[mRNA Covid vaccines: What do we know eight months after deployment]. / Vaccins à ARN messager contre le Covid-19 : piqûre de rappel.

This paper summarizes the main knowledge on mRNA vaccines in September 2021. The only contraindication for a 1st dose of vaccine is an allergy to one of the components of the vaccine, but a specialized consultation is possible for an eventual split vaccination under medical supervision. Serious side effects are rare and consist mainly of myocarditis, shingles and appendicitis, but the risk/benefit ratio is always favorable for vaccination. Efficacy against severe COVID-19 is > 90 % after 6 months, and this against all variants. It is recommended to vaccinate pregnant women. A 3rd dose is not recommended at this time, except for immunosuppressed individuals without detectable antibodies after 2 doses. Vaccine mixing is possible, including with a viral vector vaccine.

Cet article résume les connaissances principales sur les vaccins à ARN messager en septembre 2021. La seule contre-indication pour une 1re dose de vaccin est une allergie à l'un des composants du vaccin, mais une consultation spécialisée est possible pour une éventuelle vaccination fractionnée sous surveillance médicale. Les effets secondaires graves sont rares et consistent principalement en myocardite, zona et appendicite, mais le rapport risques/bénéfices est toujours favorable pour la vaccination. L'efficacité contre le Covid-19 sévère est supérieure à 90 % après 6 mois, et cela contre tous les variants. Il est recommandé de vacciner les femmes enceintes. Une 3e dose n'est pas recommandée pour l'instant, sauf pour les personnes immunosupprimées sans anticorps détectables après 2 doses. Les mélanges de vaccins sont possibles, y compris avec un vaccin à vecteur viral.

[Women's health while travelling in tropical countries]. / Santé de la femme en voyage dans les pays tropicaux.

When considering women's health during travels, it is mainly pregnant women who are concerned. Indeed, because of the physiological changes, they are more vulnerable to infectious and non-infectious diseases related to the trip itself or to specific activities. This article lists the essential risks for pregnant women travelling in tropical countries and provides specific recommendations, so that the general practitioner is better able to advise this vulnerable population. If the trip is suitable and in the absence of any pre-existing complication, travelling during pregnancy is not contraindicated.

Les problèmes de santé de la femme en voyage concernent principalement la femme enceinte qui, en raison des changements physiologiques, présente une vulnérabilité aux risques infectieux et non infectieux en lien avec le voyage en tant que tel ou les activités entreprises. Cet article aborde les risques essentiels et détaille les recommandations actuelles spécifiques à cette population vulnérable afin que le praticien soit plus à même de la conseiller avant le départ. Si le voyage est adapté et en l'absence de complication préexistante, il n'est pas contre-indiqué durant la grossesse.

Safety and immunogenicity of a synthetic nanoparticle-based, T cell priming peptide vaccine against dengue in healthy adults in Switzerland: a double-blind, randomized, vehicle-controlled, phase 1 study.

BACKGROUND: Vaccines that minimize the risk of vaccine-induced antibody-dependent enhancement and severe dengue are needed to address the global health threat posed by dengue. This study assessed the safety and immunogenicity of a gold nanoparticle (GNP)-based, multi-valent, synthetic peptide dengue vaccine candidate (PepGNP-Dengue), designed to provide protective CD8+ T cell immunity, without inducing antibodies. METHODS: In this randomized, double-blind, vehicle-controlled, phase 1 trial (NCT04935801), healthy naïve individuals aged 18-45 years recruited at the Centre for primary care and public health, Lausanne, Switzerland, were randomly assigned to receive PepGNP-Dengue or comparator (GNP without peptides [vehicle-GNP]). Randomization was stratified into four groups (low dose [LD] and high dose [HD]), allocation was double-blind from participants and investigators. Two doses were administered by intradermal microneedle injection 21 days apart. Primary outcome was safety, secondary outcome immunogenicity. Analysis was by intention-to-treat for safety, intention-to-treat and per protocol for immunogenicity. FINDINGS: 26 participants were enrolled (August-September 2021) to receive PepGNP-Dengue (LD or HD, n = 10 each) or vehicle-GNP (LD or HD, n = 3 each). No vaccine-related serious adverse events occurred. Most (90%) related adverse events were mild; injection site pain and transient discoloration were most frequently reported. Injection site erythema occurred in 58% of participants. As expected, PepGNP-Dengue did not elicit anti-DENV antibodies of significance. Significant increases were observed in specific CD8+ T cells and dengue dextramer+ memory cell subsets in the LD PepGNP-Dengue but not in the HD PepGNP-Dengue or vehicle-GNP groups, specifically PepGNP-activated CD137+CD69+CD8+ T cells (day 90, +0.0318%, 95% CI: 0.0088-0.1723, p = 0.046), differentiated effector memory (TemRA) and central memory (Tcm) CD8+ T cells (day 35, +0.8/105 CD8+, 95% CI: 0.19-5.13, p = 0.014 and +1.34/105 CD8+, 95% CI: 0.1-7.34, p = 0.024, respectively). INTERPRETATION: Results provide proof of concept that a synthetic nanoparticle-based peptide vaccine can successfully induce virus-specific CD8+ T cells. The favourable safety profile and cellular responses observed support further development of PepGNP-Dengue. FUNDING: Emergex Vaccines Holding Limited.

Human gnathostomiasis in Sri Lanka: an underreported disease?

A healthy young man from Sri Lanka, currently living in Switzerland, consulted at the University Hospital of Geneva with a history of painful erythema and swelling of the left forearm. Laboratory tests showed a slight eosinophilia. Western blot serology for Gnathostoma spp, inconclusive at presentation, became positive 2 weeks later.