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International Journal of Pediatric... Jul 2020
Review
PubMed: 32283428
DOI: 10.1016/j.ijporl.2020.110024 -
Journal of Epidemiology and Global... Mar 2020Europe has experienced a major resurgence of measles in recent years, despite the availability and free access to a safe, effective, and affordable vaccination measles,...
BACKGROUND AND OBJECTIVES
Europe has experienced a major resurgence of measles in recent years, despite the availability and free access to a safe, effective, and affordable vaccination measles, mumps and rubella vaccine (MMR). The main driver for this is suboptimal vaccine coverage. The three objectives of this study are to synthesize and critically assess parental attitudes and beliefs toward MMR uptake, to develop strategies and policy recommendations to effectively improve MMR vaccine uptake accordingly, and ultimately to identify areas for further research.
METHODS
A systematic review was conducted using primary studies from PubMed, Medline, Embase, and Scopus published between 2011 and April 2019. Inclusion criteria comprised primary studies in English conducted in Europe and studying parental attitudes and behavior regarding MMR uptake. Data were extracted using an inductive grounded theory approach.
RESULTS
In all, 20 high-quality studies were identified. Vaccine hesitancy or refusal were mainly due to concerns about vaccine safety, effectiveness, perception of measles risk and burden, mistrust in experts, and accessibility. Factors for MMR uptake included a sense of responsibility toward child and community health, peer judgement, trust in experts and vaccine, and measles severity. Anthroposophical and Gypsy, Roma, and Traveler populations presented unique barriers such as accessibility.
CONCLUSION
A multi-interventional, evidence-based approach is vital to improve confidence, competence, and convenience of measles vaccination uptake. Healthcare professionals need an understanding of individual contextual attitudes and barriers to MMR uptake to tailor effective communication. Effective surveillance is needed to identify under-vaccinated populations for vaccination outreach programs to improve accessibility and uptake.
Topics: Europe; Health Knowledge, Attitudes, Practice; Humans; Measles; Measles Vaccine; Parents; Patient Acceptance of Health Care; Qualitative Research; Vaccination
PubMed: 32175710
DOI: 10.2991/jegh.k.191117.001 -
The Journal of Dermatological Treatment Dec 2021Warts can be difficult to treat and progressing to chronic and resistant disease. Several studies have reported the successful application of mumps-measles-rubella (MMR)... (Meta-Analysis)
Meta-Analysis
Intralesional measles-mumps-rubella is associated with a higher complete response in cutaneous warts: a systematic review and meta-analysis of randomized controlled trial including GRADE qualification.
INTRODUCTION
Warts can be difficult to treat and progressing to chronic and resistant disease. Several studies have reported the successful application of mumps-measles-rubella (MMR) vaccine resulting in clearance of warts immunomodulation and induction of immune system.
METHODS
We performed a comprehensive search on the role of intralesional MMR in warts from several electronic databases. Complete response is defined as complete clearance of warts lesion.
RESULTS
There were a total of 425 subjects from five studies. Intralesional injection of MMR was associated with an increased complete response (OR 9.43 [5.78, 15.37], < .001; : 5%, = .38). Subgroup analysis on patients receiving injection for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [6.40, 21.38], < .001; : 20%, = .29. Patients receiving intralesional MMR were associated with a lower partial response (OR 0.54 [0.33, 0.88], = .01; : 0%, = .66). Intralesional MMR was associated with a reduced no-response (OR 0.16 [0.06, 0.43], < .001; : 69%, = .01). Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias. There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord's test ( = .047). Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000.
CONCLUSION
Intralesional MMR injection was associated with a higher complete response and lower no-response with a high level of certainty.
Topics: Humans; Injections, Intralesional; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Randomized Controlled Trials as Topic; Rubella; Warts
PubMed: 31985307
DOI: 10.1080/09546634.2020.1716931 -
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 -
Human Vaccines & Immunotherapeutics Mar 2020Children who had received MMR as the most recent vaccine had a pooled 35% (95%CI: 12-53%) lower risk for hospitalization due to any infectious disease, compared to... (Meta-Analysis)
Meta-Analysis
Non-specific effects of MMR vaccines on infectious disease related hospitalizations during the second year of life in high-income countries: a systematic review and meta-analysis.
Children who had received MMR as the most recent vaccine had a pooled 35% (95%CI: 12-53%) lower risk for hospitalization due to any infectious disease, compared to children who had received DTaP as the most recent vaccine (three studies, 1,919,192 children). The effect was stronger for respiratory tract infections than for gastrointestinal infections. Two studies investigated MMR alone, compared to concurrent administration of MMR and DTaP vaccines. Here, the pooled estimate for reduction in risk of hospitalization for any infectious disease was smaller and not significant (15%; 95%CI: -9% to 34%). Risk of bias was serious to critical in all studies. Moreover, two of the five studies demonstrated a significantly reduced risk for a control outcome (hospitalization for injuries), strongly indicating healthy vaccinee bias or residual confounding. The available evidence is insufficient to support a change in current vaccination schedules.
Topics: Child; Communicable Diseases; Developed Countries; Diphtheria-Tetanus-Pertussis Vaccine; Hospitalization; Humans; Infant; Measles-Mumps-Rubella Vaccine
PubMed: 31625797
DOI: 10.1080/21645515.2019.1663119 -
Journal of Travel Medicine Mar 2020Pregnant travellers and their offspring are vulnerable to severe outcomes following a wide range of infections. Vaccine-preventable diseases can have a particularly... (Meta-Analysis)
Meta-Analysis
Pregnant travellers and their offspring are vulnerable to severe outcomes following a wide range of infections. Vaccine-preventable diseases can have a particularly severe course in pregnant women, but little is known about the safety of travel vaccines in pregnant women. We performed a systematic review of all published literature concerning the safety of vaccines frequently given to travellers such as yellow fever, MMR (mumps, measles and rubella), influenza, Tdap (tetanus, diphtheria and pertussis), meningococcus, hepatitis A and B, rabies, polio, typhoid fever, tick-borne encephalitis and Japanese encephalitis vaccines. We included case series, cohort studies and randomized controlled trials (RCTs). For the meta-analysis, we included only RCTs that compared the administration of a vaccine to placebo or to no vaccine. Outcome measures included severe systemic adverse events, maternal outcomes related to the course of pregnancy, neonatal outcomes and local adverse events. We calculated the risk ratio and its 95% confidence interval as the summary measure. The safety of influenza vaccine is supported by high-quality evidence. For Tdap vaccine, no evidence of any harm was found in the meta-analysis of RCTs. A slight increase in chorioamnionitis rate was reported in 3 out of 12 observational studies. However, this small possible risk is far outweighed by a much larger benefit in terms of infant morbidity and mortality. Meningococcal vaccines are probably safe during pregnancy, as supported by RCTs comparing meningococcal vaccines to other vaccines. Data from observational studies support the safety of hepatitis A, hepatitis B and rabies vaccines, as well as that of the live attenuated yellow fever vaccine. We found little or no data about the safety of polio, typhoid, Japanese encephalitis, tick-borne encephalitis and MMR vaccines during pregnancy.
Topics: Female; Humans; Pregnancy; Travel Medicine; Travel-Related Illness; Vaccination; Vaccines
PubMed: 31616947
DOI: 10.1093/jtm/taz074 -
JPMA. the Journal of the Pakistan... Jun 2019Measles is still common in many developing countries, and its outbreaks have been on the rise since 2009 even though the disease is almost entirely preventable through...
OBJECTIVE
Measles is still common in many developing countries, and its outbreaks have been on the rise since 2009 even though the disease is almost entirely preventable through safe and effective vaccination. This paper aims to provide evidence about the systematic review of the cost-effectiveness of measles treatment in different regions worldwide.
METHODS
The methodical search began on 10th January 2019 to look for all articles on the cost-effectiveness of measles treatment published from January 2019 to April 2019 in SCOPUS, Pubmed (www.ncbi.nlm.nih.gov) and Cochrane (www.cochrane.org).We summarised the articles by using a data table to extract all information using health economic evaluation methods.
RESULTS
We identified 14 articles from the 69 total articles searched. These articles showed favourable costeffectiveness or cost-benefit ratios in high- and middle-income countries based on data organised by World Bank Income Level in 2018: the United States, Canada, Japan, India and Zambia. However, research is still limited in lowincome countries and thus the effectiveness of vaccination programmes cannot be conclusively identified.
CONCLUSIONS
This review shows the overview of the research in health economic evaluations of measles in different places, years and using different methods of intervention. Overall, it evaluates the cost-effectiveness of measles treatment.
Topics: Cost-Benefit Analysis; Humans; Immunization Programs; Measles; Measles Vaccine; Measles-Mumps-Rubella Vaccine
PubMed: 31369545
DOI: No ID Found -
International Journal of Environmental... Jul 2019A literature review was conducted to identify evidence of cases and outbreaks of vaccine-preventable diseases (VPDs) that have been reported from on board ships and the...
A literature review was conducted to identify evidence of cases and outbreaks of vaccine-preventable diseases (VPDs) that have been reported from on board ships and the methods applied on board for prevention and control, worldwide, in 1990 to April 2019. Moreover, evidence from seroprevalence studies for the same diseases were also included. The literature review was conducted according to Preferred Reporting Items for Systematic reviews (PRISMA) guidelines. A total of 1795 cases (115 outbreaks, 7 case reports) were identified, the majority were among crew (1466/1795, 81.7%) and were varicella cases (1497, 83.4%). The origin of crew cases was from sub-tropical countries in many reports. Measles (40 cases, 69% among crew), rubella (47, 88.7%), herpes zoster (9, 69.2%) and varicella cases (1316, 87.9%) were more frequent among crew. Mumps cases were equal among passengers and crew (22/22). Hepatitis A (73/92, 70.3%), meningococcal meningitis (16/29, 44.8%), and pertussis (9/9) were more frequent among passengers. Two outbreaks resulted in 262 secondary measles cases on land. Review results were used to draft a new chapter for prevention and control of VPDs in the European Manual for Hygiene Standards and Communicable Disease Surveillance on Passenger Ships. Despite past and current evidence for cross-border VPD transmission and maritime occupational risks, documented pre-employment examination of immune status, vaccination of seafarers, and travel advice to passengers are not yet regulated.
Topics: Emigration and Immigration; Employment; Humans; Immunization; Ships; Travel; Vaccine-Preventable Diseases
PubMed: 31366029
DOI: 10.3390/ijerph16152713 -
Experimental Gerontology Sep 2019Immunosenescence contributes to a decreased capacity of the immune system to respond effectively to infections or vaccines in the elderly. The full extent of the...
Immunosenescence contributes to a decreased capacity of the immune system to respond effectively to infections or vaccines in the elderly. The full extent of the biological changes that lead to immunosenescence are unknown, but numerous cell types involved in innate and adaptive immunity exhibit altered phenotypes and function as a result of aging. These manifestations of immunosenescence at the cellular level are mediated by dysregulation at the genetic level, and changes throughout the immune system are, in turn, propagated by numerous cellular interactions. Environmental factors, such as nutrition, also exert significant influence on the immune system during aging. While the mechanisms that govern the onset of immunosenescence are complex, systems biology approaches allow for the identification of individual contributions from each component within the system as a whole. Although there is still much to learn regarding immunosenescence, systems-level studies of vaccine responses have been highly informative and will guide the development of new vaccine candidates, novel adjuvant formulations, and immunotherapeutic drugs to improve vaccine responses among the aging population.
Topics: Adaptive Immunity; Aged; B-Lymphocytes; Dendritic Cells; Humans; Immune System; Immunity, Innate; Immunosenescence; Systems Biology; T-Lymphocytes; Vaccination
PubMed: 31201918
DOI: 10.1016/j.exger.2019.110632 -
BMC Public Health Mar 2019Herd immunity levels of vaccine uptake are still not reached in some high-income countries, usually in countries with persisting social inequities in uptake. Previous...
BACKGROUND
Herd immunity levels of vaccine uptake are still not reached in some high-income countries, usually in countries with persisting social inequities in uptake. Previous studies have focused on factors within one health care system. This study takes a broader health care systems approach by reviewing the socioeconomic distribution of vaccination coverage on the national level in light of structural and organizational differences of primary care for children.
METHODS
A systematic literature review of socio-economic patterns of uptake of Measles-Mumps-Rubella (MMR) and/or Diphteria-Tetanus-Pertusis (DTP) in population based studies of children 0-5 years of age living in the 30 European Economic Area (EEA) or European Free Trade Association (EFTA) countries and Australia, was carried out using the PRISMA guidelines. The health care system in the countries in the study were categorized by degree of freedom of the primary care provider (hierarchical or non-hierarchical) and whether preventive services were provided in a separate organization (well-baby clinics).
RESULTS
The review identified 15 studies from 10 European countries and Australia that fulfilled the criteria. Although the heterogeneity of the socio-economic indicators did not allow for a conclusive meta-analysis, the study pointed towards lower levels of inequities in primary care models with well-baby clinics. In non-hierarchical primary care organizations that also lacked well-baby clinics, socioeconomic gaps in uptake were often found to be large.
CONCLUSION
This review indicates that structural and organizational aspects of health care systems for young children are important for equity in vaccine uptake.
Topics: Australia; Child, Preschool; Europe; Healthcare Disparities; Humans; Infant; Socioeconomic Factors; Vaccination Coverage
PubMed: 30866881
DOI: 10.1186/s12889-019-6597-4