scholarly journals Immunity to rubella: an Italian retrospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Francesco Paolo Bianchi ◽  
Sara De Nitto ◽  
Pasquale Stefanizzi ◽  
Angela Maria Vittoria Larocca ◽  
Cinzia Annatea Germinario ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Management Strategy ◽  
Booster Dose ◽  
Seroconversion Rate ◽  
University Hospital ◽  
Medical Residents ◽  
Mmr Vaccine ◽  
Serious Adverse Events ◽  
Rubella Vaccination

Abstract Background International guidelines recommend that healthcare workers (HCWs) have presumptive evidence of immunity to rubella and that susceptible HCWs and doubt cases receive two doses of the MMR vaccine. However, a small percentage of the fully immunized will remain unprotected against wild viruses. Moreover, protective levels of antibodies induced by the vaccine have been shown to decline over time, but a formal recommendation regarding the testing of immunized HCWs for the persistence of IgG against rubella is lacking. Methods The aim of this study was to evaluate the long-term immunogenicity conferred by rubella vaccination and the effectiveness of a strategy for the management of immunized individuals in whom IgG against rubella could not be demonstrated (non-responders). The study enrolled students and medical residents who attended the Hygiene Department of Bari Policlinico University Hospital for biological risk assessment (April 2014 to June 2018). Results Two thousand students and residents with documented immunization (≥2 doses of rubella or MMR vaccine) were tested. In 181 (9%), IgG against rubella was not detectable. The seronegative rate was higher among participants vaccinated at age < 2 years (89.6%) and lower among those immunized at age ≥ 2 years (93.6%; p < 0.0001). The administration of a single MMR booster dose resulted in a seroconversion rate of 98% in the seronegative group. The seroconversion rate after a second booster dose was 100%. No serious adverse events in the re-immunized were recorded. Conclusions An important proportion of individuals immunized for rubella or MMR do not have a protective titer for the disease(s). Our management strategy (booster followed by re-test and, for those who are still negative, a second booster and re-test) is consistent with the goal of achieving immunological memory.

scholarly journals Long-term Immunogenicity of Measles Vaccine: An Italian Retrospective Cohort Study

2019 ◽  
Vol 221 (5) ◽  
pp. 721-728 ◽  
Author(s):  
Francesco Paolo Bianchi ◽  
Pasquale Stefanizzi ◽  
Sara De Nitto ◽  
Angela Maria Vittoria Larocca ◽  
Cinzia Germinario ◽  
...  
Keyword(s):  
Measles Virus ◽  
Healthcare Workers ◽  
Management Strategy ◽  
Seroconversion Rate ◽  
Measles Vaccine ◽  
Mmr Vaccine ◽  
Serious Adverse Events ◽  
Vaccine Booster ◽  
The University

Abstract Background Levels of antibodies induced by the measles virus–containing vaccine have been shown to decline over time, but there is no formal recommendation about testing immunized subjects (in particular, healthcare workers [HCWs]) to investigate the persistence of measles immunoglobulin G (IgG). Methods This study aims to evaluate the long-term immunogenicity of measles vaccine in a sample of medical students and residents of the University of Bari who attended the Hygiene Department for a biological risk assessment (April 2014–June 2018). Results Two thousand immunized (2 doses of measles-mumps-rubella [MMR] vaccine) students and residents were tested; 305 of these (15%) did not show protective anti-measles IgG. This proportion was higher among subjects who received vaccination at ≤15 months (20%) than in those who received vaccination at 16–23 months (17%) and at ≥24 months (10%) (P &lt; .0001). After an MMR vaccine booster dose, we noted a seroconversion of 74% of seronegative HCWs. The overall seroconversion rate after a second dose (booster) was 93%. No serious adverse events were noted after the booster doses. Conclusions An important proportion of subjects immunized for measles do not show a protective IgG titer in the 10 years after vaccination. Our management strategy seems consistent with the purpose of evidencing immunological memory.

scholarly journals Seroconversion rates following 2 doses of measles- mumps- rubella vaccination given at the ages 12 and 18 months: data for possible additional dose at older age

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Hana Saffar ◽  
Sayed Jaber Mousavi ◽  
Hiva Saffar ◽  
Mohammad-Reza Parsaei ◽  
Gholam-Reza Ghorbani ◽  
...  
Keyword(s):  
Immune Responses ◽  
Age Groups ◽  
High Rate ◽  
Healthy Children ◽  
Mmr Vaccine ◽  
Vaccine Failure ◽  
Iranian Children ◽  
Rubella Vaccination ◽  
Infant Pair

Abstract Background Despite high rate of vaccination coverage with 2-doses of measles containing vaccine among Iranian children, outbreaks of measles occurred among different age groups and fully vaccinated subjects. Although the main reason for these outbreaks is unknown, however, vaccine failure was supposed to be an important cause. This study was designed to determine the seroconversion rates to measles- mumps- rubella (MMR) vaccine currently in use among Iranian children. Methods This prospective study was conducted among healthy children older than 12 months who were candidates of scheduled MMR vaccination. Blood samples were obtained from each mother- infant pair just before vaccination, and from infants 4–6 weeks after MMR1 and MMR2 immunization. Collected sera were tested for specific lgG antibodies against MMR agents using ELISA method. The proportion of seroprotected subjects among mother- infant pairs before vaccination as well as the prevalence rates of seroconversion after MMR1 and MMR2 vaccination were calculated. Collected data were analyzed using descriptive statistical methods. Results During 22-months study period, 92 mother- infant pairs were participated. Seroimmunity rates against MMR viruses were 85.8%, 84.7% and 86.9% for mothers, and 3.2%, 2.1% and 1.0% for children, respectively. After MMR1 vaccination from 52 seronegative children, 80.7%, 78.8% and 75% were seroconverted. These rates increased to 94.8%, 89.7% and 94.8% after the MMR2 vaccination. Also, the specific immunity was enhanced among seropositive children. Conclusion Majority of the mothers and few infants were immune to MMR viruses prior to MMR1 vaccination. Immune responses detected after MMR1 injection, and overall seroconversion rates achieved after 2-doses of MMR vaccination were less than expected and inadequate to preserve long-term protection against MMR agents.

scholarly journals Seroconversion rates following 2 doses of Measles- Mumps- Rubella Vaccination Given at the Ages 12 and 18 Months: Data for possible additional dose at older age

2021 ◽  
Author(s):  
Hana Saffar ◽  
Sayed Jaber Mousavi ◽  
Hiva Saffar ◽  
Mohammad-Reza Parsaei ◽  
Gholam-Reza Ghorbani ◽  
...  
Keyword(s):  
Age Groups ◽  
High Rate ◽  
Healthy Children ◽  
Elisa Method ◽  
Mmr Vaccine ◽  
Vaccine Failure ◽  
Iranian Children ◽  
Rubella Vaccination ◽  
Infant Pair

Abstract Background. Despite high rate of vaccination coverage with 2-doses of measles vaccine among Iranian children, outbreaks of measles occurred among different age groups and fully vaccinated subjects. Although the main reason for these outbreaks is unknown, however, vaccine failure was supposed to be an important cause. This study was designed to determine the immunogenicity of measles- mumps- rubella (MMR) vaccine currently in use among Iranian children.Methods. This prospective study was conducted among ³ 12 month- old healthy children who were candidates of scheduled MMR vaccination. Blood samples were obtained from each mother- infant pair just before vaccination, and from infants 4- 6 weeks after MMR1 and MMR2 immunization. Collected sera were tested for specific lgG antibodies against MMR agents using ELISA method. The proportion of seroprotected subjects among mother- infant pairs before vaccination as well as the prevalence rates of seroconversion after MMR1 and MMR2 vaccination were calculated. Collected data were analyzed using descriptive statistical methods.Results. During 22-months study period, 92 mother- infant pairs were participated. Seroimmunity rates against MMR viruses were 85.8%, 84.7% and 86.9% for mothers, and 3.2%, 2.1% and 1.0% for children, respectively. After MMR1 vaccination of 52 seronegative children, 80.7%, 78.8% and 75% were seroconverted. These rates increased to 94.8%, 89.7% and 92.3% after the MMR2 vaccination. Also, the specific immunity was enhanced among seropositive children.Conclusion. Majority of the mothers and few infants were immune to MMR viruses, prior to MMR1 vaccination. Seroconversion rates detected after MMR1 injection, and overall seroprotection rates achieved after 2-doses of MMR vaccination were less than expected and inadequate to preserve long-term protection against MMR agents.

scholarly journals Long -Term Persistence of Antibodies Against Varicella in Fully Immunized Healthcare Workers: An Italian Retrospective Cohort Study

2021 ◽  
Author(s):  
Francesco Bianchi ◽  
Silvio Tafuri ◽  
Angela Larocca ◽  
Cinzia Germinario ◽  
Pasquale Stefanizzi
Keyword(s):  
Varicella Zoster Virus ◽  
Healthcare Workers ◽  
Varicella Vaccine ◽  
Serious Adverse Events ◽  
Biological Risk ◽  
Varicella Zoster ◽  
Vaccine Booster ◽  
History Of ◽  
Study Population

Abstract Background. Chickenpox is a highly contagious disease caused by the varicella zoster virus (VZV), and in infants, adolescents, adults, pregnant women, and the immunocompromised it can be serious. The best way to prevent chickenpox is immunization with the varicella vaccine. Protective levels of antibodies induced by the varicella vaccine decline over time, but there is currently no formal recommendation for testing anti-varicella zoster virus (VZV) IgG levels in immunized healthcare workers (HCWs). Methods. The aims of this study were to evaluate the seroprevalence of circulating anti-VZV IgG in a sample a sample of students and residents of the medical school of the University of Bari, the long-term immunogenicity of the varicella vaccine, and the effectiveness of a strategy consisting of a third vaccine booster dose. The study population was screened as part of a biological risk assessment conducted between April 2014 and October 2020. A strategy for the management of non-responders was also examined. Results. The 182 students and residents included in the study had a documented history of immunization (two doses of varicella vaccine). The absence of anti-VZV IgG was determined in 34% (62/182; 95%CI=27.2–41.4%), with serosusceptibility more common among males than females (p<0.05). After a third varicella dose, seroconversion was achieved in 100% of this previously seronegative group. No serious adverse events were recorded. Conclusions. One-third of the study population immunized against VZV lacked a protective antibody titer, but a third dose of vaccine restored protection. Since it is highly unlikely that VZV will be eliminated in the immediate future, the loss of immunity in a substantial portion of the population implies a risk of varicella outbreaks in the coming years. Screening for varicella immunity in routine assessments of the biological risk of medical students and HCWs may help to prevent nosocomial VZV infections.

scholarly journals Gut Microbiota Changes During Helicobacter Pylori Eradication with Vonoprazan-Containing Triple Therapy Among Adolescents: A Prospective Multicenter Study in Japan

2020 ◽  
Author(s):  
Toshihiko kakiuchi ◽  
Kentaroh Yamamoto ◽  
Ichiro Imamura ◽  
Kazutoshi Hashiguchi ◽  
Hiroharu Kawakubo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gut Microbiota ◽  
Beta Diversity ◽  
Medical Information ◽  
Eradication Therapy ◽  
Alpha Diversity ◽  
University Hospital ◽  
Healthy Children ◽  
Serious Adverse Events

Abstract Background: Whether the screening and treatment of Helicobacter pylori infection are safe for children is debated in Japan. This study aimed to evaluate the safety of Helicobacter pylori eradication therapy by examining long-term changes in the gut microbiota during therapy among children.Methods: Children with anti-Helicobacter pylori antibody in the urine and Helicobacter pylori antigen in the feces were enrolled in this study. Their stool samples were collected at three time points, which were as follows: prior to treatment, 1–2 days after treatment, and time of judgment of eradication therapy. After treatment, the relative abundance, alpha-diversity, and beta-diversity of the gut microbiota were assessed.Results: In 16 students finally included in the study, the number of Actinobacteria isolated decreased immediately after eradication therapy, and it returned to pretreatment condition at the judgment point. There was no change at the genus level. The alpha-diversity was lost immediately after eradication therapy. However, it recovered at the time of eradication judgment, and it was restored before eradication therapy. Meanwhile, there was no change in beta-diversity, and none of the participants experienced serious adverse events.Conclusion: Helicobacter pylori eradication therapy is safe even for children in the view point of gut microbiota. Thus, further long-term evaluations of changes in the gut microbiota after eradication therapy and an assessment of healthy children without Helicobacter pylori must be performed. These will in turn promote screening and treatment among adolescents to prevent gastric cancer.Trial registration: This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (no. UMIN000028726, https://upload.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000032873) on 18 August 2017.

scholarly journals Long -term persistence of antibodies against varicella in fully immunized healthcare workers: an Italian retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesco Paolo Bianchi ◽  
Silvio Tafuri ◽  
Angela Maria Vittoria Larocca ◽  
Cinzia Annatea Germinario ◽  
Pasquale Stefanizzi
Keyword(s):  
Varicella Zoster Virus ◽  
Healthcare Workers ◽  
Varicella Vaccine ◽  
Serious Adverse Events ◽  
Biological Risk ◽  
Varicella Zoster ◽  
Vaccine Booster ◽  
History Of ◽  
Study Population

Abstract Background Chickenpox is a highly contagious disease caused by the varicella zoster virus (VZV), and in infants, adolescents, adults, pregnant women, and the immunocompromised it can be serious. The best way to prevent chickenpox is immunization with the varicella vaccine. Protective levels of antibodies induced by the varicella vaccine decline over time, but there is currently no formal recommendation for testing anti-varicella zoster virus (VZV) IgG levels in immunized healthcare workers (HCWs). Methods The aims of this study were to evaluate the seroprevalence of circulating anti-VZV IgG in a sample a sample of students and residents of the medical school of the University of Bari, the long-term immunogenicity of the varicella vaccine, and the effectiveness of a strategy consisting of a third vaccine booster dose. The study population was screened as part of a biological risk assessment conducted between April 2014 and October 2020. A strategy for the management of non-responders was also examined. Results The 182 students and residents included in the study had a documented history of immunization (two doses of varicella vaccine). The absence of anti-VZV IgG was determined in 34% (62/182; 95%CI = 27.2–41.4%), with serosusceptibility more common among males than females (p < 0.05). After a third varicella dose, seroconversion was achieved in 100% of this previously seronegative group. No serious adverse events were recorded. Conclusions One-third of the study population immunized against VZV lacked a protective antibody titer, but a third dose of vaccine restored protection. Since it is highly unlikely that VZV will be eliminated in the immediate future, the loss of immunity in a substantial portion of the population implies a risk of varicella outbreaks in the coming years. Screening for varicella immunity in routine assessments of the biological risk of medical students and HCWs may help to prevent nosocomial VZV infections.

Strict Infection Control Leads to Low Incidence of Methicillin-ResistantStaphylococcus aureusBloodstream Infection over 20 Years

2015 ◽  
Vol 36 (6) ◽  
pp. 702-709 ◽  
Author(s):  
Andreas F. Widmer ◽  
Botond Lakatos ◽  
Reno Frei
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
University Hospital ◽  
Multiple Infection ◽  
Case Report Form ◽  
Contact Precautions

OBJECTIVEMethicillin-resistantStaphylococcus aureus(MRSA) is a worldwide issue associated with significant morbidity and mortality. Multiple infection control (IC) approaches have been tested to control its spread; however, the success of the majority of trials has been short-lived and many efforts have failed. We report the long-term success of MRSA control from a prospective observational study over 20 years.SETTINGUniversity Hospital Basel is a large tertiary care center with a median bed capacity of 855 and 5 intensive care units (ICUs); currently, the facility has >32,000 admissions per year.METHODSThe IC program at the University Hospital Basel was created in 1993, after 2 MRSA outbreaks. The program has included strict contact precautions with single rooms for MRSA-colonized or -infected patients, targeted admission screening of high-risk patients and healthcare workers at risk for carriage, molecular typing of all MRSA strains and routine decolonization of MRSA carriers including healthcare workers. We used the incidence of MRSA bloodstream infections (BSIs) to assess the effectiveness of this program. All MRSA cases were prospectively classified using a standardized case report form in nosocomial and nonnosocomial cases, based on CDC definitions.RESULTSBetween 1993 and 2012, 540,669 blood samples were cultured. The number of blood cultures increased from 865 per 10,000 patient days in 1993 to 1,568 per 10,000 patient days in 2012 (P<.001). We identified 1,268 episodes ofS. aureusBSI from 1,204 patients. MRSA accounted for 34 episodes (2.7%) and 24 of these (1.9%) were nosocomial. MRSA BSI incidence varied between 0 and 0.27 per 10,000 patient days and remained stable with no significant variation throughout the study period (P=.882).CONCLUSIONSLong-term control of MRSA is feasible when a bundle of IC precautions is strictly enforced over time.Infect Control Hosp Epidemiol2015;00(0): 1–8

scholarly journals Six-month antibody response to SARS-CoV-2 in healthcare workers assessed by virus neutralisation and commercial assays

2020 ◽  
Author(s):  
Antonin Bal ◽  
Mary-Anne Trabaud ◽  
Jean-Baptiste Fassier ◽  
Muriel Rabilloud ◽  
Kahina Saker ◽  
...  
Keyword(s):  
Antibody Response ◽  
Healthcare Workers ◽  
Disease Onset ◽  
University Hospital ◽  
Serum Samples ◽  
Live Virus ◽  
N Protein ◽  
A Prospective Study ◽  
The University

AbstractWe conducted a prospective study in healthcare workers (n=296) of the University Hospital of Lyon, France. Serum samples (n=296) collected six months after disease onset were tested using three commercial assays: the Wantai Ab assay detecting total antibodies against the receptor binding domain (RBD) of the S protein, the bioMerieux Vidas assay detecting IgG to the RBD and the Abbott Architect assay detecting IgG to the N protein. The neutralising antibody (NAb) titre was also determined for all samples with a virus neutralisation assay (VNA) using live virus. The positivity rate was 100% with the Wantai assay, 84.8% with the bioMerieux assay and 55.4% with the Abbott assay. Only 51% of HCWs were positive for the presence of NAb. Less than 10 % of HCWs had a NAb titre greater than 80. At a neutralising titre of 80, the area under the curves [IC 95%] was 0.71 [0.62-0.81], 0.75 [0.65-0.85] and 0.95 [0.92-0.97] for Wantai, Abbott and Vidas respectively. The data presented herein suggest that commercial assays detecting antibodies against the N protein must not be used in long-term seroprevalence surveys while the Wantai assay could be useful for this purpose. VNA should remain the gold standard to assess the protective antibody response, but some commercial assays could be used as first-line screening of long-term presence of NAb.

scholarly journals Seroconversion and adverse events in the first month after the administration of two doses of the inactivated SARS-CoV-2 vaccine in Turkey: Is a booster dose required?

2021 ◽  
Author(s):  
Burak Mete ◽  
Ferdi Tanir ◽  
Hakan Demirhindi ◽  
Ertan Kara ◽  
Filiz Kibar ◽  
...  
Keyword(s):  
Adverse Events ◽  
Healthcare Workers ◽  
Booster Dose ◽  
High Rate ◽  
Limited Information ◽  
Community Settings ◽  
Igg Antibodies ◽  
Phase 3 ◽  
Serious Adverse Events

Aims: Limited information is available about the efficacy and adverse events of COVID-19 vaccines introduced into public use with Emergency Usage Licences without completing phase-3 trials. Data refer to healthy and mostly younger people, with lacking evidence about the protectivity. This study aimed determining seroconversion rates and levels specific to anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 after the administration of two doses of the inactivated SARS-CoV-2 vaccine in Turkey, comparing three types of antibodies. It was also aimed to assess short-term adverse events due to the vaccine. It is intended to answer the questions about efficacy and safety, which lack in phase trials, especially at community level. It is also aimed to collect data, which will form the basis for assessing whether antibodies are protective at different community settings. Methods: The study carried out in Turkey, comprised 282 healthcare workers who received two doses of the inactivated SARS-CoV-2 vaccine administered in two 3µg doses, 28 days apart. In day-28 after the second dose, anti-S-RBD IgG and total anti-spike/anti-nucleocapsid IgM and IgG antibodies against SARS-CoV-2 were detected by in-vitro chemiluminescence immunoassay. Results: At day 28 after the second dose, the seroconversion rates were found to be 92.9% for total anti-spike/anti-nucleocapsid IgG and 15.2% for IgM and 98.2% for anti-S-RBD IgG antibodies. The immunogenicity was affected by pre-vaccination natural COVID-19 history and age. The incidence of at least one adverse event was found as 29.8% after the first dose and 24.1% after the second dose, with the most common events being pain at the injection site, weakness, fatigue and headache. Conclusion: A high rate of seroconversion was observed with no serious adverse events. Prior natural COVID-19 history and age significantly contributed to strong immunogenicity. A booster dose appears required for older ages and individuals without immune response.

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