scholarly journals Evidence for Residual Immunity to Smallpox After Vaccination and Implications for Re-emergence

2019 ◽  
Vol 184 (11-12) ◽  
pp. e668-e679 ◽  
Author(s):  
Mohana Priya Kunasekaran ◽  
Xin Chen ◽  
Valentina Costantino ◽  
Abrar Ahmad Chughtai ◽  
Chandini Raina MacIntyre
Keyword(s):  
Immunological Memory ◽  
Childhood Vaccination ◽  
Smallpox Vaccination ◽  
Cross Sectional ◽  
Immune Correlates ◽  
Modeling Studies ◽  
Cross Sectional Studies ◽  
Duration Of Protection ◽  
Antibody Levels ◽  
The Impact

Abstract Introduction Smallpox has been eradicated but advances in synthetic biology have increased the risk of its re-emergence. Residual immunity in individuals who were previously vaccinated may mitigate the impact of an outbreak, but there is a high degree of uncertainty about the duration and degree of residual immunity. Both cell-mediated and humoral immunity are thought to be important but the exact mechanisms of protection are unclear. Guidelines usually suggest vaccine-induced immunity wanes to zero after 3–10 years post vaccination, whereas other estimates show long term immunity over decades. Materials and Methods A systematic review of the literature was conducted to quantify the duration and extent of residual immunity to smallpox after vaccination. Results Twenty-nine papers related to quantifying residual immunity to smallpox after vaccination were identified: neutralizing antibody levels were used as immune correlates of protection in 11/16 retrospective cross-sectional studies, 2/3 epidemiological studies, 6/7 prospective vaccine trials and 0/3 modeling studies. Duration of protection of >20 years was consistently shown in the 16 retrospective cross-sectional studies, while the lowest estimated duration of protection was 11.7 years among the modeling studies. Childhood vaccination conferred longer duration of protection than vaccination in adulthood, and multiple vaccinations did not appear to improve immunity. Conclusions Most studies suggest a longer duration of residual immunity (at least 20 years) than assumed in smallpox guidelines. Estimates from modeling studies were less but still greater than the 3–10 years suggested by the WHO Committee on International Quarantine or US CDC guidelines. These recommendations were probably based on observations and studies conducted while smallpox was endemic. The cut-off values for pre-existing antibody levels of >1:20 and >1:32 reported during the period of endemic smallpox circulation may not be relevant to the contemporary population, but have been used as a threshold for identifying people with residual immunity in post-eradication era studies. Of the total antibodies produced in response to smallpox vaccination, neutralizing antibodies have shown to contribute significantly to immunological memory. Although the mechanism of immunological memory and boosting is unclear, revaccination is likely to result in a more robust response. There is a need to improve the evidence base for estimates on residual immunity to better inform planning and preparedness for re-emergent smallpox.

scholarly journals Evidence for Residual Immunity to Smallpox After Vaccination

2019 ◽  
Vol 34 (s1) ◽  
pp. s129-s129
Author(s):  
Mohana Kunasekaran ◽  
Xin Chen ◽  
Valentina Costantino ◽  
Abrar Chughtai ◽  
Raina MacIntyre
Keyword(s):  
Neutralizing Antibodies ◽  
Immunological Memory ◽  
Evidence Base ◽  
Childhood Vaccination ◽  
Smallpox Vaccination ◽  
Cross Sectional ◽  
Modeling Studies ◽  
Cdc Guidelines ◽  
Duration Of Protection ◽  
The Impact

Introduction:Smallpox has been eradicated, but advances in synthetic biology have increased the risk of its re-emergence. Residual immunity in individuals who were previously vaccinated may mitigate the impact of an outbreak, but there is a high degree of uncertainty regarding the duration and degree of residual immunity.Methods:A systematic literature review using the PRISMA criteria was conducted to quantify the duration and extent of residual immunity to smallpox after vaccination. 29 papers related to quantifying residual immunity to smallpox after vaccination were identified.Results:Duration of protection of >20 years was consistently shown in the 16 retrospective cross-sectional studies, while the lowest estimated duration of protection was 11.7 years among the modeling studies. Childhood vaccination conferred longer duration of protection than vaccination in adulthood. Multiple vaccinations did not appear to improve immunity. Most studies suggest a longer duration of residual immunity (at least 20 years) than assumed in smallpox guidelines. Estimates from modeling studies were less but still greater than the 3-10 years suggested by the WHO Committee on International Quarantine or US CDC guidelines. These recommendations were probably based on observations and studies conducted while smallpox was endemic. The cut-off values for pre-existing antibody levels of >1:20 and >1:32 reported during the period of endemic smallpox circulation may not be relevant to the contemporary population but have been used as a threshold for identifying people with residual immunity in post-eradication era studies.Discussion:Of the total antibodies produced in response to smallpox vaccination, neutralizing antibodies have shown to contribute significantly to immunological memory. Although the mechanism of immunological memory and boosting is unclear, revaccination is likely to result in a more robust response. There is a need to improve the evidence base for estimates on residual immunity to better inform planning and preparedness for re-emergent smallpox.

scholarly journals Attitudes of Suburban Kansan Parents Regarding School-Required Immunizations and the Influences of the Coronavirus Pandemic

2021 ◽  
Vol 14 ◽  
pp. 116-120
Author(s):  
Simon Beatty ◽  
Jennifer Villwock
Keyword(s):  
Influenza Vaccine ◽  
Parental Attitudes ◽  
Childhood Vaccination ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Successful Vaccine ◽  
K 12 ◽  
Vaccine Distribution ◽  
The Impact

Introduction. Understanding parental attitudes and adherence of recommended childhood vaccination schedules adopts a new level of importance in the era of the Sars-CoV-2019 (COVID-19) pandemic. With hopes for release of a safe and effective COVID-19 vaccine within the near future, understanding parental perception of vaccines is important to design successful vaccination interventions. Methods. A cross-sectional survey was administered to approximately 900 parents in the state of Kansas in May, 2020. Pearson chi square and Mann-Whitney U tests were utilized to analyze the assess the attitudes of Kansas parents towards a potential addition of the influenza vaccine to the required list for K-12 students and furthermore, their general perception of vaccinations, and the impact of COVID-19 on those beliefs. Results. 179 responded. 51% (n=92) were in favor of adding the influenza vaccine to the mandatory list (Pro-Addition). Anti-Addition parents had significantly higher levels of distrust (2.1, p<0.001) and were significantly more concerned about vaccine adverse effects. When presented with a hypothetical situation in which a “safe and effective” COVID-19 vaccine was available, these parents were significantly less likely to indicate they would receive the vaccine or obtain it for their children (53 people, p<0.001).   Conclusions. Pro-Addition and Anti-Addition parents are markedly split on their attitudes towards the addition and the effects of the pandemic. Follow-up qualitative studies of Anti-Addition parents are critical for successful vaccine distribution and coverage in the communities.

scholarly journals Health Related Quality of Life of Caregivers of Children and Adolescents With Phenylketonuria: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110653
Author(s):  
Deepa Shaji Thomas ◽  
Divya K. Y. ◽  
Judie Arulappan
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Open Label ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related ◽  
Open Label Trial ◽  
Cross Sectional Studies ◽  
The Impact

Introduction. Caregivers of children with chronic illness are at risk of having impairment in their quality of life (QOL). We systematically reviewed the available literature related to the Health Related Quality Of Life (HRQOL) of caregivers of children with Phenylketonuria (PKU). Methods. We comprehensively searched in electronic databases including Scopus, Science Direct, CINAHL, Medline, PubMed, Google scholar, and ProQuest. The search criteria included studies with samples more than one, children suffering from PKU, exploring parents or primary caregiver’s HRQOL, published from 2010 to 2020, full article available for download and published in English. Eight studies including 5 cross sectional studies, 1 open label trial, and 2 surveys were systematically reviewed. Results. Seven out of 8 studies have established a negative correlation between PKU and parent’s HRQOL in at least 1 of the domains. In one study, the HRQOL of parents is higher than their population norms. Conclusion. Most of the caregivers had poor to moderate HRQOL. More studies are required to explore HRQOL of caregivers of children with PKU using similar tools and outcome measures addressing all the domains of HRQOL in order to have more clarity on the impact of PKU on caregiver’s HRQOL. Interventional studies might help in improving the HRQOL of caregivers.

scholarly journals The Impact of COVID-19 and the Pandemic on Tinnitus: A Systematic Review

2021 ◽  
Vol 10 (13) ◽  
pp. 2763
Author(s):  
Eldre Beukes ◽  
Alyssa Jade Ulep ◽  
Taylor Eubank ◽  
Vinaya Manchaiah
Keyword(s):  
Case Series ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Design Studies ◽  
Impact Studies ◽  
Post Test ◽  
Disease Impact ◽  
Cross Sectional Studies ◽  
Meta Analyses ◽  
The Impact

This review aimed to systematically review what has been published regarding tinnitus during the coronavirus disease 2019 (COVID-19) pandemic up to March 2021 by performing both narrative and quantitative meta-analyses. Of the 181 records identified, 33 met the inclusion criteria, which generally had a fair risk of overall bias. In the included, 28 studies focused on the impact of the COVID-19 virus on tinnitus and 5 studies focused on the impact of the pandemic on tinnitus. From the studies identifying the impact of COVID-19 on tinnitus, there were 17 cross-sectional studies (n = 8913) and 11 case series or case report studies (n = 35). There were 2 cross-sectional studies (n = 3232) and 3 pre-post-test design studies (n = 326) focusing on the impact of the pandemic on tinnitus. No consistent patterns were found regarding the presentation of the tinnitus or additional factors that could have tinnitus developing in the disease impact studies. For the pandemic impact studies, the associated stress and anxiety of the pandemic were consistently suggested to contribute to tinnitus experiences. The pooled estimated prevalence of tinnitus post COVID-19 was 8% (CI: 5 to 13%). Medical professionals should be aware that tinnitus might be more problematic following the pandemic or after having COVID-19.

scholarly journals The impact of gastrointestinal nematodes on wild reindeer: experimental and cross-sectional studies

2002 ◽  
Vol 71 (6) ◽  
pp. 937-945 ◽  
Author(s):  
A. Stien ◽  
R. J. Irvine ◽  
E. Ropstad ◽  
O. Halvorsen ◽  
R. Langvatn ◽  
...  
Keyword(s):  
Gastrointestinal Nematodes ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
The Impact ◽  
Wild Reindeer

scholarly journals The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1097
Author(s):  
Ann John ◽  
Emily Eyles ◽  
Roger T. Webb ◽  
Chukwudi Okolie ◽  
Lena Schmidt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Suicidal Behaviour ◽  
Suicide Risk ◽  
Research Evidence ◽  
Inclusion Criteria ◽  
Suicidal Thoughts ◽  
Cross Sectional ◽  
Self Harm ◽  
Cross Sectional Studies ◽  
The Impact

Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people’s lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal behaviour as well as suicide prevention efforts in relation to COVID-19, with this iteration synthesising relevant evidence up to 19th October 2020. Method:  Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. We exclude one-off cross-sectional studies without either pre-pandemic measures or comparisons of COVID-19 positive vs. unaffected individuals. Results: Searches identified 6,226 articles. Seventy-eight articles met our inclusion criteria. We identified a further 64 relevant cross-sectional studies that did not meet our revised inclusion criteria. Thirty-four articles were not peer-reviewed (e.g. research letters, pre-prints). All articles were based on observational studies. There was no consistent evidence of a rise in suicide but many studies noted adverse economic effects were evolving. There was evidence of a rise in community distress, fall in hospital presentation for suicidal behaviour and early evidence of an increased frequency of suicidal thoughts in those who had become infected with COVID-19. Conclusions:  Research evidence of the impact of COVID-19 on suicidal behaviour is accumulating rapidly. This living review provides a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide risk as the longer term impacts of the pandemic on suicide risk are researched.

scholarly journals De utryghedsmæssige konsekvenser af udsathed for kriminalitet i Danmark

2020 ◽  
Vol 107 (1) ◽  
pp. 41-66
Author(s):  
Rune H. Scherg ◽  
Anders Ejrnæs
Keyword(s):  
Statistical Models ◽  
Statistical Power ◽  
Demographic Characteristics ◽  
Causal Inferences ◽  
Cross Sectional ◽  
Current Article ◽  
The Subject ◽  
Cross Sectional Studies ◽  
The Impact ◽  
Do So

AbstractThis article examines the consequences of victimisation in relation to feeling of safety in Denmark.2 Using various statistical models, we address two general questions: First, how do different victimisation patterns affect victims’ feelings of safety, and second, how do victims’ demographic characteristics modify the consequences of victimisation in relation to feelings of safety. We analyse panel data from the Danish Police’s Safety Survey (2014-2018) linked to Danish register data. Although there is an abundance of international research about the victimfear nexus, there are still gaps in our current understanding of this relationship. First, research on the impact of victimization on feelings of safety is often based on cross-sectional studies, which don’t allow for solid causal inferences. Second, potential differences between different groups of victims have not been thoroughly analysed as few studies have had the statistical power to do so. Last, there is a scarcity of Scandinavian studies on the subject. The current article shows that victimization has a consistent effect on feelings of safety. However, the size of the effect is generally moderate and short-lived. The article also demonstrates that the impacts of victimization are disproportionately distributed across different groups of victims.

scholarly journals Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study

Viruses ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 648 ◽  
Author(s):  
Harapan Harapan ◽  
Mudatsir Mudatsir ◽  
Amanda Yufika ◽  
Yusuf Nawawi ◽  
Nur Wahyuniati ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Vaccine Trial ◽  
Cross Sectional Study ◽  
Childhood Vaccination ◽  
Willingness To Participate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Financial Compensation ◽  
Explanatory Variables ◽  
The Impact

One of the crucial steps during trials for Zika and other vaccines is to recruit participants and to understand how participants’ attitudes and sociodemographic characteristics affect willingness to participate (WTP). This study was conducted to assess WTP, its explanatory variables, and the impact of financial compensation on WTP in Indonesia. A health facility-based cross-sectional study was conducted in eleven regencies in the Aceh and West Sumatra provinces of Indonesia. Participants were recruited via a convenience sampling method and were interviewed. The associations between explanatory variables and WTP were assessed using a two-step logistic regression analysis. A total of 1,102 parents were approached, and of these 956 (86.8%) completed the interview and were included in analysis. Of those, 144 (15.1%) were willing to participate in a Zika vaccine trial without a financial compensation. In the multivariate analysis, WTP was tied to an age of more than 50 years old, compared to 20–29 years (odds ratio (OR): 5.0; 95% confidence interval (CI): 2.37–10.53), to being female (OR: 2.20; 95% CI: 1.11–4.37), and to having heard about Zika (OR: 2.41; 95% CI: 1.59–3.65). Participants’ WTP increased gradually with higher financial compensation. The rate of WTP increased to 62.3% at the highest offer (US$ 350.4), and those who were still unwilling to participate (37.7%) had a poorer attitude towards childhood vaccination. This study highlights that pre-existing knowledge about Zika and attitudes towards childhood vaccination are important in determining community members being willing to participate in a vaccine trial. Financial incentives are still an important factor to enhance participant recruitment during a vaccine trial.

scholarly journals 1422. Burden of Pertussis in South Korea: Implications for adults

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S718-S718
Author(s):  
Bruce Mungall ◽  
Hyungwoo Kim ◽  
Kyu-Bin Oh
Keyword(s):  
Literature Review ◽  
South Korea ◽  
National Level ◽  
Vaccine Uptake ◽  
Childhood Vaccination ◽  
Vaccine Preventable Diseases ◽  
Vaccination Rates ◽  
Antibody Levels ◽  
The Impact ◽  
Pertussis Epidemiology

Abstract Background There are a limited number of published studies on pertussis disease burden and epidemiology in South Korea, particularly those evaluating the impact in adults. Methods We conducted a systematic literature review on pertussis epidemiology and burden of disease in South Korea. The objective was to highlight evidence gaps which could help improve awareness about pertussis disease in adults in South Korea. Results Of 940 articles published between January 2000 to December 2019, 19 articles provided data for pertussis epidemiology and 9 provided data in adults. Laboratory confirmation rates in adults varied according to methodology, likely influenced by study/sampling variations. Three studies reported serological evidence of infection in adolescents and adults (33-57%). Among cases, the average cough duration was 16.5 days (range 7-30 days) and over 85% of cases presented with paroxysmal cough, while only 25% of cases or less presented with a characteristic whoop or post-tussive vomiting. Importantly, in 4 studies reporting vaccination status, almost all adult cases had no history of pertussis vaccination since childhood. Conclusion Primary childhood vaccination rates in South Korea are among the highest globally, while adult pertussis vaccine uptake appears to be quite low. Our literature review suggests that pertussis is underreported in adults, as evidenced by serology data demonstrating that tetanus antibody levels are low while pertussis toxin antibody levels are relatively high, suggesting continued circulation of community pertussis. These findings highlight the need for strategies such as maternal immunization and decennial revaccination of adults to address the changing epidemiology and waning immunity. Active pertussis testing/reporting and better utilization of adult vaccine registries is required to help provide robust data for vaccine decision-making at the national level. In the current COVID-19 environment, strategies that can reduce clinic or hospital visits will have substantial benefits to authorities managing rapid increases in health care resource utilization, and vaccine preventable diseases provide an easy and immediate target for achieving that goal. Disclosures Bruce Mungall, PhD, the GSK group of companies (Employee, Shareholder) Hyungwoo Kim, MD, MPH, the GSK group of companies (Employee) Kyu-Bin Oh, MD, the GSK group of companies (Employee, Shareholder)

The Impact of Diabetic Neuropathy on Activities of Daily Living, Postural Balance and Risk of Falls - A Systematic Review

2021 ◽  
pp. 193229682199792
Author(s):  
Karolina Snopek Khan ◽  
Henning Andersen
Keyword(s):  
Diabetic Neuropathy ◽  
Activities Of Daily Living ◽  
Postural Balance ◽  
Fall Risk ◽  
Daily Living ◽  
Postural Stability ◽  
Cross Sectional ◽  
Risk Of Falls ◽  
Cross Sectional Studies ◽  
The Impact

Objective: The objective of this review is to discuss a compilation of the currently available literature regarding the impact of diabetic neuropathy (DN) on activities of daily living (ADL), postural stability, and risk of falls. Methods: A systematic electronic search strategy was conducted on PubMed/MEDLINE database, Cochrane Library, and Embase in March 2020. This narrative review included clinical cross-sectional studies assessing ADL, postural balance, and falls in adults with DN. All studies underwent a quality assessment based on the Newcastle Ottawa scale developed to assess cross-sectional studies. Results: Forty-two studies were identified. A total of 37 studies evaluated postural stability in DN, 10 studies assessed fall accidents, and three studies assessed ADL in individuals with DN. Seven studies assessed both postural stability and fall accidents, and one study assessed postural stability and ADL. Each of the studied outcome variables was assessed separately. Based on a quality assessment, eight studies were excluded resulting in an evaluation of 34 studies. Conclusions: Diabetic neuropathy has a negative impact on postural balance and gait kinematics combined with an increased fall risk. Because of the few number of studies available, we were unable to evaluate the impact of DN on ADL. Our findings are in concordance with previous reviews, supporting the evidence for DN as a critical measure negatively impacting postural stability and fall risk in individuals with diabetes. Further clinical investigative studies are needed.

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