scholarly journals Choice of influenza vaccine in people over 65 years old. Analysis of reports from international vaccination advisory committees

2021 ◽  
Author(s):  
Alberto Pérez-Rubio ◽  
◽  
José Javier Castrodeza ◽  
José María Eiros
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccines ◽  
High Dose ◽  
Advisory Committees ◽  
Individual Level ◽  
Age Appropriate ◽  
Working Groups ◽  
Flu Vaccine ◽  
The Individual ◽  
The Uk

Introduction. Annual recommendations on influenza vaccine use in different countries are developed by influenza-specific working groups within their Immunization Advisory Committees. Adults aged 65 years and over are included in the groups for which vaccination against influenza is particularly recommended due to the morbidity associated. A variety of influenza vaccines are available, some of which boosted immunity, are licensed for use only in this specific age group, where the immune response to traditional influenza vaccines may be suboptimal. We analyze the main annual recommendations on the use of the influenza vaccine issued by advisory committees on immunization for the population over 65 years of age. Material and methods. The latest influenza vaccination guidelines have been selected and the recommendations for people over 65 years of age published by the main vaccination advisory committees have been reviewed. Results. The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years. Conclusion. It is necessary further studies and improvement in their quality that analyze the different vaccines available and their comparability, although the use of reinforced immunity vaccines is generally recommended in the population over 65 years of age.

Providing Additional “Muscle” for Older Adults Through Optimal Influenza Vaccine Selection

2018 ◽  
Vol 52 (9) ◽  
pp. 936-941 ◽  
Author(s):  
John A. Dougherty ◽  
Elias B. Chahine
Keyword(s):  
Older Adults ◽  
Influenza Vaccine ◽  
Disease Control ◽  
Older Patients ◽  
Standard Dose ◽  
Influenza Vaccines ◽  
High Dose ◽  
Control And Prevention ◽  
Reasonable Evidence ◽  
Age Appropriate

Immunization is the best strategy to protect individuals from influenza; however, older adults tend to respond less favorably to vaccines because of immunosenescence. The Centers for Disease Control and Prevention states that any licensed, recommended, and age-appropriate influenza vaccine may be used in older adults despite reasonable evidence suggesting that the high-dose and, to a lesser extent, the adjuvanted and recombinant influenza vaccines provide better protection than the standard-dose vaccines in this vulnerable population. In this era of precision medicine, clinicians can preferentially recommend these contemporary vaccines to equip their older patients with the best possible protection against influenza.

scholarly journals LB14. Safety and Immunogenicity of High-Dose Quadrivalent Influenza Vaccine Administered by Intramuscular Route in Subjects Aged 65 Years and Older

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S764-S764 ◽  
Author(s):  
Lee-Jah Chang ◽  
Ya Meng ◽  
Helene Janosczyk ◽  
Victoria Landolfi ◽  
H Keipp Talbot ◽  
...  
Keyword(s):  
United States ◽  
Immune Response ◽  
Influenza Vaccine ◽  
Standard Dose ◽  
The United States ◽  
Influenza Vaccines ◽  
High Dose ◽  
Post Vaccination ◽  
B Lineage ◽  
Research Grant

Abstract Background Older adults (≥65 years of age) remain at increased risk of influenza because they do not respond to standard dose influenza vaccines as well as younger adults. A high dose, inactivated trivalent influenza vaccine, IIV3-HD, containing four times the antigen content (60 µg hemagglutinin per influenza strain) of standard-dose influenza vaccines has been available in the United States since 2010. Two distinct B influenza lineages (Victoria and Yamagata) have co-circulated for over a decade, making it difficult to predict which will predominate the next season. IIV4-HD has been developed to address the frequent influenza B strain mismatches by incorporating a strain from each B lineage. This pivotal Phase III study evaluated the safety and immunogenicity of IIV4-HD as compared with two IIV3-HD vaccines. Method A randomized, modified double-blind, multicenter study (NCT03282240) was conducted in 2670 healthy subjects in the United States, who were randomly assigned to receive IIV4-HD, a licensed IIV3-HD, or an IIV3-HD with the alternate B influenza strain. Using the hemagglutinin inhibition (HAI) assay at baseline and 28 days after vaccination, post-vaccination geometric mean titers and seroconversion rates were measured. Safety data were collected through 6 months post-vaccination. Result IIV4-HD was noninferior to the licensed IIV3-HD and the investigational IIV3-HD (containing the alternate B strain) for all four influenza strains as assessed by HAI GMTs and seroconversion rates. Moreover, IIV4-HD induced a superior immune response (HAI GMTs and seroconversion rates) compared with the immune response induced by the IIV3-HD that does not contain the corresponding B strain. Reactogenicity profiles were comparable across all study groups. Most unsolicited adverse events were of Grade 1 or Grade 2 intensity. One serious adverse event considered related by the Investigator was reported in the IIV4-HD group. Conclusion Vaccination of adults 65 years of age and older with IIV4-HD was found to be noninferior to two IIV3-HD vaccines with a similar safety profile. The addition of a second B lineage strain does not adversely affect the safety or immunogenicity profile of IIV4-HD compared with IIV3-HD. Disclosures L. J. Chang, Sanofi Pasteur: Employee, Salary. Y. Meng, Sanofi Pasteur: Employee, Salary. H. Janosczyk, Sanofi Pasteur: Employee, Salary. V. Landolfi, Sanofi Pasteur: Employee, Salary. H. K. Talbot, Sanofi Pasteur: Investigator, Research grant. Gilead: Investigator, Research grant. MedImmune: Investigator, Research grant. Vaxinnate: Safety Board, none. Seqirus: Safety Board, none.

scholarly journals Academic neurosurgery in the UK: present and future directions

2019 ◽  
Vol 95 (1128) ◽  
pp. 524-530
Author(s):  
Mueez Waqar ◽  
Benjamin M Davies ◽  
Rasheed Zakaria ◽  
Damiano G Barone ◽  
Angelos G Kolias ◽  
...  
Keyword(s):  
Clinical Research ◽  
Basic Science ◽  
Academic Training ◽  
Future Directions ◽  
Individual Level ◽  
International Standing ◽  
Personal Accounts ◽  
The Individual ◽  
The Uk

Academic neurosurgery encompasses basic science and clinical research efforts to better understand and treat diseases of relevance to neurosurgical practice, with the overall aim of improving treatment and outcome for patients. In this article, we provide an overview of the current and future directions of British academic neurosurgery. Training pathways are considered together with personal accounts of experiences of structured integrated clinical academic training and unstructured academic training. Life as an academic consultant is also described. Funding is explored, for the specialty as a whole and at the individual level. UK academic neurosurgical organisations are highlighted. Finally, the UK’s international standing is considered.

scholarly journals Achieving radical change

2018 ◽  
Vol 31 (2) ◽  
pp. 428-455 ◽  
Author(s):  
Noel Hyndman ◽  
Mariannunziata Liguori
Keyword(s):  
Performance Management ◽  
Radical Change ◽  
Practice Variation ◽  
Structured Interviews ◽  
Content Type ◽  
Individual Level ◽  
Incremental Change ◽  
The Individual ◽  
The Uk ◽  
Perceived Outcomes

Purpose The purpose of this paper is to focus on strategies and “spoken discourses” used to construct legitimation around change at the individual level. Comparing changes in financial accounting, budgeting and performance management at two government levels (Westminster and Scotland), it explores the use of legitimation strategies in the implementation of accounting change and its perceived outcomes. Design/methodology/approach Drawing on semi-structured interviews, six legitimation/delegitimation strategies are used to code the transcribed data. Patterns with the perceived outcomes of change are explored. Findings Changes introduced to enhance “rational” decision making are often received as pushed by some source of authority. Regardless of the interviewees’ background and level, the results suggest that for radical accounting change to embed, it is necessary for it to be perceived as rational, rather than merely driven by authorisation-based pressures. Conversely, incremental change is associated with modest legitimation via rationalisation and delegitimation based on pathos and rationalisation. Research limitations/implications The study deals with actors’ legitimation strategies and perceptions of change. These may not correspond to actual substantial change. Taken-for-granted ideas often remain “under the radar”, therefore care must be taken in interpreting the results. The focus of the empirical study is on the UK, therefore conclusions are restricted to this context. Originality/value Existing studies struggle to explain organisations’ heterogeneity and practice variation; this study sheds light on how individual legitimation, which may lead to different organisational results, occurs. Differences in how actors interpret changes may be based on their position (central vs devolved administration) and on their ownership of the changes.

scholarly journals Effecting dietary change

2004 ◽  
Vol 63 (4) ◽  
pp. 537-547 ◽  
Author(s):  
Ashley J. Adamson ◽  
John C. Mathers
Keyword(s):  
Policy Development ◽  
Dietary Intervention ◽  
Dietary Habits ◽  
Healthy Lifestyle ◽  
Eating Behaviour ◽  
Dietary Change ◽  
Individual Level ◽  
Effective Strategies ◽  
The Individual ◽  
The Uk

A world epidemic of diet-related chronic disease is currently being faced. In the UK incidence of obesity alone has tripled in the last 20 years and this trend is predicted to continue. Consensus exists for the urgent need for a change in diet and other lifestyle factors and for the direction and targets for this change. The evidence for how this change can be achieved is less certain. It has been established that disease processes begin in childhood. Recent evidence indicates that dietary habits too are established in childhood but that these habits are amenable to change. While establishing a healthy lifestyle in childhood is paramount, interventions have the potential to promote positive change throughout the life course. Success in reversing current trends in diet-related disease will depend on commitment from legislators, health professionals, industry and individuals, and this collaboration must seek to address not only the food choices of the individual but also the environment that influences such choices. Recent public health policy development in England, if fully supported and implemented, is a positive move towards this goal. Evidence for effective strategies to promote dietary change at the individual level is emerging and three reviews of this evidence are discussed. In addition, three recent dietary intervention studies, in three different settings and with different methods and aims, are presented to illustrate methods of effecting dietary change. Further work is required on what factors influence the eating behaviour and physical activity of individuals. There is a need for further theory-based research on which to develop more effective strategies to enable individuals to adopt healthier lifestyles.

scholarly journals Job separation rates of immigrants and natives in the UK during the Great Recession

2017 ◽  
Vol 38 (7) ◽  
pp. 1036-1054
Author(s):  
Dafni Papoutsaki
Keyword(s):  
Labour Market ◽  
Labour Force ◽  
The European Union ◽  
Market Outcomes ◽  
Content Type ◽  
Individual Level ◽  
The Great Recession ◽  
The Business Cycle ◽  
The Individual ◽  
The Uk

Purpose The purpose of this paper is to assess the probability of job separations of immigrants and natives in the UK before and during the economic crisis of 2008. Design/methodology/approach A mixed proportional hazard duration model with a semi-parametric piecewise constant baseline hazard is used on a data sample of inflows into employment. Findings It is found that the crisis increased the probability of exits to unemployment for all groups, while immigrants from the new countries of the European Union seemed to have the lowest hazard towards unemployment even after controlling for their demographic and labour market characteristics. More specifically, even when we account for the fact that they tend to cluster in jobs that are most vulnerable to the business cycle, they are still less likely to exit dependent employment than natives. However, this migrant group is adversely affected by the crisis the most. Research limitations/implications Possible implications of out-migration of the lower performers are discussed. Originality/value This paper makes use of the panel element of the UK Quarterly Labour Force Survey, and uses duration analysis on the individual level to assess the labour market outcomes of natives and immigrants in the UK.

scholarly journals Vaccination and Non-Pharmaceutical Interventions: When can the UK relax about COVID-19?

2021 ◽  
Author(s):  
Sam Moore ◽  
Edward M. Hill ◽  
Michael J. Tildesley ◽  
Louise Dyson ◽  
Matt J. Keeling
Keyword(s):  
Perceived Risk ◽  
Immunisation Programme ◽  
Population Level ◽  
Epidemiological Data ◽  
Vaccine Uptake ◽  
Severe Illness ◽  
Individual Level ◽  
The Individual ◽  
The Uk ◽  
Pharmaceutical Interventions

AbstractThe announcement of efficacious vaccine candidates against SARS-CoV-2 has been met with worldwide acclaim and relief. Many countries already have detailed plans for vaccine targeting based on minimising severe illness, death and healthcare burdens. Normally, relatively simple relationships between epidemiological parameters, vaccine efficacy and vaccine uptake predict the success of any immunisation programme. However, the dynamics of vaccination against SARS-CoV-2 is made more complex by age-dependent factors, changing levels of infection and the potential relaxation of non-pharmaceutical interventions (NPIs) as the perceived risk declines. In this study we use an age-structured mathematical model, matched to a range of epidemiological data, to consider the interaction between the UK vaccination programme and future relaxation (or removal) of NPIs. Our predictions highlight the population-level risks of early relaxation leading to a pronounced wave of infections, and the individual-level risk relative to vaccine status. While the novel vaccines against SARS-CoV-2 offer a potential exit strategy for this outbreak, this is highly contingent on the transmission blocking action of the vaccine and the population uptake, both of which need to be carefully monitored as vaccine programmes are rolled out in the UK and other countries.

scholarly journals 2753. Induction of Broadly Cross-Reactive Immune Responses Against A(H3N2) Airuses: Results of a Phase 2 Trial of a Novel Recombinant Hemagglutinin Saponin-Adjuvanted Nanoparticle Seasonal Influenza Vaccine

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S970-S970
Author(s):  
Vivek Shinde ◽  
Rongman Cai ◽  
Joyce S Plested ◽  
Bin Zhou ◽  
Haixia Zhou ◽  
...  
Keyword(s):  
Immune Responses ◽  
Influenza Vaccine ◽  
Seasonal Influenza ◽  
Antibody Responses ◽  
Antigenic Drift ◽  
Influenza Vaccines ◽  
High Dose ◽  
Phase 2 ◽  
Adaptive Mutations ◽  
Phase 2 Trial

Abstract Background We developed a recombinant saponin-adjuvanted (Matrix-M1) quadrivalent hemagglutinin nanoparticle influenza vaccine (qNIV; NanoFlu) for older adults to address two impediments to efficacy of current, predominantly egg-derived, seasonal influenza vaccines: (1) limited protection against antigenic drift variants, particularly H3N2 viruses; and (2) antigenic mismatch between vaccine and circulating strains due to egg-adaptive mutations arising during manufacturing. In a prior Phase 1 trial, we showed that qNIV induced robust, broadly cross-reactive antibody responses against multiple antigenically drifted H3N2 viruses, which were 47–64% better than the egg-derived comparator trivalent high-dose inactivated influenza vaccine (IIV3-HD; Fluzone-High Dose). We undertook a Phase 2 trial to optimize the formulation of qNIV, and to compare qNIV immune responses to those of IIV3-HD and quadrivalent recombinant influenza vaccine (RIV4; FluBlok). Methods In this phase 2 dose and formulation finding RCT, we randomized 1,375 subjects aged ≥65 years to be immunized with 1 of 7 test vaccines: 5 different formulations of qNIV, IIV3-HD, or RIV4; and assessed wild-type hemagglutinin-inhibition (wt-HAI) and microneutralization (wt-MN) antibody responses (Day 0/28/56). Results Matrix-M1-adjuvanted qNIV induced 15–29% higher wt-HAI titers across 5 vaccine homologous or drifted H3N2 strains at Day 28 relative to unadjuvanted qNIV (statistically significantly superior for 5 of 6 strains tested). At Day 28, several qNIV formulations induced significantly superior wt-HAI titers vs. IIV3-HD (39–45%, 17–22%, and 44–48% greater titers for homologous A/Singapore/INFIMH-16–0019/2016—H3N2, historic-drifted A/Switzerland/9715293/2013—H3N2, and forward-drifted A/Wisconsin/19/2017—H3N2, respectively); and comparable HAI titers vs. RIV4. Wt-MN and wt-HAI data showed concordant patterns across treatment groups. Conclusion qNIV induced superior wt-HAI antibody responses vs. IIV3-HD against homologous or drifted H3N2 viruses and similar responses to RIV4. qNIV may address several critical challenges confronting current egg-derived influenza vaccines, especially in the older adult population. Disclosures All authors: No reported disclosures.

Scandals of abuse: policy responses in intellectual disabilities

2015 ◽  
Vol 35 (1/2) ◽  
pp. 107-124 ◽  
Author(s):  
Peter Mark Halladay ◽  
Charlene Harrington
Keyword(s):  
Theoretical Framework ◽  
Case Study Methodology ◽  
Content Type ◽  
Descriptive Case Study ◽  
Individual Level ◽  
Policy Responses ◽  
The Social ◽  
The Usa ◽  
The Individual ◽  
The Uk

Purpose – The purpose of this paper is to compare two scandals related to the care of individuals with intellectual and developmental disabilities (I/DD) in the USA and the UK. Design/methodology/approach – A descriptive case study methodology was used to conduct an in-depth qualitative analysis of the two scandals to examine the process of scandal development, and to survey the policy response against policy trends and theories of abuse in each case. The two cases were systematically analysed against a theoretical framework derived from Bonnie and Wallace (2003) theoretical framework for understanding abuse based on its sociocultural context, the social embeddedness of organisations providing care, and the individual level characteristics and interactions of subjects and carers. Findings – In both cases the process of scandal construction was comparable, and each case offered confirmatory support to extant theories of abuse, and to wider policy trends within I/DD. Research limitations/implications – The study examines only the short-term policy responses to the scandals in two countries, based on published material only. Originality/value – This paper contributes an international comparison of the similarities and differences in the social construction of scandal and the policy responses to abuse and neglect of a vulnerable population using systematic analytical frameworks.

scholarly journals Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017–2018 and 2018–2019 Influenza Seasons

2021 ◽  
Author(s):  
Constantina Boikos ◽  
Lauren Fischer ◽  
Dan O’Brien ◽  
Joe Vasey ◽  
Gregg C Sylvester ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Relative Effectiveness ◽  
The United States ◽  
Geographic Region ◽  
Influenza Vaccines ◽  
High Dose ◽  
Large Dataset ◽  
Medical Claims ◽  
Trivalent Influenza Vaccine ◽  
Race Ethnicity

Abstract Background The effectiveness of standard, egg-derived quadrivalent influenza vaccines (IIV4) may be reduced in adults ≥65 years of age, largely because of immunosenescence. An MF59-adjuvanted trivalent influenza vaccine (aIIV3) and a high-dose trivalent influenza vaccine (HD-IIV3) offer older adults enhanced protection versus standard vaccines. This study compared the relative effectiveness of aIIV3 with IIV4 and HD-IIV3 in preventing influenza-related medical encounters over 2 US influenza seasons. Methods This retrospective cohort study included US patients ≥65 years vaccinated with aIIV3, IIV4, or HD-IIV3. The outcome of interest was the occurrence of influenza-related medical encounters. Data were derived from a large dataset comprising primary and specialty care electronic medical records linked with pharmacy and medical claims. Adjusted odds ratios (OR) were derived from an inverse probability of treatment-weighted sample adjusted for age, sex, race, ethnicity, geographic region, vaccination week, and health status. Relative vaccine effectiveness (rVE) was determined using the formula (% VE = 1 – ORadjusted) × 100. Results In 2017–2018, cohorts included: aIIV3, n = 524 223; IIV4, n = 917 609; and HD-IIV3, n = 3 377 860. After adjustment, 2017–2018 rVE of aIIV3 versus IIV4 was 18.2 (95% confidence interval [CI], 15.8–20.5); aIIV3 vs. HD-IIV3 was 7.7 (95% CI, 2.3–12.8). In 2018–2019, cohorts included: aIIV3, n = 1 031 145; IIV4, n = 915 380; HD-IIV3, n = 3 809 601, with adjusted rVEs of aIIV3 versus IIV4 of 27.8 (95% CI, 25.7–29.9) and vs. HD-IIV3 of 6.9 (95% CI, 3.1–10.6). Conclusion In the 2017–2018 and 2018–2019 influenza seasons in the United States, aIIV3 demonstrated greater reduction in influenza-related medical encounters than IIV4 and HD-IIV3 in adults ≥65 years.

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