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1.
Front Immunol ; 12: 696816, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34305933

RESUMO

Early studies on vaccination of children with oncological diseases were only dedicated to the assessment of safety and immunogenicity of the drug. Mechanisms of the post-vaccination immune response were not investigated. This study involved 41 patients aged 7-15 years who were treated for solid tumors two or more years ago. Of these, 26 were vaccinated against diphtheria and tetanus with ADS-m toxoid. Fifteen children (i.e., controls) were not vaccinated. The vaccination tolerability and clinical characteristics of the underlying disease remission ware assessed. Lymphocyte subpopulations were investigated over time by flow cytometry at 1, 6, and 12 months. IgG anti-diphtheria and anti-tetanus toxoids levels were assessed by ELISA. Within the first day of the post-vaccination period, two (7.7%) children demonstrated moderate local reactions and increased body temperature (up to 38.0°C). Relapse and metastasis were not mentioned within a year after immunization. An increase in concentration of IgG antibodies, maintained for 12 months, were noted [2.1 (1.3-3.4) IU/ml against diphtheria (p <0.001), 6.4 (2.3-9.7) IU/ml against tetanus (p <0.001)]. In contrast to healthy children, those with a history of cancer demonstrated a decrease in the relative number of mature T lymphocytes, as well as in absolute number of cytotoxic T cells and B lymphocytes. In a month after the revaccination, a significant increase in absolute (p = 0.04) and relative (p = 0.007) numbers of T lymphocytes and T helpers was revealed. In a year, these values decreased to baseline levels. As for helpers, they decreased below baseline and control values (p = 0.004). In a year after the vaccination, there was a significant (p = 0.05) increase in lymphocyte level with a decrease in the number of NK cells and B cells as compared with controls. Revaccination against diphtheria and tetanus promoted proliferation of a total lymphocytic cell pool along with restoration of the T lymphocyte subpopulation in children with a history of solid tumors. The ADS-m toxoid has a certain nonspecific immunomodulatory effect. These findings are important, also in the midst of the coronavirus pandemic.


Assuntos
Imunidade Adaptativa/imunologia , Vacina contra Difteria e Tétano/imunologia , Neoplasias/imunologia , Vacinação , Adolescente , Anticorpos Antibacterianos/imunologia , Criança , Difteria/imunologia , Difteria/prevenção & controle , Vacina contra Difteria e Tétano/administração & dosagem , Humanos , Imunização Secundária , Subpopulações de Linfócitos/imunologia , Linfócitos/imunologia , Neoplasias/patologia , Federação Russa , Tétano/imunologia , Tétano/prevenção & controle
2.
Nat Commun ; 12(1): 2871, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001895

RESUMO

Reported incidence of pertussis in the European Union (EU) and the European Economic Area (EEA) varies and may not reflect the real situation, while vaccine-induced protection against diphtheria and tetanus seems sufficient. We aimed to determine the seroprevalence of DTP antibodies in EU/EEA countries within the age groups of 40-49 and 50-59 years. Eighteen countries collected around 500 samples between 2015 and 2018 (N = 10,302) which were analysed for IgG-DTP specific antibodies. The proportion of sera with pertussis toxin antibody levels ≥100 IU/mL, indicative of recent exposure to pertussis was comparable for 13/18 countries, ranging between 2.7-5.8%. For diphtheria the proportion of sera lacking the protective level (<0.1 IU/mL) varied between 22.8-82.0%. For tetanus the protection was sufficient. Here, we report that the seroprevalence of pertussis in these age groups indicates circulation of B. pertussis across EU/EEA while the lack of vaccine-induced seroprotection against diphtheria is of concern and deserves further attention.


Assuntos
Difteria/epidemiologia , Tétano/epidemiologia , Coqueluche/epidemiologia , Adulto , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Bordetella pertussis/efeitos dos fármacos , Bordetella pertussis/imunologia , Bordetella pertussis/fisiologia , Difteria/imunologia , Difteria/prevenção & controle , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Vacina contra Difteria, Tétano e Coqueluche/imunologia , Europa (Continente)/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Tétano/imunologia , Tétano/prevenção & controle , Coqueluche/imunologia , Coqueluche/prevenção & controle
3.
Monoclon Antib Immunodiagn Immunother ; 40(2): 36-49, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33900819

RESUMO

The dawn of the 20th century saw the formative years of developments in immunology. In particular, immunochemistry, specifically pertaining to antibodies, was extensively studied. These studies laid the foundations for employing antibodies in a variety of ways. Not surprisingly, antibodies have been used for applications ranging from biomedical research to disease diagnostics and therapeutics to evaluation of immune responses during natural infection and those elicited by vaccines. Despite recent advancements in cellular immunology and the excitement of T cell therapy, use of antibodies represents a large proportion of immunotherapeutic approaches as well as clinical interventions. Polyclonal antibodies in the form of plasma or sera continue to be used to treat a number of diseases, including autoimmune disorders, cancers, and infectious diseases. Historically, antisera to toxins have been the longest serving biotherapeutics. In addition, intravenous immunoglobulins (IVIg) have been extensively used to treat not only immunodeficiency conditions but also autoimmune disorders. Beyond the simplistic suppositions of their action, the IVIg have also unraveled the immune regulatory and homeostatic ramifications of their use. The advent of monoclonal antibodies (MAbs), on the other hand, has provided a clear pathway for their development as drug molecules. MAbs have found a clear place in the treatment of cancers and extending lives and have been used in a variety of other conditions. In this review, we capture the important developments in the therapeutic applications of antibodies to alleviate disease, with a focus on some of the recent developments.


Assuntos
Anticorpos Monoclonais/uso terapêutico , COVID-19/terapia , Difteria/terapia , Neoplasias/terapia , Animais , Anticorpos Monoclonais/imunologia , COVID-19/imunologia , COVID-19/virologia , Terapia Baseada em Transplante de Células e Tecidos , Difteria/imunologia , Humanos , Imunoglobulinas/imunologia , Imunoglobulinas/uso terapêutico , Neoplasias/imunologia , SARS-CoV-2/imunologia , SARS-CoV-2/patogenicidade , Linfócitos T/imunologia
4.
EBioMedicine ; 65: 103254, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33711798

RESUMO

BACKGROUND: The Bacillus Calmette-Guérin (BCG), the only vaccine against tuberculosis (TB) currently in use, has shown beneficial effects against unrelated infections and to enhance immune responses to vaccines. However, there is little evidence regarding the influence of BCG vaccination on pertussis. METHODS: Here, we studied the ability of BCG to improve the immune responses to diphtheria, tetanus, and acellular (DTaP) or whole-cell pertussis (DTwP) vaccination in a mouse model. We included MTBVAC, an experimental live-attenuated vaccine derived from Mycobacterium tuberculosis, in our studies to explore if it presents similar heterologous immunity as BCG. Furthermore, we explored the potential effect of routine BCG vaccination on pertussis incidence worldwide. FINDINGS: We found that both BCG and MTBVAC when administered before DTaP, triggered Th1 immune responses against diphtheria, tetanus, and pertussis in mice. Immunization with DTaP alone failed to trigger a Th1 response, as measured by the production of IFN-γ. Humoral responses against DTaP antigens were also enhanced by previous immunization with BCG or MTBVAC. Furthermore, exploration of human epidemiological data showed that pertussis incidence was 10-fold lower in countries that use DTaP and BCG compared to countries that use only DTaP. INTERPRETATION: BCG vaccination may have a beneficial impact on the protection against pertussis conferred by DTaP. Further randomized controlled trials are needed to properly define the impact of BCG on pertussis incidence in a controlled setting. This could be a major finding that would support changes in immunization policies. FUNDING: This work was supported by the Ministry of "Economía y Competitividad"; European Commission H2020 program, "Gobierno de Aragón"; CIBERES; "Fundação Butantan"; Instituto de Salud Carlos III and "Fondo FEDER".


Assuntos
Vacina BCG/administração & dosagem , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Imunidade Humoral , Coqueluche/prevenção & controle , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/imunologia , Difteria/imunologia , Difteria/prevenção & controle , Modelos Animais de Doenças , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Incidência , Interferon gama/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Tétano/imunologia , Tétano/prevenção & controle , Células Th1/citologia , Células Th1/imunologia , Células Th1/metabolismo , Vacinação , Coqueluche/epidemiologia , Coqueluche/imunologia
5.
Lancet Infect Dis ; 21(6): 868-875, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33485469

RESUMO

BACKGROUND: Diphtheria is re-emerging as a public health problem in several Indian states. Most diphtheria cases are among children older than 5 years. In this study, we aimed to estimate age-specific immunity against diphtheria in children aged 5-17 years in India. METHODS: We used residual serum samples from a cross-sectional, population-based serosurvey for dengue infection done between June 19, 2017, and April 12, 2018, to estimate the age-group-specific seroprevalence of antibodies to diphtheria in children aged 5-17 years in India. 8309 serum samples collected from 240 clusters (122 urban and 118 rural) in 60 selected districts of 15 Indian states spread across all five geographical regions (north, northeast, east, west, and south) of India were tested for the presence of IgG antibodies against diphtheria toxoid using an ELISA. We considered children with antibody concentrations of 0·1 IU/mL or greater as immune, those with levels less than 0·01 IU/mL as non-immune (and hence susceptible to diphtheria), and those with levels in the range of 0·01 to less than 0·1 IU/mL as partially immune. We calculated the weighted proportion of children who were immune, partially immune, and non-immune, with 95% CIs, for each geographical region by age group, sex, and area of residence (urban vs rural). FINDINGS: 29·7% (95% CI 26·3-33·4) of 8309 children aged 5-17 years were immune to diphtheria, 10·5% (8·6-12·8) were non-immune, and 59·8% (56·3-63·1) were partially immune. The proportion of children aged 5-17 years who were non-immune to diphtheria ranged from 6·0% (4·2-8·3) in the south to 16·8% (11·2-24·4) in the northeast. Overall, 9·9% (7·7-12·5) of children residing in rural areas and 13·1% (10·2-16·6) residing in urban areas were non-immune to diphtheria. A higher proportion of girls than boys were non-immune to diphtheria in the northern (17·7% [12·6-24·2] vs 7·1% [4·1-11·9]; p=0·0007) and northeastern regions (20·0% [12·9-29·8] vs 12·9% [8·6-19·0]; p=0·0035). INTERPRETATION: The findings of our serosurvey indicate that a substantial proportion of children aged 5-17 years were non-immune or partially immune to diphtheria. Transmission of diphtheria is likely to continue in India until the immunity gap is bridged through adequate coverage of primary and booster doses of diphtheria vaccine. FUNDING: Indian Council of Medical Research.


Assuntos
Anticorpos Antibacterianos/sangue , Toxoide Diftérico/administração & dosagem , Difteria/imunologia , Vigilância da População , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Difteria/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Estudos Soroepidemiológicos
6.
Int J Infect Dis ; 104: 85-91, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33359066

RESUMO

OBJECTIVES: The aim of this study was to evaluate the development and status quo of the quality of high throughput in vitro diagnostic testing for tetanus and diphtheria antitoxin antibody (ATX) concentrations based on external quality assessment (EQA) data. METHODS: We analyzed manufacturer-specific data of 22 EQA surveys-each for the detection of tetanus and diphtheria ATX-to check the diagnostic strength of the corresponding in vitro diagnostic systems. RESULTS: While the results were mostly well aligned, individual surveys showed widely dispersed ATX concentrations. The medians of manufacturer collectives deviated from the overall median by up to 8.9-fold in the case of diphtheria ATX and by up to 3.5-fold in the case of tetanus ATX. Such a distribution in the results is particularly critical in the cut-off range for immunity and may lead to an incorrect assessment of vaccination status. CONCLUSION: These results were surprising as there are International Standards for both ATX; however, the results may be linked to the high ATX concentration of the reference material, which deviates considerably from clinically significant concentrations. To increase the accuracy and diagnostic strength of both assays, we recommend a recalibration of the test systems and verification of their traceability to the International Standards.


Assuntos
Antitoxina Diftérica/sangue , Antitoxina Tetânica/sangue , Difteria/imunologia , Humanos , Técnicas Imunológicas/normas , Ensaio de Proficiência Laboratorial , Tétano/imunologia
8.
Microbiol Immunol ; 64(9): 610-619, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32662896

RESUMO

Type I IFNs are a range of host-derived molecules with adjuvant potential; they have been used for many years in the treatment of cancer and viral hepatitis. Therefore, the safety of IFNs for human use has been established. In this study, we evaluated the mucosal adjuvanticity of IFN-ß administered intranasally to mice with diphtheria toxoid, and suggested a method to improve its adjuvanticity. When IFN-ß alone was used as a mucosal adjuvant, no clear results were obtained. However, simultaneous administration of IFN-ß and chitosan resulted in an enhancement of the specific serum immunoglobulin G (IgG) and IgA antibody responses, the mucosal IgA antibody response, and antitoxin titers. Furthermore, the intranasal administration of IFN-α alone resulted in a greater increase in antibody titer than IFN-ß, and a synergistic effect with chitosan was also observed. These findings suggest that intranasal administration of chitosan and Type I IFNs may display an effective synergistic mucosal adjuvant activity.


Assuntos
Adjuvantes Imunológicos/administração & dosagem , Formação de Anticorpos , Quitosana/administração & dosagem , Toxoide Diftérico/imunologia , Interferon Tipo I/administração & dosagem , Mucosa Nasal/imunologia , Administração Intranasal , Animais , Anticorpos Antibacterianos/sangue , Quitosana/imunologia , Citocinas/metabolismo , Difteria/imunologia , Difteria/prevenção & controle , Antitoxina Diftérica/sangue , Antitoxina Diftérica/imunologia , Toxoide Diftérico/administração & dosagem , Feminino , Humanos , Imunidade nas Mucosas , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Interferon Tipo I/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Baço/imunologia
10.
J Infect Chemother ; 26(7): 651-659, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32307307

RESUMO

BACKGROUND: Globally, the use of single DTaP-IPV/Hib vaccines that combine DTaP-IPV and Hib is widespread, but in Japan vaccination is usually concomitant at separate sites. The immunogenicity and safety of a primary vaccination series and booster of a combined pentavalent DTaP-IPV/Hib vaccine were evaluated and compared to separate administration of DTaP-IPV and Hib in Japanese infants. METHODS: Healthy Japanese infants were administered DTaP-IPV/Hib (Group A: N = 207) or DTaP-IPV + Hib (Group B: N = 207) by the subcutaneous (SC) or DTaP-IPV/Hib by the intramuscular (IM) route (Group C: N = 10). All subjects received a 3-dose primary vaccination series and a booster. Non-inferiority (Group A versus Group B) was tested post-primary series and subsequent post hoc analyses were performed for anti-Hib. Safety was assessed by parental reports. RESULTS: Non-inferiority for SC administration of Group A versus Group B for the primary series was demonstrated for antibody responses to all antigens except Hib using the threshold of 1.0 µg/mL. Post hoc analyses for anti-Hib demonstrated non-inferiority for the primary series response using 0.15 µg/mL, and for pre-booster antibody persistence and the booster response using 0.15 µg/mL and 1.0 µg/mL. The immune response was similar for each antigen following SC or IM administration. There were no safety concerns in any group, and a lower incidence of injection sites for the IM route was observed as expected. CONCLUSIONS: These data show the good immunogenicity and safety profile of the DTaP-IPV/Hib vaccine as a 3-dose infant primary series followed by a booster in the second year of life in Japan.


Assuntos
Cápsulas Bacterianas/imunologia , Vacina contra Difteria, Tétano e Coqueluche/imunologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/imunologia , Vacinas Anti-Haemophilus/imunologia , Imunização Secundária/métodos , Imunogenicidade da Vacina , Vacina Antipólio de Vírus Inativado/imunologia , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Criança , Pré-Escolar , Difteria/imunologia , Difteria/microbiologia , Difteria/prevenção & controle , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas contra Difteria, Tétano e Coqueluche Acelular/efeitos adversos , Feminino , Vacinas Anti-Haemophilus/administração & dosagem , Vacinas Anti-Haemophilus/efeitos adversos , Haemophilus influenzae tipo b/imunologia , Voluntários Saudáveis , Humanos , Esquemas de Imunização , Incidência , Lactente , Reação no Local da Injeção/epidemiologia , Reação no Local da Injeção/imunologia , Injeções Intramusculares , Injeções Subcutâneas , Japão , Masculino , Meningite por Haemophilus/imunologia , Meningite por Haemophilus/microbiologia , Meningite por Haemophilus/prevenção & controle , Poliomielite/imunologia , Poliomielite/microbiologia , Poliomielite/prevenção & controle , Vacina Antipólio de Vírus Inativado/administração & dosagem , Vacina Antipólio de Vírus Inativado/efeitos adversos , Tétano/imunologia , Tétano/microbiologia , Tétano/prevenção & controle , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/efeitos adversos , Vacinas Conjugadas/imunologia , Coqueluche/imunologia , Coqueluche/microbiologia , Coqueluche/prevenção & controle
11.
Vaccine ; 38(12): 2646-2650, 2020 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-32063435

RESUMO

The objective was to investigate the immune status against tetanus and diphtheria of healthcare workers in Catalonia. A cross-sectional multicentre study was conducted in seven health centres. Blood samples were obtained, and demographic and clinical variables collected. 509 health workers were included. The prevalence of protective antibodies against tetanus was 94.7% (95% CI: 92.3-96.4) overall and 85.1% (95% CI: 74.5-92.0) in workers aged ≥55 years. The prevalence of protective antibodies against diphtheria was 68.6% (95% CI: 64.3-72.5%) overall and 29.7% (95% CI: 19.9-41.6) in workers aged ≥55 years. Protection against tetanus in healthcare workers is high, but should be improved in workers aged ≥55 years. Protection against diphtheria has improved in healthcare workers over the past decade (68.6% vs 46.5%) but should be improved in all ages, especially in workers aged ≥55 years.


Assuntos
Anticorpos Antibacterianos/sangue , Difteria/imunologia , Pessoal de Saúde/estatística & dados numéricos , Imunização Secundária/métodos , Tétano/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antibacterianos/imunologia , Estudos Transversais , Difteria/epidemiologia , Difteria/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Espanha/epidemiologia , Tétano/epidemiologia , Tétano/prevenção & controle , Adulto Jovem
12.
Infect Disord Drug Targets ; 20(3): 323-329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30318004

RESUMO

OBJECTIVES: We report the results of the 2007 national serological survey of immunity to diphtheria in Australia to assess the impact of recent schedule changes on diphtheria immunity, and the adequacy of current policy in the context of increased international travel of people and pathogens. METHODS: Residual sera (n =1656) collected opportunistically from Australian laboratories in 2007 were tested for diphtheria antibody levels using an enzyme immunoassay, with the protective threshold defined as ≥0.1 IU/mL. About 40% of adults aged ≥30 years are susceptible to diphtheria; following the removal of the 18-month booster and its replacement with a dose in adolescence offered through school-based dTpa vaccination program, 59% of children aged 3 years were susceptible to diphtheria, whilst adolescents demonstrated improved immunity. RESULTS: There is no apparent boosting of diphtheria immunity from meningococcal group C conjugate (MCC) or seven-valent pneumococcal conjugate (7vPCV) vaccines in relevant age groups. CONCLUSION: Australians who travel to diphtheria-endemic areas should be up-to-date with their vaccinations. Close monitoring of population immunity levels against diphtheria remains important to ensure that immunity does not decline to a level where wide-spread transmission would be possible.


Assuntos
Anticorpos Antibacterianos/sangue , Difteria/epidemiologia , Difteria/imunologia , Programas de Imunização , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Criança , Pré-Escolar , Difteria/prevenção & controle , Feminino , Vacina Pneumocócica Conjugada Heptavalente/imunologia , Humanos , Programas de Imunização/estatística & dados numéricos , Imunização Secundária , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Viagem/estatística & dados numéricos , Vacinação , Adulto Jovem
13.
Epidemiol. serv. saúde ; 29(2): e2019280, 2020. tab, graf
Artigo em Inglês, Português | LILACS | ID: biblio-1101130

RESUMO

Objetivo: descrever a ocorrência de eventos adversos pós-vacinação (EAPV) com a vacina dTpa durante a gestação. Métodos: estudo descritivo, com dados de relatos das participantes de estudo de efetividade e imunogenicidade realizado em dois hospitais de São Paulo, SP, Brasil, entre 2015 e 2016. Resultados: das 201 mães incluídas no estudo, 48 (23,9%) apresentaram pelo menos um EAPV; foram identificados 60 sintomas relacionados ao uso da dTpa - dor (22,4%), inchaço (2,5%), febre (1,5%), sono (1,0%), vermelhidão (0,5%), vômito (0,5%), dor de cabeça (0,5%), reação local (0,5%) e cansaço (0,5%); não foram registrados eventos adversos raros, muito raros ou extremamente raros; todos os eventos foram considerados esperados e estão descritos em bula; todos tiveram desfecho para cura sem sequelas. Conclusão: a dTpa, na forma adotada pelo Programa Nacional de Imunizações (PNI), é segura; não foram identificados eventos adversos inesperados entre as gestantes imunizadas com a vacina.


Objetivo: describir el aparecimiento de eventos adversos posvacunación (EAPV) con la vacuna dTpa durante el embarazo. Métodos: estudio descriptivo con datos de relatos de las participantes del estudio de efectividad e inmunogenicidad realizado en dos hospitales de São Paulo, SP, Brasil, entre 2015 y 2106. Resultados: de las 201 madres del estudio, 48 (23,9%) tuvieron al menos un EAPV; se identificaron 60 síntomas relacionados al uso de dTpa - dolor (22.4%), hinchazón (2.5%), fiebre (1.5%), somnolencia (1.0%), enrojecimiento (0.5%), vómitos (0.5 %), dolor de cabeza (0.5%), reacción local (0.5%) y cansancio (0.5%) -; no se informaron eventos adversos raros, muy raros o extremadamente raros; todos los eventos se consideraron esperados y se describen en el prospecto; todos tuvieron resultados curativos sin secuelas. Conclusión: el estudio mostró que la vacuna dTpa utilizada por el Programa Nacional de Inmunización (PNI) es segura y no se identificaron eventos adversos inesperados entre las mujeres embarazadas vacunadas.


Objective: to describe occurrence of adverse events following immunization (AEFI) with Tdap vaccine during pregnancy. Methods: this was a descriptive study using data from reports by participants in an effectiveness and immunogenicity study conducted in two hospitals in São Paulo, SP, Brazil, from 2015 to 2016. Results: of the 201 mothers included in the study, 48 (23.9%) had at least one AEFI; 60 symptoms related to Tdap use were identified - pain (22.4%), swelling (2.5%), fever (1.5%), somnolence (1.0%), redness (0.5%), vomiting (0.5%), headache (0.5%), local reaction (0.5%), and fatigue (0.5%); no rare, very rare, or extremely rare adverse events were reported; all events were considered to be expected, as they are described in the vaccine package insert; outcome of all events was recovery without sequelae. Conclusion: Tdap vaccine in the form adopted by the National Immunization Program is safe; no unexpected adverse events were identified among vaccinated pregnant women.


Assuntos
Humanos , Feminino , Gravidez , Adulto , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Programas de Imunização/estatística & dados numéricos , Vacinas contra Difteria, Tétano e Coqueluche Acelular/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Imunogenicidade da Vacina/imunologia , Cuidado Pré-Natal , Tétano/imunologia , Tétano/prevenção & controle , Brasil , Coqueluche/imunologia , Coqueluche/prevenção & controle , Gestantes , Difteria/imunologia , Difteria/prevenção & controle
14.
Ig Sanita Pubbl ; 75(4): 317-325, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31887737

RESUMO

The possible risk of hyperimmunization after tetanus vaccination is currently discussed after the National Vaccine Prevention Plan 2017-2019 confirmed the recommendation of a booster dose every ten years. Due to the ubiquitous nature of tetanus spores and the inability to obtain herd-immunity through vaccination, efforts to reduce the incidence of tetanus aim at eliminating the disease. The only way to prevent infection is vaccination followed by recommended periodic booster doses. Between 2012 and 2016, Italy notified 45% (252/564) of all cases reported by the 26 EU Member States, most of them in the over 65 age group, generally women in the rural areas. The recommendation of the antipertussis vaccine, combined with anti-tetanus, in pregnancy and the indications for antitetanic prophylaxis by vaccination or specific immunoglobulins in emergency setting, gives rise to doubts about the risk of hyperimmunization. Studies generally agree on the safety of diphtheria-tetanus-pertussis combined vaccines during the third trimester of pregnancy, and the time elapsed since the previous tetanus vaccination seems not to be related to significant differences in the incidence of adverse events or obstetrical complications. In the emergency wards, given the relatively high incidence of tetanus in Italy, the risk/benefit ratio often leads to prefer vaccination to no-intervention. The administration of tetanus immunoglobulins in subjects not vaccinated in the last 10 years seems justified by the epidemiology of tetanus in Italy.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/efeitos adversos , Vacinas contra Difteria, Tétano e Coqueluche Acelular/imunologia , Difteria/prevenção & controle , Imunização Secundária/efeitos adversos , Tétano/prevenção & controle , Coqueluche/prevenção & controle , Anticorpos Antibacterianos/imunologia , Difteria/imunologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Feminino , Humanos , Itália , Tétano/imunologia , Coqueluche/imunologia
15.
BMC Pediatr ; 19(1): 480, 2019 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-31810436

RESUMO

BACKGROUND: Passive transferred antibodies to the fetus play an essential role on protecting neonates and young infants until infant vaccination is more efficacious. However, very little is known about the discrepancy of DTP vaccine associated antibodies level in neonates from different economic areas in China. METHODS: In 2018, 200 neonates hospitalized in Shunyi Women and Children's Hospital in Beijing, and 238 neonates hospitalized in Qianjiang Central Hospital located in the southwestern mountainous areas were included in this study. Antibodies specific for the antigens covered by DTP vaccine were determined using ELISA Kits (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria, anti-Dtx), > 0.1 IU/ml (anti-tetanus, anti-Ttx) and > 40 IU/ml (anti-pertussis toxin, anti-Ptx) were used to assess the percentage of protected neonates, respectively. RESULTS: The antibody levels in the neonates from Qianjiang (0.04 IU/ml for anti-Dtx IgG and 0.07 IU/ml for anti-Ttx IgG) were significantly lower than those from Shunyi (0.12 IU/ml for anti-Dtx IgG and 0.18 IU/ml for anti-Ttx IgG). The prevalence of protective anti-Dtx and anti-Ttx IgG were lower in the neonates from Qianjiang (7.1% for anti-Dtx IgG and 7.6% for anti-Ttx IgG) than in those from Shunyi (30.5% for anti-Dtx and 38.5% for anti-Ttx). The neonates from Qianjiang also had lower detectable rate of anti-Dtx (57.5%) and anti-Ttx IgG (55.8%) than neonates from Shunyi (97.5% for anti-Dtx and 71.0% for anti-Ttx). However, the detectable rate of anti-Ptx IgG in neonates from Qianjiang (39.9%) was higher significantly than in those from Shunyi (30.5%). Two neonates from Qianjiang have anti-PT IgG ≥100.0 IU/ml, which suggested that their mothers have a recent pertussis course. CONCLUSIONS: The regional discrepancy of the protective antibody rates might be caused by different vaccine coverage and pertussis exposure, which suggested the importance of Tdap booster immunization for pregnant women or women at childbearing age, those living undeveloped areas in particular.


Assuntos
Anticorpos Antibacterianos/sangue , Difteria/imunologia , Imunidade Materno-Adquirida , Tétano/imunologia , Coqueluche/imunologia , China , Feminino , Humanos , Imunoglobulina G/sangue , Recém-Nascido , Masculino , Gravidez , Vacinação/estatística & dados numéricos
16.
J Health Popul Nutr ; 38(1): 28, 2019 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-31627764

RESUMO

BACKGROUND: Owing to a declining birth rate and longer lifespan, the number of elderly people (≥ 60 years) in Thailand has grown rapidly. However, the elderly are at significant risk of infectious diseases because they have never been immunized, because they have not been completely immunized, or because their immunity has waned. Immunity against infectious diseases in the elderly is an important means of controlling diseases in the community. Our objective was to evaluate the seroprotective rate against diphtheria, tetanus, and pertussis in the elderly Thai population. METHODS: In total, 430 healthy individuals from the northeastern region of Thailand were enrolled in this study and stratified into five age groups: 60-65, 66-70, 71-75, 76-80, and > 80 years. Serum samples were collected and quantitatively analyzed for diphtheria, tetanus, and pertussis IgG antibody by using commercial ELISA kits. For anti-diphtheria toxoid and anti-tetanus toxoid ELISA, values < 0.01 IU/ml were interpreted as seronegative, and for anti-Bordetella pertussis toxin ELISA, values < 5 IU/ml were interpreted as seronegative; these definitions were in accord with previous studies. RESULTS: For diphtheria toxoid Ab, the majority of the population had antibody levels > 0.01 IU/ml. For tetanus anti-toxoid Ab, the majority of the population had antibody levels of > 0.01 IU/ml, of which approximately 34% had durable antibody protection levels (DAPL) of ≥ 1 IU/ml. Meanwhile, nearly 45% of the population had an Ab level against pertussis lower than the protectivity level. CONCLUSIONS: In total, 97.2%, 83.5%, and 55.8% of the population had a higher antibody level than the minimal protective level for diphtheria, tetanus, and pertussis, respectively. In order to prevent an outbreak of these diseases in the future, the elderly should be administered with Tdap revaccination to provide diphtheria herd immunity in the population; this will increase cocoon phenomenon for pertussis and protect the population from tetanus-prone injury.


Assuntos
Anticorpos Antibacterianos/sangue , Difteria/prevenção & controle , Tétano/prevenção & controle , Coqueluche/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/imunologia , Difteria/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunização Secundária , Masculino , Estudos Soroepidemiológicos , Tétano/imunologia , Tailândia/epidemiologia , Coqueluche/imunologia
17.
Ned Tijdschr Geneeskd ; 1632019 10 10.
Artigo em Holandês | MEDLINE | ID: mdl-31609562

RESUMO

Respiratory diphtheria is an acute respiratory tract infection. The high mortality rates (5-10%) are related to airway obstruction and local and systemic effects of the diphtheria toxin. Vaccination against diphtheria has been available through the Dutch national vaccination programme since the 1950s. The disease has now become rare as a result of herd immunity by these vaccinations. As a consequence, the disease has largely been forgotten, which can result in it not being recognised and treated in time. In addition, diphtheria antitoxin is not always available. In this article, we are drawing attention to the need for immunisation. We also look back at how diphtheria prevention started in the Netherlands.


Assuntos
Antitoxina Diftérica/imunologia , Toxoide Diftérico/imunologia , Difteria/imunologia , Humanos , Imunização , Programas de Imunização , Países Baixos , Infecções Respiratórias/imunologia
18.
Vaccine ; 37(39): 5877-5885, 2019 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-31443993

RESUMO

BACKGROUND: This study evaluated immunogenicity and safety of the adjuvanted recombinant zoster vaccine (RZV) and the reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine (Tdap) when co-administered in adults aged ≥50 years. METHODS: In this open label, multi-center study (NCT02052596), participants were randomized 1:1 to the Co-Administration group (RZV dose 1 and Tdap at Day 0 [D0], RZV dose 2 at Month 2 [M2]) or Control group (Tdap at D0, RZV dose 1 at M2, RZV dose 2 at M4). Co-primary objectives were evaluation of the vaccine response rate (VRR) to RZV in the Co-Administration group, and demonstration of non-inferiority of the humoral responses to RZV and Tdap in the Co-Administration compared to Control group. Reactogenicity and safety of RZV and Tdap were also assessed. RESULTS: VRR to RZV was 97.8% in the Co-Administration group. The non-inferiority criterion was met for the humoral response to RZV and for 4 Tdap antigens, but was not met for the Tdap antigen pertactin. Occurrences of solicited, unsolicited and serious adverse events, and potential immune-mediated diseases were similar between groups. CONCLUSIONS: Co-administration of RZV and Tdap did not interfere with the humoral immune response to RZV or 4 of the 5 Tdap antigens. No safety concerns were identified.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/imunologia , Difteria/imunologia , Vacina contra Herpes Zoster/imunologia , Herpes Zoster/imunologia , Vacina contra Coqueluche/imunologia , Tétano/imunologia , Adjuvantes Imunológicos/administração & dosagem , Adulto , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/imunologia , Feminino , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3/imunologia , Humanos , Imunização Secundária/métodos , Masculino , Vacinas Sintéticas/imunologia , Vacinas Virais/imunologia , Coqueluche/imunologia , Coqueluche/prevenção & controle
19.
Vaccine ; 37(28): 3735-3744, 2019 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-31153688

RESUMO

INTRODUCTION: Bacillus Calmette-Guérin vaccine (BCG), one of the most widely used vaccines, does not only provide protection against tuberculosis and other mycobacterial infections, but also has non-specific (heterologous) immunomodulatory effects. In participants in a randomised trial, we investigated the effect of neonatal BCG immunisation on antibody responses to routine infant vaccines given in the first year of life. METHODS: Antibodies against antigens in the diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), and the 13-valent pneumococcal conjugate vaccines were measured in 91 (45 BCG-vaccinated, 46 BCG-naïve) infants one month after, and in 310 (169 BCG-vaccinated, 141 BCG-naïve) infants seven months after immunisation at 6 weeks, 4 and 6 months of age. In addition, antibodies against meningococcus C, Hib, measles, mumps, and rubella were measured in 147 (78 BCG-vaccinated, 69 BCG-naïve) infants one month after immunisation at 12 months of age. The seroprotection rates for each vaccine and the geometric mean concentrations (GMC) of antibodies were compared in BCG-vaccinated and BCG-naïve infants. RESULTS: At 7 months of age, seroprotection rates were high in both BCG-vaccinated and BCG-naïve infants. At 13 months of age, seroprotection rates were lower than at 7 months of age, particularly for pertussis and a number of pneumococcal antigens, with generally higher rates for the latter in BCG-vaccinated infants. Although not statistically significant, antibody responses in BCG-vaccinated infants were consistently higher against diphtheria, tetanus, and pneumococcal antigens at both 7 and 13 months of age, and against measles and mumps at 13 months of age, but were lower against Hib one month after immunisation at both 7 and 13 months of age. CONCLUSION: The immunomodulatory effect of BCG on antibody responses to heterologous vaccines adds to the evidence that BCG immunisation at birth has broad heterologous effects on the infant immune system.


Assuntos
Formação de Anticorpos/imunologia , Vacina BCG/imunologia , Vacinas Conjugadas/imunologia , Anticorpos Antibacterianos/imunologia , Difteria/imunologia , Vacina contra Difteria, Tétano e Coqueluche/imunologia , Feminino , Vacinas Anti-Haemophilus/imunologia , Haemophilus influenzae tipo b/imunologia , Humanos , Imunização/métodos , Lactente , Masculino , Sarampo/imunologia , Vacinas Pneumocócicas/imunologia , Vacina Antipólio de Vírus Inativado/imunologia , Tétano/imunologia , Vacinação/métodos , Coqueluche/imunologia
20.
Methods ; 158: 44-53, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30703462

RESUMO

Serological assays detecting antibodies in serum or plasma samples are useful and versatile instruments to investigate an individual's infection and vaccination history, e.g. for clinical diagnosis, personal risk evaluation, and seroepidemiological studies. Multiplex Serology is a suspension bead array-based high-throughput methodology for simultaneous measurement of antibodies against multiple pathogens in a single reaction vessel, thus economizing sample volume, measurement time, and costs. We developed and validated bead-based pathogen-specific Monoplex Serology assays, i.e. assays including only antigens for the respective pathogen, to detect antibodies against Corynebacterium diphtheriae and Clostridium tetani toxins, rubella virus and parvovirus B19. The developed assays expand the portfolio of existing pathogen-specific bead-based serology assays and can be efficiently incorporated into larger Multiplex Serology panels. The newly developed Monoplex Serology assays consist of only one antigen per infectious agent, expressed as Glutathione S-transferase-fusion proteins in E. coli. Specificity, sensitivity and Cohen's kappa statistics in comparison with routine clinical diagnostic assays were calculated for serum dilutions 1:100 and 1:1000. All pathogen-specific assays were successfully validated at both serum dilutions with the exception of rubella Monoplex Serology which showed impaired sensitivity (57.6%) at dilution 1:1000. Specificities of successfully validated Monoplex Serology assays ranged from 85.6% to 100.0% (median: 91.7%), and sensitivities from 81.3% to 95.8% (median: 90.9%); agreement with the reference assays ranged from substantial to almost perfect (kappa: 0.66-0.86, median: 0.78). Statistical performance and slim assay design enable efficient incorporation of the developed assays into Multiplex Serology.


Assuntos
Anticorpos Antibacterianos/isolamento & purificação , Anticorpos Antivirais/isolamento & purificação , Ensaios de Triagem em Larga Escala/métodos , Testes Sorológicos/métodos , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Antígenos de Bactérias/genética , Antígenos de Bactérias/imunologia , Antígenos Virais/genética , Antígenos Virais/imunologia , Clostridium tetani/imunologia , Corynebacterium diphtheriae/imunologia , Difteria/sangue , Difteria/diagnóstico , Difteria/imunologia , Difteria/microbiologia , Ensaio de Imunoadsorção Enzimática/instrumentação , Ensaio de Imunoadsorção Enzimática/métodos , Ensaios de Triagem em Larga Escala/instrumentação , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Imunoglobulina G/isolamento & purificação , Fenômenos Magnéticos , Microesferas , Modelos Animais , Infecções por Parvoviridae/sangue , Infecções por Parvoviridae/diagnóstico , Infecções por Parvoviridae/imunologia , Infecções por Parvoviridae/virologia , Parvovirus B19 Humano/imunologia , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Rubéola (Sarampo Alemão)/sangue , Rubéola (Sarampo Alemão)/diagnóstico , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/imunologia , Sensibilidade e Especificidade , Testes Sorológicos/instrumentação , Tétano/sangue , Tétano/diagnóstico , Tétano/imunologia , Tétano/microbiologia , Toxina Tetânica/genética , Toxina Tetânica/imunologia
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