scholarly journals Long-term immunogenicity of BNT162b2 vaccination in the elderly and in younger health care workers

2021 ◽  
Author(s):  
Pinkus Tober-Lau ◽  
Tatjana Schwarz ◽  
Kanika Vanshylla ◽  
David Hillus ◽  
Henning Gruell ◽  
...  
Keyword(s):  
Immune Responses ◽  
The Elderly ◽  
Current Data ◽  
Elderly Persons ◽  
Cell Reactivity ◽  
Vaccination Rates ◽  
High Risk Populations ◽  
T Cell Reactivity ◽  
Elderly Cohort

COVID-19 mRNA vaccine BNT162b2 is highly immunogenic and effective, but recent studies have indicated waning anti-SARS-CoV-2 immune responses over time. Increasing infection rates has led authorities in several countries to initiate booster campaigns for vulnerable populations, including the elderly. However, the durability of vaccine-induced immunity in the elderly is currently unknown. Here, we describe interim results of a prospective cohort study comparing immune responses in a cohort of vaccinated elderly persons to those in healthcare workers (HCW), measured six months after first immunisation with BNT162b2. Anti-SARS-CoV-2 S1-, full Spike- and RBD -IgG seropositivity rates and IgG levels at six months were significantly lower in the elderly compared to HCW. Serum neutralization of Delta VOC measured by pseudovirus neutralisation test was detectable in 43/71 (60.6%, 95%CI: 48.9-71.1) in the elderly cohort compared to 79/83 in the HCW cohort (95.2%, 95%CI: 88.3-98.1) at six months post vaccination. Consistent with the overall lower antibody levels, SARS-CoV-2-S1 T cell reactivity was reduced in the elderly compared to HCW (261.6 mIU/ml, IQR:141.5-828.6 vs 1198.0 mIU/ml, IQR: 593.9-2533.6, p<0.0001). Collectively, these findings suggest that the established two-dose vaccination regimen elicits less durable immune responses in the elderly compared to young adults. Given the recent surge in hospitalisations, even in countries with high vaccination rates such as Israel, the current data may support booster vaccinations of the elderly. Further studies to determine long-term effectiveness of COVID-19 vaccines in high-risk populations and the safety and effectiveness of additional boosters are needed.

RAS peptide vaccination in resected pancreatic cancer patients - persistence of anti tumour response and long term survival

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4543-4543 ◽  
Author(s):  
T. Buanes ◽  
S. Bernhardt ◽  
K. Lislerud ◽  
I. Gladhaug ◽  
M. Moeller ◽  
...  
Keyword(s):  
T Cell ◽  
Immune Responses ◽  
Immunological Memory ◽  
Peptide Vaccination ◽  
Cell Reactivity ◽  
Term Survival ◽  
Long Term Survival ◽  
T Cell Reactivity

4543 Background: K-RAS mutations are found in most adenocarcinoma of the pancreas, and targeting mutant RAS by vaccination may be of clinical importance. The present follow-up study was performed to determine whether or not mutant RAS specific T cells were still present in long term survivors seven to nine years after postoperative adjuvant vaccination with synthetic mutant RAS peptides Methods: During 1995–98, all together 23 patients were recruited into two clinical studies. The patients in CTN95002 (n = 10) were given a single mutant RAS peptide (100μg) corresponding to the RAS mutation identified in the patient’s tumor. Patients in CTN98010 (n = 13) were given a mixture of seven mutant RAS peptides, (700μg), corresponding to the most common mutations in pancreatic adenocarcinoma, in a 10 week vaccination regimen, using GM-CSF as an adjuvant, and boosters for an extended period. Immune responses were measured as skin reaction (DTH) and/or in vitro T-cell response. Blood samples from the five patients, still alive in 2006, were investigated by in vitro T-cell proliferation assay for immunological memory. Results: The five surviving patients were all immune responders during the primary vaccination period. Analysis of T-cell reactivity was performed seven (one patient), eight (one patient) and nine years (three patients) after resection/vaccination. Three patients still showed immune responses against the vaccine given previously. T cell reactivity against the Gly12Val mutation was observed in one patient receiving this peptide. In another patient a strong T cell reactivity against all seven peptides present in the vaccine, was observed. Conclusions: Long term survival beyond seven to nine years was only found in patients who primarily responded immunologically on the RAS-vaccination. Long term immunological memory can be induced by peptide vaccination. No significant financial relationships to disclose.

scholarly journals Care and management demands of long-term care facilities for the elderly in Brazil: an integrative review (2004-2014)

2017 ◽  
Vol 20 (2) ◽  
pp. 286-299 ◽  
Author(s):  
Fátima Ferreira Roquete ◽  
Carolina Campos Ricci Frá Batista ◽  
Rodrigo Caetano Arantes
Keyword(s):  
Long Term Care ◽  
Quality Care ◽  
The Elderly ◽  
Integrative Review ◽  
Elderly Persons ◽  
Term Care ◽  
Care For The Elderly ◽  
Care Facilities ◽  
Care Demands

Abstract Objective: to analyze the care and management demands of Long-Term Care Facilities for the Elderly (LTCFs) in Brazil. Method: an integrative review of literature was carried out, organized into six stages: a) elaboration of a guiding question; b) online search of LILACS, SciELO, PubMed, the CAPES Portal and the Brazilian Society of Geriatrics and Gerontology databases; c) article selection, following the exclusion and inclusion criteria, with the sample composed of 17 articles; d) commented analysis of the selected articles; e) deliberation on the results obtained, formulated from the synthesis and interpretation of the selected studies; f) presentation of the results of the review. Results: the care demands identified are related to the process of caring and assume a working team with geriatric and gerontological knowledge, while the management demands include the means and resources needed so the care can be provided effectively. However, the LTCFs were found to rely on professionals who are unprepared to provide care or to assume an organizational management role, meaning care for the elderly is restricted to the essentials for their basic needs. Conclusion: the care demands were easily identified in the analyzed publications, however, there is a lack of research that evaluates management demands in a broader and more in-depth manner. It is suggested that studies aiming to broaden theoretical knowledge of the care and management demands of LTCFs are carried out, to stimulate effective and positive actions in the practices of these institutions, seeking to offer top quality care to elderly persons that live in these facilities, that responds to the real needs of their current stage of life.

scholarly journals Negligible impact of SARS-CoV-2 variants on CD4+ and CD8+ T cell reactivity in COVID-19 exposed donors and vaccinees.

2021 ◽  
Author(s):  
Alison Tarke ◽  
John Sidney ◽  
Nils Methot ◽  
Yun Zhang ◽  
Jennifer M Dan ◽  
...  
Keyword(s):  
T Cell ◽  
Immune Responses ◽  
T Cell Responses ◽  
Cd8 T Cell ◽  
Comprehensive Analysis ◽  
T Cell Epitopes ◽  
Cell Reactivity ◽  
Cell Responses ◽  
Adaptive Immune ◽  
T Cell Reactivity

The emergence of SARS-CoV-2 variants highlighted the need to better understand adaptive immune responses to this virus. It is important to address whether also CD4+ and CD8+ T cell responses are affected, because of the role they play in disease resolution and modulation of COVID-19 disease severity. Here we performed a comprehensive analysis of SARS-CoV-2-specific CD4+ and CD8+ T cell responses from COVID-19 convalescent subjects recognizing the ancestral strain, compared to variant lineages B.1.1.7, B.1.351, P.1, and CAL.20C as well as recipients of the Moderna (mRNA-1273) or Pfizer/BioNTech (BNT162b2) COVID-19 vaccines. Similarly, we demonstrate that the sequences of the vast majority of SARS-CoV-2 T cell epitopes are not affected by the mutations found in the variants analyzed. Overall, the results demonstrate that CD4+ and CD8+ T cell responses in convalescent COVID-19 subjects or COVID-19 mRNA vaccinees are not substantially affected by mutations found in the SARS-CoV-2 variants.

Sa1825 ITALIAN REAL-LIFE STUDY EVALUATING THE LONG-TERM EFFECTIVENESS OF VEDOLIZUMAB FOR THE TREATMENT OF INFLAMMATORY BOWEL DISEASE: THE ELDERLY COHORT

2020 ◽  
Vol 158 (6) ◽  
pp. S-441
Author(s):  
Daniela Pugliese ◽  
Giuseppe Privitera ◽  
Federica Crispino ◽  
Nicolò Mezzina ◽  
Lucienne Pellegrini ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Real Life ◽  
The Elderly ◽  
Life Study ◽  
Inflammatory Bowel ◽  
Real Life Study ◽  
Elderly Cohort

FoodNet Survey of Food Use and Practices in Long-Term Care Facilities

2008 ◽  
Vol 71 (2) ◽  
pp. 365-372 ◽  
Author(s):  
JENNIFER M. NELSON ◽  
ROBERT BEDNARCZYK ◽  
JOELLE NADLE ◽  
PAULA CLOGHER ◽  
JENNIFER GILLESPIE ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
The Elderly ◽  
Foodborne Illness ◽  
Elderly Persons ◽  
Surveillance Network ◽  
Term Care ◽  
Shell Eggs ◽  
Safe Food

Foodborne illness is an important problem among the elderly. One risk factor for foodborne illness and diarrhea-associated mortality among the elderly is residence in a long-term care facility (LTCF); thus, these facilities must implement measures to ensure safe food. To assess safe food practices, knowledge, and policies, we used a mailed, self-administered questionnaire to survey food service directors at LTCFs that were certified to receive Medicare or Medicaid at eight Foodborne Diseases Active Surveillance Network (FoodNet) sites. Surveys were distributed to 1,630 LTCFs; 55% (865 of 1,568) of eligible facilities returned a completed questionnaire. Only three LTCFs completely followed national recommendations for prevention of Listeria monocytogenes contamination. Nine percent of LTCFs reported serving soft cheeses made from unpasteurized milk. Most LTCFs reported routinely serving ready-to-eat deli meats; however, few reported always heating deli meats until steaming hot before serving (only 19% of the LTCFs that served roast beef, 13% of those that served turkey, and 11% of those that served ham). Most LTCFs (92%) used pasteurized liquid egg products, but only 36% used pasteurized whole shell eggs. Regular whole shell eggs were used by 62% of facilities. Few LTCFs used irradiated ground beef (7%) or irradiated poultry products (6%). The results of this survey allowed us to identify several opportunities for prevention of foodborne illnesses in LTCFs. Some safety measures, such as the use of pasteurized and irradiated foods, were underutilized, and many facilities were not adhering to national recommendations on the avoidance of certain foods considered high risk for elderly persons. Enhanced educational efforts focusing on food safety practices and aimed at LTCFs are needed.

scholarly journals Bendamustine and its role in the treatment of unfit patients with chronic lymphocytic leukaemia: a perspective review

2017 ◽  
Vol 8 (6) ◽  
pp. 197-205 ◽  
Author(s):  
Othman Al-Sawaf ◽  
Paula Cramer ◽  
Valentin Goede ◽  
Michael Hallek ◽  
Natali Pflug
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Lymphocytic Leukaemia ◽  
The Elderly ◽  
Current Data ◽  
Oral Medications ◽  
Therapeutic Decisions ◽  
Unfit Patients ◽  
Line Setting ◽  
New Compounds

With a median age of 72 years at first diagnosis, chronic lymphocytic leukaemia (CLL) is a disease of the elderly. At this age, many patients cannot bear an intensive chemoimmunotherapy like fludarabine, cyclophosphamide and rituximab (FCR), and therapeutic decisions are commonly complicated by a high burden of accompanying comorbidities. Clinical trials, on the other hand, are mostly designed to include a far healthier and younger trial population, with a median age in most studies well below 70 years, leading to an insufficient reflection of clinical reality. With the introduction of new targeted therapies, treatment of CLL is currently undergoing a profound change. New compounds like ibrutinib or idelalisib have enlarged the therapeutic options in treating CLL. However, so far, these oral medications imply continuous intake by the patient, which will at some point lead to the issue of adherence in most patients. In addition, long-term experiences are largely missing. In this setting, one of the oldest chemoactive substances remains a viable option for many CLL patients and their treating physicians: bendamustine, a nitrogen–mustard derivative, has proven to be a safe and efficient agent for treatment of CLL in the first- and second-line setting. In particular, there is some evidence that the substance is relatively well tolerated in elderly and unfit patients. In this review, we summarize the current data on bendamustine in the treatment of elderly and unfit patients with CLL and aim to provide a concise analysis and outlook on the current and future role of this substance in the era of new targeted agents.

scholarly journals Diabetes type 2 diabetes in the elderly – solved and unsolved questions

2016 ◽  
Vol 19 (4) ◽  
pp. 322-330
Author(s):  
Tat'jana Vladimirovna Saprina ◽  
Nailja Maratovna Fajzulina
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus Type 2 ◽  
Diabetes Type 2 ◽  
The Elderly ◽  
Diabetes Type ◽  
Elderly Persons ◽  
Basic Information

The number of elderly persons with diabetes mellitus type 2 is expected to progressively increase. Management of this category of patients should be individualised and include the adequate correction of hyperglycaemia, prevention of long-term complications, prevention of hypoglycaemia, reduction of cardiovascular mortality and preservation of quality of life. This article summarises basic information on the pathophysiology of carbohydrate metabolism, peculiarities of the course of diabetes and use of antidiabetic drugs in the elderly. Special attention is paid to reviewing the goals of glycaemic control and proposed clinical guidelines.

scholarly journals Long-term care of the elderly: Current status, policies and dilemmas

Stanovnistvo ◽  
2012 ◽  
Vol 50 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Gordana Matkovic
Keyword(s):  
Home Care ◽  
Elderly People ◽  
Long Term Care ◽  
The Elderly ◽  
Elderly Persons ◽  
Community Based ◽  
Term Care ◽  
Cash Benefits ◽  
The Government

In Serbia, the long-term care as a system does not actually exist. One part of the system is regulated through cash benefits, one part through institutional social care and community-based social services, and one part is just being established under the health care system. The linkages among these segments are not strong and there is insufficient awareness of the need to regard the different parts of the system as being interdependent and interconnected. According to the different surveys, home care is needed for the daily functioning of more than 80,000 elderly people, especially for around 27,000 of those who are completely immobile. More than 300 thousand elderly persons have indicated that they are in need of some type of self-care support. By tradition, elderly people in Serbia rely primarily on family support. Some are getting the state support as well. Research shows that 62 thousand elderly persons (5 percent) receive attendance allowance; 9,000 elderly are accommodated in institutions (0.7 percent), while 11.7 thousand (1 percent) persons received some type of support through home care community based services. In addition, in Belgrade there are also 2,000 elderly who are beneficiaries of medical and palliative care at home. The government expenditures for these purposes can be very roughly estimated at 0.55 percent of GDP, largely for cash benefits (0.37 percent). Considered over a medium and longer term, the government expenditures on longterm care in Serbia will inevitably increase significantly, primarily due to an increase in the number and share of elderly people and the increase in additional life years spent in ill health or in need of assistance. An increase in the expenditures will also be influenced by a change in the family models and the increasing number of elderly that will be living alone, as well as the diminishing possibilities for reliance on the closest family members, especially due to emigration flows both at local and national levels. Finally, it is important not to neglect the effect of emulating more developed countries, as well as the EU?s pressure to adequately respond to the needs of the elderly. Therefore, the state and society must promptly prepare a systematic, comprehensive, timely and fiscally responsible response. This response must recognize the capacities of all stakeholders, from family to state and non-state and match the capacities with the appropriate roles in the system of long-term care provision.

scholarly journals Aging-Related Cellular, Structural and Functional Changes in the Lymph Nodes: A Significant Component of Immunosenescence? An Overview

Cells ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 3148
Author(s):  
Marta Cakala-Jakimowicz ◽  
Paulina Kolodziej-Wojnar ◽  
Monika Puzianowska-Kuznicka
Keyword(s):  
Immune System ◽  
Immune Responses ◽  
Lymph Nodes ◽  
Immune Cell ◽  
Humoral Response ◽  
The Elderly ◽  
Cell Types ◽  
Functional Changes ◽  
B Cell Homeostasis

Aging affects all tissues and organs. Aging of the immune system results in the severe disruption of its functions, leading to an increased susceptibility to infections, an increase in autoimmune disorders and cancer incidence, and a decreased response to vaccines. Lymph nodes are precisely organized structures of the peripheral lymphoid organs and are the key sites coordinating innate and long-term adaptive immune responses to external antigens and vaccines. They are also involved in immune tolerance. The aging of lymph nodes results in decreased cell transport to and within the nodes, a disturbance in the structure and organization of nodal zones, incorrect location of individual immune cell types and impaired intercellular interactions, as well as changes in the production of adequate amounts of chemokines and cytokines necessary for immune cell proliferation, survival and function, impaired naïve T- and B-cell homeostasis, and a diminished long-term humoral response. Understanding the causes of these stromal and lymphoid microenvironment changes in the lymph nodes that cause the aging-related dysfunction of the immune system can help to improve long-term immune responses and the effectiveness of vaccines in the elderly.

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