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1.
BMC Public Health ; 23(1): 568, 2023 03 27.
Статья в английский | MEDLINE | ID: covidwho-2304077

Реферат

INTRODUCTION: The Hepatitis B virus that can cause liver cancer is highly prevalent in the Gambia, with one in ten babies at risk of infection from their mothers. Timely hepatitis B birth dose administration to protect babies is very low in The Gambia. Our study assessed whether 1) a timeliness monitoring intervention resulted in hepatitis B birth dose timeliness improvements overall, and 2) the intervention impacted differentially among health facilities with different pre-intervention performances. METHODS: We used a controlled interrupted time series design including 16 intervention health facilities and 13 matched controls monitored from February 2019 to December 2020. The intervention comprised a monthly hepatitis B timeliness performance indicator sent to health workers via SMS and subsequent performance plotting on a chart. Analysis was done on the total sample and stratified by pre-intervention performance trend. RESULTS: Overall, birth dose timeliness improved in the intervention compared to control health facilities. This intervention impact was, however, dependent on pre-intervention health facility performance, with large impact among poorly performing facilities, and with uncertain moderate and weak impacts among moderately and strongly performing facilities, respectively. CONCLUSION: The implementation of a novel hepatitis B vaccination timeliness monitoring system in health facilities led to overall improvements in both immediate timeliness rate and trend, and was especially helpful in poorly performing health facilities. These findings highlight the overall effectiveness of the intervention in a low-income setting, and also its usefulness to aid facilities in greatest need of improvement.


Тема - темы
Hepatitis B , Parturition , Infant , Pregnancy , Female , Humans , Interrupted Time Series Analysis , Gambia , Hepatitis B/prevention & control , Vaccination , Hepatitis B Vaccines
2.
BMC Infect Dis ; 23(1): 261, 2023 Apr 26.
Статья в английский | MEDLINE | ID: covidwho-2294554

Реферат

BACKGROUND: In countries with intermediate or high hepatitis B virus (HBV) endemicity, mother-to-child transmission (MTCT) represents the main route of chronic HBV infection. There is a paucity of information on HBV MTCT in Cambodia. This study aimed to investigate the prevalence of HBV infection among pregnant women and its MTCT rate in Siem Reap, Cambodia. METHODS: This longitudinal study included two parts, study-1 to screen HBsAg among pregnant women and study-2 to follow up babies of all HBsAg-positive and one-fourth of HBsAg-negative mothers at their delivery and six-month post-partum. Serum or dried blood spot (DBS) samples were collected to examine HBV sero-markers by chemiluminescent enzyme immunoassay (CLEIA), and molecular analyses were performed on HBsAg-positive samples. Structured questionnaires and medical records were used to examine the risk factors for HBV infection. MTCT rate was calculated by HBsAg positivity of 6-month-old babies born to HBsAg-positive mothers and ascertained by the homology of HBV genomes in mother-child pair at 6-month-old. RESULTS: A total of 1,565 pregnant women were screened, and HBsAg prevalence was 4.28% (67/1565). HBeAg positivity was 41.8% and was significantly associated with high viral load (p < 0.0001). Excluding subjects who dropped out due to restrictions during COVID-19, one out of 35 babies born to HBsAg-positive mothers tested positive for HBsAg at 6 months of age, despite receiving timely HepB birth dose and HBIG, followed by 3 doses of HepB vaccine. Hence the MTCT rate was 2.86%. The mother of the infected baby was positive for HBeAg and had a high HBV viral load (1.2 × 109 copies/mL). HBV genome analysis showed 100% homology between the mother and the child. CONCLUSIONS: Our findings illustrate the intermediate endemicity of HBV infection among pregnant women in Siem Reap, Cambodia. Despite full HepB vaccination, a residual risk of HBV MTCT was observed. This finding supports the recently updated guidelines for the prevention of HBV MTCT in 2021, which integrated screening and antiviral prophylaxis for pregnant women at risk of HBV MTCT. Furthermore, we strongly recommend the urgent implementation of these guidelines nationwide to effectively combat HBV in Cambodia.


Тема - темы
COVID-19 , Hepatitis B , Pregnancy Complications, Infectious , Infant , Female , Pregnancy , Humans , Hepatitis B virus/genetics , Hepatitis B Surface Antigens , Hepatitis B e Antigens , Infectious Disease Transmission, Vertical/prevention & control , Longitudinal Studies , Cambodia/epidemiology , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Hepatitis B Vaccines , Vaccination
3.
Vaccine ; 41(17): 2824-2828, 2023 04 24.
Статья в английский | MEDLINE | ID: covidwho-2257718

Реферат

INTRODUCTION: Routine vaccination for hepatitis B is recommended at birth, and most infants should be vaccinated within 24 h of life. Historically, vaccination rates have been less than ideal, and routine vaccination has been further complicated by the COVID-19 pandemic, with decreased uptake of many vaccines. This retrospective study assessed hepatitis B vaccination rates at birth before and after the start of the COVID-19 pandemic and explored the factors associated with lower vaccination rates. METHODS: Infants born at a single academic medical center in Charleston, South Carolina from November 1, 2018 through June 30, 2021 were identified. Infants were excluded if they died or received ≥ 7 days of systemic steroid therapy within the first 37 days of life. Maternal and infant baseline characteristics and uptake of the first hepatitis B vaccine during hospital admission were recorded. RESULTS: A total of 7808 infants were included in the final analysis, with an overall vaccine uptake of 91.6 %. Of the 3880 neonates in the pre-pandemic group, 3583 (92.3 %) were vaccinated, versus 3571 (90.9 %) of 3928 neonates in the pandemic group (rate difference = 1.4 %; 95 % confidence interval -2.8 % to 5.7 %, p = 0.52). Factors independently associated with lower vaccine uptake included being of non-Hispanic white race, born to a married mother, birth weight < 2 kg, and parental refusal of erythromycin eye ointment at birth. CONCLUSION: The COVID-19 pandemic did not significantly affect the uptake of inpatient neonatal hepatitis B vaccination. Several patient-specific factors were associated with suboptimal vaccination rates in this population.


Тема - темы
COVID-19 , Hepatitis B , Infant, Newborn , Infant , Female , Humans , Hepatitis B Vaccines , Retrospective Studies , Pandemics/prevention & control , COVID-19/prevention & control , Vaccination , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Mothers
4.
Vaccine ; 41(15): 2456-2465, 2023 04 06.
Статья в английский | MEDLINE | ID: covidwho-2251820

Реферат

BACKGROUND: This phase III study evaluated safety, tolerability, and immunogenicity of V114 (15-valent pneumococcal conjugate vaccine) in healthy infants. V114 contains all 13 serotypes in PCV13 and additional serotypes 22F and 33F. METHODS: Healthy infants were randomized to two primary doses and one toddler dose (2+1 regimen) of V114 or PCV13 at 3, 5, and 12 months of age; diphtheria, tetanus, pertussis (DTaP), inactivated poliovirus (IPV), Haemophilus influenzae type b (Hib), hepatitis B (HepB) vaccine was administered concomitantly. Adverse events (AEs) were collected on Days 1-14 following each vaccination. Serotype-specific anti-pneumococcal immunoglobulin G (IgG) was measured 30 days post-primary series, immediately prior to toddler dose, and 30 days post-toddler dose. Primary objectives included non-inferiority of V114 to PCV13 for 13 shared serotypes and superiority of V114 to PCV13 for serotypes 22F and 33F. RESULTS: 1191 healthy infants were randomized to V114 (n = 595) or PCV13 (n = 596). Proportions of participants with solicited AEs and serious AEs were comparable between groups. V114 met non-inferiority criteria for 13 shared serotypes, based on difference in proportions with serotype-specific IgG ≥0.35 µg/mL (lower bound of two-sided 95% confidence interval [CI] >-10.0) and IgG geometric mean concentration (GMC) ratios (lower bound of two-sided 95% CI >0.5) at 30 days post-toddler dose. V114 met superiority criteria for serotypes 22F and 33F, based on response rates (lower bound of two-sided 95% CI >10.0) and IgG GMC ratios (lower bound of two-sided 95% CI >2.0) at 30 days post-toddler dose. Antibody responses to DTaP-IPV-Hib-HepB met non-inferiority criteria, based on antigen-specific response rates. CONCLUSION: A two-dose primary series plus toddler dose of V114 was well-tolerated in healthy infants. Compared with PCV13, V114 provided non-inferior immune responses to 13 shared serotypes and superior immune responses to additional serotypes 22F and 33F.


Тема - темы
Haemophilus influenzae type b , Pneumococcal Infections , Tetanus , Humans , Infant , Pneumococcal Vaccines , Antibodies, Bacterial , Streptococcus pneumoniae , Tetanus Toxoid , Vaccines, Conjugate , Hepatitis B Vaccines , Immunoglobulin G , Pneumococcal Infections/prevention & control , Immunogenicity, Vaccine
5.
Plant Biotechnol J ; 21(6): 1176-1190, 2023 06.
Статья в английский | MEDLINE | ID: covidwho-2244047

Реферат

The recent SARS-CoV-2 pandemic has taught the world a costly lesson about the devastating consequences of viral disease outbreaks but also, the remarkable impact of vaccination in limiting life and economic losses. Vaccination against human Hepatitis B Virus (HBV), a major human pathogen affecting 290 million people worldwide, remains a key action towards viral hepatitis elimination by 2030. To meet this goal, the development of improved HBV antigens is critical to overcome non-responsiveness to standard vaccines based on the yeast-produced, small (S) envelope protein. We have recently shown that combining relevant immunogenic determinants of S and large (L) HBV proteins in chimeric antigens markedly enhances the anti-HBV immune response. However, the demand for cost-efficient, high-quality antigens remains challenging. This issue could be addressed by using plants as versatile and rapidly scalable protein production platforms. Moreover, the recent generation of plants lacking ß-1,2-xylosyltransferase and α-1,3-fucosyltransferase activities (FX-KO), by CRISPR/Cas9 genome editing, enables production of proteins with "humanized" N-glycosylation. In this study, we investigated the impact of plant N-glycosylation on the immunogenic properties of a chimeric HBV S/L vaccine candidate produced in wild-type and FX-KO Nicotiana benthamiana. Prevention of ß-1,2-xylose and α-1,3-fucose attachment to the HBV antigen significantly increased the immune response in mice, as compared with the wild-type plant-produced counterpart. Notably, the antibodies triggered by the FX-KO-made antigen neutralized more efficiently both wild-type HBV and a clinically relevant vaccine escape mutant. Our study validates in premiere the glyco-engineered Nicotiana benthamiana as a substantially improved host for plant production of glycoprotein vaccines.


Тема - темы
COVID-19 , Hepatitis B virus , Humans , Animals , Mice , Hepatitis B virus/genetics , Glycosylation , Tobacco/genetics , CRISPR-Cas Systems/genetics , COVID-19/genetics , SARS-CoV-2 , Hepatitis B Vaccines/genetics , Antibodies, Neutralizing , Hepatitis B Surface Antigens/genetics
6.
J Pediatric Infect Dis Soc ; 10(12): 1080-1086, 2021 Dec 31.
Статья в английский | MEDLINE | ID: covidwho-2189245

Реферат

BACKGROUND: Approximately 30% of US children aged 24 months have not received all recommended vaccines. This study aimed to develop a prediction model to identify newborns at high risk for missing early childhood vaccines. METHODS: A retrospective cohort included 9080 infants born weighing ≥2000 g at an academic medical center between 2008 and 2013. Electronic medical record data were linked to vaccine data from the Washington State Immunization Information System. Risk models were constructed using derivation and validation samples. K-fold cross-validation identified risk factors for model inclusion based on alpha = 0.01. For each patient in the derivation set, the total number of weighted adverse risk factors was calculated and used to establish groups at low, medium, or high risk for undervaccination. Logistic regression evaluated the likelihood of not completing the 7-vaccine series by age 19 months. The final model was tested using the validation sample. RESULTS: Overall, 53.6% failed to complete the 7-vaccine series by 19 months. Six risk factors were identified: race/ethnicity, maternal language, insurance status, birth hospitalization length of stay, medical service, and hepatitis B vaccine receipt. Likelihood of non-completion was greater in the high (77.1%; adjusted odds ratio [AOR] 5.6; 99% confidence interval [CI]: 4.2, 7.4) and medium (52.7%; AOR 1.9; 99% CI: 1.6, 2.2) vs low (38.7%) risk groups in the derivation sample. Similar results were observed in the validation sample. CONCLUSIONS: Our prediction model using information readily available in birth hospitalization records consistently identified newborns at high risk for undervaccination. Early identification of high-risk families could be useful for initiating timely, tailored vaccine interventions.


Тема - темы
Hepatitis B Vaccines , Vaccination , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Odds Ratio , Retrospective Studies , Risk Factors
7.
Emerg Infect Dis ; 28(13): S217-S224, 2022 12.
Статья в английский | MEDLINE | ID: covidwho-2162887

Реферат

The World Health Organization-designated Western Pacific Region (WPR) and African Region (AFR) have the highest number of chronic hepatitis B virus (HBV) infections worldwide. The COVID-19 pandemic has disrupted childhood immunization, threatening progress toward elimination of hepatitis B by 2030. We used a published mathematical model to estimate the number of expected and excess HBV infections and related deaths after 10% and 20% decreases in hepatitis B birth dose or third-dose hepatitis B vaccination coverage of children born in 2020 compared with prepandemic 2019 levels. Decreased vaccination coverage resulted in additional chronic HBV infections that were 36,342-395,594 in the WPR and 9,793-502,047 in the AFR; excess HBV-related deaths were 7,150-80,302 in the WPR and 1,177-67,727 in the AFR. These findings support the urgent need to sustain immunization services, implement catch-up vaccinations, and mitigate disruptions in hepatitis B vaccinations in future birth cohorts.


Тема - темы
COVID-19 , Hepatitis B, Chronic , Hepatitis B , Child , Humans , Child, Preschool , Hepatitis B virus , Hepatitis B, Chronic/epidemiology , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Hepatitis B/epidemiology , Hepatitis B/prevention & control , World Health Organization , Vaccination , Hepatitis B Vaccines , Immunization Programs
8.
Virol Sin ; 37(5): 731-739, 2022 Oct.
Статья в английский | MEDLINE | ID: covidwho-2150803

Реферат

Latent varicella-zoster virus (VZV) may be reactivated to cause herpes zoster, which affects one in three people during their lifetime. The currently available subunit vaccine Shingrix™ is superior to the attenuated vaccine Zostavax® in terms of both safety and efficacy, but the supply of its key adjuvant component QS21 is limited. With ionizable lipid nanoparticles (LNPs) that were recently approved by the FDA for COVID-19 mRNA vaccines as carriers, and oligodeoxynucleotides containing CpG motifs (CpG ODNs) approved by the FDA for a subunit hepatitis B vaccine as immunostimulators, we developed a LNP vaccine encapsulating VZV-glycoprotein E (gE) and CpG ODN, and compared its immunogenicity with Shingrix™ in C57BL/6J mice. The results showed that the LNP vaccine induced comparable levels of gE-specific IgG antibodies to Shingrix™ as determined by enzyme-linked immunosorbent assay (ELISA). Most importantly, the LNP vaccine induced comparable levels of cell-mediated immunity (CMI) that plays decisive roles in the efficacy of zoster vaccines to Shingrix™ in a VZV-primed mouse model that was adopted for preclinical studies of Shingrix™. Number of IL-2 and IFN-γ secreting splenocytes and proportion of T helper 1 (Th1) cytokine-expressing CD4+ T cells in LNP-CpG-adjuvanted VZV-gE vaccinated mice were similar to that of Shingrix™ boosted mice. All of the components in this LNP vaccine can be artificially and economically synthesized in large quantities, indicating the potential of LNP-CpG-adjuvanted VZV-gE as a more cost-effective zoster vaccine.


Тема - темы
COVID-19 , Herpes Zoster Vaccine , Herpes Zoster , Viral Envelope Proteins/immunology , Adjuvants, Immunologic , Animals , Antibodies, Viral , Hepatitis B Vaccines , Herpes Zoster/prevention & control , Herpesvirus 3, Human/genetics , Immunoglobulin G , Interleukin-2 , Liposomes , Mice , Mice, Inbred C57BL , Nanoparticles , Oligodeoxyribonucleotides , Vaccines, Attenuated , Vaccines, Subunit
9.
Vaccine ; 41(3): 623-629, 2023 01 16.
Статья в английский | MEDLINE | ID: covidwho-2159914

Реферат

The COVID-19 pandemic has disrupted access to, adherence to, and perceptions of routine vaccinations. We developed the Shift in Vaccine Confidence (SVC) survey tool to assess the impact of the pandemic on routine vaccinations, with a focus on the HBV vaccine, in Kinshasa, Democratic Republic of Congo (DRC). This study describes the content validation steps we conducted to ensure the survey tool is meaningful to measure changes in vaccine confidence to regular immunization (HBV vaccine) due to the pandemic. Three rounds of stakeholder feedback from a DRC-based study team, content and measurement experts, and study participants allowed us to produce a measure with improved readability and clarity.


Тема - темы
COVID-19 , Hepatitis B Vaccines , Humans , Pandemics/prevention & control , COVID-19/prevention & control , Democratic Republic of the Congo , Perception
10.
Med Lett Drugs Ther ; 64(1662): e1-e2, 2022 10 31.
Статья в английский | MEDLINE | ID: covidwho-2112171
11.
Przegl Epidemiol ; 76(2): 243-254, 2022.
Статья в английский | MEDLINE | ID: covidwho-2067623

Реферат

OBJECTIVE: Aim of the study was the assessment of hepatitis B epidemiological situation in Poland in 2019 compared to previous years, taking into consideration the impact of the COVID-19 pandemic during that time. MATERIAL AND METHODS: Data for 2020 included in individual reports on hepatitis B and HBV infections recorded by sanitary and epidemiological stations at EpiBaza, i.e. in the electronic epidemiological surveillance system on infectious diseases, were analyzed. In the assessment of the epidemiological situation, data published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020" were also used. Data on deaths were obtained from the Statistics Poland (GUS). RESULTS: In 2020, 2,854 cases of hepatitis B were reported, which corresponds to the incidence of 2.59 per 100,000 population, lower by 65.1% than in 2019. 14 cases of acute hepatitis B were reported, constituting 1.4% of all registered cases. The incidence of acute hepatitis B was 0.04 per 100,000 population and was lower by 67% compared to 2019 and lower by 71% compared to the median for the years 2014-2018. There were no cases of acute disease in the age group 0-29 years. A total of 978 chronic and unknown hepatitis B cases (UNK) were registered and the diagnosis rate was 2.56 per 100,000 population, lower by 64.2% than in 2019. Compared to the median diagnosis rate of chronic hepatitis B in 2014-2018, a decrease of 70.4% was observed. In the age group 0-19 years, there was no case reported. In 2020, 24 people died due to hepatitis B, including 22 from chronic hepatitis B. CONCLUSIONS: The COVID-19 pandemic resulted in a significant reduction in the number of HBV tests performed and, consequently, a reduction in the number of diagnosed infections. A decrease in the number of detected infections was observed from the second quarter of 2020, i.e. from the beginning of the COVID-19 pandemic, although already in the first quarter of 2020 the number of registered hepatitis B cases was lower than in the same period in 2019. No acute cases were reported among people who were vaccinated against hepatitis B during childhood. Vaccination with three doses of hepatitis B vaccine in children in the second year of life was only slightly lower than in 2019, which proves the stability of the implementation of the preventive vaccination program, despite the limited access to primary health care during the pandemic.


Тема - темы
COVID-19 , Communicable Diseases , Hepatitis B, Chronic , Hepatitis B , Adolescent , Age Distribution , COVID-19/epidemiology , Child , Child, Preschool , Communicable Diseases/epidemiology , Disease Outbreaks , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Hepatitis B Vaccines/therapeutic use , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/prevention & control , Humans , Incidence , Infant , Infant, Newborn , Pandemics , Poland/epidemiology , Registries , Rural Population , Urban Population , Young Adult
12.
J Physiol Pharmacol ; 73(2)2022 Apr.
Статья в английский | MEDLINE | ID: covidwho-2056910

Реферат

Vaccination against COVID-19 is a highly debated subject that brings confusion due to contradictory information coming from the scientific community and the media. Our aim was to focus on a homogeneous group of students in the healthcare field to assess their intention to vaccinate and the drivers behind this decision. A cross-sectional study was performed in the spring of 2021 in a Medical University in Romania. 725 of the undergraduates that completed an online questionnaire regarding their intention to vaccinate against COVID-19 were included in the study. Univariable analysis and logistic regression were performed on several variables to analyze factors affecting the willingness to vaccinate against COVID-19. In our study sample, 93.1% of students presented a strong intention to vaccinate, out of which the highest proportion belonged to subjects studying general medicine (96%). On logistic regression, we identified the following predictor factors: previous infection with coronavirus, prior vaccination refusal, VAX score, scientifically oriented sources of information and preference for RNA-based technology. Medical students have an increased willingness towards vaccination. Even for them, a highly educated and informed group of subjects, the general attitude towards vaccinations has a strong impact on the choice of COVID-19 vaccination.


Тема - темы
AIDS Vaccines , COVID-19 , Haemophilus Vaccines , Influenza Vaccines , Papillomavirus Vaccines , Respiratory Syncytial Virus Vaccines , SAIDS Vaccines , Students, Medical , Typhoid-Paratyphoid Vaccines , BCG Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Diphtheria-Tetanus Vaccine , Diphtheria-Tetanus-Pertussis Vaccine , Hepatitis A Vaccines , Hepatitis B Vaccines , Humans , Measles-Mumps-Rubella Vaccine , RNA , Romania , Vaccines, Inactivated , Vaccines, Synthetic
13.
Vaccine ; 40(39): 5726-5731, 2022 09 16.
Статья в английский | MEDLINE | ID: covidwho-2004586

Реферат

In the present study, immunogenicity data in 61 vaccinated healthcare workers (HCWs) either infection naïve (naïve HCWs) or with infection of Delta and/or Omicron COVID-19 (experienced HCWs) were evaluated up to 270 days after the second dose of BNT162b2 vaccine and up to 90 days after a booster dose. A decrease in antibody levels at 270 days following administration of the second dose (p = 0.0335) was observed, although values did not fall below the positivity threshold (33.8 BAU/ml). After booster vaccination, antibody levels increased after 30 days (p = 0.0486), with much higher values than after first and second vaccination. Antibody levels then decreased at 60 and 90 days after the booster dose. A comparison between mean antibody levels of naïve and experienced HCWs revealed higher values in experienced HCWs, resulting from both natural and vaccination-induced immunity. A total of 14.7% of HCWs contracted the Omicron virus variant after the vaccine booster, although none showed severe symptoms. These results support that a booster dose results in a marked increase in antibody response that subsequently decreases over time.


Тема - темы
COVID-19 , Antibodies, Viral , BNT162 Vaccine , COVID-19/prevention & control , Health Personnel , Hepatitis B Vaccines , Humans , SARS-CoV-2
16.
Cancer ; 128(18): 3319-3329, 2022 09 15.
Статья в английский | MEDLINE | ID: covidwho-1925896

Реферат

BACKGROUND: Patients with hematologic malignancies have impaired humoral immunity secondary to their malignancy and its treatment, placing them at risk of severe coronavirus disease-19 (COVID-19) infection and reduced response to vaccination. METHODS: The authors retrospectively analyzed serologic responses to initial and booster COVID-19 vaccination in 378 patients with hematologic malignancy and subsequently tracked COVID-19-related outcomes. RESULTS: Seroconversion occurred in 181 patients (48%) after initial vaccination; patients who had active malignancy or those who were recently treated with a B-cell-depleting monoclonal antibody had the lowest rates of seroconversion. For initial nonresponders to vaccination, seroconversion after a booster dose occurred in 48 of 85 patients (56%). The seroconversion rate after the booster was similar for patients on (53%) and off (58%) active therapy (p = .82). Thirty-three patients (8.8%) developed a COVID-19 infection, and there were three COVID-19-related deaths (0.8%). Although no significant association was observed between postvaccination seroconversion and the incidence of COVID-19 infection, no patient with seroconversion died from COVID-19, and no patient who received tixagevimab/cilgavimab (N = 25) was diagnosed with a COVID-19 infection. CONCLUSIONS: Booster vaccinations can promote seroconversion in a significant proportion of patients who are seronegative after the initial vaccination course regardless of the specific vaccine or on/off treatment status at the time of revaccination. Although postvaccination seroconversion may not be associated with a decrease in any (including asymptomatic) COVID-19 infection, the authors' experience suggested that effective vaccination (including a booster), supplemented by passive immunization using tixagevimab/cilgavimab in case of lack of seroconversion, effectively eliminated the risk of COVID-19 death in the otherwise high-risk population. LAY SUMMARY: Patients with hematologic malignancy, especially lymphoma, have an impaired response to coronavirus disease 2019 (COVID-19) vaccination. In this single-institution review, less than one half of the patients studied made detectable antibodies. For those who did not make detectable antibodies after initial vaccination, over one half (65%) were able to produce antibodies after booster vaccination. By the end of February 2022, 33 of the original 378 patients had a documented COVID-19 infection. The only deaths from COVID-19 were in those who had undetectable antibodies, and no patient who received prophylactic antibody therapy developed a COVID-19 infection.


Тема - темы
COVID-19 , Hematologic Neoplasms , Adult , Antibodies, Monoclonal , Antibodies, Viral , COVID-19 Vaccines , Hepatitis B Vaccines , Humans , Retrospective Studies , Seroconversion , Vaccination
17.
Bull World Health Organ ; 100(6): 375-384, 2022 Jun 01.
Статья в английский | MEDLINE | ID: covidwho-1902860

Реферат

Objective: To estimate the prevalence and explore the predictors of vaccine uptake among older adults in India. Methods: We used data from the national Longitudinal Ageing Study in India, a national household survey conducted during 2017-2018. Based on interviewees' self-reports, we calculated population-weighted estimates of the uptake of influenza, pneumococcal, typhoid and hepatitis B vaccines among 64 714 Indian adults aged 45 years or older. We performed multivariable binary logistic regression analysis to examine the sociodemographic and health-related predictors of uptake of the vaccinations. Findings: The coverage of each of the studied vaccinations was less than 2%. The estimated percentages of respondents reporting ever being vaccinated were 1.5% (95% confidence interval, CI: 1.4-1.6) for influenza, 0.6% (95% CI: 0.6-0.7) for pneumococcal disease, 1.9% (95% CI: 1.8-2.0) for typhoid and 1.9% (95% CI: 1.8-2.0) for hepatitis B. Vaccine uptake was higher among respondents with cardiovascular disease, diabetes or lung disease than those without any of these conditions. Uptake of influenza vaccine was higher among those with lung disease, while hepatitis B vaccine uptake was higher among those with cardiovascular disease or diabetes. Male sex, urban residence, wealthier household, more years of schooling, existing medical conditions and sedentary behaviours were significant predictors of vaccine uptake. Conclusion: Targeted policies and programmes are needed for improving the low vaccination coverage among older adults in India, especially among those with chronic diseases. Further research could examine vaccine access, vaccine hesitancy, and vaccine-related information and communication channels to older adults and their health-care providers.


Тема - темы
Cardiovascular Diseases , Influenza Vaccines , Influenza, Human , Lung Diseases , Typhoid Fever , Aged , Hepatitis B Vaccines , Humans , Influenza Vaccines/therapeutic use , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Male , Vaccination , Vaccination Coverage
18.
Vaccine ; 40(26): 3597-3604, 2022 06 09.
Статья в английский | MEDLINE | ID: covidwho-1873314

Реферат

BACKGROUND: At least one-half of adults beginning an immunization series with a three-dose hepatitis B virus (HBV) vaccine (ENGERIX-B, RECOMBIVAX-B) have been reported not to receive the third dose. Use of a two-dose vaccine may improve adherence and lead to greater overall levels of seroprotection. OBJECTIVE: To examine expected levels of adherence and overall seroprotection at one year among adults in routine clinical settings beginning an immunization series with either ENGERIX-B or the two-dose HBV vaccine, HEPLISAV-B. METHODS: Decision-analytic model comparing expected levels of adherence and overall seroprotection at one year among a hypothetical cohort of one million previously unvaccinated adults aged ≥ 30 years receiving first doses of either ENGERIX-B or HEPLISAV-B in a routine clinical setting. We stratified the population by age (30-49 years vs ≥ 50 years) to allow for possible differences in adherence and seroprotection. We estimated our model using published adherence rates for HBV vaccines, and reported seroprotection rates by number of doses administered. We also compared total expected costs of HBV immunization with each vaccine. RESULTS: Use of a two-dose rather than three-dose HBV vaccine would increase the expected number of adults seroprotected at one year by 275,000 per one million persons beginning immunization series, largely reflecting a gain of 290,000 in the expected number of persons fully vaccinated. Results were similar for the two age groups. While the cost per dose of HEPLISAV-B exceeds that of ENGERIX-B, its estimated mean cost per person seroprotected at one year is $50-$70 (∼15%) lower. CONCLUSIONS: Use of a two-dose HBV vaccine would increase the number of adults fully seroprotected at one year compared with the number expected with a three-dose vaccine. Notwithstanding its higher unit cost, mean expected cost per person seroprotected is substantially lower for HEPLISAV-B than ENGERIX-B as a result of much higher levels of seroprotection.


Тема - темы
Hepatitis B Vaccines , Hepatitis B , Adult , Cohort Studies , Hepatitis B/prevention & control , Hepatitis B Antibodies , Hepatitis B Surface Antigens , Humans , Immunization , Immunization Schedule
19.
West Afr J Med ; 39(4): 388-393, 2022 Apr 29.
Статья в английский | MEDLINE | ID: covidwho-1823623

Реферат

BACKGROUND: Adherence to standard precautions in hospitals is vital to control the spread of hospital-acquired infections (HAIs). OBJECTIVE: To determine the level of compliance to standard precautionary measures by clinical students and doctors in a Nigerian tertiary hospital to curb spread of infectious diseases, with focus on uptake of Hepatitis B Virus (HBV) vaccine. METHODS: This study which involved 228 participants used self-administered questionnaire to obtain data on respondents' biodata, history of exposure to patient's body fluids (PBF) in the last six months, HBV vaccination status, use and recapping of needles, handwashing, and use of Personal Protective Equipment (PPE). Data analysis was done using SPSS version18; associations were tested with Chi-square statistics, and p<0.05 was considered significant. RESULTS: Of the 228 respondents, 113(49.6%) were clinical students and 115 (50.4%) doctors with mean age of 27.61±7.48 years. A total of 140 (61.4%) respondents had been exposed to PBF: [89 (63.6%) doctors, 51(36.4%) students]. Age, student/doctor category, and number of years of practice all affected exposure to PBF (p<0.05). Recapping of needles was practiced by 167 (73.2%); hand-washing by 225 (98.7%), and lack of running water was the commonest reason for non-compliance. Also, 218 (95.6%) and 123 (53.9%) wore handgloves and face-masks respectively when attending to patients while 111 (48.7%) received at least a dose of HBV vaccine: [72 (64.9%) doctors, 39 (35.1%) students; p<0.05] but only 60.3% completed their doses. CONCLUSION: Majority had good hand-washing practice, but only about half wore face-masks while working, and recapping of needles was prominent. Doctors had more occupational exposure to PBF but received more HBV vaccine although many were yet to complete their doses. With COVID-19 added to existing list of HAIs, there is need to scale-up compliance to infection control practices through sustained training programs and better health policies which would also drive vaccine coverage in this population.


CONTEXTE: Le respect des précautions standard dans les hôpitaux est essentiel pour contrôler la propagation des infections nosocomiales (IHA). OBJECTIF: Déterminer le niveau de conformité aux mesures de précaution standard par les étudiants cliniques et les médecins d'un hôpital tertiaire nigérian pour limiter la propagation des maladies infectieuses, en mettant l'accent sur l'absorption du vaccin contre le virus de l'hépatite B (VHB). MÉTHODES: Cette étude qui a impliqué 228 participants a utilisé un questionnaire auto-administré pour obtenir des données sur les biodonnées des répondants, les antécédents d'exposition aux fluides corporels (PBF) du patient au cours des six derniers mois, le statut de vaccination contre le VHB, l'utilisation et le récapitulation des aiguilles, le lavage des mains et l'utilisation de l'équipement de protection individuelle (EPI). L'analyse des données a été effectuée à l'aide de SPSS version18; les associations ont été testées avec des statistiques sur le chi carré et inférieur ou égal à 0,05 a été considéré comme significatif. RÉSULTATS: Sur les 228 répondants, 113 (49,6%) étaient des étudiants cliniques et 115 (50,4%) des médecins avec un âge moyen de 27,61 ± 7,48 ans. Au total, 140 (61,4%) répondants avaient été exposés à la FPB: [89 (63,6%) médecins, 51 (36,4%) étudiants]. Âge, catégorie étudiant / médecin et nombre d'années de pratique, toutes les expositions au FPB (p <0,05) ont été affectées. Le récapitulation des aiguilles a été pratiqué par 167 (73,2%); lavage des mains par 225 (98,7%), et le manque d'eau courante était la raison la plus courante de non-conformité. De plus, 218 (95,6%) et 123 (53,9%) portaient des gants et des masques pour le visage respectivement lorsqu'ils s'occupaient de patients tandis que 111 (48,7%) recevaient au moins une dose de vaccin contre le VHB: [72 (64,9%) médecins, 39 (35,1%) étudiants. CONCLUSION: la majorité avait une bonne pratique de lavage des mains, mais seulement environ la moitié portait des masques faciaux pendant le travail, et le récapitulation des aiguilles était important. Les médecins étaient plus exposés au PBF mais ont reçu plus de vaccin contre le VHB, bien que beaucoup n'aient pas encore terminé leurs doses. Avec COVID-19 ajouté à la liste existante des HAI, il est nécessaire d'augmenter la conformité aux pratiques de contrôle des infections grâce à des programmes de formation soutenus et à de meilleures politiques de santé qui favoriseraient également la couverture vaccinale dans cette population. Mots clés: précautions standard, exposition professionnelle; Infections nosocomiales; Vaccin contre le VHB.


Тема - темы
COVID-19 , Cross Infection , Students, Medical , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross Infection/prevention & control , Hepatitis B Vaccines , Hepatitis B virus , Humans , Infection Control , Nigeria/epidemiology , Tertiary Care Centers , Vaccination , Young Adult
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