Vaccines delivered onto mucosal surfaces: clinical trial with a nasal vaccine against influenza, 2001

Mucosal Vaccines are easier to provide and may cause less severe side effects. Experiments on mice have shown that a "killed" vaccine against influenza may give rise to strong immunity having been given as nose drops. Our findings in humans confirmed the earlier findings performed on mice. There was no effect in humans of so-called "adjuvants" or enhancers which are commonly used in vaccines. Nor was the effect of a drug used in nose drops to increase stickiness to mucous membranes

The strength and vulnerability of school-age children

BACKGROUND Children between the ages of 5 and 14 appear to have a lower risk of dying than both younger and older individuals. OBJECTIVE We looked for possible factors influencing the mortality rates of school-age children in Norway during the German occupation from 1940 to 1945, i.e., at a time of poverty and moderate food shortage – and before the general use of vaccines. METHODS We used Norwegian mortality data by age and sex, during the period of 1930–1954, from the Human Mortality Database and obtained the main causes of death, as well as age-specific data from different regions of Norway, from Statistics Norway. RESULTS Boys and girls aged 5–14 years had lower mortality rates than any other age group below 40, even during the German occupation. However, 5–14-year-old boys as well as 5–9-year-old girls had significantly increased mortality during 1941–1945 as compared to the previous decade. Mortality as a result of diphtheria, pertussis, scarlet fever, and measles increased more than five-fold, surpassing mortality as a result of accidents, whereas mortality from these infections only doubled in adults up to 39 years. During that same period, the body weight of schoolchildren aged 8–13 years dropped slightly. CONCLUSIONS Proper nourishment, being of the utmost importance for a functioning immune system, is key to understanding the potential vulnerability of children at any age. Our study shows how vulnerable even the most resistant children can be. CONTRIBUTION The vulnerability of children 5–14 years old may not have been properly taken into account, as was also shown in the recent upward UN revision of 5–14 age mortality in low- and middle-income countrie

A Missed Summer Wave of the 1918-1919 Influenza Pandemic: Evidence From Household Surveys in the United States and Norway

Background . Reanalysis of in fl uenza survey data from 1918 to 1919 was done to obtain new insights into the geographic and host factors responsible for the various waves. Methods . We analyzed the age- and sex-speci fi cin fl uenza morbidity, fatality, and mortality for the city of Baltimore and smaller towns and rural areas of Maryland and the city of Bergen (Norway), using survey data. The Maryland surveys captured the 1918 fall wave, whereas the Bergen survey captured 3 waves during 1918 – 1919. Results . Morbidity in rural areas of Maryland was higher than in the city of Baltimore during the fall of 1918, that was almost equal to that in Bergen during the summer of 1918. In Bergen, the morbidity in the fall was only half of that in the summer, with more females than males just above the age of 20 falling ill, as seen in both regions of Maryland. In contrast, more males than females fell ill during the summer wave in Bergen. Individuals <40 years had the highest morbidity, whereas school-aged children had the lowest fatality and mortality. Conclusion . A previously unrecognized pandemic summer wave may have hit the 2 regions of Maryland in 1918

The strength and vulnerability of school-age children

BACKGROUND: Children between the ages of 5 and 14 appear to have a lower risk of dying than both younger and older individuals. OBJECTIVE: We looked for possible factors influencing the mortality rates of school-age children in Norway during the German occupation from 1940 to 1945, i.e., at a time of poverty and moderate food shortage – and before the general use of vaccines. METHODS: We used Norwegian mortality data by age and sex, during the period of 1930-1954, from the Human Mortality Database and obtained the main causes of death, as well as age-specific data from different regions of Norway, from Statistics Norway. RESULTS: Boys and girls aged 5–14 years had lower mortality rates than any other age group below 40, even during the German occupation. However, 5–14-year-old boys as well as 5–9-year-old girls had significantly increased mortality during 1941–1945 as compared to the previous decade. Mortality as a result of diphtheria, pertussis, scarlet fever, and measles increased more than five-fold, surpassing mortality as a result of accidents, whereas mortality from these infections only doubled in adults up to 39 years. During that same period, the body weight of schoolchildren aged 8–13 years dropped slightly. CONCLUSIONS: Proper nourishment, being of the utmost importance for a functioning immune system, is key to understanding the potential vulnerability of children at any age. Our study shows how vulnerable even the most resistant children can be. CONTRIBUTION: The vulnerability of children 5–14 years old may not have been properly taken into account, as was also shown in the recent upward UN revision of 5–14 age mortality in low- and middle-income countries

Influence of Intravenous Anesthesia on Mucosal and Systemic Antibody Responses to Nasal Vaccines

Inhalation of antigens may stimulate the immune system by way of the upper as well as the lower airways. We have shown that at least 1,000 times more live pneumococci were recovered from pulmonary tissue after being presented as drops of a liquid suspension onto the nares of anesthetized mice compared to the number of bacteria recovered from animals that were not anesthetized in the course of the challenge. Mice that were similarly immunized intranasally by inhalation of three different nonreplicating particulate vaccine formulations, i.e., a meningococcal outer membrane vesicle (OMV) vaccine, a formalin-inactivated whole-virus influenza (INV) vaccine, and the INV vaccine with OMVs as a mucosal adjuvant, during general intravenous anesthesia developed concentrations of vaccine-specific serum immunoglobulin G (IgG) antibodies that were four to nine times higher than in mice that were fully awake during immunizations. The concentrations of IgA antibodies in serum were also higher in anesthetized than in nonanesthetized mice and correlated positively with the corresponding levels of serum IgG antibodies in the anesthetized but not in the nonanesthetized mice. In saliva and feces, however, the concentrations of IgA antibodies were equally high whether or not the animals were dormant during immunizations. The results indicate that intrapulmonary antigen presentation, as a part of an intranasal immunization strategy, is of importance for systemic but not for mucosal antibody responses. A major portion of IgA antibodies in serum may thus be derived from nonmucosal sites