States (highly IPV-immunized) population that borders Mexico (OPV-immunized). A total of 653 stool and 20 sewage samples collected on the US side of the border were tested for the presence of poliovirus. All samples were found to be negative. These results suggest that the risk of circulating vaccine-derived poliovirus is low in fully immunized IPV-using populations in developed countries that border OPV-using populations.

Universality, Quality & Economics: Finding a Balance in Ontario and British Columbia

1994 ◽  
Vol 20 (1-2) ◽  
pp. 203-229
Author(s):  
John D. Blum
Keyword(s):  
Health Reform ◽  
New Ventures ◽  
The United States ◽  
High Price ◽  
Social Programs ◽  
Policy Makers ◽  
High Expectations ◽  
The Us ◽  
Acceptable Model ◽  
National Economies

National economies worldwide are in disarray, evidenced by escalating debts and growing deficits. As countries struggle with their faltering economies they are hard pressed to fulfill commitments of social programs made in more prosperous times, much less take on new government initiatives. The current experiences in health reform in the United States present an interesting example of the dilemmas governments now face when they embark on new ventures. While great political pressures have been launched and high expectations abound, the reality of American health reform quickly reveals that expanded access will come at a high price that won't be offset easily by conventional cost containment or market forces.In the search for an acceptable model for health reform, it was popular for policy makers and academics to turn their attentions to the health systems of other nations. Recommendations were made that the US should adopt a German or Canadian solution for our health problems.

Letter To The Editor

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 796-796
Author(s):  
Samuel L. Katz
Keyword(s):  
Oral Polio Vaccine ◽  
The United States ◽  
Sub Saharan Africa ◽  
Intestinal Immunity ◽  
Polio Vaccine ◽  
Polio Immunization ◽  
Individual Protection ◽  
Sub Saharan ◽  
Community Protection ◽  
Central Nervous System Invasion

Drs Terry and Schneider raise legitimate questions regarding changes in polio immunization recommendations. In response to the former, although two doses of inactivated polio vaccine provide humoral immunity that will protect an individual against central nervous system invasion by wild or revertant attenuated polioviruses, they do not provide intestinal immunity, a valued asset of oral polio vaccine (OPV). Because we live in a global community where jet transportation enables one to move from a polio-endemic area to a polio-free area in less than one day, the introduction of wild polio viruses from sub-Saharan Africa or Southeast Asia poses a legitimate threat and concern to those who wish to maintain community protection, in addition to individual protection, against possible reintroduction of wild virus to the United States.

7. America in the 1990s: searching for purpose

2018 ◽  
Author(s):  
John Dumbrell
Keyword(s):  
Foreign Policy ◽  
American Foreign Policy ◽  
External Environment ◽  
The United States ◽  
Bill Clinton ◽  
First Year ◽  
Policy Makers ◽  
International Environment ◽  
The Us ◽  
Internal Pressures

This chapter examines how the external environment of US foreign policy and internal pressures on policy makers both shifted radically in the 1990s. Internationally, the ‘long 1990s’ were characterized by intense democratic possibility. Yet they were also years of atavistic negativity and irrationality, as seen in Rwanda and Bosnia. Two questions arise: First, how should the United States respond to a world which was apparently both rapidly integrating and rapidly disintegrating? Second, was it inevitable, desirable, or even possible that the US should provide global leadership? Before discussing various approaches to these questions, the chapter considers the wider international environment of apparent unipolarity and globalization. It also analyzes the development of American foreign policy under presidents George H. W. Bush and Bill Clinton, focusing in particular on the so-called ‘Kennan sweepstakes’ during the first year of Clinton’s presidency as well as Clinton’s turn towards unilateralism and remilitarization.

scholarly journals Reliably quantifying the evolving worldwide dynamic state of the COVID-19 outbreak from death records, clinical parametrization, and demographic data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jose M. G. Vilar ◽  
Leonor Saiz
Keyword(s):  
Demographic Data ◽  
The United States ◽  
Global Scale ◽  
Dynamic State ◽  
Prevalence Data ◽  
Multiple Data ◽  
The Us ◽  
Nonpharmaceutical Interventions ◽  
Global States

AbstractThe dynamic characterization of the COVID-19 outbreak is critical to implement effective actions for its control and eradication but the information available at a global scale is not sufficiently reliable to be used directly. Here, we develop a quantitative approach to reliably quantify its temporal evolution and controllability through the integration of multiple data sources, including death records, clinical parametrization of the disease, and demographic data, and we explicitly apply it to countries worldwide, covering 97.4% of the human population, and to states within the United States (US). The validation of the approach shows that it can accurately reproduce the available prevalence data and that it can precisely infer the timing of nonpharmaceutical interventions. The results of the analysis identified general patterns of recession, stabilization, and resurgence. The diversity of dynamic behaviors of the outbreak across countries is paralleled by those of states and territories in the US, converging to remarkably similar global states in both cases. Our results offer precise insights into the dynamics of the outbreak and an efficient avenue for the estimation of the prevalence rates over time.

scholarly journals Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

2020 ◽  
Vol 41 (4) ◽  
pp. 196
Author(s):  
Margaret M Peel
Keyword(s):  
Late Onset ◽  
Oral Polio Vaccine ◽  
The United States ◽  
Polio Eradication ◽  
Oral Route ◽  
World Health ◽  
Paralytic Poliomyelitis ◽  
Polio Vaccine ◽  
The Central Nervous System ◽  
Health Organization

Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

scholarly journals Corrigendum to: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

2020 ◽  
Vol 41 (4) ◽  
pp. 223
Author(s):  
Margaret M Peel
Keyword(s):  
Late Onset ◽  
Oral Polio Vaccine ◽  
The United States ◽  
Polio Eradication ◽  
Oral Route ◽  
World Health ◽  
Paralytic Poliomyelitis ◽  
Polio Vaccine ◽  
The Central Nervous System ◽  
Health Organization

Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

Community Lifeline Framework for Leveraging Stabilization in Response and Recovery to Major Hurricanes

2019 ◽  
Vol 14 (1) ◽  
pp. 7-9
Author(s):  
Judy Kruger
Keyword(s):  
Transmission Lines ◽  
Critical Infrastructure ◽  
Electrical Power ◽  
The United States ◽  
Public Officials ◽  
Policy Makers ◽  
Emergency Managers ◽  
The Us ◽  
Response And Recovery ◽  
The Impact

The United States (US) and Caribbean regions remain vulnerable to the impact of severe tropical storms, hurricanes, and typhoons. In 2017, a series of hurricanes posed threats to residents living in inland and coastal communities as well as on islands isolated from the US mainland. Harvey, Irma, Jose, and Maria caused catastrophic infrastructure damage, resulting in a loss of electrical power and communications due to damaged or downed utility poles, cell towers, and transmission lines. Critical services were inoperable for many months. Emergency managers are public officials who are accountable to both political leaders and the citizens. During disaster events, emergency managers must prioritize areas of effort, manage personnel, and communicate with stakeholders to address critical infrastructure interdependences. Essential lifeline services (eg, energy and communications) were inoperable for many months, which led to increased attention from policy-makers, media, and the public.

scholarly journals The Special Relationship and the Anglo-Iranian oil crisis, 1950–4

1998 ◽  
Vol 24 (4) ◽  
pp. 529-544 ◽  
Author(s):  
STEVE MARSH
Keyword(s):  
The United States ◽  
Special Relationship ◽  
Ideal Case ◽  
Policy Makers ◽  
Bilateral Relations ◽  
The Us ◽  
Anglo American ◽  
Balance Of Forces ◽  
Oil Crisis

The Anglo-Iranian oil crisis of 1950–4 provides an ideal case-study for those interested in the postwar Anglo-American Special Relationship. This article investigates the oil crisis with two purposes in mind: first, to demonstrate how Britain and the United States struggled to adjust their bilateral relations in response to their changing postwar world positions; second, to show just how crucial both countries perceived the Special Relationship to be in the early 1950s. This is done by examining the American decision not to pursue a policy in the Iranian oil crisis that would undermine Britain's position, despite at times severe Anglo-American tension. It is concluded that the problems created by the changing balance of forces within the Special Relationship were mitigated in Iran by a combination of consanguinity and, more important, the US need for British help in its policy of global containment. In short, Anglo-American policy-makers perceived sufficient mutual need to persuade them to actively preserve and develop the Special Relationship.

Considerations of the Obstacles and Opportunities to Formalizing Cross-National Policy Transfer to the United States: A Case Study of the Transfer of Urban Environmental and Planning Policies from Germany

2009 ◽  
Vol 27 (4) ◽  
pp. 684-697 ◽  
Author(s):  
David P Dolowitz ◽  
Dale Medearis
Keyword(s):  
United States ◽  
National Policy ◽  
The United States ◽  
Policy Transfer ◽  
Adoption Process ◽  
Policy Makers ◽  
The Us ◽  
Cross National ◽  
Planning Policies

Not enough has been written about the import, adaptation, and application of urban environmental and planning policies from abroad into the United States. Even less has been written about the voluntary cross-national transfer and application of environmental policies by American subnational actors and institutions. It is our intent to begin redressing this by discussing the transfer of urban environmental and planning policies from Germany to the United States during the early part of the 21st century. This discussion is informed by data drawn from governmental reports and planning statements and over thirty-five interviews with US urban environmental and planning practitioners operating in Germany and the United States. What we discover is that, unlike more rational models of policy transfer, the voluntary importation of environmental and planning policies into the US is seldom a problem-focused, goal-oriented process. Rather, what we find is that a better depiction of the transfer and adoption process is of a relatively anarchic situation. This appears to occur due to a range of institutional and cultural filters that predispose American policy makers against gathering (and using) information and experiences from abroad. We find that this filtering process tends to encourage policy makers to discount (or reject outright) the usefulness of overseas models and that, when they do engage in this process, any information gathered appears to be based less upon well-researched and analyzed data than embedded ‘tacit’ knowledge.

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