CDC: 2018 Conference on Retroviruses and Opportunistic Infections :: MMWR News Synopsis for MARCH 8, 2018

CDC/ACIP [to 10 March 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

Latest News
2018 Conference on Retroviruses and Opportunistic Infections
Tuesday, March 6, 2018
A new CDC analysis suggests HIV prevention pill is not reaching most Americans who could benefit – especially people of color.
 
MMWR News Synopsis for MARCH 8, 2018
https://www.cdc.gov/mmwr/index2018.html
:: Noncongenital Zika Virus Disease Cases — 50 States and the District of Columbia, 2016
Based on the data in this report, CDC continues to recommend that people living in or traveling to areas with risk of Zika infection take steps to prevent mosquito bites and sexual transmission of Zika. More information is available at https://www.cdc.gov/zika/about/overview.html. Most reported cases of Zika in 2016 in the continental United States were in travelers. CDC data show that in 2016, 5,168 symptomatic cases of Zika virus disease (Zika) were reported from the 50 U.S. states and Washington, DC. Of those cases, 4,897 (more than 9 out of 10) occurred in people after travel from areas with risk of Zika outside the continental United States; 224 people were reported to have been infected with Zika from local mosquitoes in small areas of Florida and Texas. Quickly identifying and investigating cases of Zika, especially in areas where mosquitoes are spreading the virus, may help direct mosquito control efforts and may reduce the further spread of Zika.

Announcements

Announcements
 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 10 March 2018]
http://cepi.net/
March 7, 2018
CEPI Partners with Themis Bioscience to Advance Vaccines Against Lassa Fever and MERS
— First major investment by Coalition for Epidemic Preparedness Innovations (CEPI) to advance vaccine development and manufacturing on two of CEPI’s highest priority infectious diseases —
[See Milestones above for more detail]

EDCTP    [to 10 March 2018]
http://www.edctp.org/

The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
7 March 2018
Ninth EDCTP Forum: call for abstracts, scholarships and symposia opens
The Ninth EDCTP Forum will be held in Lisbon, Portugal, from 17 to 21 September 2018. The EDCTP Forum programme…
The theme of the Forum is Clinical research and sustainable development in sub-Saharan Africa: the impact of North-South partnerships.
Go to the Ninth EDCTP Forum website

European Medicines Agency  [to 10 March 2018]
http://www.ema.europa.eu/ema/
09/03/2018
Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 5-8 March 2018
Immediate measures agreed for Zinbryta and Xofigo while reviews are ongoing; public hearing decided for quinolone and fluoroquinolone antibiotics
 
 
FDA [to 10 March 2018]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
March 08, 2018 –
Remarks from FDA Commissioner Scott Gottlieb, M.D., as prepared for oral testimony before the U.S. House Committee on Energy and Commerce Subcommittee on Oversight and Investigations hearing “Examining U.S. Public Health Preparedness for and Response Efforts to Seasonal Influenza.”

March 06, 2018 –
FDA approves new HIV treatment for patients who have limited treatment options
Today, the U.S. Food and Drug Administration approved Trogarzo (ibalizumab-uiyk), a new type of antiretroviral medication for adult patients living with HIV who have tried multiple HIV medications in the past (heavily treatment-experienced) and whose HIV infections cannot be successfully treated with other currently available therapies (multidrug resistant HIV, or MDR HIV)… 
 
Gavi [to 10 March 2018]
http://www.gavi.org/library/news/press-releases/
08 March 2018
Gavi named amongst highest scorers in gender equality report
Global Health 50/50 release review of gender-related policies at 140 global health organisations.

Global Fund [to 10 March 2018]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
Global Fund Welcomes New Report on Gender Equality
08 March 2018
The Global Fund to Fight AIDS, TB and Malaria applauded today’s release of the Global Health 50/50 Report, citing steep challenges in global health related to gender equality.

IVAC  [to 10 March 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
Latest Updates
Afghanistan takes important step to prevent a silent killer of children/Rotavirus vaccine for infants could prevent 12,000 deaths in the coming decade
By Lois Privor-Dumm and Dr. Ghulam Dastagir Nazary
 
 
MSF/Médecins Sans Frontières  [to 10 March 2018]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
Press release
MSF Response to New WHO Guidelines for HIV-Related Cryptococcal Disease
March 07, 2018
The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) welcomes the launch of updated guidance by the World Health Organization (WHO) this week on the diagnosis, treatment, and management of cryptococcal disease, an opportunistic infection mainly affecting people living with advanced stages of HIV/AIDS.

 
NIH  [to 10 March 2018]
http://www.nih.gov/news-events/news-releases
March 9, 2018
NIH experts call for transformative research approach to end tuberculosis
— TB is one of the oldest known human diseases and the leading infectious cause of death worldwide.
A more intensive biomedical research approach is necessary to control and ultimately eliminate tuberculosis (TB), according to a perspective published in the March 2018 issue of The American Journal of Tropical Medicine and Hygiene. In the article, authors Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and Robert W. Eisinger, Ph.D., special assistant for scientific projects at NIAID, discuss the need to modernize TB research by applying new diagnostic, therapeutic, and vaccine approaches…

Monoclonal antibodies crucial to fighting emerging infectious diseases, say NIH officials
March 8, 2018 — Special antibodies have shown promise in the fight against cancer and autoimmune diseases.

Antiviral drug not beneficial for reducing mother-to-child transmission of hepatitis B when added to existing preventatives
March 7, 2018 — NIH-funded study observes no significant reduction of infection rates at age 6 months.

High uptake and use of vaginal ring for HIV prevention observed in open-label study
March 6, 2018 — The HOPE study launched in 2016.
Nearly 90 percent of participants in an open-label study of a vaginal ring infused with a drug to prevent HIV are using the monthly ring at least some of the time, according to an interim analysis of study data. In addition, the rate of HIV infection among participants in the open-label study, which has no placebo arm for comparison, is half of what might be expected in the absence of the ring, according to mathematical modeling that has significant limitations…

One-month tuberculosis prophylaxis as effective as nine-month regimen for people living with HIV
March 5, 2018 — Study results have the potential to dramatically change clinical practice.
 

UNAIDS [to 10 March 2018]
http://www.unaids.org/en
8 March 2018
Measuring homophobia to improve the lives of all
A new index to measure levels of homophobia that can show the impact that homophobia has on countries has been developed.
The new index, published in the European Journal of Public Health, combines both data on institutional homophobia, such as laws, and social homophobia—relations between people and groups of people.

8 March 2018
UNAIDS a top-nine gender-responsive organization
UNAIDS has emerged as a top performer in the first Global Health 50/50 report.

7 March 2018
Communities at the heart of the AIDS response in Zambia

7 March 2018
New tool to Fast-Track the AIDS response in Zambia
5 March 2018
Commemorating Zero Discrimination Day at a panel on HIV and human rights
Read

UNICEF  [to 10 March 2018]
https://www.unicef.org/media/
Selected Press Releaases
UNICEF report: Over half a billion ‘uncounted’ children live in countries unable to measure SDG progress
NEW YORK, 7 MARCH 2018 – Early assessment of progress toward achieving the Sustainable Development Goals confirms an alarming lack of data in 64 countries, as well as insufficient progress toward the SDGs for another 37 countries where the data can be tracked.
[See Research, Reports below for more detail]

25 million child marriages prevented in last decade due to accelerated progress, according to new UNICEF estimates
NEW YORK, 6 March 2018 – The prevalence of child marriage is decreasing globally with several countries seeing significant reductions in recent years, UNICEF said today. Overall, the proportion of women who were married as children decreased by 15 per cent in the last decade, from 1 in 4 to approximately 1 in 5.

Wellcome Trust  [to 10 March 2018]
https://wellcome.ac.uk/news
News / Published: 9 March 2018
The story of a superbug from genome to advocacy
A ‘typhoid superbug’ in Pakistan has been in headlines around the world. Researchers identified a typhoid strain that has become resistant to multiple antibiotics. Elizabeth Klemm, one of those researchers, tells the story behind the headlines.
The genetic structure of a strain of the bacteria that causes typhoid which is resistant to five classes of antibiotics has been uncovered by scientists at the Wellcome Sanger Institute (opens in a new tab) with collaborators at Public Health England and Aga Khan University, Pakistan.
There is currently a major outbreak of this highly resistant typhoid fever in Pakistan, and there has been a single case in the UK following travel, which was isolated and treated.
This new study shows that the typhoid strain behind the outbreak has acquired an additional piece of DNA and so has become resistant to multiple antibiotics, including a third-generation antibiotic.
The results, published in mBio (opens in a new tab), suggest that treatment options are running out for typhoid, and there is an urgent need for more stringent preventative  strategies including vaccines…

News
Sir John Sulston (1942-2018)
9 March 2018
We were deeply saddened to hear about the death of Sir John Sulston this week. John was an outstanding figure in UK biological and medical science and in Wellcome’s history.
For his remarkable work on the development of cells within the nematode worm C. elegans, he was rightfully recognised with the Nobel Prize in 2002.

But it was his leadership of the UK’s contribution to the Human Genome Project that was fundamental not only to the success of the project but also to the sequence being made freely available for all to use.

John’s close relationship with Wellcome began in the early 1990s when he was awarded the Trust’s biggest grant up to that point – £46.5m – to establish a genome sequencing centre at Hinxton near Cambridge. Over the next decade, he developed the Wellcome Trust Sanger Institute into one of the world’s leading centres for genome science.

John was adamant that the human DNA code should be released into the public domain so that other researchers could study and use it. This principle was adopted at the 1996 meeting of HUGO in Bermuda, and two years later John led the acceleration of the project – with funding from Wellcome to deliver one-third of the genome – to ensure that private interests did not threaten this accessibility.

The completion of the human genome in 2003 (a draft having been published in 2001) was a triumph for John, his team at the Wellcome Trust Sanger Institute, and the global community of researchers who worked on the project.

Eliza Manningham-Buller, Chair of Wellcome, said: “I am deeply saddened to hear of John’s death. His contribution to genetics was unparalleled and in setting up the Wellcome Sanger Institute he changed the course of genomics research. It was an honour to know him and sympathies go to his family.”

Jeremy Farrar, Director of Wellcome, said: “John was a brilliant scientist and a wonderful, kind and principled man. His leadership was critical to the establishment of the Wellcome Sanger Institute and the Human Genome Project, one of the most important scientific endeavours of the past century.

“His dedication to free access to scientific information was the basis of the open access movement, and helped ensure that the reference human genome sequence was published openly for the benefit of all humanity. It’s just one of the ways that John’s approach set the standard for researchers everywhere.”
9 March 2018
Sir John Sulston and the Human Genome Project

News   8 March 2018
8 projects to increase vital knowledge about women’s health
To mark International Women’s Day 2018, Charli Colegate from our Humanities & Social Science team highlights eight projects Wellcome is funding to explore the health experiences of women from different backgrounds around the world.

News  7 March 2018
Jeremy Farrar reappointed as Wellcome’s Director
Dr Jeremy Farrar, the Director of Wellcome, has been reappointed by Wellcome’s Board of Governors for a second five-year term.
Jeremy’s second term as Director will begin in October 2018 and run until 2023.
He joined Wellcome in 2013, succeeding Sir Mark Walport. Jeremy is a world-renowned clinical scientist and a leading figure in the field of infectious disease. Between 1996 and 2013, he was Director of the Oxford University Clinical Research Unit in Vietnam, which is supported by Wellcome…

::::::

DCVMN – Developing Country Vaccine Manufacturers Network  [to 10 March 2018]
http://www.dcvmn.org/
5 April 2018
Webinar: The new Future Vaccine Manufacturing Hub, collaborating with DCVMN
Prof Robin Shattock, Professor of Mucosal Infection and Immunity, Imperial College, London
Thursday, April 5, 2018 9:00 am
Europe Summer Time (Paris, GMT+02:00)
 
IFPMA   [to 10 March 2018]
http://www.ifpma.org/resources/news-releases/
Global Health Matters
Vaccines: Reflecting on 2017 and what’s on the 2018 horizon
5 March 2018
By Laetitia Bigger
2017 has shown how the power of collaboration and partnership is vital in extending the benefits of vaccines to an ever-growing number of people. Let me take you through some of the key moments for vaccines in 2017 and look ahead to 2018…

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org
 
 
Progress for Children in the SDG Era
UNICEF
March 2018 :: 104 pages
PDF: https://data.unicef.org/wp-content/uploads/2018/03/Progress_for_Every_Child_03.08.2018_V3.pdf
Foreward [excerpt]
The Sustainable Development Goals embody our highest aspirations for a better world – and reflect our greatest responsibility as a global community: To provide children and young people today with the services, skills and opportunities they need tomorrow to build better futures for themselves, their families, and their societies.
 
This understanding – that a sustainable future depends on how we meet the needs of children and young people today – is at the core of the SDGs, which include 44 child-related indicators integrated throughout the 17 goals. Progress for Every Child in the SDG Era, the first report of UNICEF’s new SDG tracking series, provides a preliminary assessment of how the world is doing thus far on achieving these critical targets.

Even for early days, the outlook the report reveals is foreboding.

Most urgently, UNICEF’s comprehensive report on SDG progress for children reveals that more than 650 million children – approaching one-third of the world’s children – live in 52 countries that are off track on at least two-thirds of the child-related SDG indicators for which they have data.

The concerns raised by this news are compounded by the fact that these are only the children we know about. Progress for Every Child in the SDG Era also reveals that over half a billion of the world’s children live in 64 countries that lack sufficient data for us even to assess if they are on or off track for at least two-thirds of all child-related SDG indicators.

This is a critical juncture in the SDG era: A time when the decisions we take and the investments we make can pay enormous dividends – or extract an impossible price. While it would be both counterproductive and premature to predict failure, it is never too soon to calculate its potential costs.

Given current trends, unless we accelerate progress to meet the child-related SDG targets, between 2017 and 2030, 10 million children will die from preventable causes before reaching their fifth birthdays.

As many as 31 million children will be stunted, robbed of the opportunity to fulfil their potential for lack of adequate nutrition.

At least 22 million children will miss out on pre-primary education, so critical to their later ability to succeed in school and beyond.

And without faster progress, 670 million people worldwide will still be without basic drinking water, in turn threatening children’s survival and healthy development…
 
Immunization [p.35]
Immunization averts an estimated 2 million-3 million deaths every year. Vaccines against diphtheria, tetanus, pertussis, measles and other preventable diseases also prevent millions of additional health issues and disabilities. These benefits make immunization one of the most cost-effective public health interventions.

In 2016, global coverage rates for the third dose of the diphtheria-tetanus-pertussis vaccine (DTP3) and the first dose of measles-containing vaccine (MCV1) reached 86 per cent and 85 per cent, respectively, up from 72 per cent for each in 2000. Despite this increased coverage:
:: About 20 million children did not receive three doses of DTP and about 21 million missed the first dose of MCV.
:: Regional disparities persist: West and Central Africa lags behind, with 67 per cent coverage for each.

Trajectories
Achieving the SDG target of universal coverage by 2030 will take sustained efforts. Progress in expanding DTP3 and MCV1 coverage has been slow during recent years, and uneven across countries and regions. Based on the average rate of progress during 2010-2016:
:: 74 countries are not on track to reach the SDG target for DTP3, and 87 are not on track to reach it for MCV1.
:: The countries needing acceleration represent 34 per cent in the case of DTP3, and 41 per cent in the case of MCV1, of the global population of surviving infants.
:: Sub-Saharan Africa accounts for nearly half of infants living in countries that need acceleration to reach the DTP3 target.

Disparities
Unequal access to immunization services within countries leaves millions of children from poor households at risk of vaccine-preventable diseases.

Data published in Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) make it possible to examine trajectories towards universal immunization coverage by household wealth for 32 countries. Survey data are generally not available for high-income countries, so disparities between wealthier and poorer households cannot be calculated in the same way. Comparing progress among children living in the poorest and wealthiest fifth of households in the 32 countries shows larger disparities for DTP3 coverage than for MCV1 (see Figure 1.11):
:: For DTP3, acceleration is needed to achieve the target for 60 per cent of children in the poorest quintiles and just under 40 percent of the wealthiest.
:: For MCV1, acceleration is needed for nearly 80 per cent of children in the poorest quintiles and over 60 per cent in the wealthiest.

Among the poorest in the 32 countries, the difference between the trajectories for DTP3 and MCV1 is due to three large middle-income countries – Kenya, the Philippines and Viet Nam – that are on track to meet the DTP3 target but need acceleration to meet the MCV1 target.

Wealth inequality appears to be an important factor in the rates of coverage. In Nigeria, for example, children from the wealthiest households are more than seven times as likely as children from the poorest households to have received the DTP3 vaccine. In Namibia, an upper-middle income country, children from the poorest households are 20 per cent more likely to have been vaccinated than those in the wealthiest households.
 
Call to action [p.100]
An agenda for action on data
There are no easy fixes to addressing the data deficiencies exposed in this report. Good data on children depend on strong national data institutions and capacity, which take time and investment to develop. But much can be done – and done now. Putting systems in place to generate the data required to track and enable progress will take sustained efforts and support across a number of areas.

The accountability to generate the data – and achieve the goals – is held by countries. But the international community has an obligation to work in partnership with national governments.

In Goal 17, the SDGs include a call for a revitalized global partnership for sustainable development – and working together to develop countries’ statistical capacities is an essential part of that endeavour. Target 17.18 specifically calls for capacity-building support to developing countries “to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts.”

We identify three principles that should underpin this effort and that will guide UNICEF’s work over the next 12 years:
:: Data as the spine of system strengthening.
The effort to improve data collection and capacity is inseparable from the broader effort to build strong service delivery systems, whether in health or education, social services or border control. We will invest in long-term efforts to improve the quality, coverage and coordination of governments’ administrative data systems that concern children.

:: Leave no country behind.
Global support to data monitoring and capacity resembles a messy patchwork. We will urge systematic and coordinated efforts to ensure all countries have minimum data coverage for children, irrespective of their resources and capabilities. This will require greater cooperation with industrialized economies to ensure reporting to custodian agencies, and investing in new data solutions in conflict- and disaster-affected areas, where reliance on regular surveys and routine data systems may not be feasible.

:: Shared norms, beginning with open data.
The monitoring framework of the SDGs represents a formidable exercise in agreeing on universal approaches to measurement, while still recognizing the value of local adaption for country ownership. The need for stronger shared norms on data remains great, especially when it comes to children. We will advocate for common approaches to measuring emerging threats facing children, capturing missing child populations such as those in institutions or migrating, and to sharing data to enable vulnerable children to be more effectively identified, while protecting children’s privacy.

To support countries in mainstreaming data on children and adolescents into national statistical systems and plans, UNICEF is already working to develop needed indicators and measurement tools, and support national capacities to monitor and use SDG indicators, especially the 17 indicators that UNICEF has a particular duty to support (see Box 6.1). This work is undertaken as part of the United Nations Development Group and the broader development community.

The agenda is expansive, and only by working together can it be fulfilled.
 
Press release
UNICEF report: Over half a billion ‘uncounted’ children live in countries unable to measure SDG progress
Latest data on development progress for children shows over half a billion more live in countries where the SDGs are quickly falling out of reach.
NEW YORK, 7 MARCH 2018 – Early assessment of progress toward achieving the Sustainable Development Goals confirms an alarming lack of data in 64 countries, as well as insufficient progress toward the SDGs for another 37 countries where the data can be tracked.

The UNICEF report, Progress for Children in the SDG Era, is the first thematic report assessing performance toward achieving the SDG global targets that concern children and young people. The report warns that 520 million children live in countries which completely lack data on at least two-thirds of child-related SDG indicators, or lack sufficient data to assess their progress – rendering those children effectively “uncounted.”

Where sufficient data is available, the scale of the challenge posed by the SDG targets remains daunting. The report warns that 650 million children live in countries where at least two-thirds of the SDGs are out of reach without accelerated progress. In fact, in those countries, even more children could face bad outcomes in life by 2030 than now.

“More than half the world’s children live in countries where we either can’t track their SDG progress, or where we can and they are woefully off-track,” said Laurence Chandy, UNICEF Director for the Division of Data, Research and Policy. “The world must renew its commitment to attaining the SDGs, starting with renewing its commitment to measuring them.”

The report tracks progress on five dimensions of children’s rights: health, learning, protection from violence and exploitation, a safe environment and equal opportunity. The report quantifies how far short of the global goals the world is currently expected to fall, measured in human costs.

Projections show that between now and 2030:
:: 10 million additional children would die of preventable causes before their fifth birthday;
:: 31 million children would be left stunted due to lack of adequate nutrition;
:: 22 million children would miss out on pre-primary education;
:: 150 million girls will marry before their 18th birthday;
:: 670 million people, many of them children, will still be without basic drinking water.
“Two years ago, the world agreed on an ambitious agenda to give every child the best chance in life, with cutting-edge data analysis to guide the way,” said Chandy. “And yet, what our comprehensive report on SDG progress for children reveals plainly is an abject lack of data. Most countries do not have the information even to assess whether they are on track or not. Children around the world are counting on us – and we can’t even count all of them.”

The report calls for renewed efforts to address the global data-deficiency, while recognizing that strong national data institutions and capacity take time and investment to develop. The report identifies three principles to underpin this work:
:: Building strong measurement into service delivery systems, whether in health or education, social services or border control;
:: Systematic and coordinated efforts to ensure all countries have minimum data coverage for children, irrespective of their resources and capabilities;
:: Establishing stronger shared norms on data concerning children, including common approaches to measuring emerging threats facing children, capturing missing child populations, and sharing data to enable vulnerable children to be more effectively identified, while protecting children’s privacy.
While each government is ultimately accountable to generate the data that will guide and measure achievement of the goals, the international community has an obligation to partner with them to make sure the SDG targets are met.

Journal Watch

Journal Watch

   Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

Are Infants Less than 6 Months of Age a Neglected Group for Anemia Prevention in Low-Income Countries?

American Journal of Tropical Medicine and Hygiene
Volume 98, Issue 3, 2018
http://www.ajtmh.org/content/journals/14761645/98/3

Perspective Piece
Are Infants Less than 6 Months of Age a Neglected Group for Anemia Prevention in Low-Income Countries?
Authors: Cinta Moraleda, Regina N. Rabinovich and Clara Menéndez
https://doi.org/10.4269/ajtmh.17-0487
Anemia is a major public health problem that affects mainly children, predominantly in low-income countries and most often due to iron deficiency (ID). Administration of iron supplements to prevent and treat ID anemia in malaria endemic areas has been controversial for decades; however, recent World Health Organization guidelines recommend universal iron supplementation for children in highly prevalent anemia settings, including those where malaria is endemic. However, infants younger than 6 months of age have been exempted from this recommendation because ID is not considered prevalent at this age and because of assumptions—without evidence—that they are protected from ID through breast milk. To achieve full impact of anemia prevention targeting infants less than 6 months of age who are at highest risk of ID, operational studies that conclusively demonstrate the effectiveness and safety of delivering iron supplements to young infants in settings with a high burden of infectious diseases, including malaria, are needed.

Reimagining the Research Approach to Tuberculosis

American Journal of Tropical Medicine and Hygiene
Volume 98, Issue 3, 2018
http://www.ajtmh.org/content/journals/14761645/98/3

Reimagining the Research Approach to Tuberculosis
Authors: Anthony S. Fauci and Robert W. Eisinger
https://doi.org/10.4269/ajtmh.17-0999
Controlling and ultimately ending tuberculosis (TB) as a public health scourge will require a multifaceted and comprehensive approach involving the intensification of public health efforts, including scaling-up the delivery of current diagnostic, preventive, and therapeutic tools. However, a critically important element in the effort to end TB is an accelerated biomedical research effort to address the many unanswered questions about the disease process itself and to develop improved and innovative countermeasures. An intensive effort toward these research goals will facilitate the achievement of the aspirational goal of ending TB.

Public health impact and cost effectiveness of routine childhood vaccination for hepatitis a in Jordan: a dynamic model approach

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 10 March 2018)

Research article
Public health impact and cost effectiveness of routine childhood vaccination for hepatitis a in Jordan: a dynamic model approach
As the socioeconomic conditions in Jordan have improved over recent decades the disease and economic burden of Hepatitis A has increased. The purpose of this study is to assess the potential health and economi…
Authors: Wail A. Hayajneh, Vincent J. Daniels, Cerise K. James, Muhammet Nabi Kanıbir, Matthew Pilsbury, Morgan Marks, Michelle G. Goveia, Elamin H. Elbasha, Erik Dasbach and Camilo J. Acosta
Citation: BMC Infectious Diseases 2018 18:119
Published on: 7 March 2018

Impact of a vaccination programme in children vaccinated with ProQuad, and ProQuad-specific effectiveness against varicella in the Veneto region of Italy

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 10 March 2018)

Research article
Impact of a vaccination programme in children vaccinated with ProQuad, and ProQuad-specific effectiveness against varicella in the Veneto region of Italy
Monovalent varicella vaccines have been available in the Veneto Region of Italy since 2004. In 2006, a single vaccine dose was added to the immunisation calendar for children aged 14 months. ProQuad®, a quadri…
Authors: Carlo Giaquinto, Giovanni Gabutti, Vincenzo Baldo, Marco Villa, Lara Tramontan, Nadia Raccanello, Francesca Russo, Chiara Poma, Antonio Scamarcia, Luigi Cantarutti, Rebecca Lundin, Emilia Perinetti, Xavier Cornen, Stéphane Thomas, Céline Ballandras, Audrey Souverain…
Citation: BMC Infectious Diseases 2018 18:103
Published on: 5 March 2018

 

Patient data and patient rights: Swiss healthcare stakeholders’ ethical awareness regarding large patient data sets – a qualitative study

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 10 March 2018)

Research article
Patient data and patient rights: Swiss healthcare stakeholders’ ethical awareness regarding large patient data sets – a qualitative study
Authors: Corine Mouton Dorey, Holger Baumann and Nikola Biller-Andorno
Citation: BMC Medical Ethics 2018 19:20
Published on: 7 March 2018
Abstract
Background
There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient’s rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i.e. healthcare professionals, regulators and policy makers.
Methods
We used a qualitative design to examine Swiss healthcare stakeholders’ experiences and perceptions of ethical challenges with regard to patient data in real-life settings where clinical registries are sponsored, created and/or used. A semi-structured interview was carried out with 22 participants (11 physicians, 7 policy-makers, 4 ethical committee members) between July 2014 and January 2015. The interviews were audio-recorded, transcribed, coded and analysed using a thematic method derived from Grounded Theory.
Results
All interviewees were concerned as a matter of priority with the needs of legal and operating norms for the collection and use of data, whereas less interest was shown in issues regarding patient agency, the need for reciprocity, and shared governance in the management and use of clinical registries’ patient data. This observed asymmetry highlights a possible tension between public and research interests on the one hand, and the recognition of patients’ rights and citizens’ involvement on the other.
Conclusions
The advocation of further health-related data sharing on the grounds of research and public interest, without due regard for the perspective of patients and donors, could run the risk of fostering distrust towards healthcare data collections. Ultimately, this could diminish the expected social benefits. However, rather than setting patient rights against public interest, new ethical approaches could strengthen both concurrently. On a normative level, this study thus provides material from which to develop further ethical reflection towards a more cooperative approach involving patients and citizens in the governance of their health-related big data.

Infection prevention behaviour and infectious disease modelling: a review of the literature and recommendations for the future

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 10 March 2018)

Research article
Infection prevention behaviour and infectious disease modelling: a review of the literature and recommendations for the future
Given the importance of person to person transmission in the spread of infectious diseases, it is critically important to ensure that human behaviour with respect to infection prevention is appropriately repre…
Authors: Dale Weston, Katharina Hauck and Richard Amlôt
Citation: BMC Public Health 2018 18:336
Published on: 9 March 2018

Community perception regarding childhood vaccinations and its implications for effectiveness: a qualitative study in rural Burkina Faso

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 10 March 2018)

Research article
Community perception regarding childhood vaccinations and its implications for effectiveness: a qualitative study in rural Burkina Faso
Vaccination has contributed to major reductions in global morbidity and mortality, but there remain significant coverage gaps. Better knowledge on the interplay between population and health systems regarding …
Authors: M. Kagoné, M. Yé, E. Nébié, A. Sié, O. Müller and C. Beiersmann
Citation: BMC Public Health 2018 18:324
Published on: 6 March 2018

Clinical trials recruitment planning: A proposed framework from the Clinical Trials Transformation Initiative

Contemporary Clinical Trials
Volume 66  Pages 1-92 (March 2018)
https://www.sciencedirect.com/journal/contemporary-clinical-trials/vol/66/suppl/C
Study Design, Statistical Design, Study Protocols

Clinical trials recruitment planning: A proposed framework from the Clinical Trials Transformation Initiative
Open access – Original research article
Pages 74-79
Grant D. Huang, Jonca Bull, Kelly Johnston McKee, Elizabeth Mahon, … Jamie N. Roberts
Abstract
Patient recruitment is widely recognized as a key determinant of success for clinical trials. Yet a substantial number of trials fail to reach recruitment goals—a situation that has important scientific, financial, ethical, and policy implications. Further, there are important effects on stakeholders who directly contribute to the trial including investigators, sponsors, and study participants. Despite efforts over multiple decades to identify and address barriers, recruitment challenges persist.
To advance a more comprehensive approach to trial recruitment, the Clinical Trials Transformation Initiative (CTTI) convened a project team to examine the challenges and to issue actionable, evidence-based recommendations for improving recruitment planning that extend beyond common study-specific strategies. We describe our multi-stakeholder effort to develop a framework that delineates three areas essential to strategic recruitment planning efforts: (1) trial design and protocol development, (2) trial feasibility and site selection, and (3) communication. Our recommendations propose an upstream approach to recruitment planning that has the potential to produce greater impact and reduce downstream barriers. Additionally, we offer tools to help facilitate adoption of the recommendations. We hope that our framework and recommendations will serve as a guide for initial efforts in clinical trial recruitment planning irrespective of disease or intervention focus, provide a common basis for discussions in this area and generate targets for further analysis and continual improvement.

Rebuilding patient–physician trust in China, developing a trust-oriented bioethics (pages 4–6)

Developing World Bioethics
March 2018  Volume 18, Issue 1  Pages 1–64
http://onlinelibrary.wiley.com/doi/10.1111/dewb.2018.18.issue-1/issuetoc
Special Issue: Rebuilding Patient-Physician Trust in China, Developing a Trust-Oriented Bioethics

GUEST EDITORIAL
Rebuilding patient–physician trust in China, developing a trust-oriented bioethics (pages 4–6)
Jing-Bao Nie, Joseph D. Tucker, Wei Zhu, Yu Cheng, Bonnie Wong and Arthur Kleinman
Version of Record online: 18 SEP 2017 | DOI: 10.1111/dewb.12172
In a short period of nearly four decades, China, with one fifth of the world’s population, has rapidly evolved from a predominantly agricultural, poor and developing country to an upper middle-income country. At the same time, China faces numerous daunting social challenges. One of them is the widespread, profound, and advancing crisis of patient–physician trust. Among the many manifestations of this crisis is an unprecedented process characterized by rapidly increasing levels of violence involved in disputes between patients and their relatives against medical professionals and institutions.
Like many other challenges that China faces, this crisis of trust in the health sector is by no means merely a Chinese problem. There is much convincing evidence that it is a global issue, emerging in developing and developed societies alike, although the scale and depth of such a crisis may vary considerably from one place to another. More generally, a serious crisis of trust can be observed across geographic areas and societal sectors. It affects all professions, businesses, the media, governments, and international affairs.
Though its significance often goes unrecognized, trust plays a vital role for interpersonal and social life as well as healthcare. In the field of bioethics, however, attention paid thus far to the question of trust in general, and to patient–physician trust in China in particular, is far from sufficient in spite of some pioneering studies.1 Such deficits in bioethical scholarship is in marked contrast to the fields of social and political sciences, where trust has been a key subject for the past few decades, with a large and growing literature. Due to its essential role for good social life and good healthcare, trust deserves a place in the central agenda of bioethics in China and globally.
..The first two papers are anthropological and sociological studies of the broader socio-political, cultural and healthcare context of patient–physician mistrust and its major sources in contemporary China. Yunxiang Yan demonstrates how patient–physician mistrust, and patient–physician relations in general, has been a part of a grand moral and political transformation unfolding in China over the past few decades; this include the growth of individualization and the rising awareness of the values of human dignity, respect, and individual rights. Based on two years of ethnographic research, Cheris Chan examines the major sources of medical mistrust at societal, institutional, and interactional levels. She highlights the role of funding mechanisms behind China’s healthcare system, whereby public hospitals and health professionals alike are largely forced to finance themselves, in generating mistrust.
 
…To conclude, it should be emphasized that the situation in China and the crisis of trust now unfolding on a global scale should not be framed in totally negative terms. As the two Chinese characters for crisis, weiji, aptly reflect, any crisis presents both dangers and opportunities simultaneously. In the Chinese context, distrust and mistrust of medical professionals and healthcare systems amongst individual patients and patient populations means that people are developing higher expectations of competence, caring, respect, dignity, recognition, rights, high-quality services, and active participation. In spite of its immediate and long-term negative consequences, the widespread and profound mistrust therefore presents opportunities to reform existing but ethically unsound medical practices and institutions, and ensure the moral accountability of institutions and individuals in power.

Compliance with recommended protective actions during an H7N9 emergency: a risk perception perspective (pages 207–232)

Disasters
April 2018   Volume 42, Issue 2  Pages 205–404
http://onlinelibrary.wiley.com/doi/10.1111/disa.2018.42.issue-2/issuetoc

Papers
Compliance with recommended protective actions during an H7N9 emergency: a risk perception perspective (pages 207–232)
Fei Wang PhD, Jiuchang Wei PhD and Xing Shi
Version of Record online: 11 AUG 2017 | DOI: 10.1111/disa.12240

Correlation between measles vaccine doses: implications for the maintenance of elimination

Epidemiology and Infection
Volume 146 – Issue 4 – March 2018
https://www.cambridge.org/core/journals/epidemiology-and-infection/latest-issue

Measles vaccine
Original Papers
Correlation between measles vaccine doses: implications for the maintenance of elimination
McKee, M. J. Ferrari, K. Shea
https://doi.org/10.1017/S0950268817003077
Published online: 21 February 2018, pp. 468-475

Planning and preparing for public health threats at airports

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 10 March 2018]

Short report
7 March 2018
Planning and preparing for public health threats at airports
Authors: Greg Martin and Mairin Boland
Abstract
The ever-increasing speed and scope of human mobility by international air travel has led to a global transport network for infectious diseases with the potential to introduce pathogens into non-endemic areas, and to facilitate rapid spread of novel or mutated zoonotic agents.
Robust national emergency preparedness is vital to mitigate the transmission of infectious diseases agents domestically and to prevent onward spread to other countries. Given the complex range of stakeholders who respond to an infectious disease threat being transmitted through air travel, it is important that protocols be tested and practised extensively in advance of a real emergency. Simulation exercises include the identification of possible scenarios based on the probability of hazards and the vulnerability of populations as a basis for planning, and provide a useful measure of preparedness efforts and capabilities.
In October 2016, a live simulation exercise was conducted at a major airport in Ireland incorporating a public health threat for the first time, with the notification of a possible case of MERS-CoV aboard an aircraft plus an undercarriage fire. Strengths of the response to the communicable disease threat included appropriate public health risk assessment, case management, passenger information gathering, notification to relevant parties, and communication to passengers and multiple agencies.

Understanding the principles of ethics in health care: a systematic analysis of qualitative information

International Journal of Community Medicine and Public Health
Vol 5, No 3 (2018)   March 2018
http://www.ijcmph.com/index.php/ijcmph/issue/view/36

Review Articles
Understanding the principles of ethics in health care: a systematic analysis of qualitative information
Vanishree M. Kemparaj, Umashankar G. Kadalur
DOI: 10.18203/2394-6040.ijcmph20180738

Medical and health risks associated with communicable diseases of Rohingya refugees in Bangladesh 2017

International Journal of Infectious Diseases
March 2018 Volume 68, In Progress
http://www.ijidonline.com/issue/S1201-9712(18)X0002-2

Perspective
Medical and health risks associated with communicable diseases of Rohingya refugees in Bangladesh 2017
Emily Y.Y. Chan, Cheuk Pong Chiu, Gloria K.W. Chan
p39–43
Published online: January 9, 2018
Highlights
:: Urgent health emergency disaster risk management (H-EDRM) is needed in the camp setting.
:: Limitations in access to water and poor water quality, food poisoning, hepatitis A and E, and nutritional deficiencies are pending health risks.
:: Environmental health risks include fire, poor indoor air quality, vector-borne diseases, injury, and floods.
:: There is a lack of non-food items to protect health, e.g., footwear, and to maintain dignity, e.g., female hygiene packs.
:: Portable medical documentation should be provided, e.g., immunization card and basic medical history summary card.
Abstract
Complex emergencies remain major threats to human well-being in the 21st century. More than 300 000 Rohingya people from Myanmar, one of the most forgotten minorities globally, have fled to neighboring countries over the past decades. In the recent crisis, the sudden influx of Rohingya people over a 3-month period almost tripled the accumulated displaced population in Bangladesh. Using the Rohingya people in Bangladesh as a case context, this perspective article synthesizes evidence in the published literature regarding the possible key health risks associated with the five main health and survival supporting domains, namely water and sanitation, food and nutrition, shelter and non-food items, access to health services, and information, for the displaced living in camp settlements in Asia.

Association Between Estimated Cumulative Vaccine Antigen Exposure Through the First 23 Months of Life and Non–Vaccine-Targeted Infections From 24 Through 47 Months of Age

JAMA
March 6, 2018, Vol 319, No. 9, Pages 843-943
http://jama.jamanetwork.com/issue.aspx

Original Investigation
Association Between Estimated Cumulative Vaccine Antigen Exposure Through the First 23 Months of Life and Non–Vaccine-Targeted Infections From 24 Through 47 Months of Age
Jason M. Glanz, PhD; Sophia R. Newcomer, MPH; Matthew F. Daley, MD; et al.
JAMA. 2018;319(9):906-913. doi:10.1001/jama.2018.0708
Key Points
Question
Is exposure to multiple vaccines through the first 23 months of life associated with an increased risk for infections not targeted by vaccines?
Findings
In this nested case-control study that included 193 cases with non–vaccine-targeted infections and 751 controls without non–vaccine-targeted infections, the estimated mean cumulative antigen exposure from birth through age 23 months was 240.6 for cases and 242.9 for controls, a difference that was not statistically significant.
Meaning
Among children from 24 through 47 months of age with non–vaccine-targeted infections, compared with children without such infections, there was no significant difference in estimated cumulative vaccine antigen exposure through the first 23 months of life.
Abstract
Importance
Some parents are concerned that multiple vaccines in early childhood could weaken their child’s immune system. Biological data suggest that increased vaccine antigen exposure could increase the risk for infections not targeted by vaccines.
Objective  To examine estimated cumulative vaccine antigen exposure through the first 23 months of life in children with and without non–vaccine-targeted infections from 24 through 47 months of age.
Design, Setting, and Participants
A nested case-control study was conducted in 6 US health care organizations participating in the Vaccine Safety Datalink. Cases were identified by International Classification of Diseases codes for infectious diseases in the emergency department and inpatient medical settings and then validated by medical record review. Cases of non–vaccine-targeted infection were matched to controls by age, sex, health care organization site, and chronic disease status. Participants were children ages 24 through 47 months, born between January 1, 2003, and September 31, 2013, followed up until December 31, 2015.
Exposures
Cumulative vaccine antigen exposure, estimated by summing the number of antigens in each vaccine dose received from birth through age 23 months.
Main Outcomes and Measures  Non–vaccine-targeted infections, including upper and lower respiratory infections and gastrointestinal infections, from 24 through 47 months of age, and the association between these infections and estimated cumulative vaccine exposure from birth through 23 months. Conditional logistic regression was used to estimate matched odds ratios representing the odds of non–vaccine-targeted infections for every 30-unit increase in estimated cumulative number of antigens received.
Results
Among the 944 patients (193 cases and 751 controls), the mean (SD) age was 32.5 (6.3) months, 422 (45%) were female, and 61 (7%) had a complex chronic condition. Through the first 23 months, the estimated mean (SD) cumulative vaccine antigen exposure was 240.6 (48.3) for cases and 242.9 (51.1) for controls. The between-group difference for estimated cumulative antigen exposure was −2.3 (95% CI, −10.1 to 5.4; P = .55). Among children with vs without non–vaccine-targeted infections from 24 through 47 months of age, the matched odds ratio for estimated cumulative antigen exposure through age 23 months was not significant (matched odds ratio, 0.94; 95% CI, 0.84 to 1.07).
Conclusions and Relevance
Among children from 24 through 47 months of age with emergency department and inpatient visits for infectious diseases not targeted by vaccines, compared with children without such visits, there was no significant difference in estimated cumulative vaccine antigen exposure through the first 23 months of life.

Informed Consent Training in Pediatrics—Are We Doing Enough?

JAMA Pediatrics
March 2018, Vol 172, No. 3, Pages 205-303
http://archpedi.jamanetwork.com/issue.aspx

Viewpoint
Informed Consent Training in Pediatrics—Are We Doing Enough?
Alan R. Tait, PhD; Raymond J. Hutchinson, MD, MS
JAMA Pediatr. 2018;172(3):211-212. doi:10.1001/jamapediatrics.2017.4088
Abstract
As ethics educators, we are continually struck by the wide variability in residents’ reported formative training in informed consent. Many trainees have expressed a lack of preparation and anxiety when asked to obtain consent, particularly for procedures and interventions for which they have no planned involvement. One intern remarked that he sometimes Googles the risks before meeting a patient. A lack of training in obtaining informed consent is not only legally tenuous but may also devalue its significance and lead to the perception that consent is simply a way to achieve the parent’s or patient’s acquiescence.

Waxing Understanding of Waning Immunity

Journal of Infectious Diseases
Volume 217, Issue 6, 5 March 2018
https://academic.oup.com/jid/issue

EDITORIAL COMMENTARIES
Waxing Understanding of Waning Immunity
Benjamin A Lopman; Virginia E Pitzer
The Journal of Infectious Diseases, Volume 217, Issue 6, 5 March 2018, Pages 851–853, https://doi.org/10.1093/infdis/jix670
Extract
(See the major article by Rogawski et al, on pages 861–8.)
…Of the approximately 150000 deaths due to rotavirus infection that occur globally every year, >90% are among children in settings of low and low/middle incomes [1, 2]. To counter this burden, the World Health Organization recommends that rotavirus vaccination be included in the immunization program of all countries. Despite the clear signs of progress in reducing the rotavirus disease burden globally [3], there are 2 related challenges specific to lower-income settings that hamper rotavirus vaccines from preventing more deaths and severe diarrheal disease [4]. First, rotavirus vaccines are less effective in low-income as compared to high-income…

Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study

Journal of Infectious Diseases
Volume 217, Issue 6, 5 March 2018
https://academic.oup.com/jid/issue

MAJOR ARTICLES AND BRIEF REPORTS
VIRUSES
Editor’s Choice
Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study
Elizabeth T Rogawski; James A Platts-Mills; E Ross Colgate; Rashidul Haque; K Zaman
The Journal of Infectious Diseases, Volume 217, Issue 6, 5 March 2018, Pages 861–868, https://doi.org/10.1093/infdis/jix668
In clinical trials of rotavirus vaccines, high rotavirus incidence leads to predictably lower vaccine efficacy estimates due to the acquisition of natural immunity in unvaccinated children. This phenomenon contributes to the low vaccine efficacy observed in trials in low-resource settings.

Protective Effect of Maternal Influenza Vaccination on Influenza in Their Infants: A Prospective Cohort Study

Journal of Infectious Diseases
Volume 217, Issue 6, 5 March 2018
https://academic.oup.com/jid/issue

Protective Effect of Maternal Influenza Vaccination on Influenza in Their Infants: A Prospective Cohort Study
Satoko Ohfuji; Masaaki Deguchi; Daisuke Tachibana; Masayasu Koyama; Tetsu Takagi
The Journal of Infectious Diseases, Volume 217, Issue 6, 5 March 2018, Pages 878–886, https://doi.org/10.1093/infdis/jix629
This prospective cohort study showed that the effectiveness of prenatal and postpartum influenza vaccination of mothers in preventing influenza among their infants was 61% and 53%, respectively. Maternal influenza vaccination during the prenatal or postpartum periods had beneficial effects in protecting infants from influenza.

 

 

Evaluation of a Mobile Phone–Based Intervention to Increase Parents’ Knowledge About the Measles-Mumps-Rubella Vaccination and Their Psychological Empowerment: Mixed-Method Approach

Journal of Medical Internet Research
Vol 20, No 3 (2018): March
http://www.jmir.org/2018/3
JMIR Mhealth Uhealth 2018 (Mar 07); 6(3):e59

Evaluation of a Mobile Phone–Based Intervention to Increase Parents’ Knowledge About the Measles-Mumps-Rubella Vaccination and Their Psychological Empowerment: Mixed-Method Approach
Marta Fadda, Elisa Galimberti, Maddalena Fiordelli, Peter Johannes Schulz
ABSTRACT
Background: There is mixed evidence on the effectiveness of vaccination-related interventions. A major limitation of most intervention studies is that they do not apply randomized controlled trials (RCTs), the method that, over the last 2 decades, has increasingly been considered as the only method to provide proof of the effectiveness of an intervention and, consequently, as the most important instrument in deciding whether to adopt an intervention or not. This study, however, holds that methods other than RCTs also can produce meaningful results. Objective: The aim of this study was to evaluate 2 mobile phone–based interventions aimed at increasing parents’ knowledge of the measles-mumps-rubella (MMR) vaccination (through elements of gamification) and their psychological empowerment (through the use of narratives), respectively. The 2 interventions were part of an RCT. Methods: We conducted 2 studies with the RCT participants: a Web-based survey aimed at assessing their rating of the tool regarding a number of qualities such as usability and usefulness (N=140), and qualitative telephonic interviews to explore participants’ experiences with the app (N=60). Results: The results of the survey showed that participants receiving the knowledge intervention (alone or together with the empowerment intervention) liked the app significantly better compared with the group that only received the empowerment intervention (F2,137=15.335; P<.001). Parents who were exposed to the empowerment intervention complained that they did not receive useful information but were only invited to make an informed, autonomous MMR vaccination decision. Conclusions: The results suggest that efforts to empower patients should always be accompanied by the provision of factual information. Using a narrative format that promotes parents’ identification can be an appropriate strategy, but it should be employed together with the presentation of more points of views and notions regarding, for instance, the risks and benefits of the vaccination at the same time. Trial Registration: International Standard Randomized Controlled Trial Number 30768813; http://www.isrctn.com/ ISRCTN30768813 (Archived by WebCite at http://www.webcitation.org/6xOQSJ3w8)

A Time to Save

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 1   March 2018
https://academic.oup.com/jpids/issue

SPECIAL ARTICLE
A Time to Save
Carol J Baker
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, 19 February 2018, Pages 1–5, https://doi.org/10.1093/jpids/piw080
Abstract
Group B Streptococcus (GBS), characterized by Lancefield in 1933, was not recognized as a human pathogen until the early 1970s when it emerged and replaced Escherichia coli as the most common cause of sepsis and meningitis among neonates and young infants. This article briefly gives a personnel account of the discovery of clinical syndromes of GBS distinguished by age at onset, vertical mode of transmission for early-onset disease, meningeal tropism for GBS capsular (CPS) type III strains, and protective CPS epitopes. It also reviews the difficult evolution of the now routine program for antenatal GBS culture screening and intrapartum antibiotic prophylaxis, development of the first GBS candidate vaccines, clinical trials documenting the immunogenicity and safety of CPS tetanus toxoid conjugate vaccines, ongoing need to prevent morbidity and mortality in neonates and young infants, and critical need for commercial vaccines for routine use in pregnant women.

Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 1   March 2018
https://academic.oup.com/jpids/issue

ORIGINAL ARTICLES AND COMMENTARY
Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico
Minesh P Shah; Benjamin A Lopman; Jacqueline E Tate; John Harris; Marcelino Esparza-Aguilar
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, 19 February 2018, Pages 56–63, https://doi.org/10.1093/jpids/pix004
Internet searches for “rotavirus,” as measured by Google Trends, correlated well with laboratory-confirmed rotavirus disease and hospitalizations for acute gastroenteritis in the United States, United Kingdom, and Mexico. Internet searches declined after the introduction of national rotavirus vaccination programs, mirroring rotavirus disease activity.

The Global Fund under Peter Sands

The Lancet
Mar 10, 2018 Volume 391 Number 10124 p911-998  e7-e8
http://www.thelancet.com/journals/lancet/issue/current

Editorial
The Global Fund under Peter Sands
The Lancet
Within the space of a few short weeks, the reputation of Peter Sands, incoming Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, has gone from respected to reckless according to some critics. In an Offline column last November, The Lancet’s Editor offered an unreserved welcome to Sands, praising his “credibility” and “refreshing new vision”. Sands had assiduously built a compelling argument for governments to take the economic costs of infectious diseases more seriously. His background as the former CEO of Standard Chartered strengthened his case still further. But then Heineken hit the headlines.

Before Sands had even taken up his appointment, he was being implicated in the decision by the Global Fund to enter into partnership with, among others, the alcohol beverage manufacturer, Heineken. Photographs of Sands shaking hands with company executives caused dismay among global health advocates. An open letter from a group of civil society organisations, led by Katie Dain (Executive Director of the NCD Alliance and a member of WHO’s Independent Global High-Level Commission on NCDs), pointed out that such an alliance “redirects attention from the costs of harmful use of alcohol and positions Heineken to governments, the public, and the global community as a legitimate partner in implementing sustainable development solutions”.

Peter Sands’ response has been robust. He accepts that the broader global health community is sceptical of the value of partnerships with businesses such as Heineken. He is willing to listen to critics. But he is also unapologetic about engaging with the private sector. Partnerships with business will be his signature raison d’être.

Sands is pursuing a strategy of constructive disruption at the Global Fund. A shake-up is welcome. The Global Fund needs new energy and thinking. But alienating large parts of the global health community, with whom the Global Fund should be forging productive alliances, is an error. Sands needs to take a remedial course on global health diplomacy and balance his passion for the private sector with respect for the pluralism of the global health community. The diversity of global health is a strength for the Global Fund. Draw on it, don’t dismiss it.

Factors Associated with Vaccination Status of Children Aged 12–48 Months in India, 2012–2013

Maternal and Child Health Journal
March 2018, Issue 3, Pages 283-437
https://link.springer.com/journal/volumesAndIssues/10995
Special Issue: Confronting Adversity: MCH Responds to ACEs

Original Paper
Factors Associated with Vaccination Status of Children Aged 12–48 Months in India, 2012–2013
Luke M. Shenton, Abram L. Wagner, Deepti Bettampadi… Pages 419-428
India has more unvaccinated children than any other country despite provision of free vaccines through the government’s Universal Immunization Program. In this study, we calculated the proportion of children aged 12–48 months who were fully vaccinated, under-vaccinated, or who had not received any vaccines. Childhood, household, and sociocultural factors associated with under-vaccination and non-vaccination were evaluated.

Meta-analysis and the science of research synthesis

Nature 
Volume 555 Number 7695 pp141-274  8 March 2018
http://www.nature.com/nature/current_issue.html

Review
Meta-analysis and the science of research synthesis
Jessica Gurevitch, Julia Koricheva, Shinichi Nakagawa & Gavin Stewart
Meta-analysis—the quantitative, scientific synthesis of research results—has been both Abstract
Meta-analysis is the quantitative, scientific synthesis of research results. Since the term and modern approaches to research synthesis were first introduced in the 1970s, meta-analysis has had a revolutionary effect in many scientific fields, helping to establish evidence-based practice and to resolve seemingly contradictory research outcomes. At the same time, its implementation has engendered criticism and controversy, in some cases general and others specific to particular disciplines. Here we take the opportunity provided by the recent fortieth anniversary of meta-analysis to reflect on the accomplishments, limitations, recent advances and directions for future developments in the field of research synthesis.

Towards personalized, tumour-specific, therapeutic vaccines for cancer

Nature Reviews Immunology
March 2018 Vol 18 No 3
https://www.nature.com/nri/journal/v18/n3/index.html
Focus on: Cancer immunotherapy

Reviews
Towards personalized, tumour-specific, therapeutic vaccines for cancer
Zhuting Hu, Patrick A. Ott & Catherine J. Wu
p168 | doi:10.1038/nri.2017.131
Abstract
Cancer vaccines, which are designed to amplify tumour-specific T cell responses through active immunization, have long been envisioned as a key tool of effective cancer immunotherapy. Despite a clear rationale for such vaccines, extensive past efforts were unsuccessful in mediating clinically relevant antitumour activity in humans. Recently, however, next-generation sequencing and novel bioinformatics tools have enabled the systematic discovery of tumour neoantigens, which are highly desirable immunogens because they arise from somatic mutations of the tumour and are therefore tumour specific. As a result of the diversity of tumour neoepitopes between individuals, the development of personalized cancer vaccines is warranted. Here, we review the emerging field of personalized cancer vaccination and discuss recent developments and future directions for this promising treatment strategy.

The dawn of vaccines for cancer prevention

Nature Reviews Immunology
March 2018 Vol 18 No 3
https://www.nature.com/nri/journal/v18/n3/index.html
Focus on: Cancer immunotherapy

The dawn of vaccines for cancer prevention
Olivera J. Finn
p183 | doi:10.1038/nri.2017.140
Abstract
An important role of the immune system is in the surveillance for abnormal or transformed cells, which is known as cancer immunosurveillance. Through this process, the first changes to normal tissue homeostasis caused by infectious or other inflammatory insults can be detected by the immune system through the recognition of antigenic molecules (including tumour antigens) expressed by abnormal cells. However, as they develop, tumour cells can acquire antigenic and other changes that allow them to escape elimination by the immune system. To bias this process towards elimination, immunosurveillance can be improved by the administration of vaccines based on tumour antigens. Therapeutic cancer vaccines have been extensively tested in patients with advanced cancer but have had little clinical success, which has been attributed to the immunosuppressive tumour microenvironment. Thus, the administration of preventive vaccines at pre-malignant stages of the disease holds promise, as they function before tumour-associated immune suppression is established. Accordingly, immunological and clinical studies are yielding impressive results.

Effect and cost-effectiveness of educating mothers about childhood DPT vaccination on immunisation uptake, knowledge, and perceptions in Uttar Pradesh, India: A randomised controlled trial

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 10 March 2018)

Research Article
Effect and cost-effectiveness of educating mothers about childhood DPT vaccination on immunisation uptake, knowledge, and perceptions in Uttar Pradesh, India: A randomised controlled trial
Timothy Powell-Jackson, Camilla Fabbri, Varun Dutt, Sarah Tougher, Kultar Singh
Research Article | published 06 Mar 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002519

Growth, developmental achievements and vaccines timeliness of undocumented migrant children from Eritrea compared with Israelis

PLoS One
http://www.plosone.org/
[Accessed 10 March 2018]

Research Article
Growth, developmental achievements and vaccines timeliness of undocumented migrant children from Eritrea compared with Israelis
Zohar Mor, Anat Amit Aharon, Rivka Sheffer, Haim Nehama
| published 08 Mar 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0193219
Israel has absorbed >40,000 Eritrean undocumented migrants since 2007, while the majority live in the southern neighborhoods of Tel-Aviv. As non-citizens and citizens infants in Israel receive free preventive treatment at the mother and child health clinics (MCHC), this study aimed to compare development and growth achievements between children of Eritrean mothers (CE) to children of Israeli mothers (CI), and assess their compliance to routine follow-up and vaccination-timeliness.

Vaccination can drive an increase in frequencies of antibiotic resistance among nonvaccine serotypes of Streptococcus pneumoniae

PNAS – Proceedings of the National Academy of Sciences of the United States
of America

http://www.pnas.org/content/early/

[Accessed 10 March 2018]
Vaccination can drive an increase in frequencies of antibiotic resistance among nonvaccine serotypes of Streptococcus pneumoniae
Uri Obolski, José Lourenço, Craig Thompson, Robin Thompson, Andrea Gori and Sunetra Gupta
PNAS 2018; published ahead of print March 6, 2018, https://doi.org/10.1073/pnas.1718712115

A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study (pages 429–441)

Risk Analysis          
March 2018  Volume 38, Issue 3  Pages 427–634
http://onlinelibrary.wiley.com/doi/10.1111/risa.2018.38.issue-3/issuetoc

Perspectives
A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study (pages 429–441)
Whenayon Simeon Ajisegiri, Abrar Ahmad Chughtai and C. Raina MacIntyre
Version of Record online: 15 AUG 2017 | DOI: 10.1111/risa.12876
Abstract
The 2014 Ebola virus disease (EVD) outbreak affected several countries worldwide, including six West African countries. It was the largest Ebola epidemic in the history and the first to affect multiple countries simultaneously. Significant national and international delay in response to the epidemic resulted in 28,652 cases and 11,325 deaths. The aim of this study was to develop a risk analysis framework to prioritize rapid response for situations of high risk. Based on findings from the literature, sociodemographic features of the affected countries, and documented epidemic data, a risk scoring framework using 18 criteria was developed. The framework includes measures of socioeconomics, health systems, geographical factors, cultural beliefs, and traditional practices. The three worst affected West African countries (Guinea, Sierra Leone, and Liberia) had the highest risk scores. The scores were much lower in developed countries that experienced Ebola compared to West African countries. A more complex risk analysis framework using 18 measures was compared with a simpler one with 10 measures, and both predicted risk equally well. A simple risk scoring system can incorporate measures of hazard and impact that may otherwise be neglected in prioritizing outbreak response. This framework can be used by public health personnel as a tool to prioritize outbreak investigation and flag outbreaks with potentially catastrophic outcomes for urgent response. Such a tool could mitigate costly delays in epidemic response.

The science of fake news

Science         
09 March 2018  Vol 359, Issue 6380
http://www.sciencemag.org/current.dtl

Policy Forum
The science of fake news
By David M. J. Lazer, Matthew A. Baum, Yochai Benkler, Adam J. Berinsky, Kelly M. Greenhill, Filippo Menczer, Miriam J. Metzger, Brendan Nyhan, Gordon Pennycook, David Rothschild, Michael Schudson, Steven A. Sloman, Cass R. Sunstein, Emily A. Thorson, Duncan J. Watts, Jonathan L. Zittrain
Science09 Mar 2018 : 1094-1096 Full Access
Summary
The rise of fake news highlights the erosion of long-standing institutional bulwarks against misinformation in the internet age. Concern over the problem is global. However, much remains unknown regarding the vulnerabilities of individuals, institutions, and society to manipulations by malicious actors. A new system of safeguards is needed. Below, we discuss extant social and computer science research regarding belief in fake news and the mechanisms by which it spreads. Fake news has a long history, but we focus on unanswered scientific questions raised by the proliferation of its most recent, politically oriented incarnation. Beyond selected references in the text, suggested further reading can be found in the supplementary materials.

The spread of true and false news online

Science         
09 March 2018  Vol 359, Issue 6380
http://www.sciencemag.org/current.dtl

Reports
The spread of true and false news online
By Soroush Vosoughi, Deb Roy, Sinan Aral
Science09 Mar 2018 : 1146-1151 Full Access
Lies spread faster than the truth
There is worldwide concern over false news and the possibility that it can influence political, economic, and social well-being. To understand how false news spreads, Vosoughi et al. used a data set of rumor cascades on Twitter from 2006 to 2017. About 126,000 rumors were spread by ∼3 million people. False news reached more people than the truth; the top 1% of false news cascades diffused to between 1000 and 100,000 people, whereas the truth rarely diffused to more than 1000 people. Falsehood also diffused faster than the truth. The degree of novelty and the emotional reactions of recipients may be responsible for the differences observed.
Science, this issue p. 1146
Abstract
We investigated the differential diffusion of all of the verified true and false news stories distributed on Twitter from 2006 to 2017. The data comprise ~126,000 stories tweeted by ~3 million people more than 4.5 million times. We classified news as true or false using information from six independent fact-checking organizations that exhibited 95 to 98% agreement on the classifications. Falsehood diffused significantly farther, faster, deeper, and more broadly than the truth in all categories of information, and the effects were more pronounced for false political news than for false news about terrorism, natural disasters, science, urban legends, or financial information. We found that false news was more novel than true news, which suggests that people were more likely to share novel information. Whereas false stories inspired fear, disgust, and surprise in replies, true stories inspired anticipation, sadness, joy, and trust. Contrary to conventional wisdom, robots accelerated the spread of true and false news at the same rate, implying that false news spreads more than the truth because humans, not robots, are more likely to spread it.

Complications of herpes zoster in immunocompetent older adults: Incidence in vaccine and placebo groups in two large phase 3 trials

Vaccine
Volume 36, Issue 12   Pages 1521-1710 (14 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/12

Short communications
Complications of herpes zoster in immunocompetent older adults: Incidence in vaccine and placebo groups in two large phase 3 trials
Open access
Pages 1537-1541
Martina Kovac, Himal Lal, Anthony L. Cunningham, Myron J. Levin, … Thomas C. Heineman

Mass media effect on vaccines uptake during silent polio outbreak

Vaccine
Volume 36, Issue 12   Pages 1521-1710 (14 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/12

Regular papers
Mass media effect on vaccines uptake during silent polio outbreak
Original research article
Pages 1556-1560
Iftach Sagy, Victor Novack, Michael Gdalevich, Dan Greenberg
Abstract
Background
During 2013, isolation of a wild type 1 poliovirus from routine sewage sample in Israel, led to a national OPV campaign. During this period, there was a constant cover of the outbreak by the mass media.
Aims
To investigate the association of media exposure and OPV and non-OPV vaccines uptake during the 2013 silent polio outbreak in Israel.
Methods
We received data on daily immunization rates during the outbreak period from the Ministry of Health (MoH). We conducted a multivariable time trend analysis to assess the association between daily media exposure and vaccines uptake. Analysis was stratified by ethnicity and socio-economic status (SES).
Results
During the MoH supplemental immunization activity, 138,799 OPV vaccines were given. There was a significant association between media exposure and OPV uptake, most prominent in a lag of 3–5 days from the exposure among Jews (R.R 1.79C.I 95% 1.32–2.41) and high SES subgroups (R.R 1.71C.I 95% 1.27–2.30). These subgroups also showed increased non-OPV uptake in a lag of 3–5 days from the media exposure, in all vaccines except for MMR. Lower SES and non-Jewish subgroups did not demonstrate the same association.
Conclusion
Our findings expand the understanding of public behaviour during outbreaks. The public response shows high variability within specific subgroups. These findings highlight the importance of tailored communication strategies for each subgroup.

Use of a new global indicator for vaccine safety surveillance and trends in adverse events following immunization reporting 2000–2015

Vaccine
Volume 36, Issue 12   Pages 1521-1710 (14 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/12

Regular papers
Use of a new global indicator for vaccine safety surveillance and trends in adverse events following immunization reporting 2000–2015
Open access – Original research article
Pages 1577-1582
Jiayao Lei, Madhava Ram Balakrishnan, Jane F. Gidudu, Patrick L.F. Zuber
Abstract
Reporting of adverse events following immunization (AEFI) is a key component for functional vaccine safety monitoring system. The aim of our study is to document trends in the AEFI reporting ratio globally and across the six World Health Organization (WHO) regions. We describe the number of AEFI reports communicated each year through the World Health Organization/United Nations Children’s Fund Joint Reporting Form on Immunization from 2000 to 2015. The AEFI reporting ratios (annual AEFI reports per 100,000 surviving infants) were calculated to identify WHO countries (n=191 in 2000 and n=194 by 2015) that met a minimal reporting ratio of 10, a target set by the Global Vaccine Action Plan for vaccine safety monitoring as a proxy measure for a functional AEFI reporting system. The number of countries reporting any AEFI fluctuated over time but with progress from 32 (17%) in 2000 to 124 (64%) in 2015. In 2015, the global average AEFI reporting ratio was 549 AEFI reports per 100,000 surviving infants. The number of countries with AEFI reporting ratios greater than 10 increased from 8 (4%) in 2000 to 81 (42%) in 2015. In 2015, 60% of countries in the WHO Region of the Americas reported at least 10 AEFI per 100,000 surviving infants, followed by 55% in European Region, 43% in Eastern Mediterranean Region, 33% in Western Pacific Region, 27% in South-East Asia Region and 21% in African Region. Overall, AEFI reporting has increased over the past sixteen years worldwide, but requires strengthening in a majority of low- and middle- income countries. The AEFI reporting ratio is useful for benchmarking and following trends over time; but does not provide information on the quality of the reporting system and does not guarantee capacity to detect and manage a vaccine safety problem at a national level. Additional efforts are required to ensure and improve data quality, AEFI reporting and surveillance of immunization safety in every country.

High resolution age-structured mapping of childhood vaccination coverage in low and middle income countries

Vaccine
Volume 36, Issue 12   Pages 1521-1710 (14 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/12

Regular papers
High resolution age-structured mapping of childhood vaccination coverage in low and middle income countries
Open access – Original research article
Pages 1583-1591
Edson Utazi, Julia Thorley, Victor A. Alegana, Matthew J. Ferrari, … Andrew J. Tatem
The elimination of vaccine-preventable diseases requires a strong evidence base to guide strategies and inform efficient use of limited resources. The approaches outlined here provide a route to moving beyond large area summaries of vaccination coverage that mask epidemiologically-important heterogeneities to detailed maps that capture subnational vulnerabilities. The output datasets are built on open data and methods, and in flexible format that can be aggregated to more operationally-relevant administrative unit levels.

‘The Unhealthy Other’: How vaccine rejecting parents construct the vaccinating mainstream

Vaccine
Volume 36, Issue 12   Pages 1521-1710 (14 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/12

Regular papers
‘The Unhealthy Other’: How vaccine rejecting parents construct the vaccinating mainstream
Original research article
Pages 1621-1626
Katie Attwell, David T. Smith, Paul R. Ward
Abstract
To address the phenomenon of vaccine hesitancy and rejection, researchers increasingly recognise the need to engage with the social context of parents’ decision-making. This study examines how vaccine rejecting parents socially construct the vaccinating mainstream in opposition to themselves. We analyse qualitative data from interviews with parents in Adelaide, South Australia. Applying insights from Social Identity Theory (SIT), we show how these parents bolster their own sense of identity and self-belief by employing a discourse that casts vaccinators as an Unhealthy Other. We demonstrate how the parents identify vaccination as a marker of parental conformity to the ‘toxic practices of mass industrial society’, linking it to other ways in which membership of the consumerist mainstream requires individuals to ‘neglect their health.’ This is explored through themes of appearance, diet, (over) consumption of pharmaceuticals, inadequate parenting values and wilful or misguided ignorance. This construction of the Unhealthy Other elevates the self-concept of vaccine hesitant and rejecting parents, who see themselves as part of an enlightened, but constantly besieged, group of healthy and virtuous parents. It is common for the vaccinating mainstream to present vaccine hesitant and rejecting parents as a group subject to epistemic closure, groupthink, confirmation bias and over-confidence in their own expertise. However, vaccine hesitant and rejecting parents also see mainstream society as a group—a much larger one—subject to the same problems. We suggest the need to mitigate the ‘groupness’ of vaccination and non-vaccination by extending the practice of vaccination to recognisable practitioners of holistic health.

 

Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016

Vaccine
Volume 36, Issue 12   Pages 1521-1710 (14 March 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/12

Regular papers
Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016
Open access – Original research article
Pages 1664-1672
Gudrun S. Freidl, Alma Tostmann, Moud Curvers, Wilhelmina L.M. Ruijs, … Irene K. Veldhuijzen

Immunogenicity and Safety of the New Inactivated Quadrivalent Influenza Vaccine Vaxigrip Tetra: Preliminary Results in Children ≥6 Months and Older Adults

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 10 March 2018)

Review   Open Access   
Immunogenicity and Safety of the New Inactivated Quadrivalent Influenza Vaccine Vaxigrip Tetra: Preliminary Results in Children ≥6 Months and Older Adults
by Emanuele Montomoli, Alessandro Torelli, Ilaria Manini and Elena Gianchecchi
Vaccines 2018, 6(1), 14; doi:10.3390/vaccines6010014 – 8 March 2018
Abstract
Since the mid-1980s, two lineages of influenza B viruses have been distinguished. These can co-circulate, limiting the protection provided by inactivated trivalent influenza vaccines (TIVs). This has prompted efforts to formulate quadrivalent influenza vaccines (QIVs), to enhance protection against circulating influenza B viruses. This review describes the results obtained from seven phase III clinical trials evaluating the immunogenicity, safety, and lot-to-lot consistency of a new quadrivalent split-virion influenza vaccine (Vaxigrip Tetra®) formulated by adding a second B strain to the already licensed TIV. Since Vaxigrip Tetra was developed by means of a manufacturing process strictly related to that used for TIV, the data on the safety profile of TIV are considered supportive of that of Vaxigrip Tetra. The safety and immunogenicity of Vaxigrip Tetra were similar to those of the corresponding licensed TIV. Moreover, the new vaccine elicits a superior immune response towards the additional strain, without affecting immunogenicity towards the other three strains. Vaxigrip Tetra is well tolerated, has aroused no safety concerns, and is recommended for the active immunization of individuals aged ≥6 months. In addition, preliminary data confirm its immunogenicity and safety even in children aged 6–35 months and its immunogenicity in older subjects (aged 66–80 years).