Combination Vaccines

2022 ◽  
Author(s):  
Alejandra Esteves-Jaramillo ◽  
Heinz-Josef Schmitt

Combination vaccines have been around since 1945 (trivalent influenza vaccine) and they combine either different serotypes of one microorganism (e.g., influenza or pneumococcal vaccines) or different microorganisms (e.g., DTP combinations). Potential chemical and physical interactions, unpredictable immunological interactions, and in one instance: increased AE, increasing likelihood of production failures, and reduced flexibility of a vaccination program are challenges for developing combination vaccines. With an increasing number of new vaccines for protecting the very young, DTaP- and DTwP-based combinations have become the cornerstone of pediatric vaccination programs around the globe since the mid-1990s. Live vaccine combinations include MR, MMR, and MMRV combinations as well as (trivalent) OPV. Combination vaccines for travelers include HAV-HBV combination and HAV-Ty vaccines. Dozens of diverse combination vaccine products are licensed today around the globe, some of them only in single countries to cover specific local needs. Combination vaccines have been shown to result in increased acceptance, completion and compliance with vaccination programs; in addition, they offer simplified logistics, reduce administration errors, reduce the number of medical visits and cost for the individual as well as for society, among other benefits.

2018 ◽  
Vol 14 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Staci Defibaugh

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.


2019 ◽  
Vol 11 (5) ◽  
pp. 331-333 ◽  
Author(s):  
Peter J Hotez

Abstract Over the last decade we have seen extraordinary public health gains due to expansions in global vaccination programs led by United Nations (UN) agencies, including Gavi, the Vaccine Alliance, UNICEF and the WHO. These initiatives have reduced childhood deaths from measles, tetanus and other vaccine-preventable diseases by almost one half. There is additional excitement over the potential development and introduction of new vaccines to prevent highly lethal respiratory virus infections, as well as tuberculosis, malaria, HIV/AIDS and several neglected tropical diseases. However, these successes are under threat due to political instability, conflict and an accelerating antivaccine movement. New initiatives in vaccine diplomacy will be required to combat these challenges.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S955-S956
Author(s):  
Allison McGeer ◽  
Agron Plevneshi ◽  
Karen Green ◽  
Brenda Coleman ◽  
Sarah Nayani ◽  
...  

Abstract Background In Ontario, Canada, PCV13 is covered for immunocompromised (IC) adults over 50y. PCV13 programs are thought not to be cost-effective in other adults because it is assumed that herd immunity from pediatric vaccination programs (PCV7 since 2005; PCV13 since 2010) will reduce PCV13 disease burden dramatically in adults. We analyzed data from the Toronto Invasive Bacterial Diseases Network (TIBDN) to ask whether PCV13-type invasive pneumococcal disease (IPD) in adults persists in our population. Methods TIBDN performs population-based surveillance for IPD in Toronto+Peel Region, Ontario (pop4.1M). All microbiology laboratories receiving specimens from residents report cases of IPD and submit isolates to a central study lab for serotyping; annual audits are conducted. Demographic, medical and vaccination information are obtained from patients, families and physicians. Population data are from Statistics Canada. Results Since 1995, 10,365 episodes of IPD have been identified; detailed medical information was available for 9,801 (95%) and serotyping for 9411 (91%). Among 8658 adult cases, 4,273 (49%) were in those aged 15–64 years, and 4,285 (51%) in those aged >645 years. The most common diagnoses were pneumonia (5,978/8,025, 74%) and bacteremia without focus (1,030, 13%); 470 (4.6%) cases had meningitis; the case fatality rate (CFR) was 21%. The incidence of disease due to STs in PCV13 in adults declined from 7.0/100,000/year 2001 to 2.9/100,000/year in 2015–2018 and was stable from 2015–2018 (Figure 1). The incidence was > 5/100,000/year in non-IC patients over 65 years, and younger patients with cancer and kidney disease (Figure 2). In IPD from 2015 to 2018, adult patients with PCV13 ST disease were younger (median age 64 years vs. 67 years, P = .03) than other patients; there was no significant difference in the proportion with at least one underlying chronic condition (253, 69% PCV13ST, vs. 541,74% other ST, P = 0.08), or in CFR (59, 16% PCV13 vs. 145, 20% other, P = 0.13). The ST distribution of cases due to PCV13 STs is shown in Figure 3. Conclusion A significant burden of IPD due to PCV13 serotypes persists in adults in our population despite 8 years of routine pediatric PCV13 vaccination. This burden needs to be considered in assessing the value and cost-effectiveness of PCV programs for adults. Disclosures All authors: No reported disclosures.


2020 ◽  
Vol 4 (2) ◽  
pp. 049-055
Author(s):  
Anil Batta

Herd immunity, also known as indirect protection, community immunity, or community protection, refers to the protection of susceptible individuals against an infection when a sufficiently large proportion of immune individuals exist in a population. In other words, herd immunity is the inability of infected individuals to propagate an epidemic outbreak due to lack of contact with sufficient numbers of susceptible individuals. It stems from the individual immunity that may be gained through natural infection or through vaccination. The term herd immunity was initially introduced more than a century ago. In the latter half of the 20th century, the use of the term became more prevalent with the expansion of immunization programs and the need for describing targets for immunization coverage, discussions on disease eradication, and cost-effectiveness analyses of vaccination programs. Eradication of smallpox and sustained reductions in disease incidence in adults and those who are not vaccinated following routine childhood immunization with conjugated Haemophilusinfluenzae type B and pneumococcal vaccines are successful examples of the effects of vaccine-induced herd immunity.


2020 ◽  
Author(s):  
Neil Ibata ◽  
Eugene M. Terentjev

AbstractCell spreading provides one of the simplest configurations in which eukaryotic cells develop angular symmetry-breaking assemblies of mechanosensing and mechanotransducive organelles in preparation for cell differentiation and movement. By identifying the edge of the cell-ECM adhesion area as having an important role in mechanosensor complex aggregation, we consider the spatial patterns arising on this edge, within a 1D lattice model of the nearest-neighbour interaction between individual integrin-mediated mechanosensors. We obtain the Ginzburg-Landau free energy for this model and analyse the spectrum of spatial modes as the cell spreads and increases the contact area. We test the plausibility of our model by comparing its predictions for the azimuthal angular frequency of aggregation of mechanosensors into nascent focal adhesions (FAs) to observations of the paxillin distribution in spreading fibroblasts.STATEMENT OF SIGNIFICANCEThe topic of cell adhesion on substrates is very active, with numerous theoretical, experimental and computer simulation studies probing the mechanisms and signalling pathways of cell response to interacting with substrate. Integrin-based adhesion complexes are known to be the individual units of this process, and their dense aggregation into focal adhesions leads to cells developing asymmetry, polarity, and eventually - locomotion. Here we develop a theoretical model that suggests that physical interactions between individual adhesion complexes is the factor that defines the initial breaking of symmetry of the cell spreading on substrate, and predicts the characteristic wavelength of modulation above the critical size of adhesion area.


2019 ◽  
Vol 100 (4) ◽  
pp. 680-688
Author(s):  
Yu A Tyuri ◽  
A Z Zaripova ◽  
G Sh Isaeva ◽  
I G Mustafin ◽  
L T Bayazitova

The review presents a modern strategy to improve the means of vaccine prevention of streptococcal infections aimed at finding and developing new vaccines for immunization of people belonging to risk groups. It should be noted that pneumococci (S. pneumoniae) are members of gram-positive bacteria (diplococci) and become the main cause of various nosological forms of human infectious diseases (such as pneumonia, otitis media, sinusitis, bacteremia and meningitis). Existing pneumococcal vaccines (conjugate and polysaccharide) have some important limitations, for example, serotype dependence, loss of effectiveness due to a change in the serotype landscape, insufficient protective effect from non-invasive forms of pneumococcal infections and high production costs associated with the development of these products. The main part of the review presents the most important research papers that used modern proteomic technologies in the study of the S. pneumoniae proteomic profile. These works allow us to evaluate at the molecular level the importance of bacterial proteins as candidates for creating new combination vaccines that can effectively protect against the full range of pneumococcal serotypes circulating in the human population. So, in particular, the data are provided on the new methodology for the analysis of the proteome of extracellular S. pneumoniae bacterial microvesicles to identify immunoreactive protein antigens, potential candidates for inclusion into vaccines. As a result of these studies, 15 immunoreactive proteins were discovered, 7 of which are cytosolic and 8 proteins are bound to the cell surface (MalX, ABC transporter or substrate binding transport protein, AmiA, AliA, LytC, IgA1 protease, PspA and the putative precursor of β-galactosidase). These are possible candidates for developing combination vaccines. Additionally, the review presents data on the role of significant virulence factors of the protein nature of S. pneumoniae strains in nasopharyngeal colonization, increased infectivity, as well as on overcoming reactions of the host's immune response.


2007 ◽  
Vol 10 (supp02) ◽  
pp. 255-270 ◽  
Author(s):  
ARMANDO BAZZANI ◽  
SANDRO RAMBALDI ◽  
BRUNO GIORGINI ◽  
GIORGIO TURCHETTI

We consider the problem of modeling urban mobility using the complex systems key of lecture. We discuss the properties of the Auto-mobilis model, a virtual simulator for private car mobility based on the individual citizen propensities and the existence of "chronotopoi", which are the primary causes of citizens' mobility requests. Auto-mobilis is a microscopic agent-based model that takes into account both the physical interactions and the cognitive dynamics. We present the current status of the project and discuss the applications to real situations. The model assumptions are justified by a comparison with GPS observational data on single vehicle trajectories.


2021 ◽  
pp. 136749352110552
Author(s):  
Evgnosia Effraimidou ◽  
Dimitrios C Cassimos ◽  
Snezana Medic ◽  
Maria Topalidou ◽  
Maria Theodoridou ◽  
...  

Although all European countries have vaccination policies for children, there are no comprehensive studies of pediatric vaccination programs in Europe. We studied vaccination programs for children in Europe. Vaccinations against diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, hepatitis B, measles, mumps, rubella, and influenza existed in 42 countries, against human papilloma virus in 41 countries, and against pneumococcus in 40 countries. In addition, the following vaccinations existed: against tuberculosis (35 countries), hepatitis A (33), meningococcus A, C, W, Y (30), rotavirus and varicella (28 countries each), meningococcus B (24), tick-born encephalitis (22), and meningococcus C (16). Mandatory vaccinations are implemented in 21 countries, mainly against diphtheria, tetanus, pertussis, poliomyelitis, H. influenzae type b, hepatitis B, measles, mumps, rubella, tuberculosis, and pneumococcus. There are significant differences among pediatric vaccination programs in Europe regarding number, schedules, indications, and regulatory frame (recommended or mandatory vaccinations). A consensus-based vaccination program for all children is needed.


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