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Journal of Comparative Effectiveness... Mar 2017Dengue virus (DENV) is a serious global health problem. CYD-TDC (Dengvaxia) was the first vaccine to gain regulatory approval to try and address this problem. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Dengue virus (DENV) is a serious global health problem. CYD-TDC (Dengvaxia) was the first vaccine to gain regulatory approval to try and address this problem.
AIM
Summarize all available evidence on the immunogenicity, efficacy and safety of the CYD-TDV dengue vaccine.
METHOD
Meta-analysis and systematic review.
RESULTS
The best and worst immunogenicity results were for DENV4 and DENV1, respectively. Vaccine efficacy of 60% was derived from studies with participants aged 2-16 years old, with DENV4 and DENV2 presenting the best and worst results, respectively. Erythema and swelling were more frequent with CYD-TDV. No differences were detected for systemic adverse events.
CONCLUSION
CYD-TDV showed moderate efficacy in children and adolescents. From the immunogenicity results in adults, we can expect satisfactory efficacy from vaccination in this population.
Topics: Adaptive Immunity; Adolescent; Child; Child, Preschool; Dengue; Dengue Vaccines; Female; Humans; Immunogenicity, Vaccine; Male; Patient Safety; Treatment Outcome
PubMed: 28084784
DOI: 10.2217/cer-2016-0045 -
BMC Public Health Sep 2022Cytomegalovirus (CMV) is a common pathogen that affects individuals of all ages and establishes lifelong latency. Although CMV is typically asymptomatic in healthy...
BACKGROUND
Cytomegalovirus (CMV) is a common pathogen that affects individuals of all ages and establishes lifelong latency. Although CMV is typically asymptomatic in healthy individuals, infection during pregnancy or in immunocompromised individuals can cause severe disease. Currently, treatments are limited, with no prophylactic vaccine available. Knowledge of the current epidemiologic burden of CMV is necessary to understand the need for treatment and prevention. A systematic literature review (SLR) was conducted to describe the most recent epidemiologic burden of CMV globally.
METHODS
Medline, Embase, and LILACS were searched to identify data on CMV prevalence, seroprevalence, shedding, and transmission rates. The SLR covered the time period of 2010-2020 and focused geographically on Australia, Europe, Israel, Japan, Latin America (LATAM), and North America. Studies were excluded if they were systematic or narrative reviews, abstracts, case series, letters, or correspondence. Studies with sample sizes < 100 were excluded to focus on studies with higher quality of data.
RESULTS
Twenty-nine studies were included. Among adult men, CMV immunoglobulin G (IgG) seroprevalence ranged from 39.3% (France) to 48.0% (United States). Among women of reproductive age in Europe, Japan, LATAM, and North America, CMV IgG seroprevalence was 45.6-95.7%, 60.2%, 58.3-94.5%, and 24.6-81.0%, respectively. Seroprevalence increased with age and was lower in developed than developing countries, but data were limited. No studies of CMV immunoglobulin M (IgM) seroprevalence among men were identified. Among women of reproductive age, CMV IgM seroprevalence was heterogenous across Europe (1.0-4.6%), North America (2.3-4.5%), Japan (0.8%), and LATAM (0-0.7%). CMV seroprevalence correlated with race, ethnicity, socioeconomic status, and education level. CMV shedding ranged between 0% and 70.2% depending on age group. No findings on CMV transmission rates were identified.
CONCLUSIONS
Certain populations and regions are at a substantially higher risk of CMV infection. The extensive epidemiologic burden of CMV calls for increased efforts in the research and development of vaccines and treatments.
TRIAL REGISTRATION
N/A.
Topics: Adult; Antibodies, Viral; Cytomegalovirus; Cytomegalovirus Infections; Female; Humans; Immunoglobulin G; Immunoglobulin M; Male; Pregnancy; Pregnancy Complications, Infectious; Research; Seroepidemiologic Studies; Vaccine Development
PubMed: 36050659
DOI: 10.1186/s12889-022-13971-7 -
Frontiers in Public Health 2023The purpose of this systematic review was to report on the vaccine efficacy (VE) of three SARS-CoV-2 vaccines approved by Health Canada: Pfizer BioNTech, Moderna, and...
The purpose of this systematic review was to report on the vaccine efficacy (VE) of three SARS-CoV-2 vaccines approved by Health Canada: Pfizer BioNTech, Moderna, and AstraZeneca. Four databases were searched for primary publications on population-level VE. Ninety-two publications matched the inclusion criteria, and the extracted data were separated by vaccine type: mRNA vaccines (Pfizer and Moderna) and the AstraZeneca vaccine. The median VE for PCR-positive patients and various levels of clinical disease was determined for the first and second doses of both vaccine types against multiple SARS-CoV-2 variants. The median VE for PCR-positive infections against unidentified variants from an mRNA vaccine was 64.5 and 89%, respectively, after one or two doses. The median VE for PCR-positive infections against unidentified variants from the AstraZeneca vaccine was 53.4 and 69.6%, respectively, after one or two doses. The median VE for two doses of mRNA for asymptomatic, symptomatic, and severe infection against unidentified variants was 85.5, 93.2, and 92.2%, respectively. The median VE for two doses of AstraZeneca for asymptomatic, symptomatic, and severe infection against unidentified variants was 69.7, 71, and 90.2%, respectively. Vaccine efficacy numerically increased from the first to the second dose, increased from the first 2 weeks to the second 2 weeks post-vaccination for both doses, but decreased after 4 months from the second dose. Vaccine efficacy did not differ by person's age.
Topics: Humans; COVID-19 Vaccines; SARS-CoV-2; Vaccine Efficacy; COVID-19; Vaccines
PubMed: 37942238
DOI: 10.3389/fpubh.2023.1229716 -
International Journal of Environmental... Jun 2023Vaccines effectively protect against COVID-19, but vaccine hesitancy and refusal hinder vaccination rates. This systematic review aimed to (1) review and describe... (Review)
Review
Vaccines effectively protect against COVID-19, but vaccine hesitancy and refusal hinder vaccination rates. This systematic review aimed to (1) review and describe current interventions for addressing COVID-19 vaccine hesitancy/refusal and (2) assess whether these interventions are effective for increasing vaccine uptake. The protocol was registered prospectively on PROSPERO and comprehensive search included Medline, Embase, CINAHL, PsycInfo, and Web of Science databases. Only studies that evaluated the effectiveness of non-financial interventions to address COVID-19 vaccine hesitancy were included, while those focusing intentions or financial incentive were excluded. Risk of bias for all included studies was evaluated using Cochrane risk of bias tools. In total, six articles were included in the review (total participants = 200,720). A narrative synthesis was performed due to the absence of common quantitative metrics. Except for one randomized controlled trial, all studies reported that interventions were effective, increasing COVID-19 vaccination rates. However, non-randomized studies were subject to confounding biases. Evidence on the effectiveness of COVID-19 vaccine hesitancy interventions remains limited and further evidence is needed for the development of clear guidance on effective interventions to increase vaccine uptake.
Topics: Humans; COVID-19 Vaccines; COVID-19; Biological Transport; Benchmarking; Databases, Factual; Vaccination
PubMed: 37372669
DOI: 10.3390/ijerph20126082 -
Heliyon Sep 2022Vaccination seems to be the most effective way to prevent and control the spread of COVID-19, a disease that has adversely impacted the lives of over 7 billion people...
BACKGROUND
Vaccination seems to be the most effective way to prevent and control the spread of COVID-19, a disease that has adversely impacted the lives of over 7 billion people across the globe. Vaccine hesitancy represents an important threat to combat infectious diseases worldwide. This study aims to inspect the COVID-19 vaccine acceptance rate worldwide and the regional variation of the acceptance rates among the general population and healthcare workers across different territories of the world. In addition, it compares the vaccine acceptance rates between the pre- and post-vaccine approval periods.
METHOD
A comprehensive systematic review was conducted using PRISMA statements. After quality evaluation, the data from eligible studies were analyzed using the random effect model. Q-test and statistics were used to search for heterogeneity. The publication bias was assessed by using Egger's test and funnel plot.
RESULTS
The combined COVID-19 vaccine acceptance rate among the general population and healthcare workers (n = 1,581,562) was estimated at 62.79% (95% CI: 58.98-66.60). The acceptance rate substantially decreased from 66.29% (95% CI: 61.24-71.35) to 56.69% (95% CI: 48.68-64.71) among the general population from the pre-to post-vaccine approval periods but remained almost constant at 58.25% (95% CI: 46.52-69.97) among healthcare workers. The acceptance rates also varied in different regions of the world. The highest acceptance rate was found in the South-East Asia region at 70.18% (95% CI: 58.12-82.25) and the lowest was found in African Region at 39.51% (95% CI: 23.42-55.59).
CONCLUSION
Low COVID-19 vaccine acceptance rate might be a massive barrier to controlling the pandemic. More research is needed to address the responsible factors influencing the low global rate of COVID-19 vaccine acceptance. Integrated global efforts are required to remove the barriers.
PubMed: 36168558
DOI: 10.1016/j.heliyon.2022.e10728 -
BMJ Open Aug 2022The aim of this study was to perform a systematic review and meta-analysis to estimate the vaccines' acceptance level and to find the factors influencing pregnant... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this study was to perform a systematic review and meta-analysis to estimate the vaccines' acceptance level and to find the factors influencing pregnant women's vaccination decisions, with the goal of assisting in the development of interventions and promoting more research in this area.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
MEDLINE, Embase, CINAHL and PubMed.
ELIGIBILITY CRITERIA
Studies providing any kind of quantitative assessment of overall COVID-19 vaccination acceptance among pregnant women in any country or region across the globe.
DATA EXTRACTION AND SYNTHESIS
The pooled prevalence of COVID-19 vaccine acceptance among pregnant women was calculated using the random-effects model. Subgroup (sensitivity) analysis was performed to determine the overall COVID-19 vaccine acceptance level to understand the sources of substantial heterogeneity.
RESULTS
Out of the 375 studies identified, 17 studies from four continents assessing 25 147 participants (pregnant women) were included in this study. Among the participants, only 49% (95% CI 42% to 56%, p<0.001) had COVID-19 vaccine acceptance. High-income countries (47%; 95% CI 38% to 55%, p<0.001), participants with fewer than 12 years of education (38%; 95% CI 19% to 58%, p<0.001) and multiparous women (48%; 95% CI 31% to 66%, p<0.001) had lower COVID-19 vaccine acceptance. Overall heterogeneity was high (I ≥98%), and publication bias was present (p<0.001). A very weak positive correlation between COVID-19 knowledge and COVID-19 vaccine acceptance was observed (r=0.164; 95% CI -0.946 to 0.972; p=0.8359).
CONCLUSION
Overall, COVID-19 vaccine acceptance among pregnant women was low across the studies and considerably low among some specific subgroups of participants. These research findings have implications for the development of effective interventions that could increase the COVID-19 vaccine acceptance level among pregnant women to attain herd immunity.
PROSPERO REGISTRATION NUMBER
CRD42021277754.
Topics: COVID-19; COVID-19 Vaccines; Female; Humans; Pregnancy; Pregnant Women; Vaccination; Vaccination Hesitancy
PubMed: 35981769
DOI: 10.1136/bmjopen-2022-061477 -
Frontiers in Public Health 2022COVID-19 is a major public health problem that has been seriously affecting the global community. Healthcare workers (HCWs) are at high risk of infection due to being...
COVID-19 is a major public health problem that has been seriously affecting the global community. Healthcare workers (HCWs) are at high risk of infection due to being directly involved in diagnosing and taking care of patients. Due to this, they were prioritized to receive the initial supply of vaccines. However, vaccine hesitancy has been identified as a major global public health threat. Therefore, this review aimed to synthesize pieces of evidence on the prevalence of COVID-19 vaccine acceptance and determinate factors among HCWs. A systematic search of published articles was identified using PubMed, Science Direct, Web of Science, and Google Scholar for relevant studies of vaccine acceptance and determinant factors among HCWs. Published articles were identified using abstracts and titles of the articles, and articles were assessed for eligibility criteria. The review process was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). An electronic database search identified 365 articles, from which 33 full-text articles were included in the systematic review. In this review, the highest rate of vaccine acceptance was reported at 95% and the lowest rate of vaccine acceptance was found at 21%. Factors such as sex (male), age, profession (medical doctors), and previous influenza vaccination were the main positive predictors for COVID-19 vaccine acceptance among HCWs. Concerns about vaccine safety, efficacy, and effectiveness were the main barriers and drivers for vaccine hesitancy. Therefore, to improve the COVID-19 vaccine acceptance among HCWs, governments, public health authorities, and private healthcare systems should work together to provide continuous professional development and training on the safety and effectiveness of the COVID-19 vaccine.
Topics: COVID-19; COVID-19 Vaccines; Health Personnel; Humans; Male; Prevalence; Vaccines
PubMed: 35968421
DOI: 10.3389/fpubh.2022.941206 -
Journal of Advanced Pharmaceutical... 2021Search for an effective and safe vaccine to prevent transmission of current pandemic is an unmet need. This study reviews and compares the available early phase clinical... (Review)
Review
Search for an effective and safe vaccine to prevent transmission of current pandemic is an unmet need. This study reviews and compares the available early phase clinical data of vaccine candidates which have reached phase 3 of clinical development. The latest update of "DRAFT landscape of coronavirus (CoV) disease 2019 candidate vaccines (October 2, 2020)" released by the World Health Organization was accessed to identify the potential vaccine candidates. The full text articles (published and/or preprint) of data of early clinical trials of the selected vaccines were accessed from the links provided in the same document, PubMed and/or medRxiv.com. After extraction and synthesis, the data were critically evaluated for the study efficacy and safety outcomes. Of the total 193 candidate vaccines 10 were found to reach phase 3 of the clinical development. Nine of these were included in the evaluation process. In all of the included studies, immunogenicity and serious adverse events/local or systemic adverse events/laboratory parameters abnormality was considered as efficacy and safety outcomes respectively. Immunogenicity response with most of the vaccines was either higher than or similar to the respective controls except one (recombinant adenovirus type 26 COV2 [Ad26.COV2.S]) for which it was less than that in control. Overall adverse events (related and/or unrelated) were more with vaccines than those with respective control(s) in three studies, in other two, these were similar whereas in one study, the events were less in the vaccine group than in control group and in the rest, data described were descriptive only without any mention for the same for the control. In conclusion all studies showed immunogenic response to target protein of severe acute respiratory syndrome CoV-2 and which was higher than the respective control except for Ad26.CoV2.S. Many of the vaccines caused more adverse events than the controls, however most were mild and transient and/or manageable.
PubMed: 34345597
DOI: 10.4103/japtr.JAPTR_229_20 -
Vaccine May 2017Simpler schedules for human papillomavirus (HPV) vaccine delivery could improve vaccine coverage and the effectiveness of cervical cancer prevention. The objective of... (Meta-Analysis)
Meta-Analysis Review
Simpler schedules for human papillomavirus (HPV) vaccine delivery could improve vaccine coverage and the effectiveness of cervical cancer prevention. The objective of this study was to systematically review evidence about the effects of two-dose compared with three-dose schedules for human papillomavirus (HPV) vaccine and to describe the uptake of two-dose HPV vaccination schedules globally. We searched PubMed, the Cochrane Central Registry of Controlled Trials, trials registers, and manufacturers' databases from their earliest date to February 2016. We selected randomised controlled trials and controlled clinical trials that directly compared HPV vaccine schedules with two or three doses. We extracted data on immunological and clinical outcomes and used meta-analysis where appropriate. We also described the use of two-dose HPV vaccine schedules globally. We screened 1464 items and included seven eligible noninferiority trials in 11 countries. In randomised comparisons amongst adolescent girls (three trials), geometric mean concentrations (GMC) of antibodies against HPV16 and HPV18 were non-inferior or inconclusive, up to 24months after a two-dose compared with a three-dose schedule. One trial with a clinical outcome found no persistent HPV infections occurred after either two or three doses. In non-randomised comparisons, GMC were non-inferior or superior in adolescent girls receiving the two-dose schedule compared with women receiving the three-dose schedule for at least 21months after vaccination. By February 2017, 23 low and middle income and 25 high income countries had adopted a two-dose HPV vaccination schedule. A two-dose HPV vaccine schedule provides satisfactory immunological outcomes in adolescent girls, but uptake globally is limited, particularly in countries with the highest burden of cervical cancer.
Topics: Adolescent; Adult; Antibodies, Viral; Clinical Trials as Topic; Female; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; Humans; Immunization Schedule; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Uterine Cervical Neoplasms; Vaccination; Vaccine Potency; Young Adult
PubMed: 28455170
DOI: 10.1016/j.vaccine.2017.03.096 -
Public Health Nov 2022Patients with cancer are more vulnerable to COVID-19 morbidity and morbidity than the general population and have been prioritised in COVID-19 vaccination programmes.... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Patients with cancer are more vulnerable to COVID-19 morbidity and morbidity than the general population and have been prioritised in COVID-19 vaccination programmes. This study aims to investigate COVID-19 vaccine acceptance and hesitancy among patients with cancer.
STUDY DESIGN
This was a systematic review and meta-analysis.
METHODS
PubMed, ScienceDirect and the Cochrane COVID-19 study registry were searched in addition to secondary literature using a predefined search method. Two authors independently performed the study identification, screening and eligibility assessment. This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines and Joanna Brides' Institute quality appraisal tools.
RESULTS
A total of 29 studies and reports were selected for the final review. The pooled prevalence of vaccine acceptance was 59% (95% confidence interval 52-67%, I: 99%). Concerns about vaccine-related side-effects, uncertainty about vaccine efficacy and safety, ongoing active anticancer therapies and scepticism about rapid vaccine development were the leading causes for vaccine hesitancy. Female gender and undergoing active anticancer treatments were significant factors associated with COVID-19 vaccine hesitancy. Early cancer stages (stages I and II) and good compliance with prior influenza vaccinations were significant factors associated with the acceptance of the COVID-19 vaccine.
CONCLUSIONS
Many patients with cancer are hesitant about COVID-19 vaccination. Well-designed problem-based educational interventions will increase compliance with COVID-19 vaccination.
Topics: Humans; Female; COVID-19 Vaccines; COVID-19; Vaccination Refusal; Vaccination; Vaccines; Neoplasms
PubMed: 36244261
DOI: 10.1016/j.puhe.2022.09.001