Response to Christopher S. Ambrose: Use of live attenuated influenza vaccine in individuals with asthma or a history of wheezing

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Manifesto of the pediatricians of Emilia-Romagna region, Italy, in favor of vaccination against COVID in children 5-11 years old

Background: Following the authorization by the regulatory authorities of vaccination against COVID for children aged between 5 and 11, in Emilia-Romagna Region, Italy, the pediatricians of the Italian Society of Pediatrics (SIP), the Italian Society of Neonatology (SIN), the Cultural Association of Pediatrics, the Italian Federation of Pediatricians (FIMP) and the Italian Union of Family Pediatricians (SIMPeF), who work in the hospital and in the territorial setting, have made a univocal and convinced appeal in favor of vaccination also in this age group. Main findings: In order to contribute to a conscious choice, on the part of parents, based on exhaustive and correct information, a 24-point manifesto was developed. The manifesto showed that vaccines against COVID are the most effective and safest tool we have to counter the spread of SARS-CoV-2 and vaccination against COVID is a right of children just as it is for adults. Children between 5 and 11 years are not protected from the virus and a large part of the newly infected is this age. Although SARS-CoV-2 infection is certainly more benign in children, in some cases it can cause a serious pathology and long COVID. The stress caused by the pandemic, the prolonged closure of schools and the interruption of sports and recreational activities have had a devastating effect on the mental health of children and on the development of their personality. Vaccinating children against COVID serves to protect them from severe forms of disease and long COVID, allowing them to attend school face-to-face and lead a normal social life. The safety of vaccinatin is very high and vaccines against COVID have no influence on fertility nor can they cause developmental or growth side effects. Conclusions: The manifesto highlighted that the vaccine against COVID for children aged between 5 and 11 is effective and safe and represents an extraordinary gift for safeguarding health of the younger ones. The invitation, therefore, to parents is to have their children vaccinated against COVID as early as possible

early vaccination a provisional measure to prevent measles in infants

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Influenza vaccination in pediatric age.

Influenza is a very common disease among infants and young children, with a considerable clinical and socioeconomic impact [1]. To reduce the direct and indirect effects of pediatric influenza virus infection, influenza vaccination is recommended worldwide for children considered at risk due to a severe underlying disease. In healthy children influenza vaccination is recommended only in a small number of countries, although guidelines vary regarding the minimum age [2]. In USA universal influenza vaccination in all the age groups is recommended, including all the children until 17 years of age. In UK, influenza vaccination is recommended in the age group 4-17 years, although the program has been activated only recently. Finally, in Canada and other European countries in which health autorithies recommend the vaccine also in the healthy pediatric population, school-age children and adolescents are excluded. However, a large number of European health authorities is still reluctant to include influenza vaccination in their national vaccination programs [2]. The reasons for this reluctance include the fact that the protection offered by the currently available vaccines is considered poor, particularly in younger children. Regarding immunogenicity, younger children are quite similar to the elderly, who, because of the senescence of their immune system, respond poorly to immune stimulation [2]. In both these groups of subjects, both the innate and adaptive immune system are poorly functioning. In particular, B-cells, that are essential for antibody production and immune memory, have limited responses. To increase the immune response of children to inactivated vaccines, a number of measures that have been tested and found to be effective in adults and in the elderly have been studied [3]. The use of adjuvanted vaccines, intradermal (ID) injection, the administration of an increased dose of antigens and the live attenuated influenza vaccine (LAIV) have been evaluated in controlled clinical trials, with good results [3]. Moreover, the possibility of protecting young children through the use of a quadrivalent influenza vaccine (QIV) has been evaluated [3]. None of these measures has been definitively accepted because of the fear of an increased risk of adverse events and because in some instances data regarding immunogenicity and/or clinical efficacy are lacking or are not completely convincing. However, the preliminary data are very interesting in some cases and suggest that some of these measures must be further developed if the problem of the poor protection of young infants has to be solved

Reasons in favour of universal vaccination campaign against COVID-19 in the pediatric population

Despite the growing evidence of the extreme efficacy of COVID-19 vaccines in adults and the elderly, the administration of the same prophylactic measures to pediatric subjects is debated by some parents and by a number of researchers. The aim of this manuscript is to explain the reasons for overcoming hesitancy towards COVID-19 vaccination in children and adolescents and to highlight the importance of universal COVID-19 vaccination in the pediatric population

LGBTQ+ Youth Health: An Unmet Need in Pediatrics

At present, lesbian, gay, bisexual, transgender, queer and intersex people (LGBTQ+) are increasingly being empowered to freely express themselves, particularly young people and rising generations. Although data underline the trend of more open expression of different sexual orientations and gender identities, LGBTQ+ adolescents still suffer discrimination in the health care framework. Inclusive care by providers to look after the health of LGBTQ+ indiviuals is needed. Pediatricians are often the first health care providers for LGBTQ+ youth facing their sexual and gender identities. Unfortunately, pediatricians have limited knowledge about LGBTQ+ issues, which keeps them from fulfilling the specific needs of LGBTQ+ youth. The purpose of this review is to frame the most important aspects of LGBTQ+ youths' lives, including risks, difficulties and needs, that pediatricians should investigate and meet to provide these youth with better and more individualizedassistance regarding their health. A literature analysis showed that pediatricians have insufficient knowledge of and comfort with several items regarding the management of LGBTQ+ youths. Increased awareness and knowledge of the specific and exclusive needs of LGBTQ+ adolescents are mandatory, including dedicated pediatric LGBTQ+ health care training. This would give them the opportunity to forward an inclusive health care system, thus reducing the risks related to stigma, bullying and family rejection and promoting sex education. Further studies are needed to better evaluate the prevalence of LGBTQ+ youths, gender-based medicine in pediatrics and the effects of COVID-19 on the LGBTQ+ younth population due to increased risks of psychosocial suffering, isolation and mental diseases

Effects of Coronavirus Infections in Children

These viruses should be closely monitored to prevent spread of virulent strains

Prevention of pertussis: from clinical trials to Real World Evidence

Pertussis (P) is a highly contagious infectivedisease caused by the Gram-negative bacterium Bordetella pertussis(Bp). Following the introduction of a whole-cell vaccine (wP) in the 1940s, the fear of wP-related severe adverse events led to the formulation and subsequent diffusion of acellular pertussis (aP) vaccines. A few years after the introduction of aP vaccines, several epidemiological evaluations clearly indicated that the incidence of P was slowly, though steadily, rising, and had even reached higher values than those recorded in periods of widespread wP use. The information currently available enables us to draw some conclusions that can, at least in part, explain the re-emergence of P, and hence to propose some possible solutions to the problem. Analysis of the literature showed that aPs have proved to be highly safe and immunogenic, with high efficacy and effectiveness Strategies for the control and prevention of P must involve the achievement and maintenance of high vaccination coverage rates in the entire population. Nevertheless, recent evidence has revealed some limitations of the currently available aP vaccines, regardless of the number of Bp components they contain. It is to be hoped that future developments will result in the production of pertussis vaccines whose antigenic formulation also takes into account Bp mutations and the possibility of eliciting a Th1/Th17 immune response.

MENINGOCOCCAL DISEASE IN CHILDHOOD: EPIDEMIOLOGY, CLINICAL FEATURES AND PREVENTION

Invasive meningococcal disease (IMD) represents a public health problem and a leading cause of morbidity and mortality worldwide. IMD can occur as an endemic disease with sporadic cases or epidemics with outbreaks. Neisseria meningitis strains are divided into 13 serogroups, but only five (A, B, C, W-135, and Y) are responsible for most IMD across the world. All age groups are at risk for IMD, but infants and adolescents are particularly vulnerable. The most common clinical manifestations of IMD are meningitis and septicemia, although in some cases both clinical pictures are present. The clinical pattern can differ according to age; in young children, the clinical manifestations may be more insidious and the diagnosis may be more difficult compared to older children or adolescents. Death occurs in 6-10% of cases and sequelae in 4.3-11.2% of cases. Early recognition of children with meningococcal infection is important in order to initiate systemic antibiotic therapy, although vaccination remains the best strategy to control meningococcal disease. Recently, different meningococcal vaccines have been introduced worldwide, resulting in a reduction in the overall burden of the disease. The goal of the next few years should be to increase vaccination coverage against meningococcal diseases, continue to monitor IMD and develop a unique vaccine able to cover all of the main meningococcal strains

Coronavirus disease-19 : an interim evidence Synthesis of the World Association for Infectious Diseases and Immunological Disorders (Waidid)

Coronavirus disease 2019 (COVID-19) is a rapidly evolving, highly transmissible, and potentially lethal pandemic caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of June 11 2020, more than 7,000,000 COVID-19 cases have been reported worldwide, and more than 400,000 patients have died, affecting at least 188 countries. While literature on the disease is rapidly accumulating, an integrated, multinational perspective on clinical manifestations, immunological effects, diagnosis, prevention, and treatment of COVID-19 can be of global benefit. We aimed to synthesize the most relevant literature and experiences in different parts of the world through our global consortium of experts to provide a consensus-based document at this early stage of the pandemic