A phase IV, multi-centre, randomized clinical trial comparing two pertussis-containing vaccines in pregnant women in England and vaccine responses in their infants.

BACKGROUND: Pertussis vaccines containing three or five pertussis antigens are recommended in pregnancy in many countries, but no studies have compared the effect on infants' antigen-specific immunoglobulin G (IgG) concentrations. The aim of this study was to compare anti-pertussis IgG responses following primary immunization in infants of mothers vaccinated with TdaP5-IPV (low dose diphtheria toxoid, tetanus toxoid, acellular pertussis [five antigens] and inactivated polio) or TdaP3-IPV in pregnancy (three pertussis antigens). METHODS: This multi-centre phase IV randomized clinical trial was conducted in a tertiary referral centre and primary care sites in England. Women were randomized to receive TdaP5-IPV (n = 77) or TdaP3-IPV (n = 77) at 28-32 gestational weeks. A non-randomized control group of 44 women who had not received a pertussis-containing vaccine in pregnancy and their 47 infants were enrolled post-partum. RESULTS: Following infant primary immunization, there was no difference in the geometric mean concentrations (GMCs) of anti-pertussis toxin, filamentous haemagglutinin or pertactin IgG between infants born to women vaccinated with TdaP5-IPV (n = 67) or TdaP3-IPV (n = 63). However, the GMC of anti-pertussis toxin IgG was lower in infants born to TdaP5-IPV- and TdaP3-IPV-vaccinated mothers compared to infants born to unvaccinated mothers (n = 45) (geometric mean ratio 0.71 [0.56-0.90] and 0.78 [0.61-0.98], respectively); by 13 months of age, this difference was no longer observed. CONCLUSION: Blunting of anti-pertussis toxin IgG response following primary immunization occurs in infants born to women vaccinated with TdaP5-IPV and TdaP3-IPV, with no difference between maternal vaccines. The blunting effect had resolved by 13 months of age. These results may be helpful for countries considering which pertussis-containing vaccine to recommend for use in pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov , NCT02145624 , registered 23 May 2014

Contributions for Repositioning a Regional Strategy for Healthy Municipalities, Cities and Communities (HM&C): Results of a Pan-American Survey

This article presents the results of the 1st Regional Survey of Healthy Municipalities, Cities and Communities (HM&C) carried out in 2008 by the Pan American Health Organization (PAHO) and ISALUD University of Argentina. It discusses the responses obtained from 12 countries in the Americas Region. Key informants in Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, and Uruguay were selected and encouraged to answer the survey, while informants from Canada and Honduras answered voluntarily and were included in this analysis. The discussion of the results of the Survey provides insight into the current status of HM&C in the Region and suggests key topics for repositioning the Regional strategy relative to: (1) the conceptual identity and tools for HM&C; (2) challenging areas in the implementation process (scale, legal framework, and development of capacities); (3) related strategies and participatory processes such as the ways citizen empowerment in governance is supported; (4) the need to monitor and assess the impact of the HM&C strategy on the health and quality of life of the populations involved; and (5) the need for developing a strategic research and training agenda. The analysis and discussion of these results aims to provide useful input for repositioning the strategy in the Region and contributing to the emergence of a second generation of concepts and tools capable of meeting the developing priorities and needs currently faced by the HM&C strategy

Single-dose Universal Hepatitis A Immunization in One-year-old Children in Argentina: High Prevalence of Protective Antibodies up to 9 Years After Vaccination

Fil: Urueña, Analía. Dirección Nacional de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, C.A.B.A.; Argentina.Fil: González, Jorge E. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Rearte, Analía. Dirección Nacional de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, C.A.B.A.; Argentina.Fil: Pérez Carrega, María Eugenia. Dirección Nacional de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, C.A.B.A.; Argentina.Fil: Calli Flores, Rogelio. Dirección de Epidemiología del Ministerio de Salud Pública de la Provincia de Tucumán, Tucumán; Argentina.Fil: Pagani, María F. Servicio de Gastroenterología. Hospital del Niño Jesús de Tucumán, Tucumán; Argentina.Fil: Uboldi, Andrea. Programa Ampliado de Inmunizaciones, Ministerio de Salud de la Provincia de Santa Fe, Santa Fe; Argentina.Fil: Vicentín, Rosalía. Servicio de Gastroenterología, Hospital de Niños Dr. Orlando Alassia, Santa Fe; Argentina.Fil: Caglio, Patricia. Hospital Nacional Prof. Dr. Alejandro Posadas, Provincia de Buenos Aires; Argentina.Fil: Cañero-Velasco, María C. Hospital de Niños de San Justo, Provincia de Buenos Aires; Argentina.Fil: Gentile, Angela. Hospital de Niños Ricardo Gutiérrez, C.A.B.A.; Argentina.Fil: Ramonet, Margarita. Comisión Nacional de Hepatología, Sociedad Argentina de pediatría, C.A.B.A.; Argentina.Fil: Vizzotti, Carla. Dirección Nacional de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, C.A.B.A.; Argentina.Single-dose hepatitis A virus (HAV) vaccination was implemented in all Argentinean children 12 months of age in 2005. Previous studies demonstrated high prevalence of protective antibody response 4 years after single-dose vaccination. This study assessed long-term seroprotection against HAV after vaccination