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MMWR. Morbidity and Mortality Weekly... Jul 2023This report describes the status of introductions globally for eight World Health Organization (WHO)-recommended new and underutilized vaccines, comprising 10 individual...
This report describes the status of introductions globally for eight World Health Organization (WHO)-recommended new and underutilized vaccines, comprising 10 individual vaccine antigens. By 2021, among 194 countries worldwide, 33 (17%) provided all of these 10 WHO-recommended antigens as part of their routine immunization schedules; only one low-income country had introduced all of these recommended vaccines. Universal hepatitis B birth dose; human papillomavirus vaccine; rotavirus vaccine; and diphtheria, tetanus, and pertussis-containing vaccine first booster dose have been introduced by 57%, 59%, 60%, and 72% of all countries worldwide, respectively. Pneumococcal conjugate vaccine, rubella-containing vaccine, measles-containing vaccine second dose, and Haemophilus influenzae type b vaccine have been introduced by 78%, 89%, 94%, and 99% of all countries, respectively. The annual rate of new vaccine introductions declined precipitously when the COVID-19 pandemic started, from 48 in 2019 to 15 in 2020 before rising to 26 in 2021. Increased efforts to accelerate new and underutilized vaccine introductions are urgently needed to improve universal equitable access to all recommended vaccines to achieve the global Immunization Agenda 2021-2030 (IA2030) targets.
Topics: Humans; Infant; Diphtheria-Tetanus-Pertussis Vaccine; Pandemics; Haemophilus Vaccines; COVID-19; Vaccination; Measles Vaccine; Rubella Vaccine; Immunization Schedule; Poliovirus Vaccine, Inactivated; Hepatitis B Vaccines; Vaccines, Combined
PubMed: 37410663
DOI: 10.15585/mmwr.mm7227a2 -
Annals of Medicine Dec 2024Pertussis (Whooping Cough) is a respiratory infection caused by . Pertussis usually occurs in childhood; severe infections are most common in infants. It can be fatal... (Review)
Review
BACKGROUND
Pertussis (Whooping Cough) is a respiratory infection caused by . Pertussis usually occurs in childhood; severe infections are most common in infants. It can be fatal with severe complications such as pulmonary hypertension, heart failure, and encephalitis.
OBJECTIVES
We sought to synthesize the existing literature on severe pertussis in infants and inform further study.
METHODS
A scoping review was performed based on the methodological framework developed by Arksey & O'Malley. Search in Pubmed and Embase databases, with no restrictions on the language and date of publication.
RESULTS
Of the 1299 articles retrieved, 64 were finally included. The selected articles were published between 1979 and 2022, with 90.6% (58/64) of the studies in the last two decades. The studies covered epidemiology, pathology, clinical characteristics, risk factors, treatments, and burden of disease.
CONCLUSION
The literature reviewed suggests that studies on severe pertussis in infants covered a variety of clinical concerns. However, these studies were observational, and experimental studies are needed to provide high-quality evidence.
Topics: Humans; Whooping Cough; Infant; Bordetella pertussis; Risk Factors; Severity of Illness Index; Pertussis Vaccine
PubMed: 38728617
DOI: 10.1080/07853890.2024.2352606 -
Human Vaccines & Immunotherapeutics Dec 2023While tetanus-diphtheria-acellular pertussis (Tdap) vaccines for adolescents and adults were licensed in 2005 and immunization strategies proposed, the burden of...
While tetanus-diphtheria-acellular pertussis (Tdap) vaccines for adolescents and adults were licensed in 2005 and immunization strategies proposed, the burden of pertussis in this population remains under-recognized mainly due to atypical disease presentation, undermining efforts to optimize protection through vaccination. We developed a machine learning algorithm to identify undiagnosed/misdiagnosed pertussis episodes in patients diagnosed with acute respiratory disease (ARD) using signs, diseases and symptoms from clinician notes and demographic information within electronic health-care records (Optum Humedica repository [2007-2019]). We used two patient cohorts aged ≥11 years to develop the model: a positive pertussis cohort (4,515 episodes in 4,316 patients) and a negative pertussis (ARD) cohort (4,573,445 episodes and patients), defined using ICD 9/10 codes. To improve contrast between positive pertussis and negative pertussis (ARD) episodes, only episodes with ≥7 symptoms were selected. LightGBM was used as the machine learning model for pertussis episode identification. Model validity was determined using laboratory-confirmed pertussis positive and negative cohorts. Model explainability was obtained using the Shapley additive explanations method. The predictive performance was as follows: area under the precision-recall curve, 0.24 (SD, 7 × 10); recall, 0.72 (SD, 4 × 10); precision, 0.012 (SD, 1 × 10); and specificity, 0.94 (SD, 7 × 10). The model applied to laboratory-confirmed positive and negative pertussis episodes had a specificity of 0.846. Predictive probability for pertussis increased with presence of whooping cough, whoop, and post-tussive vomiting in clinician notes, but decreased with gastrointestinal bleeding, sepsis, pulmonary symptoms, and fever. In conclusion, machine learning can help identify pertussis episodes among those diagnosed with ARD.
Topics: Adult; Adolescent; Humans; Whooping Cough; Electronic Health Records; Diphtheria-Tetanus-acellular Pertussis Vaccines; Vaccination; Tetanus; Diphtheria
PubMed: 37171155
DOI: 10.1080/21645515.2023.2209455 -
Human Vaccines & Immunotherapeutics Dec 2023We developed a machine learning algorithm to identify undiagnosed pertussis episodes in adolescent and adult patients with reported acute respiratory disease (ARD) using...
We developed a machine learning algorithm to identify undiagnosed pertussis episodes in adolescent and adult patients with reported acute respiratory disease (ARD) using clinician notes in an electronic healthcare record (EHR) database. Here, we utilized the algorithm to better estimate the overall pertussis incidence within the Optum Humedica clinical repository from 1 January 2007 through 31 December 2019. The incidence of diagnosed pertussis episodes was 1-5 per 100,000 annually, consistent with data registered by the US Centers for Disease Control and Prevention (CDC) over the same time period. Among 18,573,496 ARD episodes assessed, 1,053,946 were identified (i.e. algorithm-identified) as likely undiagnosed pertussis episodes. Accounting for these undiagnosed pertussis episodes increased the estimated pertussis incidence by 110-fold on average (34-474 per 100,000 annually). Risk factors for pertussis episodes (diagnosed and algorithm-identified) included asthma (Odds ratio [OR] 2.14; 2.12-2.16), immunodeficiency (OR 1.85; 1.78-1.91), chronic obstructive pulmonary disease (OR 1.63; 1.61-1.65), obesity (OR 1.44; 1.43-1.45), Crohn's disease (OR 1.39; 1.33-1.45), diabetes type 1 (OR 1.21; 1.17-1.24) and type 2 (OR 1.12; 1.1-1.13). Of note, all these risk factors, except Crohn's disease, increased the likelihood of severe pertussis. In conclusion, the incidence of pertussis in the adolescent and adult population in the USA is likely substantial, but considerably under-recognized, highlighting the need for improved clinical awareness of the disease and for improved control strategies in this population. These results will help better inform public health vaccination and booster programs, particularly in those with underlying comorbidities.
Topics: Humans; Adult; Adolescent; United States; Whooping Cough; Crohn Disease; Incidence; Asthma; Health Care Costs; Vaccination; Pertussis Vaccine
PubMed: 37171153
DOI: 10.1080/21645515.2023.2208514 -
Archivos de Bronconeumologia May 2024Chronic respiratory diseases (CRD) are responsible for more than four million deaths worldwide and have become especially prevalent in developed countries. Although the... (Review)
Review
Chronic respiratory diseases (CRD) are responsible for more than four million deaths worldwide and have become especially prevalent in developed countries. Although the current therapies help manage daily symptoms and improve patients' quality of life, there is a major need to prevent exacerbations triggered mainly by respiratory infections. Therefore, CRD patients are a prime target for vaccination against infectious agents. In the present manuscript we review the state of the art of available vaccines specifically indicated in patients with CRDs. In addition to pneumococcus, influenza, pertussis, and SARS-CoV-2 vaccines, recently added immunization options like vaccines and monoclonal antibodies against respiratory syncytial virus, are particularly interesting in CRD patients. As new products reach the market, health authorities must be agile in updating immunization recommendations and in the programming of the vaccination of vulnerable populations such as patients with CRDs. Organizational and educational strategies might prove useful to increase vaccine uptake by CRD patients.
PubMed: 38876918
DOI: 10.1016/j.arbres.2024.05.026 -
Journal of Korean Medical Science Oct 2023Vaccine hesitancy poses a significant global health challenge, fueled by misinformation and anti-vaccination campaigns on social media platforms (SMPs). This study... (Review)
Review
Vaccine hesitancy poses a significant global health challenge, fueled by misinformation and anti-vaccination campaigns on social media platforms (SMPs). This study examines the influence of social media on coronavirus disease 2019 (COVID-19) and non-COVID-19 vaccination in Asia during the peri-pandemic period. Through a comprehensive analysis of available literature, we aim to elucidate the role of SMPs in shaping vaccination attitudes and behaviors. The findings highlight the detrimental impact of social media on vaccination efforts and provide insights into addressing vaccine hesitancy during this critical period. A narrative review was conducted by searching the PubMed, Scopus, and Google Scholar databases from inception to May 26, 2022. Only English-language articles involving human participants from Asian countries were included in this review. Out of the 228 articles identified through the database search, 14 articles were included in the final analysis. The prevalence of COVID-19 vaccine hesitancy or negative attitudes towards COVID-19 vaccines in Asian countries was found to be high, ranging from 20% to 55% across countries. Notably, reliance on SMPs for vaccine-related information was associated with a higher likelihood of COVID-19 vaccine hesitancy. This trend coincided with the proliferation of misinformation and conspiracy theories that portrayed COVID-19 vaccines as harmful during the pandemic. Similar patterns were observed for other types of vaccines, including polio, measles mumps and rubella, and diphtheria-tetanus-pertussis vaccines. The use of SMPs was also found to be associated with increased fear among caregivers in Asian countries, as well as a 3-4 times higher likelihood of delayed immunization. SMPs negatively impact vaccine intent in Asia due to misinformation and anti-vaccination campaigns during the pandemic. However, they can be a powerful tool for healthcare providers and policymakers to promote informed decision-making. Efforts should focus on leveraging SMPs to disseminate reliable information and combat hesitancy, fostering a well-informed and vaccinated population in Asia.
Topics: Humans; Social Media; COVID-19 Vaccines; COVID-19; Vaccination; Immunization; Vaccines
PubMed: 37846789
DOI: 10.3346/jkms.2023.38.e326 -
Frontiers in Immunology 2023Antepartum maternal vaccination can protect highly sensitive newborns before they are old enough to receive their own vaccines. Two vaccines are currently recommended... (Review)
Review
Antepartum maternal vaccination can protect highly sensitive newborns before they are old enough to receive their own vaccines. Two vaccines are currently recommended during pregnancy: the flu vaccine and the Tdap vaccine against tetanus, diphtheria, and pertussis. Although there is strong evidence that maternal vaccination works to protect the offspring, limitations in the understanding of vaccines and of maternal transfer of immunity compound to obscure our understanding of how they work. Here we focus on the example of pertussis to explore the possible mechanisms involved in the transfer of protection to offspring and how these may impact the newborn's response to future exposure to pertussis. For example, Tdap vaccines induce pathogen specific antibodies, and those antibodies are known to be transferred from mother to the fetus and to the newborn via milk. But antibodies alone have modest impact on pertussis disease, and even less effect on colonization/transmission. Maternal immune cells can also be transferred to offspring and may play a direct role in protection from disease and/or influence the developing neonatal immune system. However, some of the transferred immunity may also blunt the offspring's response to subsequent vaccination. In this review we will summarize the protection conferred to offspring by maternal vaccination against pertussis and the likely mechanisms by which protection is transferred, identifying the many knowledge gaps that limit our most effective application of this approach.
Topics: Female; Pregnancy; Infant, Newborn; Humans; Whooping Cough; Diphtheria-Tetanus-acellular Pertussis Vaccines; Vaccination; Antibodies; Mothers; Bacterial Vaccines
PubMed: 37520565
DOI: 10.3389/fimmu.2023.1210580 -
JAMA Neurology Oct 2023Scientific literature is sparse about the association of vaccination with the onset of multiple sclerosis (MS) flare-ups. Immunization by vaccines of the entire...
IMPORTANCE
Scientific literature is sparse about the association of vaccination with the onset of multiple sclerosis (MS) flare-ups. Immunization by vaccines of the entire population is crucially important for public health.
OBJECTIVE
To evaluate the risk of hospitalization for severe MS flare-ups after vaccination in patients with MS.
DESIGN, SETTING, PARTICIPANTS
This cohort study included patients diagnosed with MS between January 1, 2007, and December 31, 2017, who were included in the System of National Health Databases, a national health claims database in France. In a nested case-crossover analysis, cases were defined by vaccine exposure prior to the onset of hospitalization due to an MS flare-up, and flare-up rates were compared with those that occurred prior to vaccine exposure in up to 4 control time windows immediately preceding the at-risk time window (ie, the MS flare-up) for each patient. Data were analyzed from January 2022 to December 2022.
EXPOSURE
Receipt of at least 1 vaccination, including the diphtheria, tetanus, poliomyelitis, pertussis, or Haemophilus influenzae (DTPPHi) vaccine, influenza vaccine, and pneumococcal vaccine, during follow-up.
MAIN OUTCOMES AND MEASURES
The primary outcome was the risk of hospitalization for an MS flare-up after receipt of a vaccine. Adjusted odds ratios (AORs) and 95% CIs were derived using conditional logistic regression to measure the risk of hospitalization for an MS flare-up associated with vaccination.
RESULTS
A total of 106 523 patients constituted the MS cohort (mean [SD] age, 43.9 [13.8] years; 76 471 females [71.8%]; 33 864 patients [31.8%] had incident MS and 72 659 patients [68.2%] had prevalent MS) and were followed up for a mean (SD) of 8.8 (3.1) years. Of these patients, 35 265 (33.1%) were hospitalized for MS flare-ups during the follow-up period for a total of 54 036 MS-related hospitalizations. The AORs of hospitalization for an MS flare-up and vaccine exposure in the 60 days prior to the flare-up were 1.00 (95% CI, 0.92-1.09) for all vaccines, 0.95 (95% CI, 0.82-1.11) for the DTPPHi, 0.98 (95% CI, 0.88-1.09) for the influenza vaccine, and 1.20 (95% CI, 0.94-1.55) for the pneumococcal vaccine.
CONCLUSIONS AND RELEVANCE
A nationwide study of the French population found no association between vaccination and the risk of hospitalization due to MS flare-ups. However, considering the number of vaccine subtypes available, further studies are needed to confirm these results.
PubMed: 37669073
DOI: 10.1001/jamaneurol.2023.2968 -
Annals of Allergy, Asthma & Immunology... Sep 2023Pertussis is a highly contagious respiratory disease, and those with chronic respiratory illnesses may be at higher risk of infection and severe pertussis. Acellular... (Observational Study)
Observational Study
BACKGROUND
Pertussis is a highly contagious respiratory disease, and those with chronic respiratory illnesses may be at higher risk of infection and severe pertussis. Acellular pertussis-containing vaccines (Tdap) are recommended in the United States for those with risk factors, such as asthma and chronic obstructive pulmonary disease (COPD).
OBJECTIVE
To determine Tdap vaccination rates among people with asthma or COPD compared with matched controls with type 2 diabetes and the general population.
METHODS
This observational database study identified adults with asthma or COPD, and their matched controls, from a large US administrative health claims system between January 2008 and December 2014. Vaccination with Tdap was identified using current procedural terminology and national drug codes, and vaccination rates per 1000 patient-years and adjusted rate ratios (RR) were calculated using a generalized linear model with a Poisson distribution and 95% confidence intervals (CI).
RESULTS
Vaccination rates were low overall; however, they were slightly higher in asthma than the general population cohort, with vaccination incidence RRs of 1.12 (95% CI, 1.08-1.17), 1.09 (95% CI, 1.06-1.11), and 1.11 (95% CI, 1.07-1.16) in those aged 18 to 44, 45 to 64, and 65 years and older, respectively. However, Tdap vaccination rates were lower in the COPD than in the general population cohort, with vaccination incidence RRs of 0.72 (95% CI, 0.60-0.86), 0.87 (95% CI, 0.83-0.91), and 0.94 (95% CI, 0.92-0.96), respectively.
CONCLUSION
Pertussis vaccination rates were suboptimal among adults in general and adults with asthma or COPD. Work is needed to boost Tdap vaccination uptake among people with chronic respiratory conditions.
Topics: Humans; Adult; United States; Tetanus; Diphtheria-Tetanus-acellular Pertussis Vaccines; Diphtheria; Whooping Cough; Diabetes Mellitus, Type 2; Pulmonary Disease, Chronic Obstructive; Asthma
PubMed: 37080456
DOI: 10.1016/j.anai.2023.04.008