From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
AIDS Research and Human Retroviruses
May 2014, ahead of print.
The Immune Space: A Concept and Template for Rationalizing Vaccine Development
Dr. Amapola Manrique, Dr. Elizabeth Adams, Dr. Dan Barouch, Dr. Patricia E Fast, Dr. Barney Graham, Dr. Jerome H. Kim, Dr. James Kublin, Margaret McCluskey, Dr. Giuseppe Pantaleo, Dr. Harriet L. Robinson, Dr. Nina Russell, William Snow, and Dr. Margaret I. Johnston.
doi:10.1089/AID.2014.0040.
ABSTRACT
Empirical testing of candidate vaccines has led to the successful development of a number of lifesaving vaccines. The advent of new tools to manipulate antigens and new methods and vectors for vaccine delivery has led to a veritable explosion of potential vaccine designs. As a result, selection of candidate vaccines suitable for large-scale efficacy testing has become more challenging. This is especially true for diseases such as dengue, HIV, and tuberculosis where there is no validated animal model or correlate of immune protection. Establishing guidelines for the selection of vaccine candidates for advanced testing has become a necessity. A number of factors could be considered in making these decisions, including, for example, safety in animal and human studies, immune profile, protection in animal studies, production processes with product quality and stability, availability of resources, and estimated cost of goods. The “immune space template” proposed here provides a standardized approach by which the quality, level, and durability of immune responses elicited in early human trials by a candidate vaccine can be described. The immune response profile will demonstrate if and how the candidate is unique relative to other candidates, especially those that have preceded it into efficacy testing and thus, what new information concerning potential immune correlates could be learned from an efficacy trial. A thorough characterization of immune responses should also provide insight into a developer’s rationale for the vaccine’s proposed mechanism of action. HIV vaccine researchers plan to include this general approach in up-selecting candidates for the next large efficacy trial. This “immune space” approach may also be applicable to other vaccine development endeavors where correlates of vaccine-induced immune protection remain unknown.
Quality in Primary Care
Volume 22, Number 3, June 2014
http://www.ingentaconnect.com/content/rmp/qpc/2014/00000022/00000003
Immunisation errors reported to a vaccine advice service: intelligence to improve practice
Lang, Sarah1; Ford, Karen J2; John, Tessa2; Pollard, Andrew J3; McCarthy, Noel D4
Abstract:
Background: The success of immunisation programmes depends on the quality with which they are administered. The Vaccine Advice for CliniCians Service (VACCSline) is an advice service to support immunisers and promote excellence in immunisation practice, through specialist guidance and local education, covering a catchment population of two million people. All enquiries are recorded onto a database and categorised. Vaccine error is selected when a vaccine has not been prepared or administered according to national recommendations or relevant expert guidance.
Method: All enquiries from 2009 to 2011, categorised on the VACCSline database as ‘vaccine error’ were analysed and subjected to a detailed free-text review.
Results: Of 4301 enquiries, 158 (3.7%) concerned vaccine errors. The greatest frequency of errors, 145 (92.9%) concerned immunisations delivered in primary care services; 92% of all errors occurred during either vaccine selection and preparation or history checking and scheduling. Administration of the wrong vaccine was the most frequent error recorded in 33.3% of reports. A shared first letter of the vaccine name was noted to occur in 13 error reports in which the incorrect vaccine was inadvertently administered. Consultations involving pairs of siblings were associated with various errors in seven enquiries. Failure to revaccinate after spillage (seven reports) showed a widespread knowledge gap in this area.
Conclusion: Advice line enquiries provide intelligence to alert immunisers to the errors that are commonly reported and may serve to highlight processes that predispose to errors, thus informing immuniser training and updating
American Journal of Obstetrics and Gynecology
Available online 22 May 2014
Utilization of the combined tetanus-diphtheria and pertussis vaccine during pregnancy
Ilona T. Goldfarb, MD, MPH1, , Sarah Little, MD, MPH2, Joelle Brown1, Laura E. Riley, MD1
Abstract
Objective
A recent increase in pertussis cases prompted the Advisory Committee on Immunization Practices to recommend administering the Tdap vaccine during each pregnancy. We sought to describe uptake of Tdap and identify predictors of vaccination in pregnancy.
Study Design
We conducted a retrospective study of all women delivering at a university hospital between February and June 2013. Demographic, pregnancy, and vaccination data were abstracted from the medical record. The relationship between maternal age, parity, gestational age, race/ethnicity, marital status, prenatal provider/site, insurance, influenza vaccination status, and Tdap vaccine was described by univariate analysis. Independent predictors were identified by multivariable logistic regression.
Results
In our cohort of 1467 women, 1194 (81.6%) received a Tdap vaccine. After adjusting for potential confounders, three factors were found to be independent predictors of receiving the vaccine. Patients were more likely to receive Tdap if they had been vaccinated against influenza during this pregnancy (aOR 1.7, 95% CI 1.4, 2.3). Black women were less likely to receive Tdap when compared to other women (aOR 0.42, 95% CI 0.27,0.67). Also, women who delivered preterm were less likely to receive the Tdap vaccine (aOR 0.33, 95% CI 0.22,0.48).
Conclusion
A high overall Tdap vaccination rate was observed following implementation of the ACIP guidelines. Black women, however, had significantly lower vaccine uptake than other women. Further research is needed to understand and minimize this disparity. Women who delivered prematurely also had a decreased rate of Tdap vaccination; vaccinating earlier should be considered to better capture this population.