Maintaining high levels of childhood vaccinations is important for public health. Success requires better understanding of parents' perceptions of diseases and consequent decisions about ...vaccinations, however few studies have considered this from the theoretical perspectives of risk perception and decision-making under uncertainty. The aim of this study was to examine the utility of subjective risk perception and decision-making theories to provide a better understanding of the differences between immunisers' and non-immunisers' health beliefs and behaviours.
In a qualitative study we conducted semi-structured in-depth interviews with 45 Australian parents exploring their experiences and perceptions of disease severity and susceptibility. Using scenarios about 'a new strain of flu' we explored how risk information was interpreted.
We found that concepts of dread, unfamiliarity, and uncontrollability from the subjective perception of risk and ambiguity, optimistic control and omission bias from explanatory theories of decision-making under uncertainty were useful in understanding why immunisers, incomplete immunisers and non-immunisers interpreted severity and susceptibility to diseases and vaccine risk differently. Immunisers dreaded unfamiliar diseases whilst non-immunisers dreaded unknown, long term side effects of vaccines. Participants believed that the risks of diseases and complications from diseases are not equally spread throughout the community, therefore, when listening to reports of epidemics, it is not the number of people who are affected but the familiarity or unfamiliarity of the disease and the characteristics of those who have had the disease that prompts them to take preventive action. Almost all believed they themselves would not be at serious risk of the 'new strain of flu' but were less willing to take risks with their children's health.
This study has found that health messages about the risks of disease which are communicated as though there is equality of risk in the population may be unproductive as these messages are perceived as unbelievable or irrelevant. The findings from this study have implications beyond the issue of childhood vaccinations as we grapple with communicating risks of new epidemics, and indeed may usefully contribute to the current debate especially in the UK of how these theories of risk and decision-making can be used to 'nudge' other health behaviours.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Does rotavirus turn on type 1 diabetes? Harrison, Leonard C; Perrett, Kirsten P; Jachno, Kim ...
PLOS pathogens,
10/2019, Letnik:
15, Številka:
10
Journal Article
Recenzirano
Odprti dostop
About the Authors: Leonard C. Harrison * E-mail: harrison@wehi.edu.au Affiliation: Walter and Eliza Hall Institute for Medical Research, University of Melbourne, Melbourne, Victoria, Australia ORCID ...logo http://orcid.org/0000-0002-2500-8944 Kirsten P. Perrett Affiliation: Vaccine and Immunization Research Group, Murdoch Children’s Research Institute and the Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia ORCID logo http://orcid.org/0000-0002-5683-996X Kim Jachno Affiliation: Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia ORCID logo http://orcid.org/0000-0003-2550-9674 Terry M. Nolan Affiliation: Vaccine and Immunization Research Group, Murdoch Children’s Research Institute and the Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia ORCID logo http://orcid.org/0000-0001-6018-3863 Margo C. Honeyman Affiliation: Walter and Eliza Hall Institute for Medical Research, University of Melbourne, Melbourne, Victoria, Australia ORCID logo http://orcid.org/0000-0002-8926-5384 Introduction Rotavirus (RV) remains the major cause of infantile gastroenteritis worldwide, although the advent of vaccination has substantially decreased associated mortality 1. In testing the ability of peptides to stimulate blood T cells from islet autoantibody-positive T1D relatives, we identified a dominant epitope, VIVMLTPLVEDGVKQC (amino acid aa 805–820) in IA-2, which had 56% identity and 100% similarity over 9 aa with a sequence (aa 40–48) in the major immunogenic viral protein 7 (VP7) outer-capsid protein of human RV serotype genotype 3 (G3), strain P (Fig 1A) 6,7. Mimicry between amino acid sequences in islet autoantigens IA-2 (A) and GAD65 (B) and rotavirus genotype 3 viral protein 7 (VP7). https://doi.org/10.1371/journal.ppat.1007965.g001 In addition to mimicry with IA-2, a neighbouring sequence in VP7 (aa 17–25) (Fig 1B) had 78% identity and 100% similarity over 9 aa with a known HLA-DR4-restricted T-cell epitope in GAD65 7. ...these IA-2 and GAD65 DR4-restricted epitopes encompassed T-cell epitopes for HLA class I–restricted CD8+ T cells in T1D 10, for which we coined the term “combitope.” Population-level data suggest RV vaccination may be associated with a decrease in the incidence of T1D The live oral RV vaccines Rotarix (G1P8, monovalent, GSK) and RotaTeq (G1-4, P8, pentavalent, Merck) were introduced into the Australian National Immunisation Program in 2007 and had high uptake (http://www.ncirs.org.au/sites/default/files/2018-11/Rotavirus-history-August-2017.pdf) with a substantial herd immunity effect 24.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Strategic Advisory Group of Experts (SAGE) on Immunization advises WHO on global policies for vaccines. In April, 2016, SAGE issued recommendations on the use of the first licenced dengue ...vaccine, CYD-TDV. In November, 2017, a retrospective analysis of clinical trial data, stratifying participants according to their dengue serostatus before the first vaccine dose, showed that although in high seroprevalence settings the vaccine provides overall population benefit, there was an excess risk of severe dengue in seronegative vaccinees. SAGE's working group on dengue vaccines met to discuss the new data and mainly considered two vaccination strategies: vaccination of populations with dengue seroprevalence rates above 80% or screening of individuals before vaccination, and vaccinating only seropositive individuals. We report on the deliberations that informed the recommendation of the pre-vaccination screening strategy, in April, 2018. Important research and implementation questions remain for CYD-TDV, including the development of a highly sensitive and specific rapid diagnostic test to determine serostatus, simplified immunisation schedules, and assessment of the need for booster doses.
BACKGROUND AND OBJECTIVES
Infant influenza and pertussis disease causes considerable morbidity and mortality worldwide. We examined the effectiveness of maternal influenza and pertussis vaccines in ...preventing these diseases in infants.
METHODS
This inception cohort study comprised women whose pregnancies ended between September 1, 2015, and December 31, 2017, in Victoria, Australia. Maternal vaccination status was sourced from the Victorian Perinatal Data Collection and linked to 5 data sets to ascertain infant outcomes and vaccination. The primary outcome of interest was laboratory-confirmed influenza or pertussis disease in infants aged <2 months, 2 to <6 months, and <6 months combined. Secondary outcomes included infant hospitalization (emergency presentation or admission) and death. Risk ratios and 95% confidence intervals (CIs) were estimated by Poisson regression. Vaccine effectiveness (VE) was estimated as (1 minus the risk ratio) x 100%.
RESULTS
Among 186 962 pregnant women, 85 830 (45.9%) and 128 060 (68.5%) were vaccinated against influenza and pertussis, respectively. There were 175 and 51 infants with laboratory-confirmed influenza and pertussis disease, respectively. Influenza VE was 56.1% (95% CI, 23.3% to 74.9%) for infants aged <2 months and 35.7% (2.2% to 57.7%) for infants aged 2 to <6 months. Pertussis VE was 80.1% (95% CI, 37.1% to 93.7%) for infants aged <2 months and 31.8% (95% CI, −39.1% to 66.6%) for infants aged 2 to <6 months.
CONCLUSIONS
Our study provides evidence of the direct effectiveness of maternal influenza and pertussis vaccination in preventing these diseases in infants aged <2 months. The findings strengthen the importance of maternal vaccination to prevent these diseases in infants.
Objectives
To assess variations by time of year and hospital in the uptake of influenza and pertussis vaccinations by pregnant women in Victoria; to identify factors associated with vaccination ...uptake.
Design, setting
Retrospective analysis of data in the Victorian Perinatal Data Collection (VPDC), a population surveillance system for obstetric conditions, procedures, and pregnancy and birth outcomes.
Participants
Women whose pregnancies ended in a live or stillbirth during July 2015 – June 2017.
Main outcome measures
Influenza and pertussis vaccinations during pregnancy.
Results
153 980 pregnancies in 67 hospitals ended during July 2015 – June 2017; 59 968 pregnant women (39.0%) were vaccinated against influenza and 98 583 (64.0%) against pertussis. Coverage varied by pregnancy end date, rising for influenza during winter and spring, but for pertussis rising continuously across the two years from 37.5% to 82.2%. Differences between hospitals in coverage were marked. Factors associated with vaccination included greater maternal age, primigravidity, early antenatal care, and GP‐led care. The odds of vaccination were statistically significantly lower for women born overseas and those who smoked during pregnancy; the odds of vaccination were also lower for Aboriginal and Torres Strait Islander women.
Conclusions
Pertussis vaccination of pregnant women in Victoria has increased, but influenza vaccination rates remain moderate and variable. Structural changes at the system level may improve maternal vaccination rates. Embedding the delivery of maternal vaccination programs in antenatal care pathways should be a priority.
Our understanding of the immune responses that follow SARS-CoV-2 infection and vaccination has progressed considerably since the COVID-19 pandemic was first declared on the 11
th
of March in 2020. ...Recovery from infection is associated with the development of protective immune responses, although over time these become less effective against new emerging SARS-CoV-2 variants. Consequently, reinfection with SARS-CoV-2 variants is not infrequent and has contributed to the ongoing pandemic. COVID-19 vaccines have had a tremendous impact on reducing infection and particularly the number of deaths associated with SARS-CoV-2 infection. However, waning of vaccine induced immunity plus the emergence of new variants has necessitated the use of boosters to maintain the benefits of vaccination in reducing COVID-19 associated deaths. Boosting is also beneficial for individuals who have recovered from COVID-19 and developed natural immunity, also enhancing responses immune responses to SARS-CoV-2 variants. This review summarizes our understanding of the immune responses that follow SARS-CoV-2 infection and vaccination, the risks of reinfection with emerging variants and the very important protective role vaccine boosting plays in both vaccinated and previously infected individuals.
Abstract The Australian Government has implemented new arrangements for public funding of vaccines over the past 5 years. By utilising the standard Pharmaceutical Benefits Advisory Committee (PBAC) ...application process, whether for funding under the National Immunisation Program Schedule (NIP) or under the Pharmaceutical Benefits Scheme (PBS), a predictable and transparent process for vaccine funding recommendations has been established. This process uses the high-level technical resources available through the Australian Technical Advisory Group on Immunisation (ATAGI) to ensure that both vaccine manufacturers and the PBAC are optimally informed about all relevant aspects of population benefits and delivery of vaccines. ATAGI has a long-standing and mutually beneficial dialogue with State and Territory Governments, providers, and vaccine manufacturers to ensure that pipeline awareness, supply issues, and all relevant scientific and clinical details are well understood.
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