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The Lancet. Infectious Diseases Dec 2021Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of...
Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of vaccine-preventable diseases. This information is vital to develop targeted strategies to improve the health of diverse migrant communities. We did a systematic review (PROSPERO CRD42019157473; Jan 1, 2000, to May 22, 2020) adhering to PRISMA guidelines, to identify studies on vaccine-preventable disease outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, varicella, Neisseria meningitidis, and Haemophilus influenzae) involving migrants residing in the EU/EEA and Switzerland. We identified 45 studies, reporting on 47 distinct vaccine-preventable disease outbreaks across 13 countries. Most reported outbreaks involving migrants were of measles (n=24; 6496 cases), followed by varicella (n=11; 505 cases), hepatitis A (n=7; 1356 cases), rubella (n=3; 487 cases), and mumps (n=2; 293 cases). 19 (40%) outbreaks, predominantly varicella and measles, were reported in temporary refugee camps or shelters. Of 11 varicella outbreaks, nine (82%) were associated with adult migrants. Half of measles outbreaks (n=11) were associated with migrants from eastern European countries. In conclusion, migrants are involved in vaccine-preventable disease outbreaks in Europe, with adult and child refugees residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and demographics, highlighting the importance of tailoring catch-up vaccination interventions to specific groups in order to meet regional and global vaccination targets as recommended by the new Immunisation Agenda 2030 framework for action. A better understanding of vaccine access and intent in migrant groups and a greater focus on co-designing interventions is urgently needed, with direct implications for COVID-19 vaccine delivery.
Topics: Adult; Child; Disease Outbreaks; Europe; Humans; Immunization Programs; Refugee Camps; Refugees; Transients and Migrants; Vaccination; Vaccine-Preventable Diseases
PubMed: 34626552
DOI: 10.1016/S1473-3099(21)00193-6 -
Vaccine: X Dec 2022In the pre-vaccination era, all adults acquired immunity status due to natural infections during childhood and adolescence, whereas universal mass vaccination has...
INTRODUCTION
In the pre-vaccination era, all adults acquired immunity status due to natural infections during childhood and adolescence, whereas universal mass vaccination has changed the seroepidemiology of rubella among adults, showing lack of immunity in some subgroups. National and international guidelines recommend evaluating all healthcare workers (HCWs) for their immune status to rubella and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis to estimate the susceptibility rate to rubella among HCWs in Italy and to explore possible options for the management of those found to be susceptible.
METHODS
Eight studies were included in the meta-analysis, selected from scientific papers available in the MEDLINE/PubMed and Google Scholar (till page 10) databases between January 1, 2015 and November 30, 2021. The following terms were used for the search strategy: (sero* OR seroprevalence OR prevalence OR susceptibilit* OR immunit* OR immunogenict*) AND (healthcare worker* OR health personnel OR physician* OR nurse OR student*) AND (rubella OR german measles OR TORCH) AND (Italy).
RESULTS
The prevalence of rubella-susceptible HCWs was 9.0 % (95 %CI: 6.4-12.1 %). In a comparison of female vs. male serosusceptible HCWs, the RR was 0.67 (95 %CI = 0.51-0.88). Occupational medicine examinations for rubella screening with possible subsequent vaccination of seronegatives and exclusion of susceptible HCWs from high-risk settings were common management strategies.
CONCLUSIONS
HCWs susceptible to rubella are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased.
PubMed: 36032697
DOI: 10.1016/j.jvacx.2022.100195 -
Cureus Aug 2022There is increasing literature mentioning severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19 infection) causing acute pancreatitis (AP). It... (Review)
Review
There is increasing literature mentioning severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19 infection) causing acute pancreatitis (AP). It is hypothesized that SARS-Cov-2 causes pancreatic injury either by direct cytotoxic effect of the virus on pancreatic cells through the angiotensin-converting enzyme 2 (ACE2) receptors - the main receptors for the virus located on pancreatic cells - or by the cytokine storm that results from COVID-19 infection or a component of both. Many viruses are related to AP including mumps, coxsackievirus, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and as data evolves SARS-CoV-2 virus may be one of them as well. We conducted a systematic literature review to explore the current literature and provide an overview of the evidence of AP in COVID-19 infection. We studied the presence of AP in patients with SARS-CoV-2 infection and calculated the time of diagnosis of SARS-CoV-2 infection with respect to the time of diagnosis of AP. We also studied the age, gender, clinical manifestations, time of onset of symptoms, laboratory values, imaging findings, mortality, length of stay, comorbidities, need for Intensive Care Unit (ICU) care, and excluded any other common causes of AP. We included 40 articles comprising 46 patients. All patients had a positive SARS-CoV-2 polymerase chain reaction (PCR) test and all patients had AP as per Atlanta's criteria. The most common clinical presentation was abdominal pain in 29 (63.0%). Edematous pancreas was the most common Computed Tomography Abdomen Pelvis (CTAP) scan finding in these patients (35 patients). Seventeen (37%) patients required ICU admission and six (13%) patients died. Our study provides an important overview of the available data on AP in COVID-19 patients and concludes that AP is an important complication in COVID-19 infection and should be considered as an important differential in patients with COVID-19 infection who complain of abdominal pain.
PubMed: 36168341
DOI: 10.7759/cureus.28380 -
International Journal of Environmental... Oct 2020Prison inmates are highly susceptible for several infectious diseases, including vaccine-preventable diseases. We conducted a systematic international literature review...
Prison inmates are highly susceptible for several infectious diseases, including vaccine-preventable diseases. We conducted a systematic international literature review on vaccination coverage against hepatitis B virus (HBV), hepatitis A virus (HAV), combined HAV/HBV, tetanus-diphtheria, influenza, pneumococcal, and combined measles, mumps, and rubella (MMR) in prison inmates, according to the PRISMA guidelines. The electronic databases were used Web of Science, MEDLINE, Scopus, and Cinhal. No language or time limit were applied to the search. We defined vaccination coverage as the proportion of vaccinated prisoners. There were no limitations in the search strategy regarding time period or language. Of 1079 identified studies, 28 studies were included in the review. In total, 21 reported on HBV vaccine coverage (range between 16-82%); three on HAV (range between 91-96%); two studies on combined HAV/HBV (77% in the second dose and 58% in the third); three studies on influenza vaccine (range between 36-46%), one of pneumococcal vaccine coverage (12%), and one on MMR coverage (74%). We found that data on vaccination coverage in prison inmates are scarce, heterogeneous, and do not include all relevant vaccines for this group. Current published literature indicate that prison inmates are under-immunized, particularly against HBV, influenza, MMR, and pneumococci. Strengthen immunization programs specifically for this population at risk and improvement of data record systems may contribute to better health care in prisoners.
Topics: Cross-Sectional Studies; Female; Humans; Influenza A Virus, H1N1 Subtype; Influenza Vaccines; Male; Measles-Mumps-Rubella Vaccine; Prisoners; Prospective Studies; Retrospective Studies; Vaccination; Vaccination Coverage; Viral Hepatitis Vaccines
PubMed: 33086513
DOI: 10.3390/ijerph17207589 -
Frontiers in Pharmacology 2022Mumps is caused by the mumps virus and is characterized by pain and parotid gland swelling. Although its incidence has declined due to vaccines, outbreaks still occur...
Clinical efficacy evaluation and potential mechanism prediction on Pudilan Xiaoyan oral liquid in treatment of mumps in children based on meta-analysis, network pharmacology, and molecular docking.
Mumps is caused by the mumps virus and is characterized by pain and parotid gland swelling. Although its incidence has declined due to vaccines, outbreaks still occur among children. In addition, it can lead to severe complications, so it has a certain perniciousness. Pudilan Xiaoyan oral liquid (PDL), a Chinese patent medicine, commonly treats children with mumps. However, its safety, efficacy, and specific mechanisms lack relevant evaluation and analysis. Therefore, we did a meta-analysis of the randomized controlled trials combined with a network pharmacology analysis to assess the efficacy and safety of PDL in relieving symptoms of mumps in children and investigate its pharmacological mechanisms. This study systematically searched the China National Knowledge Infrastructure (CNKI), WanFang Data Knowledge Service Platform, VIP Database, Sinomed, Chinese Medical Journal Full-text Database, PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar for the published randomized controlled trials (date up to 3 March 2022; studies in both English and Chinese) comparing PDL and antiviral drug combination treatment to standalone antiviral drug treatment. The primary outcomes in this study were the effective rate and duration of five characteristic symptoms of children's mumps. We assessed the pooled data by using a fix-effect or random-effect model. We illustrated an odds ratio (OR) or standardized mean difference (SMD) with a 95% confidence interval (CI) using the Stata 15 software. In network pharmacology, active components of PDL were collected from the traditional Chinese medicine system pharmacology technology platform and the CNKI studies, while mumps' targets were collected from databases of the Genecards and Online Mendelian Inheritance in Man (OMIM), and then we constructed a "drug-component-target" network and a protein-protein interaction network using Cytoscape 3.9.0 for screening the core components and targets. Next, we ran Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of intersection targets of PDL and mumps. Finally, molecular docking was performed between core components and targets. Of 70 identified studies, 12 were eligible and included in our analysis (N = 1,307 participants). Compared with the antiviral drug treatments, combination treatment using PDL and antiviral drugs provided higher effective rates (OR = 5.94), shorter symptom durations for fever (SMD = -1.05), headache (SMD = -0.69), parotid gland swelling (SMD = -1.30), parotid gland pain (SMD = -2.53), and loss of appetite (SMD = -0.56) with fewer reported side effects. Of the 113 active components of PDL and 57 mumps' targets, 11 core components like quercetin, isoetin, and seven core targets such as albumin (ALB) and interleukin-6 were obtained. Moreover, the potential pathways identified included cytokine-cytokine receptor interaction and T helper cell 17 (Th17 cell) differentiation. Molecular docking results revealed that most core components and targets could form stable structures. The core components, including isoetin, quercetin, and luteolin, and core targets involving heat shock protein HSP 90-alpha (HSP90AA1), estrogen receptor (ESR1), and ALB showed the best affinities. The combined use of PDL and antiviral drugs could effectively improve the efficacy of mumps among children and rapidly alleviate mumps-related symptoms. This efficacy may be associated with the anti-inflammatory and antiviral mechanisms by which PDL acts using multiple components, multiple targets, and multiple pathways. However, these results should be confirmed by further studies.
PubMed: 36210814
DOI: 10.3389/fphar.2022.956219 -
Global Public Health Jan 2023This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the...
This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine - the silent shot - causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced.
Topics: Child; Humans; Autism Spectrum Disorder; Autistic Disorder; Human Migration; Language; Measles-Mumps-Rubella Vaccine; Somalia; Sustenance; Sweden
PubMed: 37750434
DOI: 10.1080/17441692.2023.2257771 -
Indian Journal of Dermatology,... 2022Background Intralesional immunotherapy has been reported to be effective for warts and to show good safety profiles, but this has not yet been systematically studied.... (Meta-Analysis)
Meta-Analysis
Background Intralesional immunotherapy has been reported to be effective for warts and to show good safety profiles, but this has not yet been systematically studied. Aims To determine the efficacy and safety of intralesional immunotherapy for treating non-genital warts. Methods We comprehensively searched the MEDLINE, Embase, Web of Science and Cochrane Library databases from the times of their inception to January 3, 2020. The primary outcome was the rate of complete response of all lesions. The distant complete response rate of warts located in an anatomically different body part and the recurrence rate were also analyzed. Results A total of 54 prospective studies was ultimately included. The immunotherapeutic agents used were Mycobacterium w vaccine, measles, mumps and rubella vaccine, purified protein derivative, Candida antigen, interferon, bacillus Calmette-Guérin vaccine and others. The pooled rate of complete response among all patients with non-genital warts treated using intralesional immunotherapy was 60.6% (95% confidence interval 54.8-66.5%). The pooled recurrence rate was 2.0% (95% confidence interval, 1.1-2.9%). All reported adverse events were mild and transient. Limitations The heterogeneity among studies Conclusion Intralesional immunotherapy is suggested for use in patients with multiple warts, given its promising results, good safety profile and low recurrence rate.
Topics: Humans; Injections, Intralesional; Prospective Studies; Warts; Immunotherapy; Immunologic Factors; BCG Vaccine; Treatment Outcome
PubMed: 35962514
DOI: 10.25259/IJDVL_1369_20 -
Vaccines Dec 2019The growing number of available vaccines that can be potentially co-administered makes the assessment of the safety of vaccine co-administration increasingly relevant... (Review)
Review
The growing number of available vaccines that can be potentially co-administered makes the assessment of the safety of vaccine co-administration increasingly relevant but complex. We aimed to synthesize the available scientific evidence on the safety of vaccine co-administrations in children by performing a systematic literature review of studies assessing the safety of vaccine co-administrations in children between 1999 and 2019, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifty studies compared co-administered vaccines versus the same vaccines administered separately. The most frequently studied vaccines included quadrivalent meningococcal conjugate (MenACWY) vaccine, diphtheria and tetanus toxoids and acellular pertussis (DTaP) or tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccines, diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B, inactivated poliovirus and type b conjugate (DTaP-HepB-IPV/Hib) vaccine, measles, mumps, and rubella (MMR) vaccine, and pneumococcal conjugate 7-valent (PCV7) or 13-valent (PCV13) vaccines. Of this, 16% (n = 8) of the studies reported significantly more adverse events following immunization (AEFI) while in 10% (n = 5) significantly fewer adverse events were found in the co-administration groups. Statistically significant differences between co-administration and separate administration were found for 16 adverse events, for 11 different vaccine co-administrations. In general, studies briefly described safety and one-third of studies lacked any statistical assessment of AEFI. Overall, the evidence on the safety of vaccine co-administrations compared to separate vaccine administrations is inconclusive and there is a paucity of large post-licensure studies addressing this issue.
PubMed: 31906218
DOI: 10.3390/vaccines8010012 -
Telematics and Informatics Jan 2023The COVID-19 pandemic has demonstrated the importance of large-scale campaigns to facilitate vaccination adherence. Social media presents unique opportunities to reach... (Review)
Review
The COVID-19 pandemic has demonstrated the importance of large-scale campaigns to facilitate vaccination adherence. Social media presents unique opportunities to reach broader audiences and reduces the costs of conducting national or global campaigns aimed at achieving herd immunity. Nonetheless, few studies have reviewed the effectiveness of prior social media campaigns for vaccination adherence, and several prior studies have shown that social media campaigns do not increase uptake rates. Hence, our objective is to conduct a systematic review to examine the effectiveness of social media campaigns and to identify the reasons for the mixed results of prior studies. Our methodology began with a search of seven databases, which resulted in the identification of 92 interventions conducted over digital media. Out of these 92 studies, only 15 adopted social media campaigns for immunization. We analyzed these 15 studies, along with a coding scheme we developed based on reviews of both health interventions and social media campaigns. Multiple coders, who were knowledgeable about social media campaigns and healthcare, analyzed the 15 cases and obtained an acceptable level of inter-coder reliability (> .80). The results from our systematic review show that only a few social media campaigns have succeeded in enhancing vaccination adherence. In addition, few campaigns have utilized known critical success factors of social media to induce vaccination adherence. Based on these findings, we discuss a set of research questions that informatics scholars should consider when identifying opportunities for using social media to resolve one of the most resilient challenges in public health. Finally, we conclude by discussing how the insights drawn from our systematic reviews contribute to advancing theories, such as social influence and the health belief model, into the realm of social media-based health interventions.
PubMed: 36438457
DOI: 10.1016/j.tele.2022.101918 -
Journal of Travel Medicine Feb 2024Ensuring vaccination coverage reaches established herd immunity thresholds (HIT) is the cornerstone of any vaccination programme. Diverse migrant populations in European...
BACKGROUND
Ensuring vaccination coverage reaches established herd immunity thresholds (HIT) is the cornerstone of any vaccination programme. Diverse migrant populations in European countries have been associated with cases of vaccine-preventable diseases (VPD) and outbreaks, yet it is not clear to what extent they are an under-immunised group.
METHODS
We did a systematic review and meta-analysis to synthesise peer-reviewed published primary research reporting data on the immune status of migrants in EU/EEA countries, the UK and Switzerland, calculating their pooled immunity coverage for measles, mumps, rubella, and diphtheria using random-effects models. We searched on Web of Science, Embase, Global Health and MEDLINE (January 1st 2000 to June 10th 2022), with no language restrictions. The protocol is registered with PROSPERO (CRD42018103666).
FINDINGS
Of 1103 abstracts screened, 62 met eligibility criteria, of which 39 were included in the meta-analysis. The meta-analysis included 75 089 migrants, predominantly from outside Europe. Pooled immunity coverage among migrant populations was well below the recommended HIT for diphtheria (n = 7, 57.4% [95% CI: 43.1-71.7%] I2 = 99% vs HIT 83-86%), measles (n = 21, 83.7% [95% CI: 79.2-88.2] I2 = 99% vs HIT 93-95%), and mumps (n = 8, 67.1% [95% CI: 50.6-83.6] I2 = 99% vs HIT 88-93%), and midway for rubella (n = 29, 85.6% [95% CI: 83.1-88.1%] I2 = 99% vs HIT 83-94%), with high heterogeneity across studies.
INTERPRETATION
Migrants in Europe are an under-immunised group for a range of important VPDs, with this study reinforcing the importance of engaging children, adolescents, and adults in 'catch-up' vaccination initiatives on arrival for vaccines, doses, and boosters they may have missed in their home countries. Co-designing strategies to strengthen catch-up vaccination across the life-course in under-immunised groups is an important next step if we are to meet European and global targets for VPD elimination and control and ensure vaccine equity.
PubMed: 38423523
DOI: 10.1093/jtm/taae033