Malaria Risk in Travelers

Malaria risk around the world was assessed by using Swedish surveillance data from 1997 to 2003 with an extensive travel database as denominator

Predicting the next pandemic: VACCELERATE ranking of the World Health Organization's Blueprint for Action to Prevent Epidemics

Introduction: The World Health Organization (WHO)'s Research and Development (R&D) Blueprint for Action to Prevent Epidemics, a plan of action, highlighted several infectious diseases as crucial targets for prevention. These infections were selected based on a thorough assessment of factors such as transmissibility, infectivity, severity, and evolutionary potential. In line with this blueprint, the VACCELERATE Site Network approached infectious disease experts to rank the diseases listed in the WHO R&D Blueprint according to their perceived risk of triggering a pandemic. VACCELERATE is an EU-funded collaborative European network of clinical trial sites, established to respond to emerging pandemics and enhance vaccine development capabilities. Methods: Between February and June 2023, a survey was conducted using an online form to collect data from members of the VACCELERATE Site Network and infectious disease experts worldwide. Participants were asked to rank various pathogens based on their perceived risk of causing a pandemic, including those listed in the WHO R&D Blueprint and additional pathogens. Results: A total of 187 responses were obtained from infectious disease experts representing 57 countries, with Germany, Spain, and Italy providing the highest number of replies. Influenza viruses received the highest rankings among the pathogens, with 79 % of participants including them in their top rankings. Disease X, SARS-CoV-2, SARS-CoV, and Ebola virus were also ranked highly. Hantavirus, Lassa virus, Nipah virus, and henipavirus were among the bottom-ranked pathogens in terms of pandemic potential. Conclusion: Influenza, SARS-CoV, SARS-CoV-2, and Ebola virus were found to be the most concerning pathogens with pandemic potential, characterised by transmissibility through respiratory droplets and a reported history of epidemic or pandemic outbreaks

Infectious diseases in returning Swedish travellers

The number of travellers to â tropicalâ parts of the world has increased substantially during the past decades. Identifying risk groups and providing preventive measures is important both to reduce the number of travellers falling ill and to prevent introduction of diseases into new countries. The aim of this thesis is to describe the epidemiology of imported infectious diseases in Sweden and to identify risk groups. To investigate epidemiology and use of chemoprophylaxis in patients notified with P.falciparum malaria we studied compiled information on patients notified to the Swedish institute for infectious disease control (SMI) 1994-2001. Ninety percent of the patients had traveled to Africa. Malaria infection despite intake of adequate chemoprophylaxis decreased during the study period indicating more effective chemoprophylaxis at the later part of the study. Chloroquine/proguanil had been prescribed for travellers to Africa when it was no longer in line with the national recommendation. To evaluate risk groups for malaria, we conducted an observational analytic study on all malaria cases notified to SMI 1997-2003 and compared them with data from the Swedish tourist and travel database (TDB). Malaria was more often diagnosed in men than in women (OR 1.7, 95% CI 1.3-2.3), in the age group 0-6 years (OR 4.8, 95% 1.5-14-8) and in travellers to sub Saharan Africa. To evaluate the effectiveness and adverse events (AE) of malaria chemoprophylaxis in a high transmission area, we studied compiled information from Swedish soldiers (7,000 person months) in Liberia. The majority (81%) of the soldiers took mefloquine and the remaining part atovaquone/proguanil. After return to Sweden all soldiers completed a questionnaire about behavior and AE. No cases of P. falciparum malaria were notified. The AE were mostly mild. To estimate risk groups for travel related hepatitis A infection in Sweden 1997-2005 we used notification data from SMI as nominator and TDB as a denominator. The highest incidence was seen in the age-group 0-6 years and in travellers to east Africa, Middle East and India where a majority of the travellers had been going to see friends and relatives in their country of origin (VFR-travellers). To investigate causes of travel related fever we included febrile patients returning from malaria endemic areas to five Swedish hospitals 2005-2008. Additional paired sera were analyzed for influenza virus, dengue virus, chikungunya virus, Brucella spp., Leptospira spp., C.burnetii, and Rickettsia spp. In 21% of patients with unknown fever additional serology revealed a diagnosis. In 9% patients with a defined diagnosis, additional serology established a co-infection. Influenza was the most common serological finding followed by dengue fever, rickettsial infections and leptospirosis. Conclusion: The chief problem with malariaprophylaxis is the failure to use them when really needed. VFR-travellers, and especially their children, constitute a high risk group for malaria and hepatitis A and preventive measures should be focused on this group. Influenza is an underestimated cause of fever in travellers returning from sub/tropical regions

Immunogenicity and safety of the tick-borne encephalitis vaccination (2009-2019): A systematic review

BACKGROUND Tick-borne encephalitis (TBE) is increasing in Europe. We aimed to evaluate the immunogenicity and safety of TBE-vaccination. METHODS This systematic review was registered at PROSPERO (#CRD42020155737) and conducted in accordance with PRISMA guidelines. We searched CINAHL, Cochrane, Embase, PubMed, and Scopus using specific terms. Original articles, case reports and research abstracts in English, French, German and Italian were included for screening and extracting (JER; PS). RESULTS Of a total of 2464 records, 49 original research publications were evaluated for immunogenicity and safety. TBE-vaccines showed adequate immunogenicity, good safety and interchangeability in adults and children with some differences in long-term protection (Seropositivity in 90.6-100% after primary vaccination; 84.9%-99.4% at 5 year follow up). Primary conventional vaccination schedule (days 0, 28, and 300) demonstrated the best immunogenic results (99-100% of seropositivity). Mixed brand primary vaccination presented adequate safety and immunogenicity with some exceptions. After booster follow-ups, accelerated conventional and rapid vaccination schedules were shown to be comparable in terms of immunogenicity and safety. First booster vaccinations five years after primary vaccination were protective in adults aged 50 years, lower protective antibody titers were found. Allergic individuals showed an adequate response and immunosuppressed individuals a diminished response to TBE-vaccination. CONCLUSIONS The TBE-vaccination is generally safe with rare serious adverse events. Schedules should, if possible, use the same vaccine brand (non-mixed). TBE-vaccines are immunogenic in terms of antibody response but less so when vaccination is started after the age of 50 years. Age at priming is a key factor in the duration of protection

Vaccination rates in Europe are not associated with online media intensity

To map the public information about COVID-19 vaccines and vaccine trials in Europe, we have compiled an inventory of online communication materials from official sources (e.g., governments, public agencies, and NGOs) via directed online research. While information for the general public was abundant across Europe, we found a large variation in number, type and target audiences among countries. Little or no information was found for population groups that are typically underrepresented in vaccine clinical trials. Materials about clinical trials and trial participation were also limited. Interestingly, higher number of media materials was not reflected in higher national vaccination rates.publishedVersio

Vaccination rates in Europe are not associated with online media intensity

To map the public information about COVID-19 vaccines and vaccine trials in Europe, we have compiled an inventory of online communication materials from official sources (e.g., governments, public agencies, and NGOs) via directed online research. While information for the general public was abundant across Europe, we found a large variation in number, type and target audiences among countries. Little or no information was found for population groups that are typically underrepresented in vaccine clinical trials. Materials about clinical trials and trial participation were also limited. Interestingly, higher number of media materials was not reflected in higher national vaccination rates.publishedVersio

Enhancing Public Health Communication Regarding Vaccine Trials: Design and Development of the Pan-European VACCELERATE Toolkit

BACKGROUND: The pan-European VACCELERATE network aims to implement the first transnational harmonized and sustainable vaccine trial Volunteer Registry, being a single entry point for potential volunteers of large-scale vaccine trials across Europe. This work exhibits a set of harmonized vaccine trial-related educational and promotional tools for the general public, designed and disseminated by the pan-European VACCELERATE network. OBJECTIVE: This study primarily aimed to design and develop a standard toolkit to increase positive attitudes and access to trustworthy information for better access and increased recruitment to vaccine trials for the public. More specifically, the produced tools are focused on inclusiveness and equity, and are targeting different population groups, including underserved ones, as potential volunteers for the VACCELERATE Volunteer Registry (older individuals, migrants, children, and adolescents). The promotional and educational material is aligned with the main objectives of the Volunteer Registry to increase public literacy and awareness regarding vaccine-related clinical research or trials and trial participation, including informed consent and legal issues, side effects, and frequently asked questions regarding vaccine trial design. METHODS: Tools were developed per the aims and principles of the VACCELERATE project, focusing on trial inclusiveness and equity, and are adjusted to local country-wise requirements to improve public health communication. The produced tools are selected based on the cognitive theory, inclusiveness, and equity of differently aged and underrepresented groups, and standardized material from several official trustworthy sources (eg, COVID-19 Vaccines Global Access; the European Centre for Disease Prevention and Control; the European Patients' Academy on Therapeutic Innovation; Gavi, the Vaccine Alliance; and the World Health Organization). A team of multidisciplinary specialists (infectious diseases, vaccine research, medicine, and education) edited and reviewed the subtitles and scripts of the educational videos, extended brochures, interactive cards, and puzzles. Graphic designers selected the color palette, audio settings, and dubbing for the video story-tales and implemented QR codes. RESULTS: This study presents the first set of harmonized promotional and educational materials and tools (ie, educational cards, educational and promotional videos, extended brochures, flyers, posters, and puzzles) for vaccine clinical research (eg, COVID-19 vaccines). These tools inform the public about possible benefits and disadvantages of trial participation and build confidence among participants about the safety and efficacy of COVID-19 vaccines and the health care system. This material has been translated into several languages and is intended to be freely and easily accessible to facilitate dissemination among VACCELERATE network participant countries and the European and global scientific, industrial, and public community. CONCLUSIONS: The produced material could help fill knowledge gaps of health care personnel, providing the appropriate future patient education for vaccine trials, and tackling vaccine hesitancy and parents' concerns for potential participation of children in vaccine trials

Enhancing public health communication of vaccine trials: The pan-European VACCELERATE Toolkit

Background: The pan-European VACCELERATE network aims to implement the first transnational harmonised and sustainable vaccine trial Volunteer Registry, serving as single entry-point for volunteers willing to participate in large scale vaccine clinical studies across the European region. The present work exhibits a set of harmonised vaccine trial educational and promotional tools for the general public, designed and disseminated by the pan-European VACCELERATE network. Objective: The main objectives of the present study are the design and creation of a standard toolkit to increase positive attitudes, and access to trustful information for better access and increased recruitment to vaccine trials for the public community. More specifically, the produced tools are focused on inclusiveness, equity, and they are targeting different population groups, including underserved ones, as potential volunteers for the VACCELERATE Volunteer Registry (elderly, migrants, children and adolescents). The promotion/education material is aligned with the main objectives of the Volunteer Registry, to increase public literacy and awareness regarding vaccine clinical research/trials and trial participation, such as informed consent and legal issues, side effects and frequently asked questions on vaccine trial design. Methods: The tools' development has followed the aims and principles of the VACCELERATE project, focusing on trial inclusiveness and equity and they are adjusted to the local country requirements to improve public health communication. The selection of the produced tools has been based on the cognitive theory, inclusiveness and equity of different aged and under-represented groups, and standardised material from several official trustful sources (e.g. COVAX, ECDC, EUPATI, GAVI and WHO). In addition, team of specialists from different fields (infectious diseases, vaccine research, medicine, education) edited and reviewed the subtitles and scripts for the educational videos, extended brochures, interactive cards and puzzles. Graph designers also selected the colour palette, audio settings and dubbing for the video story-tales and implementation of QR codes. Results: This study presents the first set of harmonised promotional and educational materials/tools (i.e. educational cards, educational and promotional videos, extended brochures, flyers, posters, and puzzles) for vaccine clinical research (e.g. COVID-19). The developed tools inform the public about possible benefits and disadvantages of trial participation, but also build the confidence of participants about the safety and efficacy for COVID-19 vaccines and healthcare system. The present material has been translated into several languages and meant to be freely and easily accessible to facilitate dissemination among the participating countries of the VACCELERATE network, as well as among the European and global scientific, industrial, and public community, in general. Conclusions: The produced material could also be useful for filling knowledge gaps of healthcare personnel and providing the appropriate future patient education for vaccine trials, as well as to tackle vaccine hesitancy and parents' concerns for potential participation of children in vaccine trials