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PubMed2003

Vaccination trials of sea bass, Dicentrarchus labrax (L.), against Photobacterium damsela subsp. piscicida, using novel vaccine mixtures.

Bacterial cells of the marine fish pathogen Photobacterium damsela subsp. piscicida were grown in novel culture media. A mixture of whole cells and extracellular components was inactivated and used in bath, intraperitoneal (i.p.) and oral vaccination of sea bass, Dicentrarchus labrax, employing two sizes of fish. A commercial vaccine was used for comparative purposes. Control and immunized fish were either bath or intraperitoneally challenged 6 and 12 weeks post-vaccination. Small fish had significantly higher relative percentage survival with the novel vaccine mixture both at 6 and 12 weeks post-vaccination by bath, in comparison with the commercial vaccine. No protection was afforded at 6 or 12 weeks post-immunization by either vaccine after challenge via i.p. injection. Sea bass (1.5-2 g) intraperitoneally vaccinated with various adjuvanted vaccine mixtures were not protected against pasteurellosis. In contrast, larger sea bass (20 g) benefited from vaccination with the novel vaccine mixtures. Intraperitoneal challenge with the pathogen resulted in protection in both fish groups vaccinated with novel vaccine mixtures, whereas control fish suffered high mortalities (> 80%). Orally vaccinated fish were immersion challenged with the pathogen. At 6 and 12 weeks post-vaccination the control fish had a high mortality and the fish vaccinated with the novel vaccine mixture achieved good protection.

Administration, Oral↗

PubMed2003

Correlation between healthcare workers' knowledge of influenza vaccine and vaccine receipt.

OBJECTIVE: Influenza vaccine receipt by healthcare workers (HCWs) is important because HCWs are at risk for occupational exposure to influenza and may act as vectors in the nosocomial transmission of influenza. HCWs were surveyed to determine whether belief in commonly held influenza vaccine misconceptions was associated with influenza vaccine acceptance. DESIGN: Cross-sectional study. SETTING: A large urban teaching hospital. METHOD: A self-administered survey was used to assess nursing and physician staff influenza vaccine knowledge, current vaccination status, and potential reasons for vaccine declination. RESULTS: Two hundred twelve of 215 surveys were completed. The overall influenza vaccination rate was 73%. Physician staff were significantly more likely to have been vaccinated compared with nursing staff (82% vs 62%, respectively; P = .0009). HCWs answering the 5 influenza vaccine basic knowledge questions correctly were significantly more likely to have been vaccinated than those responding incorrectly to any question (84% vs 64%, respectively; P = .002). This association was present in the nursing group where 80% of those answering the knowledge questions correctly were vaccinated, but only 49% of those answering incorrectly were vaccinated (P = .000005). However, in the physician group, there was no significant difference in the influenza vaccination rates between those answering correctly and those answering incorrectly (P = .459). CONCLUSION: Belief in commonly held influenza vaccine misconceptions was significantly associated with influenza vaccine declination among nursing staff and may act as a barrier to greater rates of influenza vaccination. Reasons for influenza vaccine nonreceipt may differ between nursing and physician staff.

Academic Medical Centers↗

PubMed2006

An emergency department-based vaccination program: overcoming the barriers for adults at high risk for vaccine-preventable diseases.

BACKGROUND: More than 10% of the population visit emergency departments (ED) every year. Many of these patients are not up-to-date on routine vaccinations that could prevent future illnesses. The ED could significantly impact these vaccination trends. OBJECTIVES: This study was a feasibility study to determine whether patients would be amenable to an ED-based program that provided appropriate immunizations when they were at high risk for these diseases. In addition, the authors sought to identify barriers that predict high-risk patients who did not receive immunizations before ED presentation and to identify barriers that predict those high-risk unvaccinated patients who are unwilling to receive vaccinations when offered in the ED. METHODS: This study was a prospective cross-sectional study of all patients arriving in the ED at one inner-city trauma center between 10 am and 10 pm over the course of a three-week intervention period. The subjects completed a survey that included information about their risk of influenza (flu) and pneumococcal disease, their immunization history, and their perceptions of their need for immunization. Demographic information collected included insurance status, age, gender, and primary language. All high-risk patients who were not current with their immunizations were offered vaccination. The primary outcome was improvement in vaccination coverage based on an ED surveillance and treatment system for vaccinations. The secondary outcomes were barriers to successful vaccination before ED presentation and barriers to acceptance of vaccination in the ED. Results were compared using chi-square test and confidence interval analysis. Characteristics of barriers to immunization were determined using a logistic regression model. A p-value < 0.05 was considered significant. RESULTS: A total of 674 subjects were entered into the study. Vaccination of subjects at high risk for flu increased significantly from 16% before to 83% after ED evaluation and treatment, and vaccination of subjects at high risk for pneumococcal disease increased significantly from 18% before to 84% after ED evaluation and treatment. Significant barriers to vaccination before ED presentation were lack of insurance (odds ratio [OR] = 0.31 for flu, 0.22 for pneumococcal disease), age younger than 50 years (OR = 0.18 for flu, 0.24 for pneumococcal disease), and no perceived need for vaccination (OR = 0.07 for flu). The sole significant barrier to vaccine administration in the ED was perceived need for vaccination (OR = 0.32 for flu). CONCLUSIONS: An ED-based vaccination program is both feasible and successful. Other than a shortage of vaccine, the only ED barrier to vaccination (perceived need) might be overcome with patient education.

Adult↗

PubMed2000

Safety and immunogenicity of heptavalent pneumococcal vaccine conjugated to CRM(197) among infants with sickle cell disease. Pneumococcal Conjugate Vaccine Study Group.

OBJECTIVES: To determine the immunogenicity and safety of heptavalent pneumococcal polysaccharide vaccine (serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) conjugated to CRM(197) (7-valent conjugate pneumococcal vaccine [7VPnC]) among infants with sickle cell disease (SCD) and a comparison group of infants without SCD (non-SCD). DESIGN: Two cohorts of infants were enrolled and received open-label doses of 7VPnC vaccine; infants enrolled before 2 months of age received 7VPnC vaccine at 2, 4, and 6 months of age followed by 23-valent pneumococcal polysaccharide vaccine (PS-23) at 24 months of age for those infants with SCD (schedule A), and infants enrolled between 2 and 12 months of age received 7VPnC at 12 months of age followed by PS-23 at 24 months of age for infants with SCD (schedule B). Safety data were collected for 3 days after each dose of vaccine. Antibody concentrations were measured to each of the 7VPnC serotypes by enzyme-linked immunosorbent assay before each vaccine dose and 1 month after the last 7VPnC dose and the PS-23 vaccine dose. RESULTS: Forty-five infants (34 SCD and 11 non-SCD) were vaccinated according to schedule A and 16 infants (13 SCD and 3 non-SCD) according to schedule B. The 7VPnC vaccine was highly immunogenic for all serotypes among infants with and without SCD who received 3 doses of vaccine according to schedule A: depending on serotype, 89% to 100% achieved antibody concentrations above.15 microg/mL and 56% to 100% achieved antibody concentrations above 1.0 microg/mL. Among infants immunized according to schedule B, a single dose of 7VPnC vaccine resulted in antibody concentrations above.15 microg/mL in 53% to 92% by serotype and above 1.0 microg/mL in 31% to 71% by serotype. A single dose of PS-23 resulted in dramatic increases in the antibody concentrations to all serotypes regardless of 1- or 3-dose priming. There was no difference in the reactogenicity of the 7VPnC vaccine between those with and without SCD. There were no serious reactions to the 7VPnC or PS-23 vaccines, even among those with high antibody concentrations before immunization. CONCLUSIONS: Infants with SCD respond to 7VPnC vaccine with antibody concentrations that are at least as high as infants without SCD. Infants immunized with 7VPnC vaccine at 2, 4, and 6 months of age developed antibody concentrations in the same range as those achieved among infants without SCD enrolled in a large trial that demonstrated vaccine efficacy against invasive disease. Significant rises were seen in antibody concentrations to all 7VPnC serotypes after the PS-23 booster in children receiving schedule A or B.

Anemia, Sickle Cell↗

PubMedDate not supplied

Dose-response effects of inactivated Newcastle disease vaccines: influence of serologic assay, time after vaccination, and type of chickens.

Knowledge of the dose-response relation of inactivated vaccines and of the factors that influence this relation is essential for the evaluation of existing vaccine potency assays and the development of new potency assays that are based on the antigen content of the inactivated vaccines. We quantified the relation between vaccine dose, serologic response, and clinical protection after vaccination for three different inactivated Newcastle disease (ND) vaccines. Qualitatively, similar dose-response curves were obtained for the three vaccines when either the serologic response or the clinical protection of specific-pathogen-free (SPF) chickens was plotted against the different vaccine doses applied. However, the vaccines differed quantitatively: doses of vaccines that induced similar antibody titers or clinical protection differed 2-8-fold. In contrast with the narrow range of antibody titers induced by a full vaccine dose, a very broad range of titers was obtained after dilution of the vaccines. At least 95% of the SPF chickens with detectable antibody in the serum were protected against a challenge with virulent Herts ND virus. The relation between the dosage of two different ND vaccines and the serum antibody titers remained markedly constant between 3 and 18 wk after vaccination. Vaccination of broilers instead of layers with a dilution series of inactivated ND vaccine resulted in significantly lower antibody levels and less clinical protection against virulent challenge. In conclusion, despite quantitative differences, we found comparable dose-response relations for the three inactivated ND vaccines studied.

Animals↗

PubMed1989

Effect of vaccination with a pentavalent leptospiral vaccine containing Leptospira interrogans serovar hardjo type hardjo-bovis on type hardjo-bovis infection of cattle.

Effectiveness of 2 pentavalent leptospiral vaccines containing Leptospira interrogans serovar hardjo was evaluated for protection of steers from infection with serovar hardjo type hardjo-bovis. The hardjo component of 1 vaccine was prepared from serovar hardjo type hardjoprajitno. The hardjo component of the other vaccine was prepared from serovar hardjo type hardjo-bovis. Two steers were vaccinated once and 4 steers were vaccinated twice with the pentavalent vaccine containing type hardjoprajitno. Four steers were vaccinated once and 4 steers were vaccinated twice with the pentavalent vaccine containing type hardjo-bovis. Four steers were maintained as non-vaccinated controls. Steers given vaccine containing type hardjo-bovis developed higher mean serum microscopic agglutination titers against serovar hardjo than steers given vaccine containing hardjoprajitno. Six months after the first vaccination, all steers were challenge-exposed on 3 occasions by conjunctival instillation of 10(7) serovar hardjo type hardjo-bovis organisms, and on 1 occasion by conjunctival instillation of urine from a steer shedding hardjo-bovis. All control and all vaccinated steers became infected and shed serovar hardjo type hardjo-bovis in the urine. Lesions were detected in kidneys of 3 of 4 nonvaccinated control steers, 5 of 6 steers given hardjoprajitno vaccine, and 6 of 8 steers given hardjo-bovis vaccine. Leptospires were detected in kidneys of 4 of 4 control steers and 13 of 14 vaccinated steers.

Animals↗

PubMed2002

Simultaneous administration of meningococcal C conjugate vaccine and diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b conjugate vaccine in children: a randomized double-blind study.

BACKGROUND: Meningococcal C disease can be life-threatening in infants, young children and adolescents. New conjugate vaccines are immunogenic in young infants and induce immunologic memory, so we should consider incorporating them into the routine childhood immunization program. The objective of this study was to measure the safety and immunogenicity of a meningococcal C conjugate vaccine when given with routine childhood vaccines. METHODS: We carried out a randomized, double-blind, controlled clinical trial at children's hospitals in 3 Canadian cities. A convenience sample of 351 healthy 2-month-old infants was enrolled from the community and randomly allocated to receive either meningococcal C conjugate vaccine or the control (hepatitis B) vaccine. All participants received a concurrent injection of the combined diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b (DTaP-IPV-Hib) conjugate vaccine in the opposite limb. Participants were immunized at 2, 4, 6 and 15 months of age; adverse events were recorded after each dose. Serum bactericidal and ELISA meningococcal antibody levels in the participants were measured at 6, 7, 15 and 16 months of age; diphtheria, tetanus, H. influenzae type b, poliovirus and pertussis antibodies were measured at 7 months of age. A total of 323 (92%) participants completed all aspects of the study. The proportion of participants who suffered adverse events after each vaccine dose was the primary safety outcome. Geometric mean antibody titres and the proportion of participants with protective antibody levels after immunization were the primary immunologic outcomes. RESULTS: After 2 doses of the meningococcal C conjugate vaccine 99% of participants achieved a protective ( > or = 1:8) bactericidal meningococcal serogroup C antibody level, and after 3 doses this rate increased to 100%. Antibody levels to the concomitant vaccine antigens in the group receiving meningococcal C vaccine were similar to those in the control group except for higher antidiphtheria antibody titres (p < 0.001). Local injection site reactions (redness and induration) after the meningococcal conjugate vaccine were more frequent than after hepatitis B vaccine but less frequent than after the DTaP-IPV-Hib vaccine. CONCLUSIONS: The meningococcal C conjugate vaccine can be safely and effectively administered at the same visit as the other vaccine antigens routinely given to infants in Canada.

Antibody Formation↗

PubMed1994

Rotavirus vaccines and vaccination potential.

The development of a successful rotavirus vaccine is a complex problem. Our review of rotavirus vaccine development shows that many challenges remain, and priorities for future studies need to be established. For example, the evaluation of administration of a vaccine with OPV or breast milk might receive less emphasis until a vaccine is made that shows clear efficacy against all virus serotypes. Samples remaining from previous trials should be analyzed to determine epitope-specific serum and coproantibody responses to clarify why only some trials were successful. Detailed evaluation of the antigenic properties of the viruses circulating and causing illness in vaccinated children also should be performed for comparisons with the vaccine strains. In future trials, sample collection should include monitoring for asymptomatic infections and cellular immune responses should be analyzed. The diversity of rotavirus serotype distribution must be monitored before, during, and after a trial in the study population and placebo recipients must be matched carefully to vaccine recipients. Epidemiologic and molecular studies should be expanded to document, or disprove, the possibility of animal to human rotavirus transmission, because, if this occurs, vaccine protection may be more difficult in those areas of the world where cohabitation with animals occurs. We also need to have an accurate assessment of the rate of protection that follows natural infections. Is it realistic to try to achieve 90% protective efficacy with a vaccine if natural infections with these enteric pathogens only provide 60% or 70% protection? Subunit vaccines should be considered to be part of vaccine strategies, especially if maternal antibody interferes with the take of live vaccines. The constraints on development of new vaccines are not likely to come from molecular biology. The challenge remains whether the biology and immunology of rotavirus infections can be understood and exploited to permit effective vaccination. Recent advances in developing small animal models for evaluation of vaccine efficacy should facilitate future vaccine development and understanding of the protective immune response(s) (Ward et al. 1990b; Conner et al. 1993).

Animals↗

PubMedDate not supplied

[Vaccination of weaner pigs against classical swine fever with the subunit vaccine "Porcilis Pesti": influence of different immunization plans on excretion and transmission of challenge virus].

Excretion and transmission of CSFV after vaccination with the CSF subunit marker vaccine "Porcilis Pesti" have been studied using the following different vaccination schedules: Group A--two vaccinations with an interval of 28 d, challenge 14 d after second vaccination (p.v2.); group B--two vaccinations with an interval of 14 d, challenge 14 d later; group C--two vaccinations with an interval of 28 d, challenge at time of booster vaccination; group D--two vaccinations with an interval of 14 d, challenge 7 d p.v2.; group E--single vaccination and infection 14 d later. After infection one sentinel pig was added to the vaccinated and infected pigs of each group. A single vaccination did not induce protective immunity against a CSFV challenge. Double vaccination at a four-week interval protected piglets from clinical infection, and neither viraemia and leukopenia nor virus excretion were detected if infected 14 d p.v2. Two vaccinations at a two-week interval followed by a challenge 7 d p.v2. led to a short viraemia on day 5 p.i. but without excretion of CSFV. Though all other vaccination schedules induced a reduction in virus shedding and a decrease in CSFV replication, in all these cases in-contact controls became infected. The results of transmission of CSFV are discussed in relation to a potential use of subunit marker vaccines in CSF control.

Animals↗

PubMed2026

Simultaneous Administration of Human Papillomavirus (HPV) Vaccine With Other Recommended Vaccines Among Adolescents Aged 13-17 years, National Immunization Survey-Teen (NIS-Teen), United States, 2023.

PURPOSE: To investigate the percent of adolescents who receive human papillomavirus (HPV) vaccine with one or more other vaccines recommended for adolescents in a single medical visit. METHODS: Data from the 2023 National Immunization Survey-Teen were analyzed. Timing of receipt of HPV vaccine, tetanus, diphtheria, and acellular pertussis vaccine (Tdap), quadrivalent meningococcal conjugate vaccine (MenACWY), and influenza vaccine was assessed using provider-reported vaccination histories. RESULTS: In 2023, among adolescents aged 13-17 years, 69.5% received HPV vaccine with one or more other vaccines recommended for adolescents in a single medical visit. In addition, 47.8% received specifically HPV vaccine, Tdap, and MenACWY together in a single medical visit. DISCUSSION: The HPV vaccine is commonly given with other vaccines recommended for adolescents in a single medical visit. These findings demonstrate variation in simultaneous vaccination patterns, suggesting that flexibility in the recommended adolescent vaccination schedule allows for different approaches to vaccination across clinical settings and family preferences while maintaining adherence to the recommended schedule.

Humans↗

PubMed2001

Measles antibody responses after early two dose trials in Guinea-Bissau with Edmonston-Zagreb and Schwarz standard-titre measles vaccine: better antibody increase from booster dose of the Edmonston-Zagreb vaccine.

In Guinea-Bissau, children were randomised at 6 months of age to receive either two doses of standard-titre measles vaccine at 6 and 9 months of age or an inactivated polio vaccine at 6 months and standard-titre measles vaccine at 9 months of age. During the first 5 months, children received Edmonston-Zagreb (EZ) vaccine and during the following 11 months, the Schwarz (SW) vaccine. Five percent of the mothers, 74% of children at 6 months of age, and 92% of unvaccinated children at 9 months of age had unprotective levels (<125 mIU/ml) of measles antibodies. Among children receiving EZ vaccine, 1% were unprotected at 18 months of age after either two (3/240) or one (3/211) doses of vaccine, the geometric mean measles antibody titre (GMT) being approximately 1550 mIU/ml in both groups. Among those receiving SW vaccine 9% (34/365) and 3% (9/310) were unprotected at 18 months of age in the two-dose and the one-dose groups (RR = 3.21 (95% confidence interval (CI) 1.56-6.58)), respectively. The GMT was higher after one dose of SW vaccine at 9 months of age (2491 mIU/ml) than after two doses of SW vaccine (1125 mIU) (P < 0.001). In the EZ vaccine group, there was no significant difference in antibody level for children vaccinated in the presence of high or low levels of maternal antibodies, whereas there was a marked difference in the SW group. The second EZ vaccine induced a significant antibody increase between 9 months of age (1191 mIU) and 18 months of age (1602 mIU, P=0.011), whereas antibody levels tended to decline from 9 months (1243 mIU) to 18 months of age (998 mIU, P = 0.124) after the second dose of SW vaccine. Conclusively, after two doses of EZ measles vaccine more children were protected at 18 months of age than after two doses of SW. One dose of SW provided the highest antibody response, but a higher proportion of unprotected than one or two doses of EZ. The EZ vaccine was less sensitive to maternal antibodies, and able to increase the antibody response by revaccination, while the second SW vaccine resulted in an unchanged or lower antibody response.

Age Factors↗

PubMed2001

[Immunisation rates of routine vaccinations for school starters as a quantitative measure in the vaccination behaviour].

The aim of this retrospective long-term investigation was to compare the recommended routine vaccinations for school starters in the region of Dingolfing-Landau, recording the results separately by birth years and comparing these with one another. It was to show to what extent changes in the quantitative measures in the vaccination behaviour were recorded over a period of one decade, respectively to what extent the current recommendations of any one time of the STIKO (Permanent Vaccination Commission of the Robert Koch-Institute) were reflected within each age group. For this purpose during the annual standardised examinations of school starters the rates of vaccinations were recorded according to the various birth years and sex, determined and anonomously evaluated. It was found that of the total eleven examined birth years the vaccinations in series of BCG was reduced continually from a commencing 50 % plus to under 10 %. Regarding vaccinations against diphtheria, tetanus and polio the frequency for the total examined period commenced at a rate of under 90 %, increasing to over 90 % for the birth years of 1989 and beyond. No child of the birth year of 1984 was completely vaccinated against HiB, whereas the rate of vaccinations rose relatively quickly so that by the birth year 1994 over 90 % of the school starters were completely immunised against this infectious disease. As far as the pertussis and MMR vaccinations were concerned the rate at the beginning of the observation period was between 40 % and 60 %, increasing continually in the following period to over 80 %. By the middle 'eighties hardly any school starters had been vaccinated against hepatitis B, whereas, in the last five examined birth years the rate increased relatively quickly to 64 % maximum. At the beginning of the observed period nearly every fifth school starter had, age related, complete vaccination protection, in respect of the then valid STIKO recommendations. At the end of this decade this applied only to every twelfth child. Due to the high rates of participation of school starters examinations carried out by the Public Child and Youth Health Service it is possible to determine the vaccination rates of children as it relates to the routine vaccinations carried out over a longer period and on a topical basis. As a result the vaccination behaviour, respectively the willingness of a relevant target group during that period can be shown quantitatively. As the investigations of the RKI (Robert Koch-Institute) have shown, the share of the strict opponents of vaccinations is merely between 1.5 % and 5 % resulting in the necessity for intensive educational work and the development of effective vaccination strategies which are needed in order to stabilise the rates of vaccinations, respectively to meet epidemiological requirements at a high level and to further improve the present rate.

Child↗

PubMed2005

A reexamination of the feasibility of the administration of routine childhood vaccines in emergency departments in the era of electronic vaccine registries.

OBJECTIVES: To determine if electronic vaccine records facilitate successful routine childhood vaccination in the emergency department (ED). METHODS: We sampled consecutively over 2 calendar months children younger than 24 months presenting to the ED. Parents and legal guardians of eligible children were offered enrollment. Those consenting completed a parental survey after a nurse conducted an initial assessment of eligibility. Attending physicians then completed the assessment, and after the visit, the electronic vaccination records, when available, were accessed. No actual routine childhood vaccines were given during the study. RESULTS: Three hundred thirty-four were approached: 17 (5.1%) declined participation; 10 (3.0%) were enrolled, but the data were lost, and 7 (2.1%) were excluded. Of the 300 remaining, 235 (78.3%) had available electronic vaccine records. Only 38 (16.2%) of the 235 were late for at least 1 vaccine. Of note, physicians assessed 22 (57.9%) of the 38 as medically appropriate for vaccination in the ED. The overwhelming majority (81.8%) of the 22 parents and guardians would have assented to vaccination in the ED. Of the 38 patients found late for vaccination, 31 (81.6%) of parents incorrectly reported their children to be up-to-date on their immunizations. CONCLUSIONS: Assuming that the electronic vaccination record performed such as an online vaccine registry, the effort to access the registry might find a substantial number of children late for a routine childhood vaccination. In this setting, we found that approximately one sixth of the children with electronic vaccine records would be found late for vaccination, and based on physician assessment and parental survey, one half of those children would receive that vaccination if available in the ED. These rates offer health care planners a sense of the magnitude of the vaccination rates in the ED as we move toward regional vaccination registries with online capabilities to be accessed by EDs.

Emergency Service, Hospital↗

PubMed1983

Ontogeny of yellow fever 17D vaccine: RNA oligonucleotide fingerprint and monoclonal antibody analyses of vaccines produced world-wide.

Yellow fever 17D vaccines are currently manufactured with approval of the World Health Organization (WHO) in 11 countries. These vaccines have proven highly efficacious and safe. Nevertheless, they have not been fully characterized genetically, a problem for future standardization and modernization of vaccine manufacture now being proposed by WHO. Vaccines in use are derived from two distinct substrains (17D-204 and 17DD) which represent independently maintained passage series from original 17D. In this study, all 17D vaccines produced world-wide were characterized by RNA oligonucleotide fingerprinting. Forty-two large oligonucleotides were compared, and differences from an arbitrarily selected reference strain (produced by Connaught Laboratories in the U.S.A.) were determined. With one exception (vaccine produced in South Africa), fingerprints of vaccines derived from substrain 17D-204 were identical. The South African primary seed differed in position of one oligonucleotide, reflecting a charge shift due to a single base change. This difference occurred within one egg passage; a further change in the South African vaccine occurred within one or two passages from primary seed. No antigenic differences between 17D-204-derived vaccines (including South Africa) were demonstrated by neutralization tests using monoclonal antibody. Vaccines derived from the 17DD substrain consistently differed from 17D-204 vaccines in the absence of one oligonucleotide (No. 37). This change probably occurred during 40 additional egg passages in development of the 17DD vaccines. A clear antigenic difference was shown between 17D-204 and 17DD substrain vaccines using monoclonal antibody. 17DD vaccines showed minor genotypic differences, suggesting a higher degree of genetic instability than 17D-204 vaccines. No oligonucleotide fingerprint differences were found between avian leukosis virus (ALV)-free and ALV-contaminated vaccines. No definite genomic correlate of neurovirulence was defined by fingerprinting strains with a history of encephalitic complications in man or of failure to pass monkey neurovirulence tests. Parent Asibi virus showed several oligonucleotide differences and was serologically distinct from 17D vaccine.

Antibodies, Monoclonal↗

PubMed1995

Using a vaccine manager to enhance in-hospital vaccine administration.

BACKGROUND: Immunizations are effective and safe but underutilized. Inpatient hospitalizations offer an opportunity to update immunizations for both children and adults. METHODS: We tested two strategies for administering vaccines to hospitalized adults: a nurse practitioner vaccine manager, who assessed patient needs and administered vaccines without the attending physician's signature; and enhanced usual care, ie, need assessed by floor nurses and vaccines ordered by attending physicians. Evaluation was based on immunization rates during 2 preintervention months compared with immunization rates during the 3-month intervention period, and on interviews with nurses and physicians regarding their evaluation of the acceptability of the two strategies. RESULTS: Three percent of patients needing a vaccine received it during hospitalization in the 2-month baseline period before our intervention. During the intervention period, 1252 patients were admitted and available for assessment; 821 were assigned to the "enhanced usual-care" floors and 431 to the "vaccine-manager" floors. Of the patients receiving enhanced usual care, 54% had either inadequate or no assessment of vaccine need. Seventy-three percent of those who were properly assessed needed at least one vaccine, yet only 4% of those patients received a vaccine. All patients on the vaccine-manager floors were assessed; of these, 47% needed one or more vaccines. Thirty-four percent of patients needing a vaccine received it; however, 47% of patients needing a vaccine refused it. The family nurse practitioner spent an average of 15 minutes per patient in providing this service. Qualitative interviews with staff nurses and physicians demonstrated support for a separate vaccine manager program to immunize patients. CONCLUSIONS: A specially dedicated vaccine manager can be more effective in assessing the need for and in delivering vaccines than can attending physicians working with floor nurses. Using a vaccine manager, these tasks also can be accomplished in a reasonable time. Hospital staff regard this approach as acceptable.

Adult↗

PubMed2001

Hepatitis B vaccines: assessment of the seroprotective efficacy of two recombinant DNA vaccines.

BACKGROUND: In universal vaccination programs, when there is no postvaccination sero-1 logic assessment of response, there must be confidence that the vaccines used provide a high degree of seroprotection. OBJECTIVE: This parallel analysis of 2 recombinant hepatitis B vaccines (Engerix B and Recombivax/HB-Vax II) was conducted to review the seroprotective efficacy of each vaccine in defined populations. METHODS: Clinical studies of the 2 vaccines published as manuscripts or conference abstracts in the public domain between January 1986 and April 1999 were identified retrospectively by unrestricted screening of journals through BIOSIS, MEDLINE, and EMBASE and the Internet. Unpublished or internal company data were excluded to maintain impartiality. The studies were reviewed and analyzed. The studies were not assessed for quality other than a judgment of their eligibility for inclusion in the analysis. The primary outcome measure was the proportion of subjects in defined populations who showed an early seroprotective response to currently licensed vaccination schedules. Summary statistical analyses of seroprotective response rates and 95% CIs were calculated for each vaccine for each population. Seroprotective response was defined by an anti-hepatitis B surface antigen titer > or =10 IU/L measured between 1 and 3 months after the final vaccination. Because the study was designed specifically to review published immunogenicity data, safety data were not assessed. The study was not designed to demonstrate superiority of one vaccine over the other. RESULTS: A total of 181 clinical studies representing 32,904 vaccinated subjects were reviewed and analyzed, of whom 24,277 had been vaccinated with Engerix B and 8627 vaccinated with Recombivax/ HB-Vax II. Seroprotection was achieved in 20,060 subjects (95.8%) with Engerix B and in 7774 subjects (94.3%) with Recombivax/HB-Vax II in the normal population vaccinated according to currently licensed 3-dose schedules. In a subgroup analysis, response rates in health care workers were 6492 subjects (94.5%) for Engerix B and 3245 subjects (92.2%) for Recombivax/HB-Vax II. Children and adolescents (1-19 years) showed the highest response rates to vaccination (4612 [98.6%], Engerix B; 2292 [98.9%], Recombivax/HB-Vax II). A total of 2875 infants (<1 year) (95.8%) achieved seroprotection with Engerix B; 701 (88.5%) achieved seroprotection with Recombivax/ HB-Vax II. CONCLUSIONS: Hepatitis B vaccination programs using either Engerix B or Recombivax/HB-Vax II can achieve high seroprotective response rates, particularly in childhood and adolescence. Ideally, younger populations should be a primary target in current universal vaccination programs.

Adolescent↗

PubMed1988

Serologic response to oral polio vaccine and enhanced-potency inactivated polio vaccines.

In a randomized, controlled trial carried out from November 1980 to July 1983 involving 1,114 infants in Baltimore City and in Baltimore and Prince George's counties, Maryland, the serologic response to three doses of two enhanced-potency inactivated polio vaccines was compared with the response to three doses of oral polio vaccine. The mean ages at vaccination were 2.2, 4.7, and 19.9 months, respectively, for the three doses. Seroconversion after the first dose varied from 35% to 84%, and it was higher after oral polio vaccine than after either of the enhanced-potency inactivated polio vaccines for polioviruses types 2 and 3. Approximately two and one-half and 16 months after the second dose, almost all inactivated polio vaccine recipients had antibodies against all three virus types (98-100%). Fewer oral polio vaccine recipients had detectable antibodies to type 1 (89-92%) and to type 3 (96%). After three doses of vaccine, all children had antibodies against types 2 and 3. Approximately 1% of the inactivated polio vaccine recipients and 3% of the oral polio vaccine recipients lacked antibody to type 1. One or two doses of oral polio vaccine stimulated higher reciprocal geometric mean antibody titers against type 2 poliovirus than did the inactivated polio vaccine. For the other two types, the results were mixed. The third dose of inactivated polio vaccine produced significant increases in the reciprocal geometric mean titers against each of the three poliovirus types and resulted in significantly higher reciprocal geometric mean titers after three doses of vaccine for recipients of inactivated polio vaccine than for recipients of oral polio vaccine.

Antibodies, Viral↗

PubMed1997

[Effect of the prior influenza vaccination on serum antibody titer induction by subsequent inactivated influenza vaccine in the elderly].

In order to investigate the effects of prior influenza vaccination on subaequent annual influenza vaccination in the geriatric population, we analyzed serum hemagglutinine inhibition antibody tirers (HI titer) before and after vaccination with inactivated influenza vaccine in elderly inpatients. A total of 163 inpatients of 60 years or older were enrolled with informed consent. They were classified by vaccination status in the previous year, 53 patients had inactivated vaccine (inactivated). 52 patients had genetically assorted cold-adapted influenza live attenuated vaccine (cold-adapted), and 53 had no influenza vaccine history during the past year. The HI titer was higher in the inactivated group than in the cold-adapted and non-vaccinated groups, suggesting residual immunological effects of inactivated influenza vaccine from the previous year vaccination. The HI titer after the inactivated vaccine in 1993 was higher in both the inactivated and cold-adapted groups than in the non-vaccinated group. The number of patients with HI titers of 2(7) or higher, which is the putative protective HI titer level for influenza infection, was significantly higher in both the inactivated and cold-adapted groups than the non-vaccinated group. These results suggest that continuous annual influenza vaccination does not impair the effects of vaccination, and may actively promote elevated HI titers.

Aged↗