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).

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary  

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
 
 
BMJ Open
Volume 8, Issue 3 2018
Impact and acceptability of self-consent procedures for the school-based human papillomavirus vaccine: a mixed-methods study protocol
S Audrey, HB Ferrer, J Ferrie, K Evans, M Bell, J Yates…
Abstract
Introduction
The human papillomavirus (HPV) vaccine, administered in early adolescence, can substantially reduce cervical cancer incidence and mortality. However, lack of written parental consent is a key reason why some young women do not receive the vaccine. The national legal framework allows girls to be vaccinated without parental consent provided they are deemed Gillick competent, but there is some reticence about vaccinating without written parental consent. Self-consent procedures are being implemented in Bristol and South Gloucestershire. This study will examine the implementation, acceptability and impact of these new procedures.
Methods and analysis
Statistical analyses of routine data from Public Health England and the Child Health Information System will test if there has been an increase in HPV vaccination uptake in two ways: (a) Is there an increase when comparing before and after the change in our intervention sites? and (b) Does the percentage change in our intervention sites differ from comparison sites (similar to our intervention sites in terms of initial HPV uptake, ethnicity and deprivation levels) in England where no such intervention took place and how? For the process evaluation, we will develop a logic model and use questionnaires, observations and audio-recorded interviews with young women, school nurses, school staff and parents to examine the context, implementation of self-consent and response to the new procedures.
Ethics and dissemination
The University of Bristol Faculty of Health Sciences Research Ethics Committee and the National Health Service Health Research Authority provided approvals for the study. We will produce a report with recommendations about self-consent procedures in conjunction with key stakeholders. At least two papers will be written for publication in peer-reviewed journals and for conference presentations. A summary of results will be shared with participating immunisation nurses, school staff, young people and parents as requested.
Trial registration number ISRCTN49086105; Pre-results
 
 
Systematic Reviews
20187:40  Published: 2 March 2018
Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: a systematic review protocol
KJ Mrklas, S MacDonald, MA Shea-Budgell…
Abstract
Background
Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples.
Methods
Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive synthesis and quantitative summary of measures for interventions.
Discussion
To our knowledge, this study will contribute the first systematic review of documented barriers, supports, and interventions for vaccination in general and for HPV vaccination. The results of this study are expected to inform future research, policies, programs, and community-driven initiatives to enhance acceptability and uptake of HPV vaccination among Indigenous peoples.
Systematic review registration
PROSPERO Registration Number: CRD42017048844

Academic Pediatrics
March 2018 Volume 18, Issue 2, Supplement, Pages S14–S16
Advancing human papillomavirus vaccine delivery: 12 priority research gaps
PL Reiter, MA Gerend, MB Gilkey, RB Perkins…
Abstract
Human papillomavirus (HPV) vaccine has been available in the United States for a decade, yet vaccination coverage remains modest. A recent review identified numerous interventions for increasing HPV vaccination,1 but effects were small and evidence was often insufficient to identify best practices. The National HPV Vaccination Roundtable sponsored a 1-day national meeting in 2016 on best and promising practices in HPV vaccine delivery, in part to identify important research gaps.
Meeting attendees were HPV vaccine delivery experts including scientists, clinicians, and other stakeholders. Approximately 100 people attended in-person and approximately 400 additional people streamed the meeting online (livestream.com/ACS/events/5892004). Throughout the meeting, the meeting facilitators encouraged attendees to identify gaps that future research should address and write them on display boards (or send via e-mail or Twitter). Facilitators did not provide attendees with a predefined list of gaps. Attendees identified a total of 33 gaps (Table). In-person attendees voted for up to 5 gaps they believed were top priorities. We categorized the gaps into themes. The 12 gaps that received the most votes generally fit into these themes: 1) social media and vaccine confidence, 2) health care provider interventions, or 3) system-level approaches. Two gaps in the top 12 that did not fit these themes were determining what interventions work in rural areas (gap 7) and the impact of survivor testimonials (gap 9)…

Media/Policy Watch

Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.
We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.
 
 
Forbes
http://www.forbes.com/
Accessed 10 March 2018
Disease X Is What May Become The Biggest Infectious Threat To Our World
Bruce Y. Lee, Contributor
Disease X appeared in a World Health Organization (WHO) list of pathogens that could cause a public health emergency and for which there aren’t adequate drugs and/or vaccines.
 
New York Times
http://www.nytimes.com/
Accessed 10 March 2018
Sanofi may seek U.S. approval for Dengvaxia despite Philippines outrage
7 March 2018
By REUTERS
PARIS — Sanofi will decide shortly whether to seek regulatory approval for its dengue vaccine Dengvaxia in the United States and remains committed to the medicine despite a health scare in the Philippines, a senior executive said on Wednesday.

David Loew, head of Sanofi Pasteur, the French drugmaker’s vaccines division, said his teams had complied with all regulations regarding Dengvaxia and had no regrets about the way the product had been developed.

The Philippines, where more than 800,000 school-age children were vaccinated in 2016, suspended a vast public immunisation programme last year because of safety concerns.
Sanofi warned in November that the use of Dengvaxia was to be limited due to evidence it can worsen the disease in people who have not previously been exposed to the infection.

In February, a Philippine government agency filed a lawsuit against Sanofi, demanding compensation for the parents of a 10-year-old girl who the agency said had died as a result of receiving Dengvaxia.
Sanofi has repeatedly said it knew of no deaths resulting from the vaccine. While some experts have said the company and regulators might have ignored warnings about how the vaccine was developed, executives at Sanofi deny any wrongdoing.

“On the whole path of development, we always worked with the World Health Organisation (WHO) and experts in the dengue community. We were always transparent,” Loew told Reuters in an interview, referring to the WHO and other regulators.

“You need to ask yourself: what was done with the information that was available at the time? Looking back, I would say no, we would not have done anything differently.”…
Loew said the company would decide within two months whether to make a regulatory filing for Dengvaxia with the U.S. Food and Drug Administration.

He also said Sanofi was holding discussions with external partners and universities to come up with a test which would be applicable before vaccination. Such a test would take at least two years to bring to the market.

“We operate in environments where the temperature is 30-40 degrees Celsius so you want to be sure that the tests resist (…) If you have a vaccination campaign taking place in a school for example, you want to make sure it is ‘implementable,'” he said.

Dengvaxia has been approved and registered in 19 countries so far, mostly in the developing world. It is currently under review by the European Medicines Agency.

Yellow Fever Circles Brazil’s Huge Cities
5 March 2018
By SHASTA DARLINGTON and DONALD G. McNEIL Jr. MARCH 5, 2018
“Good morning!” a loudspeaker blared recently in the working class São Paulo suburb called Jardim Monte Alegre. “We’ve got your yellow fever vaccine, and today we’re going house to house! You better wake up because mosquitoes never sleep!” Twenty health workers piled out of cars. Though they laughed and chatted with locals, their mission was deadly serious…
 
Scientific American
https://www.scientificamerican.com/
Accessed 10 March 2018
How to Understand, and Help, the Vaccine Doubters
Understand the values behind people’s fears
By Avnika B. Amin, Saad B. Omer, Jesse Graham
6 March 2018
We are in the golden age for vaccines. We have dozens of highly effective vaccines licensed for infectious disease, promising new technologies contributing to massive advancement of vaccine development, and several promising vaccines on the horizon. Unfortunately, vaccines have been a victim of their own success. With the drastic reduction of once-devastating diseases like whooping cough and measles, it seems like some parents think that the vaccines themselves are the new danger. But the threat isn’t gone; it’s been kept at bay by vaccinations. With clusters of vaccine-hesitant individuals especially worrisome, we need to find effective ways to convince people that the true danger is still disease…
 
Washington Post
http://www.washingtonpost.com/
Accessed 10 March 2018
FDA did not issue new statement on vaccines and autism
By Associated Press March 7
Some health websites have misrepresented the fine print on an old vaccine label to falsely claim that the “FDA announced that vaccines are causing autism.” Vaccines do not cause autism and the U.S. Food and Drug Administration did not make any new statement this week about the long-debunked claim.
Autism was listed as one of many “adverse events” on the 2005 label of Sanofi Pasteur’s Tripedia childhood vaccine for diphtheria, tetanus and pertussis. When the vaccine was first approved, such reports were generated voluntarily by consumers and were automatically added to the FDA label, even if there was no plausible connection to the product.
The 2005 label notes that such reports do not “establish a causal relationship” to the vaccine. Since then, the FDA has changed its labeling rules and now only includes adverse events “for which there is some basis to believe there is a causal relationship,” the agency said in a statement.

Vaccines and Global Health: The Week in Review 3 March 2018

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.– Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

 pdf version A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_3 March 2018

– blog edition: comprised of the approx. 35+ entries posted below.

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

NIAID unveils strategic plan for developing a universal influenza vaccine

Milestones :: Perspectives
 
 
NIH  [to 3 March 2018]
http://www.nih.gov/news-events/news-releases
February 28, 2018
NIAID unveils strategic plan for developing a universal influenza vaccine
Developing a universal influenza vaccine — a vaccine that can provide durable protection for all age groups against multiple influenza strains, including those that might cause a pandemic — is a priority for the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Writing in the Journal of Infectious Diseases, NIAID officials detail the Institute’s new strategic plan for addressing the research areas essential to creating a safe and effective universal influenza vaccine. They describe the scientific goals that will be supported to advance influenza vaccine development. The strategic plan builds upon a workshop NIAID convened in June 2017 that gathered scientists from academia, industry and government who developed criteria for defining a universal influenza vaccine, identified knowledge gaps, and delineated research strategies for addressing those gaps.

The cornerstone of both seasonal and pandemic influenza prevention and control is the development of vaccines against specific influenza strains that pose a potentially significant risk to the public. Seasonal influenza vaccines are made anew each year to best match the strains projected to circulate in the upcoming season. However, this approach has limitations and difficulties. To reduce the public health consequences of both seasonal and pandemic influenza, vaccines must be more broadly and durably protective. Advances in influenza virology, immunology and vaccinology make the development of a universal influenza vaccine more feasible than a decade ago, according to the authors. To develop a universal influenza vaccine, NIAID will focus resources on three key areas of influenza research: improving the understanding of the transmission, natural history and pathogenesis of influenza infection; precisely characterizing how protective influenza immunity occurs and how to tailor vaccination responses to achieve it; and supporting the rational design of universal influenza vaccines, including designing new immunogens and adjuvants to boost immunity and extend the duration of protection.

The authors state that a coordinated effort of guided discovery, facilitated product development and managed progress through iterative clinical testing will be critical to achieving the goal of a universal influenza vaccine. NIAID will establish and support a consortium of scientists to meet designated goals for a universal influenza vaccine and will expand the Institute’s research resources by establishing long-term human cohorts, supporting improved animal models of influenza infection and expanding capacity for conducting human challenge studies.

The authors emphasize that broad collaboration and coordination in many disciplines and involving government, academia, philanthropies and the private sector will be vital to achieving the goal of developing a universal influenza vaccine. NIAID intends for the plan to serve as the foundation for its research investment strategy to achieve this important public health goal.
Article
AS Fauci et al. A universal influenza vaccine: The strategic plan for the National Institute of Allergy and Infectious Diseases (link is external). Journal of Infectious Diseases  DOI: 10.1093/infdis/jiy103 (2018).

Cost effectiveness methodology for vaccination programmes

 Milestones :: Perspectives

Cost effectiveness methodology for vaccination programmes – Open consultation

U.K. Department of Health and Social Care
Published 26 February 2018
Summary
Consultation on the 2016 report into the cost effectiveness methodology for immunisation programmes and procurement (CEMIPP).
 
Consultation description
The report sets out recommendations from the independent CEMIPP group that was set up by the government to consider whether the method for appraising cost effectiveness of vaccination programmes should change.
We are looking for views from organisations and committees that appraise cost effectiveness within the health and care sector, as well as specialists with an interest in health economics, including:
:: health economists based in academia
:: public health practitioners
:: epidemiologists
:: charities and patient groups
:: clinicians and vaccine industry professionals
 
Documents
:: Cost effectiveness methodology for vaccination programmes: consultation on the CEMIPP report  PDF, 450KB, 19 pages
:: Review of cost effectiveness methodology for immunisation programmes and procurements: 2016 report PDF, 232KB, 26 pages