Plan nacional de vacunación contra la COVID-19: República de Guatemala / National COVID-19 vaccination plan: Republic of Guatemala

Para facilitar la introducción de la vacuna contra la COVID-19 el Ministerio de Salud Pblica y Asistencia Social (MSPAS) estableció el Comité Nacional de Coordinación para Vacunación contra COVID-19 (CNVCOVID) a través del Acuerdo Ministerial No 0262-2020, con la finalidad de desarrollar e implementar el plan estratégico nacional de vacunación contra la COVID-19. Este documento representa ese producto, en el cual se integran y describen los componentes esenciales para el despliegue de la vacunación contra la COVID-19 el cual se actualizará periódicamente, a medida que se obtenga información actualizada, científica, legal y técnico-operativa para fortalecer la estrategia de vacunación contra la COVID-19 en Guatemala

Vacina Covid-19 ­ Brasil / Covid-19 vaccine - Brazil

De acordo com informações da Agência Nacional de Vigilância Sanitária (ANVISA), quatro vacinas contra a COVID-19 estão sendo testadas no Brasil, todas elas para faixa etária maior ou igual a 18 anos; exceto a vacina da Pfizer que contempla a faixa etária maior ou igual a 16 anos. Com relação ao uso de tais vacinas, até o dia 18 de janeiro de 2021 (última atualização disponível), duas vacinas encontram-se aprovadas para uso emergencial no Brasil: 1) Vacina Covisheld produzida pela Astrazeneca/Oxford em parceria FIOCRUZ) e 2) Vacina Coronavac produzida pela Sinovac (parceria Instituto Butantan)

According to information from the National Health Surveillance Agency (ANVISA), four vaccines against COVID-19 are being tested in Brazil, all of them for age aged 18 years or older; pfizer vaccine that includes the age group greater than or equal to 16 years. Regarding the use of such vaccines, until January 18, 2021 (last available update), two vaccines are approved for emergency use in Brazil: 1) Covisheld vaccine produced by Astrazeneca/Oxford in fiocruz partnership) and 2) Coronavac vaccine produced by Sinovac (Butantan Institute partnership)

Actualización sobre la pandemia COVID-19 en la Región de las Américas, preparación para el COVAX y acceso equitativo a las vacunas contra la COVID-19 / Update on the COVID-19 pandemic in the Region of the Americas, preparedness for COVAX and equitable access to vaccines against COVID-19

Entre el 21 de enero y el 2 de diciembre del 2020,1 los 54 países y territorios de la Región de las Américas notificaron en total 27.145.021 casos confirmados por laboratorio de infección por el SARS-CoV-2 y 732.329 muertes. Treinta y ocho de estos países y territorios con datos disponibles desglosados por edad y sexo notificaron 89% de los casos (24.035.426) y 56,5% de las muertes (413.869). En este grupo de países y territorios, 72% de los casos fueron en personas de 20 a 59 años, y 78% de las muertes notificadas fueron personas de 60 años o más. Si bien no hay diferencia en la proporción de casos por sexo, se observa una mayor tasa de mortalidad en los hombres, que representan 59% del total de muertes

Coming together in the Region to tackle COVID-19.

The COVID-19 pandemic continues to pose multiple health challenges in the Eastern Mediterranean Region. Morbidity and mortality from the disease remain a serious cause for concern. As of 31 August 2020, a total of 1 924 511 laboratory-confirmed cases of SARS-CoV-2 virus infection had been reported in the Region, including 51 019 deaths. Moreover, there are worrying signs that cases are now rising again in some countries after a period of decline and the indirect impact of the pandemic on health care is arguably even more troubling. Access to essential health services is being compromised as scarce resources are diverted to fight the pandemic, social restriction measures such as lockdowns disrupt service provision, while fear and rumor deter people from approaching health facilities. Initial studies indicate that services such as immunization, elective surgery and chronic disease management have been severely affected. The long-term consequences threaten to be grave indeed.

COVID-19 and Bacillus Calmette-Guérin: What is the Link?

The debate around the role of vaccination with Bacillus Calmette-Guérin has revived right in the time of the Coronavirus disease 19 pandemic. Since Bacillus Calmette-Guérin is one of the most commonly delivered therapies in urology, in this editorial we discuss some points that we think will be of interest and guidance to practicing urologists during this public health emergency.

Vacunas para la COVID-19: capacidad de producción y distribución e implicaciones económicas y políticas. Síntesis rápida. / Vaccines for COVID-19: production, distribution capacity, and economic and political implications. Rapid living synthesis

A pesar de los 58.5 millones de casos notificados hasta ahora en el mundo, la mayor parte de la población sigue siendo susceptible a la infección, con un importante número de estudios de seroprevalencia reportando un bajo porcentaje de anticuerpos contra el SARSCoV-2, en un rango entre 1.0% y 10.8% (12­15). Como conclusión, se espera en 2021 una gran demanda de vacunas para la COVID-19. Todo este panorama se esta desarrollando en un contexto complejo, pues la pandemia por la COVID-19 ha hecho evidentes las grandes inequidades a nivel mundial, tanto dentro de los países, como entre ellos, y ha sembrado controversias y preocupaciones asociadas a la capacidad y estrategias de distribución de las vacunas, la priorización de grupos poblacionales y países con mayor riesgo en el contexto de la equidad, y el temor de una monopolización de la vacuna por los países de mayores ingresos, con las implicaciones políticas y económicas que todo esto puede desencadenar (8­11,16­18). Esta síntesis de evidencia aborda las consideraciones sobre la producción y distribución de estas vacunas para COVID-19 y sus implicaciones políticas y económicas.

[Antiviral therapy for general practitioners]. / Traitements antiviraux pour le praticien.

Viral infections are extremely common and generally self-restricted, thus antiviral therapy is limited to precise indications. Apart from HIV (not reviewed in this article), the principal treatable viruses are HSV 1 and 2, VZV, CMV, Influenza A and B, and hepatitis B and C. Vaccination is another cornerstone of viral infections control. This article summarizes actual and available therapy. New treatments arrived recently on the market or are being developed : HCV can now be treated with a high success rate, baloxavir against the flu, a new zoster vaccine will probably soon be available in Switzerland and letermovir improves CMV prophylaxis in the case of hematopoietic stem cell transplant.

Les infections virales sont extrêmement fréquentes et guérissent le plus souvent spontanément. Un traitement antiviral est réservé à des indications précises. A l'exception du VIH (non abordé dans cet article), les principaux virus traitables sont : herpès simplex 1 et 2 (HSV-1 et 2), Varicella zoster (VZV), cytomégalovirus (CMV), influenza A et B ainsi que les virus des hépatites B et C. La vaccination est une autre stratégie de lutte importante. Ce domaine étant en plein développement, cet article effectue un survol des traitements actuellement disponibles sur le marché suisse. Durant ces dernières années, l'hépatite C a pu être traitée avec un haut taux de succès. Le baloxavir contre la grippe et un nouveau vaccin contre le zona seront sans doute prochainement disponibles en Suisse. Le letermovir améliore la prophylaxie du CMV en cas de transplantation de moelle osseuse.

[Virus-Like Particles as an Instrument of Vaccine Production].

The paper discusses the techniques which are currently implemented for vaccine production based on virus-like particles (VLPs). The factors which determine the characteristics of VLP monomers assembly are provided in detail. Analysis of the literature demonstrates that the development of the techniques of VLP production and immobilization of target antigens on their surface have led to the development of universal platforms which make it possible for virtually any known antigen to be exposed on the particle surface in a highly concentrated form. As a result, the focus of attention has shifted from the approaches to VLP production to the development of a precise interface between the organism's immune system and the peptides inducing a strong immune response to pathogens or the organism's own pathological cells. Immunome-specified methods for vaccine design and the prospects of immunoprophylaxis are discussed. Certain examples of vaccines against viral diseases and cancers are considered.

Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention.

Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The disease is more severe and dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 50 serotypes of AdV have been identified. Different serotypes display different tissue tropisms that correlate with clinical manifestations of infection. The predominant serotypes circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been conducted. Cidofovir is the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States, but currently are not available to civilians.

Beyond Oncolytics: E1B55K-Deleted Adenovirus as a Vaccine Delivery Vector.

Type 5 human adenoviruses (Ad5) deleted of genes encoding the early region 1B 55-kDa (E1B55K) protein including Onyx-015 (dl1520) and H101 are best known for their oncolytic potential. As a vaccine vector the E1B55K deletion may allow for the insertion of a transgene nearly 1,000 base pairs larger than now possible. This has the potential of extending the application for which the vectors are clinically known. However, the immune priming ability of E1B55K-deleted vectors is unknown, undermining our ability to gauge their usefulness in vaccine applications. For this reason, we created an E1B55K-deleted Ad5 vector expressing full-length single chain HIVBaLgp120 attached to a flexible linker and the first two domains of rhesus CD4 (rhFLSC) in exchange for the E3 region. In cell-based experiments the E1B55K-deleted vector promoted higher levels of innate immune signals including chemokines, cytokines, and the NKG2D ligands MIC A/B compared to an E1B55K wild-type vector expressing the same immunogen. Based on these results we evaluated the immune priming ability of the E1B55K-deleted vector in mice. The E1B55K-deleted vector promoted similar levels of Ad5-, HIVgp120, and rhFLSC-specific cellular and humoral immune responses as the E1B55K wild-type vector. In pre-clinical HIV-vaccine studies the wild-type vector has been employed as part of a very effective prime-boost strategy. This study demonstrates that E1B55K-deleted adenoviruses may serve as effective vaccine delivery vectors.

Does India need an indigenous HPV vaccine and why?

Cervical cancer is the most common form of cancer in Indian women, causing high morbidity and mortality. Two effective and safe vaccines exist, but these remain out of reach of most people due to their high cost. It is imperative that an Human Papillomavirus (HPV) vaccine be affordable and cheap so that the target population can be vaccinated, to make a real impact in reducing the disease burden. We argue that in the long run India needs to develop and manufacture its own HPV vaccine in order to bridge this price gap. We also explore other strategies that can be adopted to increase the accessibility and affordability of this life-saving vaccine during the interim period.

Molecular epidemiology of adenovirus type 4 infections in US military recruits in the postvaccination era (1997-2003).

BACKGROUND: Military recruits are at a higher risk of respiratory infection than their civilian counterparts. Continuous outbreaks of adenovirus (Ad)-associated acute respiratory disease were documented among US trainees before the implementation of serotype 4 (Ad4) and serotype 7 vaccines in 1971. The discontinuation of Ad vaccination programs in 1999 precipitated the reemergence of Ad in training sites, with Ad4 accounting for 98% of all diagnosed cases. METHODS: A total of 724 Ad4 strains isolated from recruits presenting with febrile respiratory illness at 8 training sites nationwide between 1997 and 2003 were genome typed by restriction enzyme analysis. RESULTS: Seven genome types were identified, all of which were distinct from the prototype Ad4p and the vaccine type 4p1. Results showed very different, and often stable, genome type distributions at different geographic sites, despite the homogeneity of the recruit source population. CONCLUSIONS: The data support the hypothesis that reservoirs for Ad outbreaks are within recruit training sites or in their immediate environments, not in the incoming recruit population. Molecular characterization beyond serotype is critical to understanding the transmission dynamics of Ad infection in these unique susceptible populations and to the implementation of effective prevention approaches.

[Preventive vaccines against papillomavirus and cervix cancer will soon enter clinical practice]. / Preventiva vacciner mot papillomvirus och cervixcancer når snart kliniken.

A vaccine may protect against cancers caused by high-risk human papillomaviruses (HPVs). Sexually transmitted high-risk HPV types are almost always found in cervical cancer. Incidents of HPV type 16 and cervical cancer has more than doubled after the 1980's in Finland. HPV L1 capsid protein can be produced in the yeast, after which it assembles into virus-like-particles (VLP) and can be readily used for vaccine production. HPV VLP vaccine is well tolerated and induces ten-fold higher serum antibody levels as compared to natural infection. HPV16 VLP vaccine has shown to be 91% protective effect against HPV16 infections in the first phase III study. Neutralizing HPV antibodies, induced by HPV VLP vaccination, effectively reduce the viral load even though total elimination of the virus may not be needed. It is not known for how long the vaccine induced protection will last. Recruitment of adolescents into population-based phase III vaccination studies should be large to allow reliable cancer registry based evaluation of protective effect against grave dysplasia and cervical cancer.

[Can human papillomavirus testing and vaccination prevent cervical cancer?]. / Kan testing og vaksinering for humant papillomavirus forebygge livmorhalskreft?

BACKGROUND: Cervical cancer is the third most frequent cancer among women worldwide. Human papillomavirus (HPV) infection is a necessary risk factor and the first step in cervical carcinogenesis. MATERIAL AND METHODS: This article reviews the current literature concerning the possibility of preventing cervical cancer by HPV testing and vaccination. RESULTS: HPV testing cannot replace cytology, but will reduce false negative cytology and may improve the screening programme for cervical neoplasia. It has not yet been incorporated in any national cervical cancer screening program, but trials are ongoing in Scandinavia and in the Netherlands. The cost-effectiveness of HPV testing in screening has to be proven and whether it can affect the recommended screening-intervals. Therapeutic and prophylactic vaccines for HPV associated disease are in progress. Evaluating the clinical trials that are ongoing will take several years. Several anti-HPV vaccines are now in clinical trials; Norway will also participate. Therapeutic vaccines against cervical cancer have so far not been successful, but anogenital dysplasias and condylomas may be more susceptible. Prophylactic vaccines against HPV 6, 11, 16 and 18 have been evaluated in clinical phase I and II trials, and phase III trials are in progress. INTERPRETATION: HPV testing improves the specificity and sensitivity of cervical cytology and it can be used to clarify cases with atypical cells of undetermined significance (ASCUS) and low-grade intraepithelial neoplasia. In the near future it may also be included in the cervical cancer screening programme for women above the age of 30. The first results in clinical vaccine trials are encouraging, and final conclusions about the effectiveness of these vaccines may be achieved in five years' time.