Safety of influenza vaccination during pregnancy Tamma, Pranita D., MD; Ault, Kevin A., MD; del Rio, Carlos, MD ...
American journal of obstetrics and gynecology,
12/2009, Letnik:
201, Številka:
6
Journal Article
Recenzirano
The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices recommends routine influenza vaccination for all women who are or will be pregnant during the influenza ...season. During seasonal influenza epidemics, during previous pandemics, and with the current influenza A (H1N1) pandemic, pregnancy places otherwise healthy women at increased risk for serious complications from influenza, including death. Inactivated influenza vaccine can be safely and effectively administered during any trimester of pregnancy. No study to date has demonstrated an increased risk of either maternal complications or adverse fetal outcomes associated with inactivated influenza vaccination. Moreover, no scientific evidence exists that thimerosal-containing vaccines are a cause of adverse events among children born to women who received influenza vaccine during pregnancy. In this article, we review the evidentiary basis for the recommendation of vaccination of all women who will be pregnant during the influenza season and safety data of influenza vaccination during pregnancy.
Background Physician recommendation is a key predictor of human papillomavirus (HPV) vaccine uptake. Understanding factors associated with recommendation is important for efforts to increase current ...suboptimal vaccine uptake. Purpose This study aimed to examine physician recommendations to vaccinate female patients aged 11–26 years, in 2009 and 2011, at 3 and 5 years postvaccine licensure, respectively. A second aim was to identify trends in factors associated with vaccine recommendation for ages 11 and 12 years. Methods Nationally representative samples of physicians practicing family medicine, pediatrics, and obstetrics and gynecology were randomly selected from the American Medical Association Physician Masterfile ( n =1538 in 2009, n =1541 in 2011). A mailed survey asked physicians about patient and clinical practice characteristics; immunization support; and frequency of HPV vaccine recommendation (“always” ≥75% of the time vs other). Analyses were conducted in 2012. Results Completed surveys were received from 1013 eligible physicians (68% response rate) in 2009 and 928 (63%) in 2011. The proportion of physicians who reported always recommending HPV vaccine increased significantly from 2009 to 2011 for patients aged 11 or 12 years (35% vs 40%, respectively; p =0.03), but not for patients aged 13–17 years (53% vs 55%; p =0.28) or 18–26 years (50% vs 52%; p =0.52). Physician specialty, age, and perceived issues/barriers to vaccination were associated with vaccine recommendation for patients aged 11 or 12 in both years. Conclusions Results suggest a modest increase in recommendations for HPV vaccination of girls aged 11 or 12 years over a 2-year period; however, recommendations remain suboptimal for all age groups despite national recommendations for universal immunization.
...the source of porcine gelatin used for insolubilization onto the ImmunoCAP allergosorbent was different from that available for soluble antigen competitive inhibition. ...16% and 38% of beef and ...pork meat-sensitized children, respectively, have IgE antibodies to gelatins that are cross-reactive.
Irritant skin test reactions to common vaccines Wood, Robert A., MD; Setse, Rosanna, MD, MPH; Halsey, Neal, MD
Journal of allergy and clinical immunology,
08/2007, Letnik:
120, Številka:
2
Journal Article
Recenzirano
Vaccine Trade name Manufacturer DtaP Infanrix GlaxoSmithKline, Glenval, Belgium DT Diphtheria and Tetanus Toxoids Adsorbed USP (For Pediatric Use) Sanofi Pasteur, Swiftwater, Pa MMR M-M-R II Merck & ...Co, Inc, Whitehouse Station, NJ Hib ActHIB Sanofi Pasteur, Lyon, France Hepatitis B Engerix-B GlaxoSmithKline, Glenval, Belgium IPV IPOL Sanofi Pasteur, Lyon, France Varicella Varivax Merck & Co, Inc, Whitehouse Station, NJ Hepatitis A Havrix GlaxoSmithKline, Glenval, Belgium Pneumococcal Prevnar Wyeth, Collegeville, Pa Influenza virus Fluzone Sanofi Pasteur, Swiftwater, Pa Table I Specific vaccines tested DTaP, Diphtheria-tetanus-acellular pertussis; DT, diphtheria-tetanus; MMR, measles, mumps, and rubella; Hib, Haemophilus influenzae b; IPV, inactivated poliomyelitis vaccine. 1:100 0 -- -- 0 0 1:10 0 -- -- 6 2 Full strength 20 4-8 7-30 8 3 Table II Immediate- and delayed-type responses to intradermal testing No immediate or delayed responses occurred to skin prick testing.DT, Diphtheria-tetanus; DTaP, diphtheria-tetanus-acellular pertussis; Hib, Haemophilus influenzae b; IPV, inactivated poliomyelitis vaccine; MMR, measles, mumps, and rubella.
Summary Because of the advent of a new influenza A H1N1 strain, many countries have begun mass immunisation programmes. Awareness of the background rates of possible adverse events will be a crucial ...part of assessment of possible vaccine safety concerns and will help to separate legitimate safety concerns from events that are temporally associated with but not caused by vaccination. We identified background rates of selected medical events for several countries. Rates of disease events varied by age, sex, method of ascertainment, and geography. Highly visible health conditions, such as Guillain-Barré syndrome, spontaneous abortion, or even death, will occur in coincident temporal association with novel influenza vaccination. On the basis of the reviewed data, if a cohort of 10 million individuals was vaccinated in the UK, 21·5 cases of Guillain-Barré syndrome and 5·75 cases of sudden death would be expected to occur within 6 weeks of vaccination as coincident background cases. In female vaccinees in the USA, 86·3 cases of optic neuritis per 10 million population would be expected within 6 weeks of vaccination. 397 per 1 million vaccinated pregnant women would be predicted to have a spontaneous abortion within 1 day of vaccination.
Summary Oncogenic human papillomavirus (HPV) is a common genital infection that has the potential to develop into cervical cancer in some women. This Review summarises current knowledge on the ...mechanisms of host immunity that help prevent and control HPV infection and the viral factors that exist to avoid immune surveillance. Although most women clear the infection within a few months, the virus induces a shift towards immune tolerance that can facilitate persistence and permit tumorigenesis. Mechanisms used by HPV to avoid immune surveillance and control include infecting only the basal layer of the cervical epithelium, limiting expression of viral proteins until later stages of epithelial differentiation, undergoing non-lytic replication, and downregulating the expression of important receptors on cells of the innate immune system. Furthermore, HPV suppresses the expression of several proinflammatory proteins that are crucial in clearing infection and activating the cytotoxic T lymphocytes involved in killing virus-infected cells. Interestingly, neutralising antibodies, although of uncertain effectiveness in preventing infection or reinfection after natural exposure (prior infection), are highly protective after immunisation with HPV virus-like-particle-based vaccines. Understanding what is known and unknown about the interaction between the immune system and HPV is important in the assessment of the potential contribution of prophylactic vaccination in reducing the incidence of cervical cancer. However, despite our growing understanding, many aspects of the interactions between HPV and the host immune system remain unknown, and this Review draws attention to several of these unresolved issues and their implications.
Prenatal Immunization Education Návar, Ann Marie, MHS; Halsey, Neal A., MD; Carter, Terrell C., MHS ...
American journal of preventive medicine,
2007, Letnik:
33, Številka:
3
Journal Article
Recenzirano
Background Vaccine safety concerns and lack of knowledge regarding vaccines contribute to delays in infant immunization. Prenatal vaccine education could improve risk communication and timely ...vaccination. This study sought to determine the proportion of obstetric practices and hospital-based prenatal education classes that provide pregnant women with infant immunization information, the willingness of obstetric practices to provide infant immunization information, and the proportion of first-time mothers who receive a pediatric prenatal visit. Methods A telephone survey was conducted of 100 pediatric practices and 100 obstetric practices randomly selected from the American Medical Association Physician Masterfile between January and March 2005, with analysis performed April 2005. Results Seventy-one of 100 (71%) selected obstetric practices and 85 of 100 (85%) selected pediatric practices participated. Sixteen obstetric practices (23%) reported providing pregnant women with information on routine childhood immunizations. Thirty-four of the 52 practices (65%) that did not provide such information reported willingness to do so. Ten of 51 hospitals (20%) did not provide information about routine childhood immunizations to prenatal class participants. Sixty-six of the 85 pediatric practices (78%) provided a pediatric prenatal visit. Among these, the median percentage of first-time mothers who received a visit was 30%. Conclusions Prenatal visits are a missed opportunity for providing education about infant immunizations. Incorporating immunization education into routine obstetric prenatal care may increase maternal knowledge of infant vaccines and reduce delayed immunization.
Summary Haemophilus influenzae type b (Hib) is an important cause of invasive bacterial disease in children, including meningitis and pneumonia. The introduction of Hib conjugate vaccines into ...routine vaccination schedules has contributed to a substantial reduction in the burden of Hib-related disease in many developed countries. However, introduction of Hib conjugate vaccines in developing countries has progressed more slowly. We review the worldwide use and effectiveness of Hib conjugate vaccines. At present, 119 countries have programmes for routine Hib immunisation. WHO estimates that in the developed world 92% of the eligible population is vaccinated against Hib; however, average coverage is 42% in developing countries and only 8% in the poorest countries. Africa and southeast Asia have the lowest rates of Hib vaccine introduction. Vaccine costs and debate about the burden of disease are obstacles to the global use of Hib conjugate vaccine. Even with new funding support, there are many ongoing challenges and vaccine use remains suboptimal, particularly in developing countries.
It has been assumed that whole-cell pertussis vaccines (WCVs) commercially distributed in the United States are of comparable immunogenicity, as all must comply with established standards for ...licensure. However, we have recently noted significant differences in antibody responses between groups of infants receiving the two WCVs commercially available in the United States. In separate studies performed concurrently under similar protocols at Vanderbilt and Johns Hopkins universities, infants were randomized to receive either an acellular pertussis vaccine or WCV. The acellular pertussis vaccine used at the two sites was identical, but the WCVs were from different manufacturers. Antibody responses to acellular pertussis vaccine did not differ between the two studies; responses to WCV differed dramatically, with infants receiving the Lederle WCV producing a 46-fold increase in antibody to pertussis toxin, compared with a 2.4-fold increase for infants receiving the Connaught WCV (P = .00003). Evaluation of other comparative data sets that were available provided further support for the conclusion that the two commercially available WCVs consistently differed in their ability to induce antibody to pertussis toxin. These findings have important implications for the design and interpretation of clinical trials comparing acellular and WCV products.
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