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1.
Blood ; 139(12): 1903-1907, 2022 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-35113987

RESUMEN

Vaccine-induced thrombotic thrombocytopenia (VITT) is triggered by vaccination against COVID-19 with adenovirus vector vaccines (ChAdOx1 nCoV-19; Ad26.COV2-S). In this observational study, we followed VITT patients for changes in their reactivity of platelet-activating antiplatelet factor 4 (PF4) immunoglobulin G (IgG) antibodies by an anti-PF4/heparin IgG enzyme immunoassay (EIA) and a functional test for PF4-dependent, platelet-activating antibodies, and new thrombotic complications. Sixty-five VITT patients (41 females; median, 51 years; range, 18-80 years) were followed for a median of 25 weeks (range, 3-36 weeks). In 48/65 patients (73.8%; CI, 62.0% to 83.0%) the functional assay became negative. The median time to negative functional test result was 15.5 weeks (range, 5-28 weeks). In parallel, EIA optical density (OD) values decreased from median 3.12 to 1.52 (P < .0001), but seroreversion to a negative result was seen in only 14 (21.5%) patients. Five (7.5%) patients showed persistent platelet-activating antibodies and high EIA ODs for >11 weeks. None of the 29 VITT patients who received a second vaccination dose with an mRNA COVID-19 vaccine developed new thromboses or relevant increase in anti-PF4/heparin IgG EIA OD, regardless of whether PF4-dependent platelet-activating antibodies were still present. PF4-dependent platelet-activating antibodies are transient in most patients with VITT. VITT patients can safely receive a second COVID-19 mRNA-vaccine shot.


Asunto(s)
COVID-19 , Trombocitopenia , Trombosis , Vacunas , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Femenino , Heparina/efectos adversos , Humanos , Inmunoglobulina G , Factor Plaquetario 4 , Trombocitopenia/inducido químicamente , Vacunas/efectos adversos
3.
J. Health Biol. Sci. (Online) ; 10(1): 1-3, 01/jan./2022. ilus
Artículo en Portugués | LILACS | ID: biblio-1358188

RESUMEN

Na atualidade, fotografar ou gravar o instante da imunização contra a Covid-19 se tornou rotina compartilhada nas redes sociais. Essa exposição instigou a observação de uma questão relevante: a técnica de aplicação está correta? Com a veiculação de imagens, é possível visualizar as vacinas sendo administradas em diferentes áreas do músculo deltoide, o que pode acarretar efeitos adversos. A otimização da qualificação técnica e pedagógica dos profissionais que elaboram e ministram as capacitações, bem como o envolvimento efetivo dos vacinadores nos treinamentos para injeção intramuscular é uma necessidade constante para evitar mais danos à saúde da população


Currently, photographing or recording the instant of immunization against Covid-19 has become a shared routine on social networks. This exposition prompted the observation of a relevant question: is the application technique correct? With the transmission of images, it is possible to visualize the vaccines being administered in different areas of the deltoid muscle, which can cause adverse effects. The optimization of the technical and pedagogical qualification of the professionals who design and deliver the training, as well as the effective involvement of vaccinators in training for intramuscular injection, is a constant need to avoid further damage to the health of the population


Asunto(s)
COVID-19 , Vacunas , Inmunización , Optimización de Procesos , Músculo Deltoides , Inyecciones
4.
Am J Epidemiol ; 191(4): 570-583, 2022 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-34999751

RESUMEN

We estimated the trends and correlates of vaccine hesitancy and its association with subsequent vaccine uptake among 5,458 adults in the United States. Participants belonged to the Communities, Households, and SARS-CoV-2 Epidemiology COVID (CHASING COVID) Cohort, a national longitudinal study. Trends and correlates of vaccine hesitancy were examined longitudinally in 8 interview rounds from October 2020 to July 2021. We also estimated the association between willingness to vaccinate and subsequent vaccine uptake through July 2021. Vaccine delay and refusal decreased from 51% and 8% in October 2020 to 8% and 6% in July 2021, respectively. Compared with non-Hispanic (NH) White participants, NH Black and Hispanic participants had higher adjusted odds ratios (aOR) for both vaccine delay (for NH Black, aOR = 2.0 (95% confidence interval (CI): 1.5, 2.7), and for Hispanic, 1.3 (95% CI: 1.0, 1.7)) and vaccine refusal (for NH Black, aOR = 2.5 (95% CI: 1.8, 3.6), and for Hispanic, 1.4 (95% CI: 1.0, 2.0)) in June 2021. COVID-19 vaccine hesitancy, compared with vaccine-willingness, was associated with lower odds of subsequent vaccine uptake (for vaccine delayers, aOR = 0.15, 95% CI: 0.13, 0.18; for vaccine refusers, aOR = 0.02; 95% CI: 0.01, 0.03 ), adjusted for sociodemographic factors and COVID-19 history. Vaccination awareness and distribution efforts should focus on vaccine delayers.


Asunto(s)
COVID-19 , Vacunas , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , Estudios Longitudinales , SARS-CoV-2 , Estados Unidos/epidemiología , Vacunación
5.
J Med Case Rep ; 16(1): 182, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35524323

RESUMEN

BACKGROUND: Many scientists across the world got involved in the race to develop successful anti-SARS-CoV-2 vaccines to overcome COVID-19 pandemic. Among the different vaccines developed against SARS-CoV-2, Covishield was the first vaccine approved for emergency use in Nepal. We report two cases of Superficial Vein Thrombosis (SVT) for the first time in the literature after vaccination with the Chimpanzee Adenovirus-vectored Vaccine (ChAdOx1 nCoV-19 vaccine). CASES PRESENTATION: Two cases, a 24-year-old young Chhetri male and a 62-year-old Chhetri female who have received Covishield (ChAdOx1 nCoV-19) vaccine, developed pain in left calf after 2 weeks and 10 weeks of vaccination, respectively. Both the case belongs to the Chhetri ethnic group of Nepal. The pain became severe on the fourth week of immunization in the first case while the pain was acute and severe on the 10th week of vaccination in the second case. The first presented to emergency room and second case was referred to the emergency room from Orthopedic Clinic. On evaluation the first patient had normal vitals with no history of fever and swelling yet displayed non-radiating mild to moderate intensity pain localized to left leg below the knee which became aggravated by movements. In the second case however pain was more intense with other characteristics as first case. Both cases had low wells score (< 4). On local examination tenderness was noted on squeezing but other systemic examination findings of the patient were within normal limits in both cases. Among the numerous vaccines used to fight the battle against COVID-19 disease, the ChAdOx1 nCoV-19 vaccine, Covishield, has been widely used in Nepal and India. Apart from other minor side effects, in few cases thromboses have been reported after vaccination of ChAdOx1 nCoV-19, Covishield, vaccine. CONCLUSION: These cases reporting Superficial Vein Thrombosis may be an additional adverse effect to the list of adverse events associated with ChAdOx1 nCoV-19, Covishield, vaccine. However, the benefits of the vaccine in breaking the chain of COVID 19 spread are certainly greater than the risk of thromboses.


Asunto(s)
COVID-19 , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Trombosis , Vacunas , Adulto , COVID-19/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor , Pandemias , SARS-CoV-2 , Vacunación , Adulto Joven
6.
Cogn Res Princ Implic ; 7(1): 38, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35524896

RESUMEN

On April 13, 2021, the CDC announced that the administration of Johnson and Johnson's COVID-19 vaccine would be paused due to a rare blood clotting side effect in ~ 0.0001% of people given the vaccine. Most people who are hesitant to get a COVID-19 vaccine list potential side effects as their main concern (PEW, 2021); thus, it is likely that this announcement increased vaccine hesitancy among the American public. Two days after the CDC's announcement, we administered a survey to a group of 2,046 Americans to assess their changes in attitudes toward COVID-19 vaccines. The aim of this study was to investigate whether viewing icon arrays of side effect risk would prevent increases in COVID-19 vaccine hesitancy due to the announcement. We found that using icon arrays to illustrate the small chance of experiencing the blood clotting side effect significantly prevented increases in aversion toward the Johnson and Johnson vaccine as well as all other COVID-19 vaccines.


Asunto(s)
COVID-19 , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Vacunas , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Humanos , SARS-CoV-2 , Encuestas y Cuestionarios , Estados Unidos
8.
BMJ ; 377: o1148, 2022 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-35523434
9.
PLoS One ; 17(5): e0268020, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503797

RESUMEN

BACKGROUND: COVID-19 vaccination rates among Black Americans have been lower than White Americans and are disproportionate to their population size and COVID-19 impact. This study examined reasons for low vaccination intentions and preferred strategies to promote COVID-19 vaccination. METHODS: Between November 2020 and March 2021, we conducted semi-structured interviews with 24 participants who expressed low vaccination intentions in a RAND American Life Panel survey; we also interviewed five stakeholders who represent organizations or subgroups in Black communities that have been highly affected by COVID-19. RESULTS: Many interviewees discussed the "wait-and-see" approach, citing that more time and evidence for vaccine side effects and efficacy are needed. Perceived barriers to COVID-19 vaccination included structural barriers to access (e.g., transportation, technology) and medical mistrust (e.g., towards the vaccines themselves, the government, healthcare providers and healthcare systems, and pharmaceutical companies) stemming from historical and contemporary systematic racism against Black communities. Interviewees also discussed strategies to promote COVID-19 vaccines, including acknowledging systemic racism as the root cause for mistrust, preferred messaging content (e.g., transparent messages about side effects), modes, and access points (e.g., a variety of medical and non-medical sites), and trusted information sources (e.g., trusted leaders, Black doctors and researchers). CONCLUSIONS: These insights can inform ways to improve initial and booster vaccination uptake as the COVID-19 pandemic progresses.


Asunto(s)
COVID-19 , Vacunas , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , Intención , Pandemias , SARS-CoV-2 , Confianza , Estados Unidos , Vacunación
10.
BMJ Open ; 12(5): e062599, 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35504634

RESUMEN

INTRODUCTION: It is unknown if a temporary break in long-term immune-suppressive treatment after vaccination against COVID-19 improves vaccine response. The objective of this study was to evaluate if a 2-week interruption in low-dose weekly methotrexate treatment after SARS-CoV-2 vaccine boosters enhances the immune response compared with continuing treatment in adults with autoimmune inflammatory conditions. METHODS AND ANALYSIS: An open-label, pragmatic, prospective, parallel group, randomised controlled superiority trial with internal feasibility assessment and nested mechanistic substudy will be conducted in rheumatology and dermatology clinics in approximately 25 UK hospitals. The sample size is 560, randomised 1:1 to intervention and usual care arms. The main outcome measure is anti-spike receptor-binding domain (RBD) antibody level, collected at prebooster (baseline), 4 weeks (primary outcome) and 12 weeks (secondary outcome) post booster vaccination. Other secondary outcome measures are patient global assessments of disease activity, disease flares and their treatment, EuroQol 5- dimention 5-level (EQ-5D-5L), self-reported adherence with advice to interrupt or continue methotrexate, neutralising antibody titre against SARS-CoV-2 (mechanistic substudy) and oral methotrexate biochemical adherence (mechanistic substudy). Analysis of B-cell memory and T-cell responses at baseline and weeks 4 and 12 will be investigated subject to obtaining additional funding. The principal analysis will be performed on the groups as randomised (ie, intention to treat). The difference between the study arms in anti-spike RBD antibody level will be estimated using mixed effects model, allowing for repeated measures clustered within participants. The models will be adjusted for randomisation factors and prior SARS-CoV-2 infection status. ETHICS AND DISSEMINATION: This study was approved by the Leeds West Research Ethics Committee and Health Research Authority (REC reference: 21/HRA/3483, IRAS 303827). Participants will be required to give written informed consent before taking part in the trial. Dissemination will be via peer review publications, newsletters and conferences. Results will be communicated to policymakers. TRIAL REGISTRATION NUMBER: ISRCTN11442263.


Asunto(s)
COVID-19 , Vacunas , COVID-19/tratamiento farmacológico , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , Metotrexato/uso terapéutico , Estudios Multicéntricos como Asunto , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , SARS-CoV-2
11.
Cell Mol Life Sci ; 79(5): 275, 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35505125

RESUMEN

In response to infection or vaccination, the immune system initially responds non-specifically to the foreign insult (innate) and then develops a specific response to the foreign antigen (adaptive). The programming of the immune response is shaped by the dispersal and delivery of antigens. The antigen size, innate immune activation and location of the insult all determine how antigens are handled. In this review we outline which specific cell types are required for antigen trafficking, which processes require active compared to passive transport, the ability of specific cell types to retain antigens and the viruses (human immunodeficiency virus, influenza and Sendai virus, vesicular stomatitis virus, vaccinia virus) and pattern recognition receptor activation that can initiate antigen retention. Both where the protein antigen is localized and how long it remains are critically important in shaping protective immune responses. Therefore, understanding antigen trafficking and retention is necessary to understand the type and magnitude of the immune response and essential for the development of novel vaccine and therapeutic targets.


Asunto(s)
Antígenos , Vacunas , Humanos , Sistema Inmunológico , Receptores de Reconocimiento de Patrones , Virus Vaccinia
12.
Sci Adv ; 8(18): eabm3948, 2022 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-35507661

RESUMEN

Broadly HIV-1-neutralizing VRC01-class antibodies bind the CD4-binding site of Env and contain VH1-2*02-derived heavy chains paired with light chains expressing five-amino acid-long CDRL3s. Their unmutated germline forms do not recognize HIV-1 Env, and their lack of elicitation in human clinical trials could be due to the absence of activation of the corresponding naïve B cells by the vaccine immunogens. To address this point, we examined Env-specific B cell receptor sequences from participants in the HVTN 100 clinical trial. Of all the sequences analyzed, only one displayed homology to VRC01-class antibodies, but the corresponding antibody (FH1) recognized the C1C2 gp120 domain. For FH1 to switch epitope recognition to the CD4-binding site, alterations in the CDRH3 and CDRL3 were necessary. Only germ line-targeting Env immunogens efficiently activated VRC01 B cells, even in the presence of FH1 B cells. Our findings support the use of these immunogens to activate VRC01 B cells in humans.


Asunto(s)
VIH-1 , Vacunas , Anticuerpos Neutralizantes , Anticuerpos ampliamente neutralizantes , Anticuerpos Anti-VIH/química , Humanos , Homología de Secuencia
13.
Sci Data ; 9(1): 196, 2022 05 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534493

RESUMEN

Rheumatoid arthritis (RA) is a chronic inflammatory disorder with poorly defined aetiology characterised by synovial inflammation with variable disease severity and drug responsiveness. To investigate the peripheral blood immune cell landscape of early, drug naive RA, we performed comprehensive clinical and molecular profiling of 267 RA patients and 52 healthy vaccine recipients for up to 18 months to establish a high quality sample biobank including plasma, serum, peripheral blood cells, urine, genomic DNA, RNA from whole blood, lymphocyte and monocyte subsets. We have performed extensive multi-omic immune phenotyping, including genomic, metabolomic, proteomic, transcriptomic and autoantibody profiling. We anticipate that these detailed clinical and molecular data will serve as a fundamental resource offering insights into immune-mediated disease pathogenesis, progression and therapeutic response, ultimately contributing to the development and application of targeted therapies for RA.


Asunto(s)
Artritis Reumatoide , Bancos de Muestras Biológicas , Vacunas , Artritis Reumatoide/genética , Artritis Reumatoide/inmunología , Artritis Reumatoide/metabolismo , Autoanticuerpos , Humanos , Monocitos/inmunología , Proteómica
16.
Adv Exp Med Biol ; 1368: 95-110, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35594022

RESUMEN

The host immune system recognizes and responds to the selective antigens or epitopes (immunome) of the intruding pathogen over an entire organism. The immune response so generated is ample to confer the desired immunity and protection to the host. This led to the conception of immunome-derived vaccines that exploit selective genome-derived antigens or epitopes from the pathogen's immunome and not its entire genome or proteome. These are designed to elicit the required immune response and confer protection against future invasions by the same pathogen. Immunoinformatics through its epitope mapping tools allows direct selection of antigens from a pathogen's genome or proteome, which is critical for the generation of an effective vaccine. This paved way for novel vaccine design strategies based on the mapped epitopes for translational applications that includes prophylactic, therapeutic, and personalized vaccines. In this chapter, various Immunoinformatics tools for epitope mapping are presented along with their applications. The methodology for immunoinformatics-assisted vaccine design is also outlined.


Asunto(s)
Epítopos de Linfocito T , Vacunas , Biología Computacional/métodos , Mapeo Epitopo , Epítopos de Linfocito T/genética , Simulación del Acoplamiento Molecular , Proteoma , Vacunas de Subunidad
17.
Cell Chem Biol ; 29(5): 730-740, 2022 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-35594849

RESUMEN

Staphylococcus aureus (SA) is a leading cause of bacterial infection and antibiotic resistance globally. Therefore, development of an effective vaccine has been a major goal of the SA field for the past decades. With the wealth of understanding of pathogenesis, the failure of all SA vaccine trials has been a surprise. We argue that experimental SA vaccines have not worked because vaccines have been studied in naive laboratory animals, whereas clinical vaccine efficacy is tested in immune environments reprogrammed by SA. Here, we review the failed SA vaccines that have seemingly defied all principles of vaccinology. We describe major SA evasion strategies and suggest that they reshape the immune environment in a way that makes vaccines prone to failures. We propose that appropriate integration of concepts of host-pathogen interaction into vaccine study designs could lead to insight critical for the development of an effective SA vaccine.


Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Vacunas , Animales , Interacciones Huésped-Patógeno , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/prevención & control , Staphylococcus aureus
18.
J Adolesc Health ; 70(6): 1002-1005, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35597558

RESUMEN

Worldwide, a number of COVID-19 vaccines have been approved or granted Emergency Use Authorization (EUA) or Emergency Use Listing for adolescents and young adults (AYA), which has brought hope to many across the globe. Extension of the EUA for a COVID-19 vaccine to children and adolescents aged 5 through 15 years is exciting news for children, adolescents, parents, and providers of AYA. Many countries around the globe have extended immunization against COVID-19 to younger age groups. At the same time, the COVID-19 pandemic has led to a decrease globally in administration of other adolescent vaccines. This highlights that vaccine recommendations do not necessarily lead to successful and equitable vaccine distribution, and overcoming barriers to vaccination is critical. Certain subpopulations of AYA, particularly those who are marginalized/underrepresented, do not receive appropriate health care. AYA should be offered protection against all vaccine-preventable illnesses at every opportunity. Creating innovative strategies to improve vaccine uptake among AYA should be encouraged.


Asunto(s)
COVID-19 , Vacunas , Adolescente , COVID-19/prevención & control , Vacunas contra la COVID-19 , Niño , Humanos , Inmunización , Pandemias/prevención & control , Adulto Joven
19.
Sci Transl Med ; 14(643): eabf3685, 2022 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-35507671

RESUMEN

Epstein-Barr virus (EBV) is the major cause of infectious mononucleosis and is associated with several human cancers and, more recently, multiple sclerosis. Despite its prevalence and health impact, there are currently no vaccines or treatments. Four viral glycoproteins (gp), gp350 and gH/gL/gp42, mediate entry into the major sites of viral replication, B cells, and epithelial cells. Here, we designed a nanoparticle vaccine displaying these proteins and showed that it elicits potent neutralizing antibodies that protect against infection in vivo. We designed single-chain gH/gL and gH/gL/gp42 proteins that were each fused to bacterial ferritin to form a self-assembling nanoparticle. Structural analysis revealed that single-chain gH/gL and gH/gL/gp42 adopted a similar conformation to the wild-type proteins, and the protein spikes were observed by electron microscopy. Single-chain gH/gL or gH/gL/gp42 nanoparticle vaccines were constructed to ensure product homogeneity needed for clinical development. These vaccines elicited neutralizing antibodies in mice, ferrets, and nonhuman primates that inhibited EBV entry into both B cells and epithelial cells. When mixed with a previously reported gp350 nanoparticle vaccine, gp350D123, no immune competition was observed. To confirm its efficacy in vivo, humanized mice were challenged with EBV after passive transfer of IgG from mice vaccinated with control, gH/gL/gp42+gp350D123, or gH/gL+gp350D123 nanoparticles. Although all control animals were infected, only one mouse in each vaccine group that received immune IgG had detectable transient viremia. Furthermore, no EBV lymphomas were detected in immune animals. This bivalent EBV nanoparticle vaccine represents a promising candidate to prevent EBV infection and EBV-related malignancies in humans.


Asunto(s)
Infecciones por Virus de Epstein-Barr , Vacunas , Animales , Anticuerpos Neutralizantes , Infecciones por Virus de Epstein-Barr/prevención & control , Hurones , Herpesvirus Humano 4 , Inmunoglobulina G , Ratones , Vacunas Combinadas
20.
Rev Med Suisse ; 18(780): 890-893, 2022 May 04.
Artículo en Francés | MEDLINE | ID: mdl-35510280

RESUMEN

While no vaccine is on the horizon to prevent traveler's diarrhea, progress has been made in the field of malaria and dengue fever. In both cases, the objective is not primarily the prevention among travelers but rather the reduction of morbidity and mortality in populations living in endemic areas. The immune mechanisms protecting against parasitosis are not well understood, which further complicates vaccine development. The fact that veterinary vaccines against the parasites causing cysticercosis and echinococcosis are available for animals, justifies a certain optimism that vaccines against parasitosis will also be available for humans in the future. We report on recent developments in dengue, malaria, schistosomiasis, and hookworm vaccines.


Si aucun vaccin ne pointe à l'horizon pour prévenir la diarrhée des voyageurs, des progrès ont été faits dans le domaine de la malaria et de la dengue. Dans les deux cas, l'objectif n'est pas prioritairement la prévention chez les voyageurs mais plutôt la diminution de la morbidité et mortalité dans les populations vivant en zone d'endémie. Les mécanismes immunitaires protégeant contre les parasitoses ne sont pas bien connus, ce qui complique encore le développement vaccinal. Le fait que des vaccins vétérinaires contre les parasites causant la cysticercose et l'échinococcose soient disponibles pour les animaux justifie un certain optimisme de voir à l'avenir aussi chez l'humain des vaccins contre des parasitoses. Nous faisons le point sur les développements récents des vaccins contre la dengue, la malaria, la schistosomiase et l'ankylostomiase.


Asunto(s)
Malaria , Vacunas , Diarrea , Humanos , Malaria/prevención & control , Viaje , Vacunas/uso terapéutico
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