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1.
Cell Host Microbe ; 27(5): 695-698, 2020 05 13.
Artículo en Inglés | MEDLINE | ID: mdl-32407707

RESUMEN

As scientists consider SARS-CoV-2 vaccine design, we discuss problems that may be encountered and how to tackle them by what we term "rational vaccine design." We further discuss approaches to pan-coronavirus vaccines. We draw on experiences from recent research on several viruses including HIV and influenza, as well as coronaviruses.


Asunto(s)
Anticuerpos Antivirales/inmunología , Antígenos Virales/inmunología , Betacoronavirus/inmunología , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Vacunas Virales/inmunología , Vacunas contra el SIDA/inmunología , Vacunas contra el SIDA/normas , Infecciones por Coronavirus/inmunología , Humanos , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/normas , Neumonía Viral/inmunología , Proyectos de Investigación/tendencias
4.
Health Psychol ; 38(11): 975-983, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31259597

RESUMEN

OBJECTIVE: Flu vaccinations are recommended for almost everyone, but uptake may vary because of perceived social norms. We aimed to examine the relationship between perceived social circle vaccine coverage (including family, friends, and acquaintances) and own vaccination behavior as well as potential mediators. METHODS: In 2011, 357 participants from RAND's American Life Panel reported perceived social circle vaccine coverage for the 2010-2011 flu season, own vaccination behavior for the 2009-2010 and 2010-2011 flu seasons, perceived flu risk without and with vaccination, and perceived vaccine safety. In 2012 and 2016, respectively, participants returned to report their own vaccination behavior for the 2011-2012 flu season (N = 338) and 2015-2016 flu season (N = 216). RESULTS: Perceiving greater percentage of 2010-2011 social circle vaccine coverage was associated with a greater likelihood of getting vaccinated in the 2010-2011 flu season (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01, 1.04) and the subsequent 2011-2012 flu season (OR = 1.02, 95% CI = 1.01, 1.03) but not the 2015-2016 flu season (OR = 1.00, 95% CI = .99, 1.01), as seen in logistic regressions that controlled for demographics and 2009-2010 vaccination behavior. All significant relationships between social circle vaccine coverage and own vaccination behavior were mediated by perceived flu risk without vaccination. CONCLUSIONS: Perceived social circle vaccine coverage is associated with own vaccination behavior in the current and subsequent flu season, establishing behavior patterns that may persist into the future. People's vaccination decisions may be informed by their perceptions of their peers' beliefs and behaviors. We discuss intervention strategies for promoting vaccine uptake by counteracting negative and promoting positive perceived social norms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Vacunas contra la Influenza/normas , Gripe Humana/epidemiología , Psicología Social/métodos , Femenino , Humanos , Estudios Longitudinales , Masculino , Encuestas y Cuestionarios
5.
Crit Care ; 23(1): 258, 2019 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-31324202

RESUMEN

Influenza virus affects the respiratory tract by direct viral infection or by damage from the immune system response. In humans, the respiratory epithelium is the only site where the hemagglutinin (HA) molecule is effectively cleaved, generating infectious virus particles. Virus transmission occurs through a susceptible individual's contact with aerosols or respiratory fomites from an infected individual. The inability of the lung to perform its primary function of gas exchange can result from multiple mechanisms, including obstruction of the airways, loss of alveolar structure, loss of lung epithelial integrity from direct epithelial cell killing, and degradation of the critical extracellular matrix.Approximately 30-40% of hospitalized patients with laboratory-confirmed influenza are diagnosed with acute pneumonia. These patients who develop pneumonia are more likely to be < 5 years old, > 65 years old, Caucasian, and nursing home residents; have chronic lung or heart disease and history of smoking, and are immunocompromised.Influenza can primarily cause severe pneumonia, but it can also present in conjunction with or be followed by a secondary bacterial infection, most commonly by Staphylococcus aureus and Streptococcus pneumoniae. Influenza is associated with a high predisposition to bacterial sepsis and ARDS. Viral infections presenting concurrently with bacterial pneumonia are now known to occur with a frequency of 30-50% in both adult and pediatric populations. The H3N2 subtype has been associated with unprecedented high levels of intensive care unit (ICU) admission.Influenza A is the predominant viral etiology of acute respiratory distress syndrome (ARDS) in adults. Risk factors independently associated with ARDS are age between 36 and 55 years old, pregnancy, and obesity, while protective factors are female sex, influenza vaccination, and infections with Influenza A (H3N2) or Influenza B viruses.In the ICU, particularly during the winter season, influenza should be suspected not only in patients with typical symptoms and epidemiology, but also in patients with severe pneumonia, ARDS, sepsis with or without bacterial co-infection, as well as in patients with encephalitis, myocarditis, and rhabdomyolysis.


Asunto(s)
Gripe Humana/fisiopatología , Adulto , Enfermedad Crítica/epidemiología , Enfermedad Crítica/mortalidad , Femenino , Humanos , Vacunas contra la Influenza/normas , Vacunas contra la Influenza/uso terapéutico , Gripe Humana/complicaciones , Gripe Humana/epidemiología , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/mortalidad , Obesidad/fisiopatología , Orthomyxoviridae/patogenicidad , Factores Protectores , Síndrome de Dificultad Respiratoria del Adulto/epidemiología , Síndrome de Dificultad Respiratoria del Adulto/etiología , Síndrome de Dificultad Respiratoria del Adulto/fisiopatología , Sepsis/epidemiología , Sepsis/etiología , Sepsis/fisiopatología , Factores Sexuales
7.
Future Microbiol ; 14: 45-49, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31210543

RESUMEN

Several studies have reported that influenza infections in healthcare workers (HCWs) can lead to nosocomial outbreaks. HCWs can potentially be infected with influenza every year, and may continue to work, encouraging the spread of the virus. Different strategies, such as informative interventions on influenza and influenza vaccination, 'onsite' vaccination weeks, communicative strategies through dedicated web and social media pages, and mandatory informed dissent form, were organized for HCWs working at the University Hospital of Palermo, during previous influenza seasons. However, the increased vaccination rates observed among HCWs still remain far from the 75% recommended by Public Health Authorities. The level of coverage observed in countries with mandatory vaccination policies for HCWs, could suggest the adoption of this strategy for increase influenza vaccination adherence in Italy.


Asunto(s)
Personal de Salud , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Gripe Humana/prevención & control , Programas Obligatorios , Vacunación/estadística & datos numéricos , Actitud del Personal de Salud , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Hospitales Universitarios , Humanos , Vacunas contra la Influenza/normas , Gripe Humana/epidemiología , Italia/epidemiología , Programas Obligatorios/estadística & datos numéricos , Vacunación/legislación & jurisprudencia , Vacunación/psicología , Cobertura de Vacunación
8.
Intern Med J ; 49(5): 662-665, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31083800

RESUMEN

Influenza vaccination is an important preventative health measure. A significant proportion of general medical inpatients meets indications for annual inactivated influenza vaccination (IIV), as recommended by the Australian National Immunisation Programme. This study explores opportunities to provide IIV to eligible general medical inpatients and associated barriers.


Asunto(s)
Programas de Inmunización/tendencias , Vacunas contra la Influenza/uso terapéutico , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Admisión del Paciente/tendencias , Vacunación/tendencias , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Estudios Transversales , Femenino , Humanos , Programas de Inmunización/normas , Vacunas contra la Influenza/normas , Gripe Humana/diagnóstico , Masculino , Vacunación/normas
10.
Vaccine ; 37(5): 755-762, 2019 01 29.
Artículo en Inglés | MEDLINE | ID: mdl-30600119

RESUMEN

BACKGROUND: To support timely, annual estimation of influenza vaccine effectiveness (VE), we explored the use of automated data extraction from general practice records to estimate VE over four consecutive southern hemisphere influenza seasons. METHODS: A software tool installed at 130 practices in Western Australia identified all outpatients tested for influenza by polymerase-chain-reaction (PCR) during annual influenza seasons occurring 2012-2015. Laboratory test results were collated with any existing record of influenza vaccine administered in the same year; limited patient demographic and clinical information was also collected. A case test-negative control analysis compared the odds of seasonal influenza vaccination between patients positive or negative for influenza by PCR with VE = 1 - the odds ratio. RESULTS: A total of 7270 influenza PCR test results were identified of which 1907 (26.2%) were positive; 9.4% of patients with a positive result had received contemporaneous influenza vaccination ≥14 days prior to specimen collection, compared to 17.9% of those with a negative result. Overall VE was 52% (95% CI, 43-60%); annual VE estimates ranged from 46% (95% CI, 22-63%) in 2012 to 60% (95% CI, 41-73%) in 2014. CONCLUSION: Electronic records routinely maintained by general practice provide a promising opportunity for estimating annual influenza VE in a timely and resource-efficient manner.


Asunto(s)
Registros Electrónicos de Salud/estadística & datos numéricos , Vacunas contra la Influenza/normas , Gripe Humana/prevención & control , Atención Primaria de Salud/estadística & datos numéricos , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Subtipo H1N1 del Virus de la Influenza A/inmunología , Subtipo H3N2 del Virus de la Influenza A/inmunología , Virus de la Influenza B/inmunología , Vacunas contra la Influenza/administración & dosificación , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pacientes Ambulatorios , Estaciones del Año , Vigilancia de Guardia , Vacunación , Adulto Joven
11.
Hum Vaccin Immunother ; 15(1): 80-90, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30148691

RESUMEN

BACKGROUND: Avian H7N9 influenza viruses possess a potential pandemic threat to public health worldwide, and have caused severe infection and high mortality in humans. A series of clinical trials of H7N9 vaccines have been completed. Meta-analyses need to be performed to assess the immunogenicity and safety of H7N9 vaccines. METHODS: Database research with defined selection criteria was conducted in PubMed, Cochrane Central Register of Controlled Trials, the World Health Organization's International Clinical Trials Registry Platform, ClinicalTrials.gov, etc. Data from randomized clinical trials regarding the immunogenicity and safety of H7N9 vaccines were collected and meta-analyzed. RESULTS: For non-adjuvanted H7N9 vaccines, high dose formulations induced limited immunogenicity and increased the risk of local and systemic adverse events, simultaneously. For adjuvanted H7N9 vaccines, on the one hand, ISCOMATRIX, MF59, AS03 and aluminium adjuvants applied in H7N9 vaccines could improve immune responses effectively, and non-aluminium adjuvants had superior performance in saving vaccine dose; on the other hand, aluminium adjuvant had the advantages of safety amongst these adjuvants applied in H7N9 vaccines. CONCLUSION: H7N9 influenza vaccines with adjuvant might represent the optimal available option in an influenza pandemic, at present.


Asunto(s)
Subtipo H7N9 del Virus de la Influenza A , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/normas , Gripe Humana/prevención & control , Adyuvantes Inmunológicos/administración & dosificación , Adyuvantes Inmunológicos/normas , Femenino , Humanos , Inmunogenicidad Vacunal , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto
12.
Hum Vaccin Immunother ; 15(2): 481-486, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30261144

RESUMEN

BACKGROUND: A field effectiveness evaluation of the influenza vaccine among children younger than five years is important due to the high burden of influenza in this age group. The epidemiology of influenza virus changes rapidly each year. Moreover, the development of a new type of influenza vaccine is accelerating, necessitating a new field effectiveness evaluation. METHODS: This multi-center, open-label cohort study was conducted in the northern part of Seoul from December 2014 to May 2015 and in Gyeong-gi Province from December 2015 to May 2016. The cohort comprised an influenza vaccinated group and non-vaccinated group. During the influenza seasons, we conducted influenza rapid tests and polymerase chain reaction assays for individuals with suspected influenza and checked for the presence of influenza virus. We calculated the influenza vaccine effectiveness by comparing the incidence rates of influenza between the vaccinated and non-vaccinated groups. RESULTS: During the 2014-2015 season, the field effectiveness of the influenza vaccine was 38.4%. In particular, the vaccine effectiveness against type A influenza virus was 50.7%. During the 2015-2016 season, the vaccine effectiveness reached 23.8% and the vaccine effectiveness against type A influenza virus was 48.5%. The vaccine effectiveness against influenza B virus was markedly reduced in both seasons. CONCLUSION: The influenza vaccine was supposed to be effective against influenza A, but may have a limited effectiveness against influenza B among Korean children aged < 5 years.


Asunto(s)
Vacunas contra la Influenza/normas , Vacunas contra la Influenza/uso terapéutico , Gripe Humana/prevención & control , Potencia de la Vacuna , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Virus de la Influenza A , Virus de la Influenza B , Masculino , República de Corea , Proyectos de Investigación
13.
Sci China Life Sci ; 61(12): 1465-1473, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30414008

RESUMEN

The H7N9 viruses that emerged in China in 2013 were nonpathogenic in chickens but mutated to a highly pathogenic form in early 2017 and caused severe disease outbreaks in chickens. The H7N9 influenza viruses have caused five waves of human infection, with almost half of the total number of human cases (766 of 1,567) being reported in the fifth wave, raising concerns that even more human infections could occur in the sixth wave. In September 2017, an H5/H7 bivalent inactivated vaccine for chickens was introduced, and the H7N9 virus isolation rate in poultry dropped by 93.3% after vaccination. More importantly, only three H7N9 human cases were reported between October 1, 2017 and September 30, 2018, indicating that vaccination of poultry successfully eliminated human infection with H7N9 virus. These facts emphasize that active control of animal disease is extremely important for zoonosis control and human health protection.


Asunto(s)
Brotes de Enfermedades/prevención & control , Subtipo H7N9 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/administración & dosificación , Gripe Aviar/prevención & control , Gripe Humana/prevención & control , Zoonosis/prevención & control , Animales , China/epidemiología , Humanos , Subtipo H7N9 del Virus de la Influenza A/genética , Vacunas contra la Influenza/inmunología , Vacunas contra la Influenza/aislamiento & purificación , Vacunas contra la Influenza/normas , Gripe Aviar/epidemiología , Gripe Aviar/transmisión , Gripe Humana/epidemiología , Gripe Humana/transmisión , Aves de Corral/virología , Vacunación/estadística & datos numéricos , Vacunación/tendencias , Vacunación/veterinaria
15.
Healthc Manage Forum ; 31(5): 214-217, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30092667

RESUMEN

Each year, many healthcare organizations deal with low influenza immunization rates among staff. Mandatory influenza vaccination programs may be considered in order to address this issue. These types of programs have caused controversy in the past, as staff has argued that they infringe upon their liberties and right to autonomy. However, if viewed from a public health perspective, mandatory vaccination programs are beneficial for both employees and patients and can be justified. When individuals make the decision to work in the medical field, it is assumed that their values align with those of the organization for which they work. This overrides their right to autonomy, since they are expected to put the safety of their patients ahead of their own personal interests. Although some may argue that receiving a flu shot is unsafe, evidence has demonstrated the opposite, and the minimal discomfort that may result from a vaccine is not enough to negate the responsibilities that healthcare workers have toward the patients they serve.


Asunto(s)
Personal de Salud , Vacunas contra la Influenza/uso terapéutico , Programas Obligatorios , Personal de Salud/organización & administración , Personal de Salud/normas , Derechos Humanos , Humanos , Vacunas contra la Influenza/efectos adversos , Vacunas contra la Influenza/normas , Programas Obligatorios/normas , Responsabilidad Social
17.
Vaccine ; 36(23): 3195-3198, 2018 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-29716772

RESUMEN

To evaluate the reliability of information in general practice (GP) electronic health records (EHRs), 2100 adult patients were randomly selected for interview regarding the presence of specific medical conditions and recent influenza vaccination. Agreement between self-report and data extracted from EHRs was compared using Cohen's kappa coefficient (k) and interpreted in accordance with Altman's Kappa Benchmarking criteria; 377 (18%) patients declined participation, and 608 (29%) could not be contacted. Of 1115 (53%) remaining, 856 (77%) were active patients (≥3 visits to the GP practice in the last two years) who provided complete information for analysis. Although a higher proportion of patients self-reported being vaccinated or having a medical condition compared to the EHR (50.7% vs 36.9%, and 39.4% vs 30.3%, respectively), there was "good" agreement between self-report and EHR for both vaccination status (κ = 0.67) and medical conditions (κ = 0.66). These findings suggest EHR may be useful for public health surveillance.


Asunto(s)
Registros Electrónicos de Salud , Vacunas contra la Influenza , Vacunación/normas , Adulto , Anciano , Femenino , Encuestas de Atención de la Salud , Humanos , Vacunas contra la Influenza/normas , Masculino , Persona de Mediana Edad , Autoinforme , Vacunación/estadística & datos numéricos , Australia Occidental
18.
Proc Natl Acad Sci U S A ; 115(20): 5151-5156, 2018 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-29712866

RESUMEN

The efficacy of influenza vaccines varies from one year to the next, with efficacy during the 2017-2018 season anticipated to be lower than usual. However, the impact of low-efficacy vaccines at the population level and their optimal age-specific distribution have yet to be ascertained. Applying an optimization algorithm to a mathematical model of influenza transmission and vaccination in the United States, we determined the optimal age-specific uptake of low-efficacy vaccine that would minimize incidence, hospitalization, mortality, and disability-adjusted life-years (DALYs), respectively. We found that even relatively low-efficacy influenza vaccines can be highly impactful, particularly when vaccine uptake is optimally distributed across age groups. As vaccine efficacy declines, the optimal distribution of vaccine uptake shifts toward the elderly to minimize mortality and DALYs. Health practitioner encouragement and concerted recruitment efforts are required to achieve optimal coverage among target age groups, thereby minimizing influenza morbidity and mortality for the population overall.


Asunto(s)
Virus de la Influenza A/inmunología , Vacunas contra la Influenza/normas , Gripe Humana/economía , Gripe Humana/prevención & control , Asignación de Recursos/normas , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Lactante , Recién Nacido , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/epidemiología , Persona de Mediana Edad , Morbilidad , Vigilancia de la Población , Asignación de Recursos/economía , Asignación de Recursos/legislación & jurisprudencia , Estaciones del Año , Tasa de Supervivencia , Estados Unidos/epidemiología , Adulto Joven
19.
J Immunol Methods ; 459: 70-75, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29803776

RESUMEN

Analytical techniques are essential in the process of standardizing and validating vaccines. In this study we described a methodology to establish an ELISA sandwich for the quantification of a new vaccine against avian influenza virus H5N1 based on the main antigenic determinant of the virus, the extracellular domain of the glycoprotein hemagglutinin (HA), fused to the extracellular domain of the chicken CD154 glycoprotein (HACD). The chimerical proteins HA and HACD were produced in SiHa cells and the experiments were performed by using three monoclonal antibodies (MAb-HA1, MAb-HA2 and MAb-HA3), alone or conjugated to horseradish peroxidase (HRP-HA1, HRP-HA2 and HRP-HA3). The hemagglutination inhibition assay was carried out with a negative and a positive H5N2 reference serum, together with the antigen H5N1 A/Mallard/Italy/3401/05, all purchased from the "Istituto Zooprofilattico delle Venezie", Italy. After demonstrating the similar recognition pattern between the HA and the HACD proteins, the MAb-HA2 at a concentration of 2,5 µg/mL was selected as the capture antibody and the HRP-HA3 at a dilution of 1/20000 was selected as the detection antibody due to their optimal values of optical density at these conditions. The best dynamic range of the standard curve using the protein HACD was achieved at concentrations from 100 to 1,56 ng/mL. There were no significant differences when five batches of HACD were quantified by the ELISA sandwich and the bicinchoninic acid method linked to densitometry. In conclusion, the final parameters for the quantification of the chimeric protein HACD using an ELISA sandwich were described, which could contribute to develop a large-scale process for the final vaccine production.


Asunto(s)
Anticuerpos Antivirales/sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Glicoproteínas Hemaglutininas del Virus de la Influenza/inmunología , Subtipo H5N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/inmunología , Animales , Pollos/inmunología , Epítopos/inmunología , Glicoproteínas Hemaglutininas del Virus de la Influenza/genética , Vacunas contra la Influenza/normas , Gripe Aviar
20.
Obstet Gynecol ; 131(6): 1188-1191, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29794676

RESUMEN

Immunization is an essential part of care for adults, including pregnant women. Influenza vaccination for pregnant women is especially important because pregnant women who contract influenza are at greater risk of maternal morbidity and mortality in addition to fetal morbidity, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. Other vaccines provide maternal protection from severe morbidity related to specific pathogens such as pneumococcus, meningococcus, and hepatitis for at-risk pregnant women. Obstetrician-gynecologists and other obstetric care providers should routinely assess their pregnant patients' vaccination status. Based on this assessment they should recommend and, when possible, administer needed vaccines to their pregnant patients. There is no evidence of adverse fetal effects from vaccinating pregnant women with inactivated virus, bacterial vaccines, or toxoids, and a growing body of data demonstrate the safety of such use. Women who are or will be pregnant during influenza season should receive an annual influenza vaccine. All pregnant women should receive a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during each pregnancy, as early in the 27-36-weeks-of-gestation window as possible.


Asunto(s)
Inmunización/normas , Atención Prenatal/normas , Vacunas/normas , Adulto , Femenino , Humanos , Vacunas contra la Influenza/normas , Embarazo
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