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47 ud af 47 tidsskrifter valgt, søgeord (vaccination) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
420 emner vises.
Ulf M. Geisen, Mathias Voß, Ruben Rose, Franziska Neumann, Carina Bäumler, Sina Müller, Lea Paltzow, Christina M. Christophersen, Merle Münier, Elena Hildebrand, Paula Hoff, Ann C. Longardt, Thomas Lorentz, Jan H. Schirmer, Melike Sümbül, Florian Tran, Dennis Berner, Helmut Fickenscher, Sascha Gerdes, Stefan Schreiber, Andi Krumbholz, Bimba F. Hoyer
Journal of Medical Virology, 20.12.2023
Tilføjet 20.12.2023
Journal of Infectious Diseases, 20.12.2023
Tilføjet 20.12.2023
Abstract Immunocompromised COVID-19 patients were prospectively enrolled from March to November 2022 to understand the association between antibody responses and SARS-CoV-2 shedding. A total of 62 patients were analyzed and the results indicated a faster decline in genomic and subgenomic viral RNA in patients with higher neutralizing and S1-specific IgG antibodies (both P
Læs mere Tjek på PubMedWolde, M., Wasihun, Y., Melesse, A., Tadesse, T., Sharma, R., Mon, H. S., Challa, A., Simireta, T., Addisu, H.
BMJ Open, 20.12.2023
Tilføjet 20.12.2023
ObjectiveThis research aimed to assess COVID-19 vaccine acceptance and the factors influencing it among the population of the Somali region in Ethiopia through a cross-sectional COVID-19 survey. DesignCommunity-based cross-sectional study. SettingThe survey was conducted in eight selected districts of the Somali region in Ethiopia from 20 October 2021 to 30 October 2021. ParticipantsParticipants were chosen using simple random sampling and data analysis used Stata V.14. Both bivariable and multivariable binary logistic regression methods were applied, with variables having a p value below 0.2 considered for inclusion in the final model, where statistically significant factors were identified at p
Læs mere Tjek på PubMedMaan, Irfaan; Kohli, Manik; Gilson, Richard
Current Opinion in Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
Purpose of review The 2022 global outbreak of mpox disproportionally affected people with HIV (PWH). We review the data on the presentation, treatment, and prevention of mpox in PWH. Recent findings Most PWH with mpox had a mild and self-limiting illness, no different to people without HIV. A higher rate of rectal symptoms has been reported among PWH and those with advanced HIV disease were at higher risk of severe disease, hospitalization, and death. Treatment with antivirals was widely used in hospitalized patients without any randomized control trial data to support its use and without any data specifically in PWH. Use of smallpox vaccines to prevent mpox is safe in PWH regardless of CD4+ cell count. There is limited data on efficacy in those with lower CD4+ cell count and on long-term protective efficacy. Summary PWH should be offered vaccination against mpox in line with national guidelines. PWH should be individually risk-assessed for severe mpox, based on their CD4+ cell count and co-morbidities and ideally recruited into treatment trials to build an evidence base on efficacy. HIV and other sexually transmitted infection testing should be offered to all people diagnosed with mpox.
Læs mere Tjek på PubMedWaltmann, Andreea; Chen, Jane S.; Duncan, Joseph A.
Current Opinion in Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
Purpose of review While effective vaccines to prevent invasive infections by Neisseria meningitidis have been deployed around the world, development of a vaccine to prevent Neisseria gonorrhoeae has lagged. After multiple failed vaccine candidates, vaccine development for N. gonorrhoeae is showing promise for the first time in several decades. This review highlights recent progress in the field. Recent findings Vaccines containing outer-membrane vesicles (OMV) have been used to manage outbreaks of the serogroup B N. meningitidis in a number of countries. Epidemiologic studies indicate these vaccination campaigns were associated with reductions in reported N. gonorrhoeae infections. Recently, a serogroup B N. meningitidis vaccine containing both recombinant antigens and OMV has been licensed through much of the world. Epidemiologic studies also demonstrate associations between 4CMenB immunization and reduced N. gonorrhoeae infections. Additionally, mathematical modeling studies have begun to identify potential strategies for vaccine deployment to maximize reduction of infections. Summary After several decades with little progress towards an effective gonococcal vaccine, large observational studies have provided evidence that a new generation of group B N. meningitidis vaccines containing OMV have serendipitously restarted the field. Ongoing clinical trials will soon provide definitive evidence regarding the efficacy of these vaccines in preventing N. gonorrhoeae infection.
Læs mere Tjek på PubMedMalaria Journal, 19.12.2023
Tilføjet 19.12.2023
Abstract Background Early phase malaria vaccine field trials typically measure malaria infection by PCR or thick blood smear microscopy performed on serially sampled blood. Vaccine efficacy (VE) is the proportion reduction in an endpoint due to vaccination and is often calculated as VEHR = 1–hazard ratio or VERR = 1–risk ratio. Genotyping information can distinguish different clones and distinguish multiple infections over time, potentially increasing statistical power. This paper investigates two alternative VE endpoints incorporating genotyping information: VEmolFOI, the vaccine-induced proportion reduction in incidence of new clones acquired over time, and VEC, the vaccine-induced proportion reduction in mean number of infecting clones per exposure. Methods Power of VEmolFOI and VEC was compared to that of VEHR and VERR by simulations and analytic derivations, and the four VE methods were applied to three data sets: a Phase 3 trial of RTS,S malaria vaccine in 6912 African infants, a Phase 2 trial of PfSPZ Vaccine in 80 Burkina Faso adults, and a trial comparing Plasmodium vivax incidence in 466 Papua New Guinean children after receiving chloroquine + artemether lumefantrine with or without primaquine (as these VE methods can also quantify effects of other prevention measures). By destroying hibernating liver-stage P. vivax, primaquine reduces subsequent reactivations after treatment completion. Results In the trial of RTS,S vaccine, a significantly reduced number of clones at first infection was observed, but this was not the case in trials of PfSPZ Vaccine or primaquine, although the PfSPZ trial lacked power to show a reduction. Resampling smaller data sets from the large RTS,S trial to simulate phase 2 trials showed modest power gains from VEC compared to VEHR for data like those from RTS,S, but VEC is less powerful than VEHR for trials in which the number of clones at first infection is not reduced. VEmolFOI was most powerful in model-based simulations, but only the primaquine trial collected enough serial samples to precisely estimate VEmolFOI. The primaquine VEmolFOI estimate decreased after most control arm liver-stage infections reactivated (which mathematically resembles a waning vaccine), preventing VEmolFOI from improving power. Conclusions The power gain from the genotyping methods depends on the context. Because input parameters for early phase power calculations are often uncertain, these estimators are not recommended as primary endpoints for small trials unless supported by targeted data analysis. Trial registrations: NCT00866619, NCT02663700, NCT02143934.
Læs mere Tjek på PubMedJournal of the American Medical Association, 19.12.2023
Tilføjet 19.12.2023
New results suggest that a live-virus vaccine intended to protect against shingles—a condition caused by reactivation of the varicella-zoster virus, which also causes chickenpox—prevented illness in 67% of people in the first year after vaccination. But after 10 years, the vaccine’s efficacy against shingles, also known as herpes zoster, had declined to 15%. The study used electronic health record data from more than 500 000 adults aged 50 years or older who received the shot between 2007 and 2018 in California.
Læs mere Tjek på PubMedJournal of the American Medical Association, 19.12.2023
Tilføjet 19.12.2023
Although the proportion of people vaccinated against measles grew to 86% worldwide between 2000 and 2019, that number fell to 81% during the COVID-19 pandemic and still has not returned to prepandemic levels. The decline has left millions vulnerable to the virus, which can cause complications including encephalitis and death, the US Centers for Disease Control and Prevention and World Health Organization wrote in a joint report.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 18.12.2023
Tilføjet 18.12.2023
Abstract Background The recently approved AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine (RSVPreF3 OA) demonstrated high efficacy against RSV-related disease in ≥60-year-olds.Methods This ongoing phase 3 study in ≥60-year-olds evaluates the immune persistence until three years post-RSVPreF3 OA vaccination. Here, we describe interim results on humoral and cell-mediated immunogenicity, reactogenicity, and safety until one year post-dose 1.Results In total, 1653 participants were vaccinated. One month post-dose 1, neutralization titers increased 10.5-fold (RSV-A) and 7.8-fold (RSV-B) versus pre-dose 1. Titers then declined to levels 4.4-fold (RSV-A) and 3.5-fold (RSV-B) above pre-dose 1 at month 6, and remained 3.1-fold (RSV-A) and 2.3-fold (RSV-B) above pre-dose 1 levels after one year. RSVPreF3-binding immunoglobulin G levels and CD4+ T-cell frequencies showed similar kinetics. Solicited administration-site and systemic adverse events (mostly mild to moderate and transient) were reported by 62.2% and 49.5% of participants. Serious adverse events were reported by 3.9% of participants within 6 months post-dose 1; one case was considered vaccine-related.Conclusions One RSVPreF3 OA dose elicited cell-mediated and RSV-A and RSV-B-specific humoral immune responses that declined over time but remained above pre-dose 1 levels for at least one year. The vaccine was well tolerated with an acceptable safety profile.Clinicaltrials.gov NCT04732871.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.12.2023
Tilføjet 17.12.2023
Abstract Background COVID-19 has caused millions of deaths globally, with vulnerable populations such as people experiencing homelessness (PEH) at higher risk. This systematic review and meta-analysis aims to identify the prevalence and key factors contributing to vaccine acceptance experienced by PEH. Methods The protocol of this study was registered in PROSPERO (CRD42023391659). We included studies that reported relevant information about vaccine acceptance or vaccine hesitant/refusal among PEH. Eight databases were systematically searched in January 2023. Meta-analysis was conducted for the prevalence of vaccine acceptance, vaccine uptake, and factors associated with vaccine acceptance. Attitudes toward vaccines were combined into bar charts. Result A total of 29 papers were included in this systematic review and 19 papers were included for meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance among PEH was 66% (95%CI: 58%-73%). Our meta-regression showed vaccine acceptance was significantly increased over time. Moreover, subgroup meta-analysis showed that PEH were more likely to accept the COVID-19 vaccine after June 2021 (78%, 95%CI: 65%-86%) compared with earlier period (56%, 95%CI: 54%-59%). Subgroup meta-analysis also revealed that women and participants without underlying medical condition (chronic diseases) were significantly less likely to accept the COVID-19 vaccine, compared to men and those with medical conditions, respectively. Conclusion The study emphasizes the need for targeted public health interventions aimed at increasing vaccine acceptance among PEH, especially at the early stage of the pandemic, among females, those without underlying medical conditions, being Black (in Canada and the USA), and young people. These interventions should address the common concerns of vaccine safety, adverse effects, effectiveness, and distrust in health care systems. In addition to offering vaccinations in different areas convenient to them, education programs could be established to increase vaccine acceptance among PEH.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.12.2023
Tilføjet 17.12.2023
Abstract Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student’s t and Mann–Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson’s chi-square and Fisher’s exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p
Læs mere Tjek på PubMedJames Yiu Hung Tsoi, Jianpiao Cai, Jianwen Situ, Winston Jim Lam, Estie Hon Kiu Shun, Joy Ka Yi Leung, Lin Lei Chen, Brian Pui Chun Chan, Man Lung Yeung, Xin Li, Kwok Hung Chan, Joshua Sung Chih Wong, Mike Yat Wah Kwan, Kelvin Kai Wang To, Kwok Yung Yuen, Siddharth Sridhar
Journal of Medical Virology, 16.12.2023
Tilføjet 16.12.2023
BMC Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
Abstract Background COVID-19 has caused millions of deaths globally, with vulnerable populations such as people experiencing homelessness (PEH) at higher risk. This systematic review and meta-analysis aims to identify the prevalence and key factors contributing to vaccine acceptance experienced by PEH. Methods The protocol of this study was registered in PROSPERO (CRD42023391659). We included studies that reported relevant information about vaccine acceptance or vaccine hesitant/refusal among PEH. Eight databases were systematically searched in January 2023. Meta-analysis was conducted for the prevalence of vaccine acceptance, vaccine uptake, and factors associated with vaccine acceptance. Attitudes toward vaccines were combined into bar charts. Result A total of 29 papers were included in this systematic review and 19 papers were included for meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance among PEH was 66% (95%CI: 58%-73%). Our meta-regression showed vaccine acceptance was significantly increased over time. Moreover, subgroup meta-analysis showed that PEH were more likely to accept the COVID-19 vaccine after June 2021 (78%, 95%CI: 65%-86%) compared with earlier period (56%, 95%CI: 54%-59%). Subgroup meta-analysis also revealed that women and participants without underlying medical condition (chronic diseases) were significantly less likely to accept the COVID-19 vaccine, compared to men and those with medical conditions, respectively. Conclusion The study emphasizes the need for targeted public health interventions aimed at increasing vaccine acceptance among PEH, especially at the early stage of the pandemic, among females, those without underlying medical conditions, being Black (in Canada and the USA), and young people. These interventions should address the common concerns of vaccine safety, adverse effects, effectiveness, and distrust in health care systems. In addition to offering vaccinations in different areas convenient to them, education programs could be established to increase vaccine acceptance among PEH.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
Abstract Background Solid organ transplant recipients (SOTRs) are at higher risk for severe infection. However, the risk for severe COVID-19 and vaccine effectiveness among SOTRs remain unclear.Methods This retrospective study used a nationwide health care claims database and COVID-19 registry from the Republic of Korea (2020 to 2022). Adult SOTRs diagnosed with COVID-19 were matched with up to 4 non-SOTR COVID-19 patients by propensity score. Severe COVID-19 was defined as treatment with high-flow nasal cannulae, mechanical ventilation, or extracorporeal membrane oxygenation.Results Among 6783 SOTRs with COVID-19, severe COVID-19 was reported with the highest rate in lung transplant recipients (13.16%), followed by the heart (6.30%), kidney (3.90%), and liver (2.40%). SOTRs had a higher risk of severe COVID-19 compared to non-SOTRs, and lung transplant recipients showed the highest risk (adjusted odds ratio, 18.14; 95% confidence interval [CI], 8.53–38.58). Vaccine effectiveness against severe disease among SOTRs was 47% (95% CI, 18%–65%), 64% (95% CI, 49%–75%), and 64% (95% CI, 29%–81%) for 2, 3, and 4 doses, respectively.Conclusions SOTRs are at significantly higher risk for severe COVID-19 compared to non-SOTRs. Vaccination is effective in preventing the progression to severe COVID-19. Efforts should be made to improve vaccine uptake among SOTRs, while additional protective measures should be developed.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Abstract Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student’s t and Mann–Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson’s chi-square and Fisher’s exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Abstract Background and aims Refugees are at higher risk for hepatitis B (HBV) and hepatitis C (HCV), but often face unique healthcare barriers to vaccination, testing, and treatment. This scoping review aimed to identify and characterize HBV and HCV prevention and care services serving refugee populations globally. Methods A literature search was conducted on Embase, Cochrane, and PubMed databases. Research studies published in English between January 2010 to July 2022 describing an HBV or HCV prevention, testing, or treatment intervention for refugees were included. Results There were a total of 69 articles reporting viral hepatitis prevalence, implementation of services, or economic modelling. Of the 38 implementation studies, 14 were stand-alone HBV and/or HCV interventions, while 24 studies included HBV and/or HCV in an intervention targeting multiple infectious diseases and/or parasitic infections. Interventions commonly included a testing (n = 30) or referral (n = 24) component. Frequently reported features to promote program accessibility included bilingual services (n = 25), community partnerships (n = 21), and multidisciplinary staff members (n = 18), such as cultural and/or linguistic mediators, community health workers, community health leaders, lay health workers, local health staff, members of the refugee community, and social workers. The most commonly reported challenge was the transience of refugees (n = 5). Twenty studies noted funding sources, of which twelve reported governmental funding (not including national health insurance) and eight reported that refugees received national health insurance. Conclusions This is the first scoping review to characterize the types of hepatitis prevention, screening, and treatment interventions serving refugee populations globally. Published experiences of HBV and HCV services for refugee populations remain limited. Additional efforts are needed to disseminate models of hepatitis interventions for refugees to ensure access to care for this key population. To achieve hepatitis elimination globally, best practices must be identified and shared to expand access to hepatitis services for refugee populations.
Læs mere Tjek på PubMedAngelica C. Kottkamp, Marie I. Samanovic, Ralf Duerr, Aaron L. Oom, Hayley M. Belli, Jane R. Zucker, Jennifer B. Rosen, Mark J. Mulligan
New England Journal of Medicine, 14.12.2023
Tilføjet 14.12.2023
New England Journal of Medicine, Volume 389, Issue 24, Page 2299-2301, December 2023.
Læs mere Tjek på PubMedKantor, J., Vanderslott, S., Morrison, M., Pollard, A. J., Carlisle, R. C.
BMJ Open, 14.12.2023
Tilføjet 14.12.2023
ObjectivesTo develop and validate the Oxford Needle Experience (ONE) scale, an instrument to assess needle fear, attitudes and expectations in the general population. DesignCross-sectional validation study. SettingInternet-based with participants in the UK and USA. ParticipantsUK and US representative samples stratified by age, sex, and ethnicity using the Prolific Academic platform. Main outcome measuresExploratory factor analysis with categorical variables and a polychoric correlation matrix followed by promax oblique rotation on the UK sample for the ONE scale. Confirmatory factor analysis (CFA) with a Satorra-Bentler scaled test statistic evaluating the root mean squared error of approximation (RMSEA), standardised root mean squared residual (SRMR) and comparative fit index (CFI) on the US sample. Reliability as internal consistency using McDonald’s omega. Convergent validity using the Pearson correlation coefficient. Predictive and discriminant validity using logistic regression ORs of association (OR). ResultsThe population included 1000 respondents, 500 in the UK and 500 in the USA. Minimum average partial correlation and a scree plot suggested four factors should be retained: injection hesitancy, blood-related hesitancy, recalled negative experiences and perceived benefits, yielding a 19-question scale. On CFA, the RMSEA was 0.070 (90% CI, 0.064 to 0.077), SRMR 0.053 and CFI 0.925. McDonald’s omega was 0.92 and 0.93 in the UK and US samples, respectively. Convergent validity with the four-item Oxford Coronavirus Explanations, Attitudes and Narratives Survey (OCEANS) needle fear scale demonstrated a strong correlation (r=0.83). Predictive validity with a single-question COVID-19 vaccination status question demonstrated a strong association, OR (95% CI) 0.97 (0.96 to 0.98), p
Læs mere Tjek på PubMedRamia Zakhour, Hani Tamim, Farah Faytrouni, Maha Makki, Rayan Hojeij, Lama Charafeddine
PLoS One Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
by Ramia Zakhour, Hani Tamim, Farah Faytrouni, Maha Makki, Rayan Hojeij, Lama Charafeddine Introduction Human papillomavirus (HPV) is the most common sexually transmitted infection. HPV is responsible for cancer of cervix uteri. Despite its safety and immunogenicity, HPV vaccine hesitancy is one of the most challenging topics that pediatricians face. Methods We aimed to describe the impact of knowledge, attitude, and practice towards vaccines in general, on practice related to HPV vaccination in Lebanon. A questionnaire addressed to parents of students (3–18 years of age) was distributed in 2 public and 2 private schools randomly selected from the greater Beirut area during the school year 2017–2018. Questionnaires covered knowledge, attitude, and practices of vaccination in general and HPV vaccine in particular. Results Out of 400 distributed questionnaires, 306 (76.5%) were returned. Of the 185 parents aware of HPV vaccine, 60% hadn’t given or were not planning to give the HPV vaccine to their children. Of parents not in favor of HPV vaccine, 7.5 thought that vaccines aren’t necessary versus none among those in favor of HPV vaccine(p = 0.02). Thirteen percent of those not in favor of HPV vaccine thought that vaccines are not safe versus 2.7% in the group in favor (p = 0.02). An effect of gender on vaccine acceptance was noted: mothers vs fathers and daughters vs sons. Lack of recommendation by pediatricians and the thought that too little is known about the vaccine were the most selected reasons for parents not wanting to vaccinate their children against HPV, whereas cost and religious and cultural beliefs seemed to have no impact. Conclusion Most parents in our study did not vaccinate or weren’t willing to vaccinate their children against HPV even when they were in favor of vaccines in general. Physician recommendation was shown to be one of the most important predictors of vaccination. Effort should be put into educating parents about the importance of the vaccine and its well-established safety and efficacy regardless of gender. Lebanese physicians should also be educated and empowered to recommend HPV vaccine more strongly and consistently.
Læs mere Tjek på PubMedAmber Sacre, Clare Bambra, Josephine M. Wildman, Katie Thomson, Natalie Bennett, Sarah Sowden, Adam Todd
PLoS One Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
by Amber Sacre, Clare Bambra, Josephine M. Wildman, Katie Thomson, Natalie Bennett, Sarah Sowden, Adam Todd This global umbrella review aimed to synthesise evidence of socioeconomic inequalities in the uptake of routine vaccinations and identify the mechanisms that may contribute to the association. To our knowledge, no attempt has been made to synthesise the global body of systematic reviews across a variety of vaccines, geographical locations, and measures of SES. The inclusion criteria were as follows: studies assessing vaccination uptake according to education, income, occupation/employment, and/or area-level deprivation; any country or universally recommended routine vaccination (according to the WHO); qualitative or quantitative reviews, published 2011-present. The searches were performed in eight databases. The screening process followed PRISMA-E guidelines, each stage was performed by one reviewer, and a 10% sample checked by a second for consistency. Included reviews underwent data extraction, quality appraisal (AMSTAR-2), and narrative synthesis according to country-context. After deduplication, 9,163 reports underwent title and abstract screening, leaving 119 full texts to be assessed for eligibility. Overall, 26 studies were included in the umbrella review. Evidence for lower uptake amongst disadvantaged SES individuals was found in all 26 reviews. However, 17 reviews showed mixed results, as inverse associations were also identified (lower uptake for advantaged SES, and/or higher uptake for disadvantaged SES). Those that explored high-income countries had a greater prevalence of mixed findings than those focusing on low/middle-income countries. The two most frequently cited mechanisms were vaccination knowledge, and confidence in vaccination or vaccination providers. These mechanisms were often understood by review authors as varying by level of education. We find socioeconomic differences in routine vaccination uptake, but the association did not always follow a gradient. Whilst education may be associated with uptake globally, our study indicates that its role varies by country-context. A limitation is the overlap of some primary studies across the included systematic reviews.
Læs mere Tjek på PubMedLouise Benning, Marie Bartenschlager, Heeyoung Kim, Florian Kälble, Christian Nusshag, Mirabel Buylaert, Paula Reichel, Matthias Schaier, Christian Morath, Martin Zeier, Paul Schnitzler, Ralf Bartenschlager, Claudius Speer
Journal of Medical Virology, 12.12.2023
Tilføjet 12.12.2023
Heng-Jui Chang, Sin-Hua Moi, Yu-Jiun Chan, Tzuo-Yun Lan
PLoS One Infectious Diseases, 11.12.2023
Tilføjet 11.12.2023
by Heng-Jui Chang, Sin-Hua Moi, Yu-Jiun Chan, Tzuo-Yun Lan Background Benign prostatic hyperplasia (BPH) is common in aging Asian males and is associated with an excess risk of developing prostate cancer (PCa). However, discussions about socially-sensitive experiences such as sexual activity, which can significantly predict PCa risk, may be considered stigmatized in Asian culture. This study aimed to develop a predictive model for PCa risk in Asian males with BPH using non-socially-sensitive information. Methods A cross-sectional case-control study, with PCa patients as the cases and remaining as the controls, was conducted on a cohort of Taiwanese males with BPH from four medical institutions. Patients who met the inclusion criteria were enrolled, excluding those aged over 86 years or who had received human papillomavirus (HPV) vaccination. Non-socially-sensitive variables such as obesity, occupational exposure, HPV infection, and PCa family history score (FH score) were included in a fully adjusted logistic regression model, and depicted using a nomogram. Results Among 236 BPH patients, 45.3% had PCa. Obesity, occupational exposure, HPV infection, and family history of PCa were significantly associated with PCa risk. The FH score (OR = 1.89, 95% CI = 1.03–3.47, P = 0.041) had the highest impact, followed by HPV infection (OR = 1.47, 95% CI = 1.03–2.11, P = 0.034), occupational exposure (OR = 1.32, 95% CI = 1.15–1.51, P
Læs mere Tjek på PubMedMweso, O., Simwanza, J., Malambo, W., Banda, D., Fwoloshi, S., Sinyange, N., Yoo, Y. M., Feldstein, L. R., Kapina, M., Mulenga, L. B., Liwewe, M. M., Musonda, K., Kapata, N., Mwansa, F. D., Agolory, S., Bobo, P., Hines, J., Chilengi, R.
BMJ Open, 10.12.2023
Tilføjet 10.12.2023
ObjectivesThe study aim was to evaluate vaccine effectiveness (VE) of COVID-19 vaccines in preventing symptomatic COVID-19 among healthcare workers (HCWs) in Zambia. We sought to answer the question, ‘What is the vaccine effectiveness of a complete schedule of the SARS-CoV-2 vaccine in preventing symptomatic COVID-19 among HCWs in Zambia?’ Design/settingWe conducted a test-negative case–control study among HCWs across different levels of health facilities in Zambia offering point of care testing for COVID-19 from May 2021 to March 2022. Participants1767 participants entered the study and completed it. Cases were HCWs with laboratory-confirmed SARS-CoV-2 and controls were HCWs who tested SARS-CoV-2 negative. Consented HCWs with documented history of vaccination for COVID-19 (vaccinated HCWs only) were included in the study. HCWs with unknown test results and unknown vaccination status, were excluded. Primary and secondary outcome measuresThe primary outcome was VE among symptomatic HCWs. Secondary outcomes were VE by: SARS-CoV-2 variant strains based on the predominant variant circulating in Zambia (Delta during May 2021 to November 2021 and Omicron during December 2021 to March 2022), duration since vaccination and vaccine product. ResultsWe recruited 1145 symptomatic HCWs. The median age was 30 years (IQR: 26–38) and 789 (68.9%) were women. Two hundred and eighty-two (24.6%) were fully vaccinated. The median time to full vaccination was 102 days (IQR: 56–144). VE against symptomatic SARS-CoV-2 infection was 72.7% (95% CI: 61.9% to 80.7%) for fully vaccinated participants. VE was 79.4% (95% CI: 58.2% to 90.7%) during the Delta period and 37.5% (95% CI: –7.0% to 63.3%) during the Omicron period. ConclusionsCOVID-19 vaccines were effective in reducing symptomatic SARS-CoV-2 among Zambian HCWs when the Delta variant was circulating but not when Omicron was circulating. This could be related to immune evasive characteristics and/or waning immunity. These findings support accelerating COVID-19 booster dosing with bivalent vaccines as part of the vaccination programme to reduce COVID-19 in Zambia.
Læs mere Tjek på PubMedTuan, W.-J., Kindt, H. M., Lennon, R. P.
BMJ Open, 10.12.2023
Tilføjet 10.12.2023
ObjectiveDespite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The study assessed the risk of COVID-19 reinfection and severe illness among adults with SUD and their vaccination status to inform management in this vulnerable population as the pandemic continues. DesignRetrospective cohort study. SettingNationwide electronic health records (TriNetX database) in the USA among adults with COVID-19 infection from January 2020 to June 2022. ParticipantsAdults (age ≥18 years) who were infected by COVID-19, excluding those who had cancer or lived in nursing homes or palliative care facilities. Outcome measuresCOVID-19 reinfection was defined as a new diagnosis after 45 days of the initial infection. Logistic regression was applied to assess the OR of COVID-19 reinfection and severe outcomes within 30 day of reinfection for adults with alcohol (AUD), opioid (OUD), cocaine (CUD), stimulant (STUD), cannabis (CAUD) and other use disorders, controlled for demographic and comorbid conditions. ResultsThe SUD cohort was 13%–29% more likely to be reinfected by COVID-19 and had significantly higher 30-day mortality. Adults with AUD, STUD and OUD were at greater risks (adjusted ORs, AORs=1.69–1.86) of emergency department, hospital and intensive care admissions after 30 days of reinfection. Individuals with SUD and multiple vaccines doses were associated with decreased risks of worse COVID-19 outcomes. Lower COVID-19 reinfection rates (AORs=0.67–0.84) were only found among individuals with AUD, CUD or CAUD who had COVID-19 vaccination. ConclusionsIndividuals with SUD had greater risks of COVID-19 reinfection and poor outcomes, especially those with OUD, STUD and AUD. Multiple vaccinations are recommended to reduce severe illness after COVID-19 reinfection in the SUD population.
Læs mere Tjek på PubMedMantina, N. M., Nakayima Miiro, F., Smith, J., McClelland, D. J., Magrath, P. A., Madhivanan, P.
BMJ Open, 10.12.2023
Tilføjet 10.12.2023
IntroductionHuman papillomavirus (HPV) is the causative agent of nearly all cervical cancers. Despite the proven safety and efficacy of HPV vaccines in preventing HPV-related cancers, the global vaccine coverage rate is estimated to only be 15%. HPV vaccine coverage rates are more actively tracked and reported for adolescents 17 years and younger but there is still a critical window of opportunity to intervene and promote HPV vaccination among young adults aged 18–26 years who are still eligible to be vaccinated. This protocol for a qualitative evidence synthesis aims to review perspectives of HPV vaccination among young adults (18–26 years) and identify facilitators and barriers that influence HPV vaccination uptake and decision-making. Methods and analysisSeven databases will be searched from 1 January 2006 to the date of final search. For inclusion, studies must report HPV vaccination perspectives of young adults aged 18–26 years and use qualitative study methods or analysis techniques. Studies will be screened in a two-stage process guided by the eligibility criteria. Final included studies will be evaluated for methodological strengths and limitations using the Critical Appraisal Skills Programme quality assessment tool for qualitative studies. After data extraction, framework analysis will be used to analyse the data applying the socioecological model. Finally, the Grading of Recommendations Assessment, Development and Evaluation - Confidence in the Evidence from Reviews of Qualitative research will be applied to evaluate the confidence in synthesised qualitative findings. The methodology of this review follows the Cochrane Handbook guidelines on qualitative evidence syntheses. Ethics and disseminationFormal ethical approval is not required for this study. Findings will be disseminated through peer-reviewed publications, conference presentations and professional networks. PROSPERO registration numberCRD42023417052.
Læs mere Tjek på PubMedFischer, H.-T., Müller, K., Wenham, C., Hanefeld, J.
BMJ Open, 10.12.2023
Tilføjet 10.12.2023
IntroductionFour years after the devastating Ebola outbreak, governments in West Africa were quick to implement non-pharmaceutical interventions (NPIs) in response to the rapid spread of SARS-CoV-2. The NPIs implemented included physical distancing, closure of schools and businesses, restrictions on public gatherings and mandating the use of face masks among others. In the absence of widely available vaccinations, NPIs were the only known means to try to slow the spread of COVID-19. While numerous studies have assessed the effectiveness of these NPIs in high-income countries, less is known about the processes that lead to the adoption of policies and the factors that influence their implementation and adherence in low-income and middle-income countries. The objective of this scoping review is to understand the extent and type of evidence in relation to the policy formulation, decision-making and implementation stages of NPIs in West Africa. Methods and analysisA scoping review will be undertaken following the guidance developed by Arskey and O’Malley, the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA guidelines for Scoping Reviews. Both peer-reviewed and grey literature will be searched using Web of Science, Embase, Scopus, APA PsycInfo, WHO Institutional Repository for Information Sharing, JSTOR and Google Advanced Search, and by searching the websites of the WHO, and the West African Health Organisation. Screening will be conducted by two reviewers based on inclusion and exclusion criteria, and data will be extracted, coded and narratively synthesised. Ethics and disseminationWe started this scoping review in May 2023, and anticipate finishing by April 2024. Ethics approval is not required since we are not collecting primary data. This protocol was registered at Open Science Framework (https://osf.io/gvek2/). We plan to disseminate this research through publications, conference presentations and upcoming West African policy dialogues on pandemic preparedness and response.
Læs mere Tjek på PubMedLoria, V., Aparicio, A., Hildesheim, A., Cortes, B., Barrientos, G., Retana, D., Sun, K., Ocampo, R., Prevots, D. R., Zuniga, M., Waterboer, T., Wong-McClure, R., Morera, M., Butt, J., Binder, M., Abdelnour, A., Calderon, A., Gail, M. H., Pfeiffer, R. M., Solis, C. B., Fantin, R., Vanegas, J. C., Mercado, R., Avila, C., Porras, C., Herrero, R.
BMJ Open, 9.12.2023
Tilføjet 9.12.2023
PurposeThe RESPIRA cohort aims to describe the nature, magnitude, time course and efficacy of the immune response to SARS-CoV-2 infection and vaccination, population prevalence, and household transmission of COVID-19. ParticipantsFrom November 2020, we selected age-stratified random samples of COVID-19 cases from Costa Rica confirmed by PCR. For each case, two population-based controls, matched on age, sex and census tract were recruited, supplemented with hospitalised cases and household contacts. Participants were interviewed and blood and saliva collected for antibodies and PCR tests. Participants will be followed for 2 years to assess antibody response and infection incidence. Findings to dateRecruitment included 3860 individuals: 1150 COVID-19 cases, 1999 population controls and 719 household contacts from 304 index cases. The age and regional distribution of cases was as planned, including four age strata, 30% rural and 70% urban. The control cohort had similar sex, age and regional distribution as the cases according to the study design. Among the 1999 controls recruited, 6.8% reported at enrolment having had COVID-19 and an additional 12.5% had antibodies against SARS-CoV-2. Compliance with visits and specimens has been close to 70% during the first 18 months of follow-up. During the study, national vaccination was implemented and nearly 90% of our cohort participants were vaccinated during follow-up. Future plansRESPIRA will enable multiple analyses, including population prevalence of infection, clinical, behavioural, immunological and genetic risk factors for SARS-CoV-2 acquisition and severity, and determinants of household transmission. We are conducting retrospective and prospective assessment of antibody levels, their determinants and their protective efficacy after infection and vaccination, the impact of long-COVID and a series of ancillary studies. Follow-up continues with bimonthly saliva collection for PCR testing and biannual blood collection for immune response analyses. Follow-up will be completed in early 2024. Trial registration numberNCT04537338.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.12.2023
Tilføjet 9.12.2023
Abstract Background and aims Refugees are at higher risk for hepatitis B (HBV) and hepatitis C (HCV), but often face unique healthcare barriers to vaccination, testing, and treatment. This scoping review aimed to identify and characterize HBV and HCV prevention and care services serving refugee populations globally. Methods A literature search was conducted on Embase, Cochrane, and PubMed databases. Research studies published in English between January 2010 to July 2022 describing an HBV or HCV prevention, testing, or treatment intervention for refugees were included. Results There were a total of 69 articles reporting viral hepatitis prevalence, implementation of services, or economic modelling. Of the 38 implementation studies, 14 were stand-alone HBV and/or HCV interventions, while 24 studies included HBV and/or HCV in an intervention targeting multiple infectious diseases and/or parasitic infections. Interventions commonly included a testing (n = 30) or referral (n = 24) component. Frequently reported features to promote program accessibility included bilingual services (n = 25), community partnerships (n = 21), and multidisciplinary staff members (n = 18), such as cultural and/or linguistic mediators, community health workers, community health leaders, lay health workers, local health staff, members of the refugee community, and social workers. The most commonly reported challenge was the transience of refugees (n = 5). Twenty studies noted funding sources, of which twelve reported governmental funding (not including national health insurance) and eight reported that refugees received national health insurance. Conclusions This is the first scoping review to characterize the types of hepatitis prevention, screening, and treatment interventions serving refugee populations globally. Published experiences of HBV and HCV services for refugee populations remain limited. Additional efforts are needed to disseminate models of hepatitis interventions for refugees to ensure access to care for this key population. To achieve hepatitis elimination globally, best practices must be identified and shared to expand access to hepatitis services for refugee populations.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.12.2023
Tilføjet 9.12.2023
Abstract Background The characteristics of otological symptoms in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are lacking. Almost no research has been conducted to explore the emergence of otological symptoms after coronavirus disease 2019 infection. The aims of this study were to investigate the prevalence and specific clinical characteristics of and risk factors for otological symptoms among patients with SARS-CoV-2 infection. Methods We included two groups to investigate the prevalence and clinical characteristics of otological symptoms among patients with SARS-CoV-2 infection. The first sample (S1) was drawn retrospectively from four communities via questionnaires, and the second sample (S2) from an outpatient clinic. Results A total of 189 participants were included in S1 (124 women [65.6%]; mean [standard deviation (SD)] age, 33.66 [13.56] years), and 47 in S2 (25 women [53.2%]; mean [SD] age, 45.28 [14.64] years). The most prevalent otological symptoms in S1 were dizziness (15.9%), tinnitus (7.9%), aural fullness (6.9%), otalgia (5.3%), hearing loss (1.6%), and otopyorrhoea (1.1%). Moreover, for each additional typical symptom of SARS-CoV-2 infection, the risk (odds ratio) of otological symptoms increased by 1.33 (95% confidence interval: 1.10–1.61, p = 0.003). The prevalence of aural fullness was higher in the unvaccinated group than that in the group receiving two or three vaccinations (p = 0.018). Conclusions Various otological symptoms may occur in patients with SARS-CoV-2 infection. The number of typical symptoms of SARS-CoV-2 infection is positively associated with the probability of otological symptoms. However, vaccination may reduce the probability of certain otological symptoms.
Læs mere Tjek på PubMedInfection, 9.12.2023
Tilføjet 9.12.2023
Abstract Respiratory syncytial virus (RSV) inflicts severe illness and courses of infections not only in neonates, infants, and young children, but also causes significant morbidity and mortality in older adults and in people with immunosuppression, hemato-oncologic disease, chronic lung disease, or cardiovascular disease. In June and August 2023, effective vaccines against RSV were approved for the first time by the European Medicines Agency (EMA) for the EU. The respective pivotal studies showed a very high efficacy of the vaccine in preventing severe RSV-associated respiratory infections. At this point, use of the respective vaccines is restricted to persons aged 60 years or older, according to the registration studies. We therefore recommend use of the vaccination in persons aged 60 years or older. In addition, we recommend use of the vaccination in adults of any age with severe pulmonary or cardiovascular pre-existing conditions, as well as in adults with significant immune compromise, after individual consultation with the treating physician. Cost coverage can be applied for individually with the responsible health insurance company.
Læs mere Tjek på PubMedInfection, 9.12.2023
Tilføjet 9.12.2023
Sam Hogan, Andrew Page, Sameer Dixit, Kate A. McBride
PLoS One Infectious Diseases, 9.12.2023
Tilføjet 9.12.2023
by Sam Hogan, Andrew Page, Sameer Dixit, Kate A. McBride Background Hepatitis B virus (HBV) is a major source of disease burden worldwide, with an estimated 296 million individuals living with infections worldwide. Although vaccine programs exist to control infections, certain sub-populations around the world continue to have very high prevalence of HBV infection. Methods A systematic search of studies of HBV published after 2010 was conducted for India, Pakistan, Bangladesh, Nepal, Sri Lanka and Bhutan. Each paper was independently screened for risk of bias and inclusion. Data were extracted from included studies before being analysed to estimate pooled prevalence, and to conduct sub-group analyses. Random-effects models were used for estimating summary prevalence due to a high level of heterogeneity between studies, and funnel plots were combined with Egger’s test to assess publication bias. Meta-regression was conducted to investigate sources of between-study heterogeneity. Results The pooled prevalence of HBV across all studies was 3% (95% CI 0.02, 0.05). For countries with multiple studies, the pooled prevalence in India was 3% (95% CI 0.02, 0.04), in Pakistan 6% (95% CI 0.03, 0.09), in Bangladesh 5% (95% CI of 0.02, 0.12), and in Nepal 1% (95% CI 0.00, 0.08). There was some evidence of publication bias, and a high level of heterogeneity across studies. Risk of bias analysis found most studies to be of fair or moderate quality. Conclusions The prevalence of HBV among countries in the sub-continent was higher than the global average, but was not as high as some other regions. Countries with greater numbers of displaced persons had higher prevalence of HBV, with a wide range of prevalence between subpopulations likely reflecting differential uptake, and implementation, of vaccination programs.
Læs mere Tjek på PubMedBurenjargal Batmunkh, Dashpagma Otgonbayar, Shatar Shaarii, Nansalmaa Khaidav, Oyu-Erdene Shagdarsuren, Gantuya Boldbaatar, Nandin-Erdene Danzan, Myagmartseren Dashtseren, Tsolmon Unurjargal, Ichinnorov Dashtseren, Munkhbaatar Dagvasumberel, Davaalkham Jagdagsuren, Oyunbileg Bayandorj, Baasanjargal Biziya, Seesregdorj Surenjid, Khongorzul Togoo, Ariunzaya Bat-Erdene, Zolmunkh Narmandakh, Gansukh Choijilsuren, Ulziisaikhan Batmunkh, Chimidtseren Soodoi, Enkh-Amar Boldbaatar, Ganbaatar Byambatsogt, Otgonjargal Byambaa, Zolzaya Deleg, Gerelmaa Enebish, Bazardari Chuluunbaatar, Gereltsetseg Zulmunkh, Bilegtsaikhan Tsolmon, Batbaatar Gunchin, Battogtokh Chimeddorj, Davaalkham Dambadarjaa, Tsogtsaikhan Sandag
PLoS One Infectious Diseases, 9.12.2023
Tilføjet 9.12.2023
by Burenjargal Batmunkh, Dashpagma Otgonbayar, Shatar Shaarii, Nansalmaa Khaidav, Oyu-Erdene Shagdarsuren, Gantuya Boldbaatar, Nandin-Erdene Danzan, Myagmartseren Dashtseren, Tsolmon Unurjargal, Ichinnorov Dashtseren, Munkhbaatar Dagvasumberel, Davaalkham Jagdagsuren, Oyunbileg Bayandorj, Baasanjargal Biziya, Seesregdorj Surenjid, Khongorzul Togoo, Ariunzaya Bat-Erdene, Zolmunkh Narmandakh, Gansukh Choijilsuren, Ulziisaikhan Batmunkh, Chimidtseren Soodoi, Enkh-Amar Boldbaatar, Ganbaatar Byambatsogt, Otgonjargal Byambaa, Zolzaya Deleg, Gerelmaa Enebish, Bazardari Chuluunbaatar, Gereltsetseg Zulmunkh, Bilegtsaikhan Tsolmon, Batbaatar Gunchin, Battogtokh Chimeddorj, Davaalkham Dambadarjaa, Tsogtsaikhan Sandag The SARS-CoV-2 vaccination campaign began in February 2021 and achieved a high rate of 62.7% of the total population fully vaccinated by August 16, 2021, in Mongolia. We aimed to assess the initial protective antibody production after two doses of a variety of types of SARS-CoV-2 vaccines in the Mongolian pre-vaccine antibody-naïve adult population. This prospective study was conducted from March-April to July-August of 2021. All participants received one of the four government-proposed COVID-19 vaccines including Pfizer/BioNTech (BNT162b2), AstraZeneca (ChAdOx1-S), Sinopharm (BBIBP-CorV), and Sputnik V (Gam-COVID-Vac). Before receiving the first shot, anti-SARS-CoV-2 S-RBD human IgG titers were measured in all participants (n = 1833), and titers were measured 21–28 days after the second shot in a subset of participants (n = 831). We found an overall average protective antibody response of 84.8% (705 of 831 vaccinated) in 21–28 days after two doses of the four types of COVID-19 vaccines. Seropositivity and titer of protective antibodies produced after two shots of vaccine were associated with the vaccine types, age, and residence of vaccinees. Seropositivity rate varied significantly between vaccine types, 80.0% (28 of 35) for AstraZeneca ChAdOx1-S; 97.0% (193 of 199) for Pfizer BNT162b2; 80.7% (474 of 587) for Sinopharm BBIBP-CorV, and 100.0% (10 of 10) for Sputnik V Gam-COVID-Vac, respectively. Immunocompromised vaccinees with increased risk for developing severe COVID-19 disease had received the Pfizer vaccine and demonstrated a high rate of seropositivity. A high geometric mean titer (GMT) was found in vaccinees who received BNT162b2, while vaccinees who received ChAdOx1-S, Sputnik V, and BBIBP-CorV showed a lower GMT. In summary, we observed first stages of the immunization campaign against COVID-19 in Mongolia have been completed successfully, with a high immunogenicity level achieved among the population with an increased risk for developing severe illness.
Læs mere Tjek på PubMedF.A. Niessen, A.R. de Boer, C.H. van Werkhoven
Clinical Microbiology and Infection, 8.12.2023
Tilføjet 8.12.2023
There is an ongoing interest in immunization as a means to reduce antibiotic use and mitigate antibiotic resistance. However, the overall effect of vaccination on antibiotic use is not as simple as extrapolating the direct protective effect against the infection of interest. Additional to the direct effect of vaccination, indirect effects may contribute to the effect on antibiotic consumption in different directions. For example, pneumococcal vaccination of infants reduces carriage of vaccine-type pneumococcal strains and replacement by non-vaccine serotypes which changes the epidemiology in older adults as well (1).
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.12.2023
Tilføjet 8.12.2023
Abstract Background The characteristics of otological symptoms in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are lacking. Almost no research has been conducted to explore the emergence of otological symptoms after coronavirus disease 2019 infection. The aims of this study were to investigate the prevalence and specific clinical characteristics of and risk factors for otological symptoms among patients with SARS-CoV-2 infection. Methods We included two groups to investigate the prevalence and clinical characteristics of otological symptoms among patients with SARS-CoV-2 infection. The first sample (S1) was drawn retrospectively from four communities via questionnaires, and the second sample (S2) from an outpatient clinic. Results A total of 189 participants were included in S1 (124 women [65.6%]; mean [standard deviation (SD)] age, 33.66 [13.56] years), and 47 in S2 (25 women [53.2%]; mean [SD] age, 45.28 [14.64] years). The most prevalent otological symptoms in S1 were dizziness (15.9%), tinnitus (7.9%), aural fullness (6.9%), otalgia (5.3%), hearing loss (1.6%), and otopyorrhoea (1.1%). Moreover, for each additional typical symptom of SARS-CoV-2 infection, the risk (odds ratio) of otological symptoms increased by 1.33 (95% confidence interval: 1.10–1.61, p = 0.003). The prevalence of aural fullness was higher in the unvaccinated group than that in the group receiving two or three vaccinations (p = 0.018). Conclusions Various otological symptoms may occur in patients with SARS-CoV-2 infection. The number of typical symptoms of SARS-CoV-2 infection is positively associated with the probability of otological symptoms. However, vaccination may reduce the probability of certain otological symptoms.
Læs mere Tjek på PubMedSe Eun Kim, So Hee Park, Woo-Jung Park, Gayeong Kim, Seo Yeon Kim, Hyeran Won, Yun-Ho Hwang, Heeji Lim, Hyeon Guk Kim, You-Jin Kim, Dokeun Kim, Jung-Ah Lee
PLoS One Infectious Diseases, 8.12.2023
Tilføjet 8.12.2023
by Se Eun Kim, So Hee Park, Woo-Jung Park, Gayeong Kim, Seo Yeon Kim, Hyeran Won, Yun-Ho Hwang, Heeji Lim, Hyeon Guk Kim, You-Jin Kim, Dokeun Kim, Jung-Ah Lee Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 and caused the coronavirus disease 2019 (COVID-19) pandemic worldwide. As of September 2023, the number of confirmed coronavirus cases has reached over 770 million and caused nearly 7 million deaths. The World Health Organization assigned and informed the characterization of variants of concern (VOCs) to help control the COVID-19 pandemic through global monitoring of circulating viruses. Although many vaccines have been proposed, developing an effective vaccine against variants is still essential to reach the endemic stage of COVID-19. We designed five DNA vaccine candidates composed of the first isolated genotype and major SARS-CoV-2 strains from isolated Korean patients classified as VOCs, such as Alpha, Beta, Gamma, and Delta. To evaluate the immunogenicity of each genotype via homologous and heterologous vaccination, mice were immunized twice within a 3-week interval, and the blood and spleen were collected 1 week after the final vaccination to analyze the immune responses. The group vaccinated with DNA vaccine candidates based on the S genotype and the Alpha and Beta variants elicited both humoral and cellular immune responses, with higher total IgG levels and neutralizing antibody responses than the other groups. In particular, the vaccine candidate based on the Alpha variant induced a highly diverse cytokine response. Additionally, we found that the group subjected to homologous vaccination with the S genotype and heterologous vaccination with S/Alpha induced high total IgG levels and a neutralization antibody response. Homologous vaccination with the S genotype and heterologous vaccination with S/Alpha and S/Beta significantly induced IFN-γ immune responses. The immunogenicity after homologous vaccination with S and Alpha and heterologous vaccination with the S/Alpha candidate was better than that of the other groups, indicating the potential for developing novel DNA vaccines against different SARS-CoV-2 variants.
Læs mere Tjek på PubMedBinyaruka, P., Mtenga, S. M., Mashasi, I., Karugu, C. H., Mohamed, S. F., Asiki, G., Mair, F. S., Gray, C. M.
BMJ Open, 8.12.2023
Tilføjet 8.12.2023
BackgroundPeople with type 2 diabetes (T2D) are at increased risk of poor outcomes from COVID-19. Vaccination can improve outcomes, but vaccine hesitancy remains a major challenge. We examined factors influencing COVID-19 vaccine uptake among people with T2D in two sub-Saharan Africa countries that adopted different national approaches to combat COVID-19, Kenya and Tanzania. MethodsA mixed-methods study was conducted in February-March 2022, involving a survey of 1000 adults with T2D (500 Kenya; 500 Tanzania) and 51 in-depth interviews (21 Kenya; 30 Tanzania). Determinants of COVID-19 vaccine uptake were identified using a multivariate logistic regression model, while thematic content analysis explored barriers and facilitators. ResultsCOVID-19 vaccine uptake was lower in Tanzania (26%) than in Kenya (75%), which may reflect an initial political hesitancy about vaccines in Tanzania. People with college/university education were four times more likely to be vaccinated than those with no education (Kenya AOR=4.25 (95% CI 1.00 to 18.03), Tanzania AOR=4.07 (1.03 to 16.12)); and people with health insurance were almost twice as likely to be vaccinated than those without health insurance (Kenya AOR=1.70 (1.07 to 2.70), Tanzania AOR=1.81 (1.04 to 3.13)). Vaccine uptake was higher in older people in Kenya, and among those with more comorbidities and higher socioeconomic status in Tanzania. Interviewees reported that wanting protection from severe illness promoted vaccine uptake, while conflicting information, misinformation and fear of side-effects limited uptake. ConclusionCOVID-19 vaccine uptake among people with T2D was suboptimal, particularly in Tanzania, where initial political hesitancy had a negative impact. Policy-makers must develop strategies to reduce fear and misconceptions, especially among those who are less educated, uninsured and younger.
Læs mere Tjek på PubMedWang, M., Hu, M., Wang, Y., Long, C., Xia, Y., Zhu, D., Zhao, W., Yuan, B., He, P.
BMJ Open, 8.12.2023
Tilføjet 8.12.2023
ObjectiveAlthough the herpes zoster vaccine has been available in mainland China since June 2020, residents’ knowledge of herpes zoster and the herpes zoster vaccine is poor, and vaccination rates are low, especially among the elderly, who are at high risk for herpes zoster. This study assessed willingness to be vaccinated against herpes zoster and factors associated with vaccination among urban residents in China. MethodsA mixed-methods study was conducted in community health centres from August 2022 to September 2022. We used convenience sampling to select 2864 residents from 9 Chinese cities for the quantitative study and 67 adults for the qualitative study. A structured questionnaire was used for the quantitative study, and data were collected through face-to-face interviews. Multinomial logistic regression was used to analyse factors associated with willingness to vaccinate. Qualitative data were analysed using thematic analysis of barriers to herpes zoster vaccination. ResultsA total of 2864 eligible respondents were included in the study. Of these, 42.67% intended to receive the herpes zoster vaccine, 21.44% refused and 35.89% were hesitant. The results of the quantitative and qualitative analyses showed that the factors associated with respondents’ willingness to be vaccinated against herpes zoster included: personal characteristics such as gender, age and income; knowledge and attitudes about herpes zoster and the vaccine; vaccine characteristics such as efficacy, safety and price; and other factors such as pain tolerance and accessibility to vaccination. ConclusionThe low willingness to vaccinate, especially among the elderly, is mainly related to their poor knowledge and negative attitude towards the infection and vaccination. Therefore, health education about herpes zoster, immunisation promotion, and improvement of accessibility and affordability would be valuable in China.
Læs mere Tjek på PubMedJinyoung Yang, Hye‐Jin Kim, Jun‐Won Kim, Jin Yang Baek, Young Jae Lee, Ju‐yeon Choi, Su‐Hwan Kim, Hyeonji Jeong, Eun Joo Chung, Gi‐eun Rhie, Byoung Kwon Park, So‐Young Lee, Kyong Ran Peck, Byoungguk Kim, Jae‐Hoon Ko
Journal of Medical Virology, 7.12.2023
Tilføjet 7.12.2023
Infection, 7.12.2023
Tilføjet 7.12.2023
Abstract Respiratory syncytial virus (RSV) inflicts severe illness and courses of infections not only in neonates, infants, and young children, but also causes significant morbidity and mortality in older adults and in people with immunosuppression, hemato-oncologic disease, chronic lung disease, or cardiovascular disease. In June and August 2023, effective vaccines against RSV were approved for the first time by the European Medicines Agency (EMA) for the EU. The respective pivotal studies showed a very high efficacy of the vaccine in preventing severe RSV-associated respiratory infections. At this point, use of the respective vaccines is restricted to persons aged 60 years or older, according to the registration studies. We therefore recommend use of the vaccination in persons aged 60 years or older. In addition, we recommend use of the vaccination in adults of any age with severe pulmonary or cardiovascular pre-existing conditions, as well as in adults with significant immune compromise, after individual consultation with the treating physician. Cost coverage can be applied for individually with the responsible health insurance company.
Læs mere Tjek på PubMedInfection, 6.12.2023
Tilføjet 6.12.2023
Infection, 6.12.2023
Tilføjet 6.12.2023
Journal of the American Medical Association, 6.12.2023
Tilføjet 6.12.2023
To the Editor A recent Review recommended human papillomavirus (HPV) testing as the primary screening test for cervical cancer. However, the authors neglected to explore the consequences of endorsing HPV primary screening over cotesting, which includes cytological evaluation. The authors did not discuss the importance of HPV-negative neoplasms. These cases include cervical intraepithelial neoplasia grade 3 or worse (CIN3+) lesions (false-negative results as well as HPV subtypes not included in commonly used HPV testing kits) and neoplasms that are not caused by HPV, for example, about 20% of cervical adenocarcinomas. In addition, the salutary impact of HPV vaccination on the incidence of cervical cancer has the potential to be significant but must be forecast in the setting of the growing antivaccination movement in the US. Reducing death rates from cervical cancer, the long-standing goal of HPV vaccination, may not be achievable given the underwhelming vaccination rates.
Læs mere Tjek på PubMedRuanne V. Barnabas, Elizabeth R. Brown, Maricianah A. Onono, Elizabeth A. Bukusi, Betty Njoroge, Rachel L. Winer, Denise A. Galloway, Leeya F. Pinder, Deborah Donnell, Imelda N. Wakhungu, Charlene Biwott, Syovata Kimanthi, Kate B. Heller, Diane G. Kanjilal, Daniel Pacella, Susan Morrison, Elena A. Rechkina, Stephen L. Cherne, Torin T. Schaafsma, R. Scott McClelland, Connie Celum, Jared M. Baeten, Nelly R. Mugo, Peter Dull, Reena Gulati, Sara Vernam, Abdul Rawuf Yousufzay, Krissa Gunderson, Amra Hercinovic, Lisa Ondrejcek, Gavin Robertson, Angela Williams, Elizabeth Brown, Jody Carter, Denise Galloway, Leeya Pinder, Priya R. Prabhu, Robin Smith, Marci Wright, Stephen O. Abiero, Maqline A. Achola, Meldah O. Adipo, Katherine L. Amukonyi, Cynthia Akinyi, Teresia O. Akinyi, Penina N. Amboka, Karl D. Arum, Veronica O. Atogo, Pius O. Atonga, Adero J. Cate, Daisy Chepkoros, Oyamo O. Christopher, Imelda N. Imali, Mildred Imbayi, Lizzie N. Kabete, Enericah K. Kanampiu, Geoffrey Kebaso, Dennis Kegode, Timothy Kwena, Reina Lenturkana, Celestine Lihavi, David N. Marwa, Patricia Matti, Peter O. Mboya, Elijah Mbuya, Lyna A. Memo, Robai M. Mituyi, Benard M. Muga, David E. Muhoma, Elizabeth L. Musi, Gilbert C. Mutai, Simon M. Muthusi, Ivy M. Mutuiri, Catherine W. Mwakio, Bill Nyongesa, Maureen A. Ochieng, Vincent R. Ochuka, Belder A. Odedo, Esther A. Odeny, Vincent O. Odera, Debora A. Odhiambo, Perez O. Odhiambo, Janet A. Okeyo, Linet A. Okode, Nollyne A. Okuku, Irene Okumu, Lydiah A. Okumu, Christine A. Olweny, Hellen A. Olweyo, George O. Omondi, Donnavane A. Ondego, Florence A. Ondiek, Joan A. Ongere, Maricianah Onono, Kevin O. Onyango, Annette A. Opondo, Millicent A. Oronje, Beryl A. Osoga, Rebecca A. Otieno, Job A. Ouma, Mildred A. Owenga, Samya S. Rashid, Vincent K. Salano, Moses O. Siaji, Roseline Sikolia, Imelda N. Wakhungu, Nicholas Walukana, Nobert B. Walusala, Caren A. Wemali, Faith Ambiyo, Emily Anyango, Esther K. Charles, David Chege, Jane Gacheru, Anne Gaitho, Stephen Gakuo, Zachary Gathu, Mathew Irungu, Vincent Juma, Irene Kamau, Mary Kibatha, Dorcas Kiboi, Francis Khaemba, Hellen W. Kimani, Catherine Kiptinness, Caren Koli, Erick Koome, Solomon Maina, Linet Makena, Sarah Mbaire, Veronica Muchoki, Victor Munene, Edwin Mugo, Nelly R. Mugo, Umi W. Mugo, Faith Munyaka, Paul Mutunga, Margaret Mwangi, Stanley Mwangi, Peter Mwenda, Gladys Namboka, Grace Ndung’u, Rispa Nduuru, Esther Neema, Sammy Ng’ang’a, Josephine Njeri, Irene Njeru, Alice Njoki, John Njoroge, Sarah Njoroge, Peter Nzuve, Fridah Nkatha, Jemimah Nyakio, Edna Nyandiga, Jacinta Nyokabi, Rose Odera, John Okumu, Lynda Oluoch, Linda Orwa, Nina Ouko, Matilda Saina, Agata Thumi, Innes Wambui, Victoria Wambui, Virginia Wangechi, Scholastica Wanjiku, Ruanne Barnabas, Francesca Caramazza, Kate Heller, Diane Kanjilal, Kyle Kennedy, Odunayo Kolawole Talabi, Rukiya Hassan, Emmanuel Kabare, Fatma H. Mwidadi, Khamis Mwinyikai, Salwa Mustafa, Juma Shafi, Stephen L. Cherne, Daphne Hamilton, Rachel Johnson, John Lin, Justice Quame-Amaglo, Elena A. Rechkina, Torin T. Schaafsma
Nature, 6.12.2023
Tilføjet 6.12.2023
Clinical Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
AbstractBackgroundTwo prefusion F protein-based vaccines, Arexvy and Abrysvo, have been authorized by the US Food and Drug Administration for protecting older adults against respiratory syncytial virus (RSV)-associated lower respiratory tract illness. We evaluated the health benefits and cost-effectiveness of these vaccines.MethodsWe developed a discrete-event simulation model, parameterized with the burden of RSV disease including outpatient care, hospitalization, and death for adults aged 60 years or older in the United States. Taking into account the costs associated with these RSV-related outcomes, we calculated the net monetary benefit using quality-adjusted life-year (QALY) gained as a measure of effectiveness and determined the range of price-per-dose (PPD) for Arexvy and Abrysvo vaccination programs to be cost-effective from a societal perspective.ResultsUsing a willingness-to-pay of $95 000 per QALY gained, we found that vaccination programs could be cost-effective for a PPD up to $127 with Arexvy and $118 with Abrysvo over the first RSV season. Achieving an influenza-like vaccination coverage of 66% for the population of older adults in the United States, the budget impact of these programs at the maximum PPD ranged from $6.48 to $6.78 billion. If the benefits of vaccination extend to a second RSV season as reported in clinical trials, we estimated a maximum PPD of $235 for Arexvy and $245 for Abrysvo, with 2-year budget impacts of $11.78 and $12.25 billion, respectively.ConclusionsVaccination of older adults would provide substantial direct health benefits by reducing outcomes associated with RSV-related illness in this population.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundThe 2022-2023 United States influenza season had unusually early influenza activity with high hospitalization rates. Vaccine-matched A(H3N2) viruses predominated, with lower levels of A(H1N1)pdm09 activity also observed.MethodsUsing the test-negative design, we evaluated influenza vaccine effectiveness (VE) during the 2022-2023 season against influenza-A-associated emergency department/urgent care (ED/UC) visits and hospitalizations from October 2022-March 2023 among adults (age ≥18 years) with acute respiratory illness (ARI). VE was estimated by comparing odds of seasonal influenza vaccination among case-patients (influenza A test-positive by molecular assay) and controls (influenza test-negative), applying inverse-propensity-to-be-vaccinated weights.ResultsThe analysis included 85,389 ED/UC ARI encounters (17.0% influenza-A-positive; 37.8% vaccinated overall) and 19,751 hospitalizations (9.5% influenza-A-positive; 52.8% vaccinated overall). VE against influenza-A-associated ED/UC encounters was 44% (95% confidence interval [95%CI]: 40-47%) overall and 45% and 41% among adults aged 18-64 and ≥65 years, respectively. VE against influenza-A-associated hospitalizations was 35% (95%CI: 27-43%) overall and 23% and 41% among adults aged 18-64 and ≥65 years, respectively.ConclusionsVE was moderate during the 2022-2023 influenza season, a season characterized with increased burden of influenza and co-circulation with other respiratory viruses. Vaccination is likely to substantially reduce morbidity, mortality, and strain on healthcare resources.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundAlong with many global jurisdictions, Toronto, Canada experienced an outbreak of mpox in the spring/summer of 2022. Case counts declined following the implementation of a large vaccination campaign. A surge of case reports in early 2023 led to speculation that asymptomatic and/or undetected local transmission was occurring in the city.MethodsMpox cases and positive laboratory results are reported to Toronto Public Health. Epidemic curves and descriptive risk factor summaries for the 2022 and 2023 outbreaks were generated. First and second dose vaccination was monitored. Monkeypox virus wastewater surveillance and whole genome sequencing (WGS) were conducted to generate hypotheses about the source of the 2023 resurgence.Results515 cases were reported in the spring/summer outbreak of 2022 and 17 in the 2022-2023 resurgence. Wastewater data correlated with the timing of reported cases. WGS showed that the 2022-2023 resurgent cases were distinct from the other 2022 cases and closer to sequences from another country, suggesting a new importation as a source for recent cases. At the start of the 2022-2023 resurgence, it was estimated that only 16% of first dose vaccine recipients had completed their second dose vaccination.DiscussionThis investigation demonstrates the importance of ongoing surveillance and preparedness for mpox outbreaks. Undetected local transmission was not a likely source of the 2022-2023 resurgence. Ongoing pre-exposure vaccine promotion remains important to mitigate disease burden.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract Research has shown that multidimensional approaches to Chagas disease (CD), integrating its biomedical and psycho-socio-cultural components, are successful in enhancing early access to diagnosis, treatment and sustainable follow-up. For the first time, a consulate was selected for a community-based CD detection campaign. Two different strategies were designed, implemented and compared between 2021 and 2022 at the Consulate General of Bolivia and a reference health facility in Barcelona open to all Bolivians in Catalonia. Strategy 1 consisted in CD awareness-raising activities before referring those interested to the reference facility for infectious disease screening. Strategy 2 offered additional in-situ serological CD screening. Most of the 307 participants were Bolivian women residents in Barcelona. In strategy 1, 73 people (35.8% of those who were offered the test) were screened and 19.2% of them were diagnosed with CD. Additionally, 53,4% completed their vaccination schedules and 28.8% were treated for other parasitic infections (strongyloidiasis, giardiasis, eosinophilia, syphilis). In strategy 2, 103 people were screened in-situ (100% of those who were offered the test) and 13.5% received a CD diagnosis. 21,4% completed their vaccination schedule at the reference health facility and 2,9% were referred for iron deficiency anemia, strongyloidiasis or chronic hepatitis C. The fact that the screening took place in an official workplace of representatives of their own country, together with the presence of community-based participants fueled trust and increased CD understanding. Each of the strategies assessed had different benefits. Opportunities for systematic integration for CD based on community action in consulates may enhance early access to diagnosis, care and disease prevention.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
Abstract Research has shown that multidimensional approaches to Chagas disease (CD), integrating its biomedical and psycho-socio-cultural components, are successful in enhancing early access to diagnosis, treatment and sustainable follow-up. For the first time, a consulate was selected for a community-based CD detection campaign. Two different strategies were designed, implemented and compared between 2021 and 2022 at the Consulate General of Bolivia and a reference health facility in Barcelona open to all Bolivians in Catalonia. Strategy 1 consisted in CD awareness-raising activities before referring those interested to the reference facility for infectious disease screening. Strategy 2 offered additional in-situ serological CD screening. Most of the 307 participants were Bolivian women residents in Barcelona. In strategy 1, 73 people (35.8% of those who were offered the test) were screened and 19.2% of them were diagnosed with CD. Additionally, 53,4% completed their vaccination schedules and 28.8% were treated for other parasitic infections (strongyloidiasis, giardiasis, eosinophilia, syphilis). In strategy 2, 103 people were screened in-situ (100% of those who were offered the test) and 13.5% received a CD diagnosis. 21,4% completed their vaccination schedule at the reference health facility and 2,9% were referred for iron deficiency anemia, strongyloidiasis or chronic hepatitis C. The fact that the screening took place in an official workplace of representatives of their own country, together with the presence of community-based participants fueled trust and increased CD understanding. Each of the strategies assessed had different benefits. Opportunities for systematic integration for CD based on community action in consulates may enhance early access to diagnosis, care and disease prevention.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
Abstract Research has shown that multidimensional approaches to Chagas disease (CD), integrating its biomedical and psycho-socio-cultural components, are successful in enhancing early access to diagnosis, treatment and sustainable follow-up. For the first time, a consulate was selected for a community-based CD detection campaign. Two different strategies were designed, implemented and compared between 2021 and 2022 at the Consulate General of Bolivia and a reference health facility in Barcelona open to all Bolivians in Catalonia. Strategy 1 consisted in CD awareness-raising activities before referring those interested to the reference facility for infectious disease screening. Strategy 2 offered additional in-situ serological CD screening. Most of the 307 participants were Bolivian women residents in Barcelona. In strategy 1, 73 people (35.8% of those who were offered the test) were screened and 19.2% of them were diagnosed with CD. Additionally, 53,4% completed their vaccination schedules and 28.8% were treated for other parasitic infections (strongyloidiasis, giardiasis, eosinophilia, syphilis). In strategy 2, 103 people were screened in-situ (100% of those who were offered the test) and 13.5% received a CD diagnosis. 21,4% completed their vaccination schedule at the reference health facility and 2,9% were referred for iron deficiency anemia, strongyloidiasis or chronic hepatitis C. The fact that the screening took place in an official workplace of representatives of their own country, together with the presence of community-based participants fueled trust and increased CD understanding. Each of the strategies assessed had different benefits. Opportunities for systematic integration for CD based on community action in consulates may enhance early access to diagnosis, care and disease prevention.
Læs mere Tjek på PubMed