Immunogenicity and tolerability of an MF59-adjuvanted, egg-derived, A/H1N1 pandemic influenza vaccine in children 6-35 months of age

Background: Vaccines against pandemic A/H1N1 influenza should provide protective immunity in children, because they are at greater risk of disease than adults. This study was conducted to identify the optimal dose of an MF59 (R)-adjuvanted, egg-derived, A/H1N1 influenza vaccine for young children. Methods: Children 6-11 months (N = 144) and 12-35 months (N = 186) of age received vaccine formulations containing either 3.75 mu g antigen with half the standard dose of MF59 or 7.5 mu g antigen with a standard dose of MF59, or a nonadjuvanted formulation containing 15 mu g antigen (children 12-35 months only). Participants were given 2 primary vaccine doses 3 weeks apart, followed by 1 booster dose of MF59-adjuvanted seasonal influenza vaccine 1 year later. Immunogenicity was assessed by hemagglutination inhibition and microneutralization assays. Results: All vaccine formulations were highly immunogenic and met all 3 European licensure criteria after 2 doses. MF59-adjuvanted vaccines met all licensure criteria after 1 dose in both age cohorts, while nonadjuvanted vaccine did not meet all criteria after 1 dose in children 12-35 months. A single booster dose was highly immunogenic, and stable antibody persistence was observed in response to all vaccines. All vaccines were well tolerated. Conclusions: In this study, a single dose of 3.75 mu g antigen with half the standard dose of MF59 was shown to be optimal, providing adequate levels of immediate and long-term antibodies in pediatric subjects 6-35 months of age. These data demonstrated that MF59 adjuvant allowed for reduced antigen content and promoted significant long-term antibody persistence in children, with a satisfactory safety profile

Reemergence of pertussis in the highly vaccinated population of the Netherlands: observations on surveillance data.

We analyzed pertussis reporting, death, hospitalization, and serodiagnostic data from 1976 to 1998 to help explain the cause of the 1996 pertussis outbreak in the Netherlands. The unexpected outbreak was detected by an increase in pertussis reporting and by other surveillance methods. In 1996, according to reporting and serologic data, the increase in pertussis incidence among (mostly unvaccinated) children less than 1 year of age was similar to the increase in hospital admissions. Among older (mostly vaccinated) persons, the increase in hospital admissions was relatively small. The increase in pertussis incidence was higher among vaccinated than among unvaccinated persons of all ages. This resulted in lower estimates of vaccine effectiveness. The proportion of pertussis infections resulting in recognizable symptoms may have increased among vaccinated persons because of a mismatch of the vaccine strain and circulating Bordetella pertussis strains. The small immunogenicity profile of the Dutch vaccine may have resulted in greater vulnerability to antigenic changes in B. pertussis

Pertussis in The Netherlands: an outbreak despite high levels of immunization with whole-cell vaccine.

In 1996, a sudden increase in pertussis incidence was reported in the Netherlands (2.1 per 100,000 in 1995, 18 per 100,000 in 1996). Although not all potential surveillance artifacts could be excluded, it is highly probable that the data reflect a true outbreak. However, the cause of this increase has not yet been determined. Further research is directed to the severity of disease and a possible mismatch between the vaccine and the circulating Bordetella strains

Особенности художественного отображения агрессии, направленной против Азербайджана

[EN]: The micromammals remains from the Late Pleistocene site of the cave of El Castillo studied here in detail, came from the Aurignacian levels 18b and 18c (dated in 40.000-45.000 BP), level 19, and the Musterian levels 20b, 20c, 20d, 20e (dated in 41.000-49.000 BP), 21a and 21b. The micromammal association is the following: Erinaceus europaeus, Crocidura russula, Sorex coronatus, Sorex minutus, Neomys fodiens, Talpa europaea, Galemys pyrenaicus, cf. Miniopterus schreibersii, Chiroptera indet., Pliomys lenki, Microtus arvalis – Microtus agrestis, Microtus lusitanicus, Microtus oeconomus, Chionomys nivalis, Arvicola terrestris, Apodemus sylvaticus – Apodemus flavicollis and Lepus sp. Most of these species are in the present fauna of Cantabria, except Pliomys lenki that got extinct in the last third of the Upper Pleistocene, and Microtus oeconomus that disappeared from the Iberian Peninsula during the Holocene, in historical times, and is nowadays present in northern Euroasiatic regions. There is a great continuity of most of the taxa in all the levels. The faunal association seems to indicate a mainly open environment, in general with wet meadows (and few dry meadows), with good vegetation cover in the soil, with perhaps also some tree-covered areas, and some watercourses. The thermophiles indicators are very scarce, which could indicate that the climate could be a lesser temperate than other Upper Pleistocene periods and the present-day climate in the area.[ES]: El material de micromamíferos del yacimiento del Pleistoceno Superior de la cueva de El Castillo, objeto de estudio detallado en este trabajo, proviene de los niveles auriñacienses 18b y 18c (datados en 40.000-45.000 BP), nivel 19, y niveles musterienses 20b, 20c, 20d, 20e (datados en 41.000-49.000 BP), 21a y 21b. La asociación de micromamíferos es la siguiente: Erinaceus europaeus, Crocidura russula, Sorex coronatus, Sorex minutus, Neomys fodiens, Talpa europaea, Galemys pyrenaicus, cf. Miniopterus schreibersii, Chiroptera indet., Pliomys lenki, Microtus arvalis – Microtus agrestis, Microtus lusitanicus, Microtus oeconomus, Chionomys nivalis, Arvicola terrestris, Apodemus sylvaticus – Apodemus flavicollis y Lepus sp. La mayoría de estas especies están presentes en la fauna actual de Cantabria, excepto Pliomys lenki que se extinguió en el último tercio del Pleistoceno Superior, y Microtus oeconomus, que persistió en la península ibérica durante el Holoceno bien avanzado hasta su desaparición en tiempos históricos, y que actualmente está en regiones euroasiáticas más septentrionales. Hay una gran continuidad de la gran mayoría de los taxones en todos los niveles. La fauna en su conjunto parece indicar un medio predominantemente abierto, por lo general de praderas húmedas (y en mucha menor medida praderas secas) con una buena cobertura vegetal a nivel del suelo, en el que habría también algunas zonas arboladas o boscosas, y algún curso de agua. Los indicadores termófilos son escasos y poco abundantes, lo que podría indicar que el clima podría ser algo menos templado que en otros periodos del Pleistoceno Superior y quizás también que actualmente en la zona.Peer Reviewe

H5N1 Influenza Vaccine Formulated with AS03A Induces Strong Cross-Reactive and Polyfunctional CD4 T-Cell Responses

Objective Adjuvantation of an H5N1 split-virion influenza vaccine with AS03(A) substantially reduces the antigen dose required to produce a putatively protective humoral response and promotes cross-clade neutralizing responses. We determined the effect of adjuvantation on antibody persistence and B- and T-cell-mediated immune responses. Methods Two vaccinations with a split-virion A/Vietnam/1194/2004 (H5N1, clade 1) vaccine containing 3.75-30 mu g hemagglutinin and formulated with or without adjuvant were administered to groups of 50 volunteers aged 18-60 years. Results Adjuvantation of the vaccine led to better persistence of neutralizing and hemagglutination-inhibiting antibodies and higher frequencies of antigen-specific memory B cells. Cross-reactive and polyfunctional H5N1-specific CD4 T cells were detected at baseline and were amplified by vaccination. Expansion of CD4 T cells was enhanced by adjuvantation. Conclusion Formulation of the H5N1 vaccine with AS03(A) enhances antibody persistence and induces stronger T- and B-cell responses. The cross-clade T-cell immunity indicates that the adjuvanted vaccine primes individuals to respond to either infection and/or subsequent vaccination with strains drifted from the primary vaccine strain

The burden of varicella from a parent's perspective and its societal impact in The Netherlands: an Internet survey

<p>Abstract</p> <p>Background</p> <p>Varicella is a common childhood disease. Only 5% of first varicella-zoster-virus infections occur asymptomatically. Most data on the burden of varicella stem from health service databases. This study aims to provide insight in the burden of varicella from a parent's perspective including cases outside the healthcare system.</p> <p>Methods</p> <p>An internet questionnaire was developed for parents in the Netherlands to report health care resource use and productivity losses during the varicella episode in their child younger than 6 years. 11,367 invitations were sent out to members with children of an internet panel of a market research agency. 4,168 (37%) parents started the questionnaire (response rate), of which 360 (9%) stopped before completion and 1,838 (44%) were out of the target group. In total 1,970 parents completed the questionnaire. The questionnaire provided a symptom list ranging from common symptoms, such as skin vesicles, itching to fits or convulsions. A posteriori, in the analyses, the symptoms 'skin infections', 'fits/convulsions', 'unconsciousness', and 'balance and movement disorders' were labelled as complications. There was no restriction to time since the varicella episode for inclusion in the analyses.</p> <p>Results</p> <p>The 1,970 respondents had in total 2,899 children aged younger than six years, of which 2,564 (88%) children had had varicella. In 62% of the episodes the parent did not seek medical help. In 18% of all episodes symptoms labelled as complications were reported; in 11% of all episodes parents visited a medical doctor (MD) for a complication. Reporting of complications did not differ (X²; p = 0.964) between children with a recent (≤ 12 months ago) or a more distant (> 12 months) history of varicella. Prescription drugs were used in 12% of the children with varicella; OTC drugs in 72%. Parents reported work loss in 17% of the varicella-episodes (23% when MD visit; 14% when no MD-visit) for on average 14 hours, which equals to 2.5 hours of work loss for any given varicella-episode.</p> <p>Conclusions</p> <p>This study shows the full spectrum of varicella-episodes and associated healthcare use, including the large proportion of cases not seeking medical care and the societal impact associated with those cases.</p

In-depth Characterization of Vaccine Breakthrough Infections With SARS-CoV-2 Among Health Care Workers in a Dutch Academic Medical Center

Severe acute respiratory syndrome coronavirus 2 infection after coronavirus disease 2019 vaccination raises concerns about the emergence of vaccine escape variants. Here we characterize 14 breakthrough infections among 5860 fully vaccinated Dutch health care workers ≥14 days after the final dose of vaccination with either BNT162b2, mRNA-1273, or Ad26.COV2.S. These breakthrough infections presented with regular B.1.1.7 (Alpha) and B.1.617.2 (Delta) variants and high viral loads, despite normal vaccine-induced B- and T-cell immune responses detected by live virus neutralization assays and ELISpot. High-risk exposure settings, such as in households, indicate a potential risk of viral transmission despite full vaccination