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Priming for rotavirus neutralizing antibodies by a VP4 protein-derived synthetic peptide.

In the rotavirus SA11 surface protein VP4, the trypsin cleavage sites associated with the enhancement of infectivity are flanked by two amino acid regions that are highly conserved among different rotaviruses. We have tested the ability of synthetic peptides that mimic these two regions to induce and prime for a rotavirus neutralizing antibody response in mice. After the peptide immunization schedule, both peptides induced peptide antibodies, but neither was able to induce virus antibodies, as measured by an enzyme-linked immunosorbent assay or a neutralization assay. However, when the peptide-inoculated mice were subsequently injected with intact SA11 virus, a rapid and high neutralizing antibody response was observed in mice that had previously received the peptide comprising amino acids 220 to 233 of the VP4 protein. This neutralizing activity was serotype specific; however, this peptide was also able to efficiently prime the immune system of mice for a neutralizing antibody response to the heterotypic rotavirus ST3 when the ST3 virus was used for the secondary inoculation.

Amino Acid Sequence↗

Haemophilus influenzae type b vaccine in India: need and timing, immunogenecity and tolerance.

OBJECTIVE: (i) To assess the natural immunity and susceptibility to Haemophilus influenzae type b (Hib) infections in children in India. (ii) To study the immunogenecity and tolerance of Hib vaccine (ACTHIB) in young infants. DESIGNS: (i) Cross sectional study. (ii) Prospective trial. SETTING: Well baby and immunization clinics. METHODS: (i) PRP antibody titers against Hib estimated in 172 healthy infants and children aged 1 month to 10 years. (ii) Antibody titres estimated before and after ACTHIB vaccine given with primary immunization (age group 6 to 8 weeks) in 50 babies. RESULTS: (i) Naturally protective levels of Hib antibodies found in less than 20% of infants under one year, but in over 80% above 4 years. (ii) Seroconversion after ACTHIB vaccination was 100% with very high protective levels. There were no significant adverse reactions. CONCLUSIONS: ACTHIB vaccine proved to be safe and highly immunogenic. As susceptibility to Hib is highest in the first year of life, the vaccine should be recommended in the primary immunization schedule (combined with DPT). The very high titers achieved suggest the possibility of decreasing the number of doses or the amount of antigen to reduce the prevalent high cost.

Child↗

Rabies post-exposure treatment and side-effects in man using HDC (MRC 5) vaccine.

126 patients underwent a post-exposure antirabies treatment using the beta-propiolactone inactivated (HDC) MRC-5 vaccine. The immunization schedule consisted of single doses of 1 ml of vaccine administered on days 0, 3, 7, 14, 30 and 90. Within the post-exposure group several patients suffered wounds from known rabid animals. Serum samples were collected on days 0, 14, 30, 90 and 104. Neutralizing antibodies against the rabies virus were determined in the rapid-fluorescent-focus-inhibition (RFFI) test. The rise in neutralizing antibodies was steeper than that in the prophylactic group whereas the mean titer at day 30 did not significantly exceed the values obtained with the preventive immunization scheme. A 1 ml booster injection on day 90 resulted in a three-fold increase of antibody titer within two weeks. Although no major side-effects were observed, an analysis of questionnaires filled out by the patients is presented.

Adolescent↗

Prevention of childhood diseases through vaccination.

Many childhood diseases can be prevented by proper immunization. The purpose of this article is to provide information about the risks and benefits associated with vaccines used in the United States for children under one year of age. Vaccines can be made from live or killed organisms and can stimulate both local and systemic immunity. The immunization schedule recommended by the American Academy of Pediatrics is presented. Information about the use of routine vaccines, their risks and the diseases they prevent, is presented. Vaccines included are diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus influenzae, influenza viruses and hepatitis B. Research is ongoing to develop new vaccines and improve those currently in use.

Antigen-Antibody Reactions↗

Flexible approaches in the design of subcutaneous immunotherapy protocols for Hymenoptera venom allergy.

BACKGROUND: Venom immunotherapy is an effective method for the treatment of Hymenoptera venom allergy. Different extracts and treatment schedules are available. OBJECTIVE: To compare the safety and efficacy of immunotherapy in 3 cohorts of patients sensitized to Vespula species. METHODS: In this open study, 43 patients were treated with a subcutaneous aqueous extract for induction and maintenance (AA), 34 with a subcutaneous depot extract for induction and maintenance (DD), and 29 with subcutaneous aqueous and subcutaneous depot extracts for induction and maintenance, respectively (AD). Cluster schedules were followed to reach maintenance, and adverse effects during treatment and after naturally occurring stings were recorded. RESULTS: Depot immunotherapy was better tolerated mainly owing to the lower frequency of local adverse effects in the induction phase (5.9% vs 42.5% and 1.3% vs 5.1% on a per patient and per dose basis, respectively; P < .001 for both) and for effects occurring within 60 minutes after vaccination (2.9% vs 19.2% and 0.2% vs 2.8% on a per patient and per dose basis; P = .03 and P < .001, respectively). Furthermore, 19 of 20 AA, 9 of 9 AD, and 10 of 10 DD patients who were restung experienced only minor local effects. CONCLUSIONS: Venom immunotherapy is efficacious. Although there was no decrease in systemic reactions, depot immunotherapy to Vespula venom induced fewer early local adverse effects. Patients undergoing an induction phase with an aqueous extract can benefit from switching to a depot extract during maintenance. Increasing the flexibility of the immunization schedules may improve compliance with this potentially lifesaving treatment.

Adsorption↗

A consideration to immune doses of staphlococcal enterotoxin B to rabbits.

Immune doses of staphylococcal enterotoxin B to rabbits were studied by comparing the efficiency of various immunization schedules. It was experienced that even two subcutaneous injections each with such a small dose as 10 mug of enterotoxin B, the primary one with Freund's complete adjuvant and a booster one without adjuvant, could stimulate a rabbit to develop the antibody to a satisfactorily high titer determined by agar gel diffusion and passive hemagglutination.

Animals↗

[Effect of duration of the intervals between immunization with DPT vaccine on the serological indices in children].

The influence of the interval between injections of adsorbed DPT vaccine on the effectiveness of immunization has been studied. The intensity of antibody formation to the pertussis component has been found to decrease 2.7-3.7 times if the interval between the injections constituting the course of primary immunization is prolonged for more than 6 months. The interval between the course of primary immunization and the first booster injection, which lasts 1.5-2 years in accordance with the currently accepted immunization schedule, is unreasonably long. Immunological characteristics in respect to pertussis have been found to decrease 8-45 times as early as 16 months after the first booster injection. Most of the vaccines catching pertussis at that time had the moderately severe form of this infection.

Age Factors↗

Poor serologic responses five to seven years after immunization with high and standard titer measles vaccines.

BACKGROUND: Few data exist on the persistence of measles antibodies after vaccination of West African infants. Therefore we examined measles antibody titers 5 to 7 years after children in rural Senegal had received high titer Edmonston-Zagreb (EZ-HT), high titer Schwarz (SW-HT) or standard titer Schwarz (SW-STD) measles vaccines in infancy. METHODS: Children had received either high titer vaccines at 5 months of age or standard titer at 10 months of age. Finger prick blood samples were tested for measles antibody 5 to 7 years later by the hemagglutinin inhibition test. RESULTS: Persistence of antibody after high titer vaccines was poor with the result that 39 and 50% of the EZ-HT and the SW-HT groups had low titers of hemagglutinin inhibition measles antibodies (< or =125 mIU/ml). Nineteen percent of the children in the SW-STD group had low titers which is a lower prevalence than in the high titer groups [relative risk (95% confidence intervals), 0.05 (0.28 to 0.88) vs. EZ-HT; relative risk, 0.38 (0.22 to 0.66) vs. SW-HT]. Geometric mean (95% confidence interval) antibody titers in children with detectable values were 616 (435 to 871) in the EZ-HT, 1106 (616 to 1866) in the SW-HT and 1271 (871 to 1741) mIU/ml in the SW-STD groups, respectively. Multivariant regression analysis showed that mean titers were 2.00 (1.03 to 3.89) times higher for children with low prevaccination antibody titers (< or =125 mIU/ml) and 3.06 (1.90 to 4.94) times higher if blood was collected in the rainy season. INTERPRETATION: Given the rapid decline in antibody titers over a 5- to 6-year period in an area where measles vaccine coverage was high, it seems likely that multiple dose immunization schedules will be needed in the future to maintain protective antibody concentrations (>125 mIU/ml) in West Africa. The role of subclinical boosting by exposure to natural measles and the possible role of malaria, which increases immunoglobulin turnover, in influencing long term antibody persistence after vaccination deserve further investigation.

Antibodies, Viral↗

The role of vaccine research and development in the scientific development of middle-income countries.

As a new global strategy for improving public health, the Children's Vaccine Initiative implicitly raises, once again, the question of the role of science in developing countries. If there are to be new and improved vaccines, better delivery systems, and simplified immunization schedules, there must be substantial analysis, laboratory activity, and fieldwork to ensure that the new products are ready for effective use. In the context of these requirements, this paper reviews the possibilities for vaccine research and development in middle-income countries and the benefits in terms of fostering socioeconomic development through integrated scientific health research.

Delivery of Health Care↗

Dose response study of an inactivated hepatitis A virus vaccine.

In this dose-response study evaluating 3 different doses and 2 time schedules, the highest dose, 25 units of viral protein antigen, induced a seroconversion antibody response against hepatitis A virus (anti-HAV) over 10 mIU in all vaccinees by week 3 after one dose, indicating rapid onset of protective antibody levels. Following the second dose, given 4 weeks later, rising titers were observed for 20 weeks, when the third and final dose of 25 units was given. The GMT of anti-HAV at 24 weeks (before the third vaccine injection) was 398 mIU/ml for the 25-unit dose, compared to 42 and 65 mIU/ml, respectively, for the 12.5 unit and 6.25 unit doses. The third vaccine dose at 24 weeks gave a booster response in all vaccinees, but the increase in titers was most pronounced in the 25 unit group, which had reached a GMT of 6593 mIU/ml when tested 4 weeks later. Side-effects included mainly local reactions and a few cases of mild diarrhoea, and did not differ for the 3 doses studied. In Scandinavia, hepatitis A vaccines will probably be used mainly for vaccination of foreign travellers. This category usually requires a rapid immunization schedule with few doses. Two doses approximately 3-4 weeks apart will probably be accepted by most travellers, and a single dose may provide short-term protection for most individuals. The need and timing for a booster dose will have to be further studied.

Adult↗

Current status of pediatric vaccines.

Pediatric immunization schedules have become more complex, especially with the approval of two new vaccines for Haemophilus influenzae type b and changes in recommendations for measles vaccine. In addition, vaccines for other infections (eg, rotavirus, varicella, and respiratory syncytial virus) are in development and likely will become available in the future. These recent advances raise hope that the list of diseases eradicated through vaccination will be expanded.

Adolescent↗

Factors affecting the retention and use of child health cards in a slum community in Kampala, Uganda, 2005.

OBJECTIVES: The child health card provides a way of following up all of the important aspects of a child's health particularly immunization and nutrition. Two previous studies in Uganda showed that up to 57% of mothers did not have their children's cards. This is likely to place the child's health and well-being at risk. Factors responsible for the low use and retention of child health cards were not known. We set out to explore and identify factors affecting child health card use and retention, and its effects on immunization. METHODS: This was a cross-sectional household survey. The study population was children 0-24 months and their mothers/caretakers. A sampling frame of eligible households was generated with the assistance of local area officials. From the sampling frame (1126), 260 households were randomly selected. Data was analyzed using the Epi Info version 3.2.2. Odds Ratios and corresponding 95% confidence intervals were used to test for statistical significance. Logistic regression was used to control for confounding. RESULTS: Sixty-six percent of children had a child health card. Children delivered at a health facility were 4 times more likely to have a card compared to those delivered at home (AOR 3.74, 95% CI 1.35, 7.64). Children whose mothers had a health problem during pregnancy were 2(1/2) times more likely to have a card (AOR 2.4, 95% CI 1.23, 4.59), and children taken to a health facility in the 3 months preceding the survey were twice as likely to have a card (AOR 2.37, 95% CI 1.04, 3.96). Children who had cards were 10 times more likely to be up to date with the immunization schedule (OR=9.55, 95% CI 3.19, 29.45). CONCLUSIONS: Child health cards help health workers and caretakers follow up child health issues, inherently promoting child health. The factors associated with card retention include whether the mother or child used a formal facility where cards are issued. It is therefore important that the health sector promotes the utilization of antenatal care, delivery, postnatal care and other services for mother and child.

Adult↗

Haemophilus influenzae type b vaccination: long-term protection.

OBJECTIVE: To identify evidence of the impact of Haemophilus influenzae type b (Hib) conjugate vaccine on the epidemiology of invasive Hib disease. SOURCES OF DATA: This review was based on a search of MEDLINE, LILACS, technical reports, national and international guidelines (publications from 1991 to 2005). The keywords Haemophilus influenzae type b, immunization, impact, and effectiveness, alone or in combination, were used to retrieve the articles. Studies published before 1991 and cited in the references of the studies reviewed were analyzed for useful information. SUMMARY OF THE FINDINGS: Introduction of the Hib conjugate vaccine produced great decline in the incidence of invasive Hib disease in childhood in countries where this vaccine was introduced into the routine immunization schedule. Nevertheless, the resurgence of invasive Hib disease in some regions has challenged several researchers to identify the reasons for this epidemiological pattern, as well as the measures to be implemented in order to avoid such a phenomenon. CONCLUSIONS: The use of Hib conjugate vaccine on a population scale has been greatly effective; nonetheless, changes in the vaccination scheme seem to be necessary to keep invasive Hib disease under control.

Bacterial Capsules↗

Production and characterization of monoclonal antibodies for aflatoxin B1.

Hybridomas that secreted antibodies for aflatoxin B1 were selected using two immunization protocols referred to as A and B. Protocol A is a standard immunization method and resulted in the selection of only two clones that produced monoclonal antibodies against aflatoxin B1. In protocol B a unique immunization schedule which resulted in the generation of 10 hybridomas is described. Of the 10, one antibody was highly specific to B1, four antibodies reacted equally strongly with B1, G1 and weakly with B2. Another four reacted strongly with B1 and weakly with B2 and G1. One clone reacted equally strongly with B1, G1 and B2. Interestingly all the 10 antibodies showed little or no cross-reaction with G2.

Aflatoxin B1↗

Peritoneal cell populations during tumour injection.

The response of peritoneal cells to the SL2 lymphoma was studied in immunized and non-immunized mice to elucidate further the cellular events that lead to tumour rejection in an allogeneic and a syngeneic tumour system. Anti-tumor immunity was induced by intraperitoneal injection of normal, irradiated or mitomycin-C treated tumour cells. Four different immunization schedules were tested. The response of the peritoneal cells was investigated by studying the peritoneal cell population kinetics (appearance and/or disappearance of various cell types e.g. mononuclear phagocytes, lymphocytes, PMNS and mast cells). Total cell counts were done using phase contrast microscopy, differential cell counts were done on cytocentrifuge slides, stained with May Grünwald-Giemsa. The activity of the lysosomal enzyme beta-glucuronidase present in mononuclear phagocytes was also studied. The results indicated that the composition and morphology of the cellular fraction of the peritoneal exudate changes quite dramatically during tumour rejection. Especially the beta-glucuronidase activity of the mononuclear phagocytes line varies significantly. The observed changes in the cellular population depended upon the dose of tumour cells injected i.p. No significant differences were observed between the peritoneal cell populations of mice grafted i.p. with irradiated or with mitomycin-C treated tumour cells. On the other hand when mice previously immunized with three injections with 10 irradiated or mitomycin-C treated tumour cells were challenged i.p. with various doses of tumour cells, the immune potency against the tumour is greater after previous immunization with irradiated SL2 cells than after immunization with mitomycin-C treated tumour cells.

Animals↗

Hepatitis B vaccine in infants: a randomized controlled trial comparing gluteal versus anterolateral thigh muscle administration.

A significantly diminished antibody response to hepatitis B vaccine has been demonstrated in adults when the buttock is used as the injection site. However, in Brazil, the buttock continues to be recommended as site of injection for intramuscular administration of vaccines in infants. In this age group, there are no controlled studies evaluating the immunogenicity of the hepatitis B vaccine when administered at this site. In the present study, 258 infants were randomized to receive the hepatitis B vaccine either in the buttock (n = 123) or in the anterolateral thigh muscle (n = 135). The immunization schedule consisted of three doses of hepatitis B vaccine (Engerix Bregister mark or target, 10 microg) at 2, 4 and 9 months of age. There were no significant differences in the proportion of seroconversion (99.3% x 99.2%), or in the geometric mean titer of ELISA anti-HBs (1,862.1 x 1,229.0 mIU/mL) between the two groups. This study demonstrates that a satisfactory serological response can be obtained when the hepatitis B vaccine is administered intramuscularly into the buttock.

Buttocks↗

[Adverse reactions and immune response to Heberbiovac-HB vaccine administered to infants simultaneously with DPT and VA-MENGOC-BC].

The Cuban recombinant yeast-derived hepatitis B vaccine (Heberbiovac-HB) was administered to 2 groups of infants aged 3 months. A dosage of 10 micrograms was used through a scheme of 0, 1 and 6 and 0, 1, 2 and 12, coinciding with the DPT and anti-meningococcal vaccines, according to the immunization schedule. Reactogenicity and immunogenicity were studied in both groups. The reactions observed were mild and similar to other studies, where fever , erythema and induration were the most common signs. These 2 groups had high percentages of children with titres of antibodies anti HBs above 100 UI/L-1. It is demonstrated the acceptable reactogenicity of the vaccine and the non-immunological interference of other vaccines.

Antibodies, Bacterial↗

Immunologic activity of myelin basic protein in strain 2 and strain 13 guinea pigs.

The resistance of Strain 2 guinea pigs to experimental allergic encephalomyelitis (EAE) induced by inoculation with whole CNS tissue in complete Freund's adjuvant (CFA) has been confirmed. The resistance is even more pronounced when myelin basic protein (BP) is used in attempts to induce EAE. Strain 2 guinea pigs are also resistant to an immunization schedule (multiple injections with BP in IFA followed by a single injection of BP in CFA) known to induce significant levels of antibody in susceptible strains. The poor response of Strain 2 guinea pigs to BP is not the result of lack of specific B cells--antibody equivalent to that produced by Strain 13 animals is obtained when the inoculum contains 0.5 mg BP and 2.5 mycobacteria.

Amino Acid Sequence↗