Vaccine
Volume 32, Issue 42, Pages 5371-5530 (22 September 2014)
http://www.sciencedirect.com/science/journal/0264410X/32/42

Obituary
Remembering Dr. Ciro de Quadros
Pages 5371-5374
Jon Kim Andrus
[No abstract]

Adjuvants for vaccines to drugs of abuse and addiction
Review Article
Pages 5382-5389
Carl R. Alving, Gary R. Matyas, Oscar Torres, Rashmi Jalah, Zoltan Beck
Abstract
Immunotherapeutic vaccines to drugs of abuse, including nicotine, cocaine, heroin, oxycodone, methamphetamine, and others are being developed. The theoretical basis of such vaccines is to induce antibodies that sequester the drug in the blood in the form of antibody-bound drug that cannot cross the blood brain barrier, thereby preventing psychoactive effects. Because the drugs are haptens a successful vaccine relies on development of appropriate hapten-protein carrier conjugates. However, because induction of high and prolonged levels of antibodies is required for an effective vaccine, and because injection of T-independent haptenic drugs of abuse does not induce memory recall responses, the role of adjuvants during immunization plays a critical role. As reviewed herein, preclinical studies often use strong adjuvants such as complete and incomplete Freund’s adjuvant and others that cannot be, or in the case of many newer adjuvants, have never been, employed in humans. Balanced against this, the only adjuvant that has been included in candidate vaccines in human clinical trials to nicotine and cocaine has been aluminum hydroxide gel. While aluminum salts have been widely utilized worldwide in numerous licensed vaccines, the experience with human responses to aluminum salt-adjuvanted vaccines to haptenic drugs of abuse has suggested that the immune responses are too weak to allow development of a successful vaccine. What is needed is an adjuvant or combination of adjuvants that are safe, potent, widely available, easily manufactured, and cost-effective. Based on our review of the field we recommend the following adjuvant combinations either for research or for product development for human use: aluminum salt with adsorbed monophosphoryl lipid A (MPLA); liposomes containing MPLA [L(MPLA)]; L(MPLA) adsorbed to aluminum salt; oil-in-water emulsion; or oil-in-water emulsion containing MPLA.

The Vaccine Safety Datalink: successes and challenges monitoring vaccine safety
Review Article
Pages 5390-5398
Michael M. McNeil, Julianne Gee, Eric S. Weintraub, Edward A. Belongia, Grace M. Lee, Jason M. Glanz, James D. Nordin, Nicola P. Klein, Roger Baxter, Allison L. Naleway, Lisa A. Jackson, Saad B. Omer, Steven J. Jacobsen, Frank DeStefano
Abstract
The Vaccine Safety Datalink (VSD) is a collaborative project between the Centers for Disease Control and Prevention (CDC) and 9 health care organizations. Established in 1990, VSD is a vital resource informing policy makers and the public about the safety of vaccines used in the United States. Large linked databases are used to identify and evaluate adverse events in over 9 million individuals annually. VSD generates rapid, important safety assessments for both routine vaccinations and emergency vaccination campaigns. VSD monitors safety of seasonal influenza vaccines in near-real time, and provided essential information on the safety of influenza A (H1N1) 2009 monovalent vaccine during the recent pandemic. VSD investigators have published important studies demonstrating that childhood vaccines are not associated with autism or other developmental disabilities. VSD prioritizes evaluation of new vaccines; searches for possible unusual health events after vaccination; monitors vaccine safety in pregnant women; and has pioneered development of biostatistical research methods.

Primary care providers human papillomavirus vaccine recommendations for the medically underserved: A pilot study in U.S. Federally Qualified Health Centers
Original Research Article
Pages 5432-5435
Katherine B. Roland, Vicki B. Benard, April Greek, Nikki A. Hawkins, Mona Saraiya
Abstract
Introduction
In the United States, Federally Qualified Health Centers (FQHCs) are safety-net clinics that provide cervical cancer screening and human papillomavirus (HPV) vaccination to medically underserved women, some of whom may be at risk for developing cervical cancer. National guidelines recommend against using screening test results or sexual history to determine vaccine eligibility. Documenting HPV vaccine recommendations and beliefs of primary care providers in FQHCs may aid in promoting evidence-based practices and prioritizing health interventions for vulnerable populations.
Methods
Between 2009 and 2010, we collected data from 98 primary care providers in 15 FQHC clinics in IL, USA using a cross-sectional survey. Questions assessed provider and practice characteristics, HPV vaccine recommendations, and provider’s belief about whether their screening and management procedures would change for women who were vaccinated.
Results
93% of providers recommended the HPV vaccine, most frequently for females aged 13–26 years (98%). Some providers reported sometimes to always using HPV test results (12%), Pap test results (7%), and number of sexual partners (33%) to determine vaccine eligibility. More than half of providers (55%) reported they will not change their screening and management practices for vaccinated females, yet believe vaccination will yield fewer abnormal Pap tests (71%) and referrals for colposcopy (74%).
Conclusion
Study providers routinely recommended the HPV vaccine for their patients. However, providers made fewer recommendations to vaccinate females ages 9–12 years (which includes the target age for vaccination) compared to older females, and used pre-vaccination assessments not recommended by U.S. guidelines, such as screening test results and number of sexual partners. In order to maximize the public health benefit of the HPV vaccine to prevent cervical cancer, adherence to guidelines is necessary, especially in settings that provide care to medically underserved women.

Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario, Canada
Original Research Article
Pages 5436-5446
Hong Anh T. Tu, Shelley L. Deeks, Shaun K. Morris, Lisa Strifler, Natasha Crowcroft, Frances B. Jamieson, Jeffrey C. Kwong, Peter C. Coyte, Murray Krahn, Beate Sander
Abstract
Highlights
:: Neisseria meningitidis serotype B (MenB) causes invasive meningococcal disease.
:: Examined novel MenB vaccine (Bexsero®) approved in Europe, Canada and Australia.
:: Assessed cost-effectiveness of MenB infant vaccination program in Ontario, Canada.
:: Program is highly unlikely to be cost-effective in this low incidence setting.

Maternal determinants of timely vaccination coverage among infants in rural Bangladesh
Original Research Article
Pages 5514-5519
Lavanya Vasudevan, Alain B. Labrique, Sucheta Mehra, Lee Wu, Orin Levine, Danny Feikin, Rolf Klemm, Parul Christian, Keith P. West Jr.
Abstract
Highlights
:: Timely vaccination rates among infants in rural Bangladesh examined between 2001 and 2007.
:: 23,435 infants classified as vaccinated on time by 14 weeks of age with all vaccines or not.
:: Only 19% of infants included in study received timely vaccinations by 14 weeks of age.
:: Mothers’ receipt of antenatal care positively associated with timely vaccination status of infants.
:: Timely vaccination rates lower for infants perceived as small at birth by their mothers.