Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 4 Issue 3 September 2015
http://jpids.oxfordjournals.org/content/current

.
Measles in Latin America: Current Situation
Robério Dias Leite1 and Eitan Naaman Berezin2
Extract
The Region of the Americas (North, Central, and South America and the Caribbean) successfully interrupted endemic measles transmission in 2002, but recent outbreaks in Latin America threaten to reverse this impressive achievement. Before widespread measles immunization in Latin America, measles was a common illness in early childhood and was associated with substantial mortality. During the 1960s, 600 000 measles cases were reported annually in the Region of the Americas [1]. Although measles vaccine was introduced during the 1960s, it was the creation of the World Health Organization (WHO) Expanded Program on Immunization in 1977 that marked the beginning of sustained decreases in case numbers. During 1970–1979, Latin American countries reported 220 000 measles cases annually, with incidence rates of 47–116 cases/100 000 population [2]. The highest mortality rates occurred among young children; from 1971 through 1980, measles associated mortality was 14–55 measles-associated deaths per 100 000 infants and 8–54 deaths/100 000 children aged 1–4 years. By 1980, most countries in the region had established national immunization programs; however, the mean infant measles vaccine coverage in the region was only 42%. In 2002, after more than 30 years of successful strategies and joint efforts of many countries in the region, interruption of endemic measles transmission in the Americas was achieved [3]. However, isolated cases continue to occur, due to the importation of measles from other areas of the world, sometimes causing short chains of transmissions over a few months…

Post-Licensure Surveillance of Trivalent Live-Attenuated Influenza Vaccine in Children Aged 2–18 Years, Vaccine Adverse Event Reporting System, United States, July 2005–June 2012
Penina Haber1, Pedro L. Moro1, Maria Cano1, Claudia Vellozzi1, Paige Lewis1, Emily Jane Woo2 and Karen Broder1
Author Affiliations
1Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
2Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US Food and Drug Administration, Rockville, Maryland
Abstract
Background
The first trivalent live-attenuated influenza vaccine (LAIV3) was licensed in 2003 for use in healthy persons 5–49 years of age. In 2007, the US Food and Drug Administration expanded its indication to healthy children 2–4 years of age.
Methods
We searched the Vaccine Adverse Event Reporting System (VAERS) for US reports after LAIV3 from July 1, 2005 to June 30, 2012 in children aged 2–18 years. Medical records were requested for nonmanufacturer reports coded as serious (ie, death, hospitalization, prolonged hospitalization, life-threatening illness, disability). We characterized electronic data and clinically reviewed all serious reports and reports of special interest. Empirical Bayesian data mining was used to identify new or unexpected adverse events (AEs).
Results
During the study period, VAERS received 2619 US LAIV3 reports for children aged 2–18 years; 197 (7.5%) reports were serious, including 5 deaths. The 2 most frequent nonfatal serious reports involved neurological and respiratory systems, with 56 (29.2%) and 43 (22.4%) reports, respectively. The most frequent neurological diagnoses were seizures and Guillain-Barré Syndrome, and the most frequent respiratory conditions were pneumonia and asthma or reactive airway disease. Data mining showed increased proportions for reports of medication errors, most commonly vaccine administration errors not associated with an AE.
Conclusions
In this VAERS analysis of reports following LAIV3, we found no new or unexpected AEs patterns. Reports of LAIV3 administration to persons, for whom it is not recommended, including children with a history of asthma or reactive airway disease or wheezing, indicate that ongoing monitoring and education in vaccine indications are needed.

Safety and Immunogenicity of Full-Dose Trivalent Inactivated Influenza Vaccine (TIV) Compared With Half-Dose TIV Administered to Children 6 Through 35 Months of Age
Natasha B. Halasa1, Michael A. Gerber2, Andrea A. Berry3, Edwin L. Anderson4, Patricia Winokur5, Harry Keyserling6, Allison Ross Eckard6, Heather Hill7, Mark C. Wolff7, Monica M. McNeal2, Kathryn M. Edwards1 and David I. Bernstein2
Author Affiliations
1Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
2Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Ohio
3Center for Vaccine Development, University of Maryland, Baltimore
4Department of Medicine, St Louis University, Missouri
5Department of Medicine, University of Iowa, Iowa City
6Department of Pediatrics, Emory University, Atlanta, Georgia
7EMMES Corporation, Rockville, Maryland
Abstract
Background Children 6 through 35 months of age are recommended to receive half the dose of influenza vaccine compared with older children and adults.
Methods This was a 6-site, randomized 2:1, double-blind study comparing full-dose (0.5 mL) trivalent inactivated influenza vaccine (TIV) with half-dose (0.25 mL) TIV in children 6 through 35 months of age. Children previously immunized with influenza vaccine (primed cohort) received 1 dose, and those with no previous influenza immunizations (naive cohort) received 2 doses of TIV. Local and systemic adverse events were recorded. Sera were collected before immunization and 1 month after last dose of TIV. Hemagglutination inhibition antibody testing was performed.
Results Of the 243 subjects enrolled (32 primed, 211 naive), data for 232 were available for complete analysis. No significant differences in local or systemic reactions were observed. Few significant differences in immunogenicity to the 3 vaccine antigens were noted. The immune response to H1N1 was significantly higher in the full-dose group among primed subjects. In the naive cohort, the geometric mean titer for all 3 antigens after 2 doses of TIV were significantly higher in the 12 through 35 months compared with the 6 through 11 months age group.
Conclusions Our study confirms the safety of full-dose TIV given to children 6 through 35 months of age. An increase in antibody responses after full- versus half-dose TIV was not observed, except for H1N1 in the primed group. Larger studies are needed to clarify the potential for improved immunogenicity with higher vaccine doses. Recommending the same dose could simplify the production, storage, and administration of influenza vaccines.