Vaccines

15 pages, 4855 KiB

Open AccessArticle

Case Study: Contribution of Extended Sequencing and Phylogeographic Analysis in the Investigation of Measles Outbreaks in Tunisia in 2019

by Anissa Chouikha, Marwa Arbi, Oussama Souiai, Henda Touzi, Zina Meddeb, Essia Ben Farhat, Mahrez Yahyaoui, Amel Ben Said, Chokri Hamouda and Henda Triki

Vaccines 2024, 12(9), 1085; https://doi.org/10.3390/vaccines12091085 (registering DOI) - 23 Sep 2024

Abstract

Despite the availability of an effective vaccine for several decades, the measles virus continues to spread worldwide. From 2018 to 2019, several countries experienced large measles outbreaks with genotype B3, including Tunisia. We analyzed 66 samples collected from serologically confirmed measles cases during [...] Read more.

Despite the availability of an effective vaccine for several decades, the measles virus continues to spread worldwide. From 2018 to 2019, several countries experienced large measles outbreaks with genotype B3, including Tunisia. We analyzed 66 samples collected from serologically confirmed measles cases during this outbreak. Fifty-five percent were aged less than 12 months and had not received a measles vaccine. Phylogenetic analysis using the 450 nucleoprotein (N450) window revealed that all strains belonged to genotype B3, with five different variants identified. The N450 sequence of the predominant one, which circulated all through the epidemic period, was identical to the named strain MVs/Kabul.AFG/20.14/3. For better molecular discrimination, the amplification and sequencing of 1018 nucleotides in the non-coding region between the M and F genes (MF-NCRs) revealed higher variability with at least nine clusters. A phylogeographic study using Bayesian methods suggested the Governorate of Kasserine (on the borders of Algeria) as the introduction point with a TMRCA (Time to Most Recent Common Ancestor) for the 2019 sequences estimated around October 2018. These findings emphasize the crucial role of advanced molecular investigations in tracing measles transmission pathways which, together with good vaccine coverage, will help the final success of the global measles elimination program. Full article

(This article belongs to the Special Issue A World without Measles and Rubella: Meeting the Regional Elimination Targets on the Path to Global Eradication)

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15 pages, 1524 KiB

Open AccessArticle

Exploring Important Attributes, the Potential Use Cases and Feasibility of Introduction of Measles and Rubella Microarray Patches (MR-MAPs): Insights from Nine Countries

by Mateusz Hasso-Agopsowicz, Dijana Spasenoska, Maarten Paul Maria Jansen, Balcha Girma Masresha, Desiree Pastor, Abay Hagos Gebrekidan, Olivi Silalahi, Janice Woolford, Annet Kisakye, Anna-Lea Kahn and Birgitte Giersing

Vaccines 2024, 12(9), 1084; https://doi.org/10.3390/vaccines12091084 (registering DOI) - 23 Sep 2024

Abstract

Background: Microarray patches (MAPs) are innovative, needle-free vaccine delivery systems, suitable for administration by minimally trained health care workers or trained community health workers. Their introduction may transform immunization programmes, particularly for vaccines where high coverage is required for population immunity, such [...] Read more.

Background: Microarray patches (MAPs) are innovative, needle-free vaccine delivery systems, suitable for administration by minimally trained health care workers or trained community health workers. Their introduction may transform immunization programmes, particularly for vaccines where high coverage is required for population immunity, such as measles, and where vaccine delivery is challenging, such as in low- and middle-income countries. Recognizing the need to understand how best to tailor these products to reflect country priorities, workshops on measles and rubella MAPs (MR-MAPs) were conducted in multiple regions to collect insights on needs and preferences from relevant stakeholders at country level. Methods: The CAPACITI Innovation Framework was used to structure stakeholder discussions in nine countries in the period from August 2022 to July 2023. The discussions, building on the findings from a situation analysis on the barriers related to measles and rubella vaccine delivery, followed the four-step process outlined in the framework. Results: Key barriers hindering delivery of measles and rubella vaccines across the countries were in the categories of human resource management, service delivery, and demand generation. MR-MAP attributes that stakeholders believed would reduce or eliminate these barriers included ease of preparation and administration, improved thermostability, fewer (ancillary) components, and single-dose presentation. Some attributes such as the site of administration, wear time, and storage volume could exacerbate certain barriers. Based on an understanding of key barriers, product attributes, and underserved populations, stakeholders identified several potential use cases for MR-MAPs: (i) delivery at a fixed health post, (ii) delivery through outreach sessions conducted by health workers, and (iii) administration by community health workers. To enable robust national decision making about the introduction of MR-MAPs and successful implementation, global and national evidence on feasibility and acceptability of MR-MAPs should be generated. To prepare for the potential introduction of MR-MAPs, immunization programmes should evaluate their immunization policies based on their preferred use cases and modify them if needed, for example, to enable community health workers to administer vaccines, along with making programmatic adjustments to waste management and training. Conclusions: MR-MAPs have the potential to reduce key barriers to MR delivery. Yet, their future impact depends on the ability of global stakeholders to steer the development of MR-MAPs to be responsive to country needs and preferences. The generation of evidence to enable robust decision making, timely modification of vaccine policies, and addressing programmatic considerations will be key to successful uptake. Full article

(This article belongs to the Special Issue A World without Measles and Rubella: Meeting the Regional Elimination Targets on the Path to Global Eradication)

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17 pages, 1139 KiB

Open AccessArticle

Estimates of Potential Demand for Measles and Rubella Microarray Patches

by Lidia K. Kayembe, Leah S. Fischer, Bishwa B. Adhikari, Jennifer K. Knapp, Emily B. Khan, Bradford R. Greening, Mark Papania and Martin I. Meltzer

Vaccines 2024, 12(9), 1083; https://doi.org/10.3390/vaccines12091083 (registering DOI) - 23 Sep 2024

Abstract

Global measles vaccine coverage has stagnated at approximately 85% for over a decade. By simplifying vaccine logistics and administration, the measles and rubella microarray patch (MR-MAP) may improve coverage. Clinical trials have demonstrated similar safety and immunogenicity in 9-month-old infants for MR-MAPs compared [...] Read more.

Global measles vaccine coverage has stagnated at approximately 85% for over a decade. By simplifying vaccine logistics and administration, the measles and rubella microarray patch (MR-MAP) may improve coverage. Clinical trials have demonstrated similar safety and immunogenicity in 9-month-old infants for MR-MAPs compared with syringe-and-needle vaccination. To aid commercialization, we present estimates of MR-MAP demand. We created a spreadsheet-based tool to estimate demand for MR-MAPs using data from 180 WHO countries during 2000–2016. Five immunization scenarios were analyzed: (1a) Supplementary Immunization Activities (SIAs) in Gavi, the Vaccine Alliance (Gavi)-eligible countries and (1b) WHO countries where preventive SIAs are routinely conducted; (2) SIAs and outbreak response immunization in all WHO countries; (3) routine immunization (RI) and SIAs in six high-burden measles countries (the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and Pakistan); (4) RI and SIAs in six high-burden countries and Gavi-eligible countries; and (5) hard-to-reach populations. MR-MAP demand varied greatly across scenarios. Forecasts for 2025–2034 estimate from 137 million doses in hard-to-reach populations (scenario 5) to 2.587 billion doses for RI and SIAs in six high-burden countries and Gavi-eligible countries (scenario 4). When policymakers and manufacturers assess MR-MAP demand, they may consider multiple scenarios to allow for a complete consideration of potential markets and public health needs. Full article

(This article belongs to the Special Issue A World without Measles and Rubella: Meeting the Regional Elimination Targets on the Path to Global Eradication)

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13 pages, 727 KiB

Open AccessArticle

Differences in PCV13 Recommendation Practices between Pediatric Care Providers and Primary Care Providers in China: A Cross-Sectional Survey of Behavior and Social Drivers

by Yuan Dang, Lin Wang, Yuming Liu, Boyan Wang, Huiwen Deng, Can Ye, Chunping Wang and Yangmu Huang

Vaccines 2024, 12(9), 1082; https://doi.org/10.3390/vaccines12091082 (registering DOI) - 22 Sep 2024

Abstract

Objectives: This study examines the recommendation behaviors and influencing factors for the 13-valent Pneumococcal Conjugate Vaccine (PCV13) among 3579 Chinese healthcare workers (HCWs), including 1775 pediatric care providers (Peds-PCPs) and 1804 primary care providers (PCPs). Data were collected from May to July 2023 through a national cross-sectional survey using a structured [...] Read more.

Objectives: This study examines the recommendation behaviors and influencing factors for the 13-valent Pneumococcal Conjugate Vaccine (PCV13) among 3579 Chinese healthcare workers (HCWs), including 1775 pediatric care providers (Peds-PCPs) and 1804 primary care providers (PCPs). Data were collected from May to July 2023 through a national cross-sectional survey using a structured questionnaire, distributed across hospitals providing pediatric services in five provincial-level administrative divisions. Methods: The sociodemographic data, vaccine knowledge, and recommendation practices were analyzed using Pearson’s chi-square test, Wilcoxson rank-sum test, and multivariate logistic regression. Results show that while PCPs are more likely to recommend PCV13, vaccine hesitancy persists among Peds-PCPs. Logistic regression revealed that higher influenza vaccination intention, salary, vaccine consultation frequency, familiarity with immunization, work ethic, and flexible schedules positively impacted HCWs’ recommendation behavior. Results: Factors influencing Peds-PCPs’ recommendations include vaccine training (OR: 1.470, CI: 1.049–2.509), safety recognition (OR: 1.986, CI: 1.163–3.391), concern over rejection (OR = 1.274, CI: 1.076–1.508) and vaccine cost (OR = 1.203, CI: 1.023–1.414). For PCPs, influencing factors were the perceived susceptibility of children to pneumonia (OR = 2.185, CI: 1.074–4.445), acceptance of herd immunity (OR: 1.717, CI: 1.101–2.677), and belief that parents with better family conditions are more likely to accept vaccine recommendations (OR = 1.229, CI: 1.024–1.477). Conclusion: This survey underscores the need for tailored interventions to address differing perceptions and enhance confidence in the safety and efficacy of vaccines among HCWs, particularly Peds-PCPs. Full article

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26 pages, 6130 KiB

Open AccessArticle

Comprehensive Spatial-Temporal and Risk Factor Insights for Optimizing Livestock Anthrax Vaccination Strategies in Karnataka, India

by Jayashree Anandakumar, Kuralayanapalya Puttahonnappa Suresh, Archana Veeranagouda Patil, Chethan A. Jagadeesh, Sushma Bylaiah, Sharanagouda S. Patil and Divakar Hemadri

Vaccines 2024, 12(9), 1081; https://doi.org/10.3390/vaccines12091081 (registering DOI) - 22 Sep 2024

Abstract

Anthrax, a zoonotic disease affecting both livestock and humans globally, is caused by Bacillus anthracis. The objectives of this study were the following: (1) to identify environmental risk factors for anthrax and use this information to develop an improved predictive risk map, and [...] Read more.

Anthrax, a zoonotic disease affecting both livestock and humans globally, is caused by Bacillus anthracis. The objectives of this study were the following: (1) to identify environmental risk factors for anthrax and use this information to develop an improved predictive risk map, and (2) to estimate spatial variation in basic reproduction number (Ro) and herd immunity threshold at the village level, which can be used to optimize vaccination policies within high-risk regions. Based on the anthrax incidences from 2000–2023 and vaccine administration figures between 2008 and 2022 in Karnataka, this study depicted spatiotemporal pattern analysis to derive a risk map employing machine learning algorithms and estimate Ro and herd immunity threshold for better vaccination coverage. Risk factors considered were key meteorological, remote sensing, soil, and geographical parameters. Spatial autocorrelation and SaTScan analysis revealed the presence of hotspots and clusters predominantly in the southern, central, and uppermost northern districts of Karnataka and temporal cluster distribution between June and September. Factors significantly associated with anthrax were air temperature, surface pressure, land surface temperature (LST), enhanced vegetation index (EVI), potential evapotranspiration (PET), soil temperature, soil moisture, pH, available potassium, sulphur, and boron, elevation, and proximity to waterbodies and waterways. Ensemble technique with random forest and classification tree models were used to improve the prediction accuracy of anthrax. High-risk areas are expected in villages in the southern, central, and extreme northern districts of Karnataka. The estimated Ro revealed 11 high-risk districts with Ro > 1.50 and respective herd immunity thresholds ranging from 11.24% to 55.47%, and the assessment of vaccination coverage at the 70%, 80%, and 90% vaccine efficacy levels, all serving for need-based strategic vaccine allocation. A comparison analysis of vaccinations administered and vaccination coverage estimated in this study is used to illustrate difference in the supply and vaccine force. The findings from the present study may support in planning preventive interventions, resource allocation, especially of vaccines, and other control strategies against anthrax across Karnataka, specifically focusing on predicted high-risk regions. Full article

(This article belongs to the Special Issue Infectious Diseases: Importance for Public Health, Epidemiology, Promoting Factors, and Vaccines Prevention)

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13 pages, 586 KiB

Open AccessArticle

Changes in Attitudes towards Influenza and Pneumococcal Vaccination during the Subsiding COVID-19 Pandemic—Results of a Longitudinal Survey Study among Risk Groups in Germany between 2021 and 2023

by Sebastian Born, Daniel Schwarzkopf, Norman Rose, Mathias W. Pletz, Konrad Reinhart and Carolin Fleischmann-Struzek

Vaccines 2024, 12(9), 1080; https://doi.org/10.3390/vaccines12091080 (registering DOI) - 21 Sep 2024

Abstract

Background: In many countries, an increase in influenza and pneumococcal vaccination rates was observed during the COVID-19 pandemic. We examined how attitude, risk perception and knowledge towards influenza and pneumococcal vaccines of at-risk patients developed when the COVID-19 pandemic subsided and if COVID-19 [...] Read more.

Background: In many countries, an increase in influenza and pneumococcal vaccination rates was observed during the COVID-19 pandemic. We examined how attitude, risk perception and knowledge towards influenza and pneumococcal vaccines of at-risk patients developed when the COVID-19 pandemic subsided and if COVID-19 vaccination attitude (VA) was still associated with the attitudes towards the two other vaccines. Methods: We used longitudinal data from two surveys conducted in Germany in 2021 and 2023 among persons with chronic diseases. We assessed VA, risk perception, vaccination knowledge and further psychological determinants of vaccine acceptance. Structural equation modelling using full information maximum likelihood was used to estimate multivariate regressions with planned missing data. Results: Among 543 respondents, the influenza and pneumococcal vaccination rates remained relatively stable between 2021 and 2023. VA also remained unchanged at a moderately positive level, while COVID-19 VA decreased. A constantly positive association between COVID-19 VA and influenza as well as pneumococcal VA was found, independent from a general VA. The perceived danger of influenza increased between 2021 and 2023 and was among the strongest predictors of influenza VA. Conclusions: Also at the subsiding pandemic, COVID-19 VA was constantly associated with the influenza and pneumococcal VA. It seems sensible to take these aspects into account when designing future vaccination campaigns for at-risk patients. Trial registration: DRKS00024561. Registered 9 March 2021. Full article

(This article belongs to the Special Issue Navigating Public Perceptions of Vaccination: Understanding Attitudes and Challenges)

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13 pages, 2253 KiB

Open AccessArticle

Antibody Persistence and Risk of COVID-19 Infection: Insights from Modeling

by Laurent Coudeville, Eleine Konate, Tabassome Simon, Xavier de Lamballerie, Scott Patterson, Clotilde El Guerche-Séblain and Odile Launay

Vaccines 2024, 12(9), 1079; https://doi.org/10.3390/vaccines12091079 (registering DOI) - 21 Sep 2024

Abstract

Background: In this post hoc exploratory study of the APHP-COVIBOOST trial (NCT05124171), we used statistical modeling to describe the evolution of neutralizing antibody (nAb) titers over time, asses its impact on SARS-CoV-2 infection, and explore potential differences between three booster vaccine formulations (D614, [...] Read more.

Background: In this post hoc exploratory study of the APHP-COVIBOOST trial (NCT05124171), we used statistical modeling to describe the evolution of neutralizing antibody (nAb) titers over time, asses its impact on SARS-CoV-2 infection, and explore potential differences between three booster vaccine formulations (D614, B.1.351, and BNT162b2). Methods: Antibody titers were measured for 208 adult participants at day 28, 3 months, and 6 months using a microneutralization assay against different Omicron subvariants. We developed four specific Bayesian statistical models based on a core model, accounting for vaccine-specific antibody decline, boosting of nAb for breakthrough infection, and risk of infection according to nAb levels. The model findings were cross-verified using another validated microneutralization assay. Results: The decrease in nAb titers was significantly lower for the B.1.351 vaccine than for the other booster formulations. An inverse relationship was found between risk of infection upon exposure and nAb levels. With Omicron BA.1 data, these results translated into a positive relative vaccine efficacy against any infection over 6 months for the B.1.351 vaccine compared to the BNT162b2 (31%) and D614 (21%) vaccines. Conclusions: Risk of infection decreased with increasing nAb titers for all vaccines. Statistical models predicted significantly better antibody persistence for the B.1.351 booster formulation compared to the other evaluated vaccines. Full article

(This article belongs to the Special Issue Immune Correlates of Protection in Vaccines)

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19 pages, 3297 KiB

Open AccessReview

Pseudorabies Virus Glycoproteins E and B Application in Vaccine and Diagnosis Kit Development

by Sara Amanuel Bude, Zengjun Lu, Zhixun Zhao and Qiang Zhang

Vaccines 2024, 12(9), 1078; https://doi.org/10.3390/vaccines12091078 (registering DOI) - 20 Sep 2024

Abstract

Background: Pseudorabies virus (PRV) is a highly infectious pathogen that affects a wide range of mammals and imposes a significant economic burden on the global pig industry. The viral envelope of PRV contains several glycoproteins, including glycoprotein E (gE) and glycoprotein B [...] Read more.

Background: Pseudorabies virus (PRV) is a highly infectious pathogen that affects a wide range of mammals and imposes a significant economic burden on the global pig industry. The viral envelope of PRV contains several glycoproteins, including glycoprotein E (gE) and glycoprotein B (gB), which play critical roles in immune recognition, vaccine development, and diagnostic procedures. Mutations in these glycoproteins may enhance virulence, highlighting the need for updated vaccines. Method: This review examines the functions of PRV gE and gB in vaccine development and diagnostics, focusing on their roles in viral replication, immune system interaction, and pathogenicity. Additionally, we explore recent findings on the importance of gE deletion in attenuated vaccines and the potential of gB to induce immunity. Results: Glycoprotein E (gE) is crucial for the virus’s axonal transport and nerve invasion, facilitating transmission to the central nervous system. Deletion of gE is a successful strategy in vaccine development, enhancing the immune response. Glycoprotein B (gB) plays a central role in viral replication and membrane fusion, aiding viral spread. Mutations in these glycoproteins may increase PRV virulence, complicating vaccine efficacy. Conclusion: With PRV glycoproteins being essential to both vaccine development and diagnostic approaches, future research should focus on enhancing these components to address emerging PRV variants. Updated vaccines and diagnostic tools are critical for combating new, more virulent strains of PRV. Full article

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19 pages, 4867 KiB

Open AccessArticle

Vaccine Potency and Structure of Yeast-Produced Polio Type 2 Stabilized Virus-like Particles

by Qin Hong, Shuxia Wang, Xiaoli Wang, Wenyu Han, Tian Chen, Yan Liu, Fei Cheng, Song Qin, Shengtao Zhao, Qingwei Liu, Yao Cong and Zhong Huang

Vaccines 2024, 12(9), 1077; https://doi.org/10.3390/vaccines12091077 (registering DOI) - 20 Sep 2024

Abstract

Poliovirus (PV) is on the brink of eradication due to global vaccination programs utilizing live-attenuated oral and inactivated polio vaccines. Recombinant PV virus-like particles (VLPs) are emerging as a safe next-generation vaccine candidate for the impending polio-free era. In this study, we investigate [...] Read more.

Poliovirus (PV) is on the brink of eradication due to global vaccination programs utilizing live-attenuated oral and inactivated polio vaccines. Recombinant PV virus-like particles (VLPs) are emerging as a safe next-generation vaccine candidate for the impending polio-free era. In this study, we investigate the production, antigenicity, thermostability, immunogenicity, and structures of VLPs derived from PV serotype 2 (PV2) wildtype strain and thermally stabilized mutant (wtVLP and sVLP, respectively). Both PV2 wtVLP and sVLP are efficiently produced in Pichia pastoris yeast. The PV2 sVLP displays higher levels of D-antigen and significantly enhanced thermostability than the wtVLP. Unlike the wtVLP, the sVLP elicits neutralizing antibodies in mice at levels comparable to those induced by inactivated polio vaccine. The addition of an aluminum hydroxide adjuvant to sVLP results in faster induction and a higher magnitude of neutralizing antibodies. Furthermore, our cryo-EM structural study of both sVLP and wtVLP reveals a native conformation for the sVLP and a non-native expanded conformation for the wtVLP. Our work not only validates the yeast-produced PV2 sVLP as a promising vaccine candidate with high production potential but also sheds light on the structural mechanisms that underpin the assembly and immunogenicity of the PV2 sVLP. These findings may expedite the development of sVLP-based PV vaccines. Full article

(This article belongs to the Special Issue The 3rd Edition: Development of Vaccines Based on Virus-Like Particles)

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16 pages, 752 KiB

Open AccessArticle

SMS-Based Active Surveillance of Adverse Events following Immunization in Children: The VigiVax Study

by Laura Augusta Gonella, Francesca Moretti, Annalisa Capuano, Caterina De Sarro, Lorenza Ferrara, Elisabetta Geninatti, Greta Guarnieri, Xhikjana Hysolakoj, Margherita Lalli, Olivia Leoni, Antea Maria Pia Mangano, Patrizia Marani Toro, Viviana Mecchia, Maria Caterina Merlano, Caterina Palleria, Anna Maria Potenza, Paola Rossi, Marco Rossi, Francesca Sanità, Ester Sapigni, Cristina Scavone, Claudia Sommaro, Marco Tuccori, Giovanna Zanoni, Ugo Moretti and VigiVax Working Group Show full author list Hide full author list

Vaccines 2024, 12(9), 1076; https://doi.org/10.3390/vaccines12091076 (registering DOI) - 20 Sep 2024

Abstract

Underreporting is the main limitation of spontaneous reporting systems. This cohort-event monitoring study aims to examine the potential of short message service (SMS)-based surveillance compared to traditional surveillance systems. Using VigiVax software, parents of vaccinated children aged two years or younger, in the [...] Read more.

Underreporting is the main limitation of spontaneous reporting systems. This cohort-event monitoring study aims to examine the potential of short message service (SMS)-based surveillance compared to traditional surveillance systems. Using VigiVax software, parents of vaccinated children aged two years or younger, in the period March 2021–May 2022, received a single SMS inquiry about adverse events following immunization (AEFI). Responses were collected, validated by health operators and integrated with the information on electronic immunization registries. AEFI reports were automatically submitted to the Italian Pharmacovigilance system. Among 254,160 SMS messages sent, corresponding to 451,656 administered doses (AD), 71,643 responses were collected (28.2% response rate), and 21,231 of them (8.3%) reported AEFI. After a seriousness assessment based on clinical criteria, 50 reports (0.24%) were classified as serious. Among these, a causality assessment identified 31 reports at least potentially related to the vaccination (RR: 6.86/100,000 AD). Febrile seizures following MMRV (measles, mumps, rubella, varicella) vaccination accounted for 11 of these 31 cases, with an incidence of 32 per 100,000 AD. No fatal outcomes were reported. Our findings support the highly favorable risk profile of pediatric vaccinations and the possibility to improve spontaneous reporting through the integration of digital technologies. Full article

(This article belongs to the Special Issue Impact of Immunization Safety Monitoring on Vaccine Coverage)

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24 pages, 2652 KiB

Open AccessArticle

An Application of an Initial Full Value of Vaccine Assessment Methodology to Measles-Rubella MAPs for Use in Low- and Middle-Income Countries

by Melissa Ko, Collrane Frivold, Mercy Mvundura, Adam Soble, Christopher Gregory, Hans Christiansen, Mateusz Hasso-Agopsowicz, Han Fu, Mark Jit, Shan Hsu, Jessica Joyce Mistilis, Tiziana Scarna, Kristen Earle, Marion Menozzi-Arnaud, Birgitte Giersing, Courtney Jarrahian, Ahmadu Yakubu, Stefano Malvolti and Jean-Pierre Amorij

Vaccines 2024, 12(9), 1075; https://doi.org/10.3390/vaccines12091075 - 19 Sep 2024

Abstract

Measles and rubella micro-array patches (MR-MAPs) are a promising innovation to address limitations of the current needle and syringe (N&S) presentation due to their single-dose presentation, ease of use, and improved thermostability. To direct and accelerate further research and interventions, an initial full [...] Read more.

Measles and rubella micro-array patches (MR-MAPs) are a promising innovation to address limitations of the current needle and syringe (N&S) presentation due to their single-dose presentation, ease of use, and improved thermostability. To direct and accelerate further research and interventions, an initial full value vaccine assessment (iFVVA) was initiated prior to MR-MAPs entering phase I trials to quantify their value and identify key data gaps and challenges. The iFVVA utilized a mixed-methods approach with rapid assessment of literature, stakeholder interviews and surveys, and quantitative data analyses to (i) assess global need for improved MR vaccines and how MR-MAPs could address MR problem statements; (ii) estimate costs and benefits of MR-MAPs; (iii) identify the best pathway from development to delivery; and (iv) identify outstanding areas of need where stakeholder intervention can be helpful. These analyses found that if MR-MAPs are broadly deployed, they can potentially reach an additional 80 million children compared to the N&S presentation between 2030–2040. MR-MAPs can avert up to 37 million measles cases, 400,000 measles deaths, and 26 million disability-adjusted life years (DALYs). MR-MAPs with the most optimal product characteristics of low price, controlled temperature chain (CTC) properties, and small cold chain volumes were shown to be cost saving for routine immunization (RI) in low- and middle-income countries (LMICs) compared to N&S. Uncertainties about price and future vaccine coverage impact the potential cost-effectiveness of introducing MR-MAPs in LMICs, indicating that it could be cost-effective in 16–81% of LMICs. Furthermore, this iFVVA highlighted the importance of upfront donor investment in manufacturing set-up and clinical studies and the critical influence of an appropriate price to ensure country and manufacturer financial sustainability. To ensure that MR-MAPs achieve the greatest public health benefit, MAP developers, vaccine manufacturers, donors, financiers, and policy- and decision-makers will need close collaboration and open communications. Full article

(This article belongs to the Special Issue Estimating Vaccines' Value and Impact)

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16 pages, 2175 KiB

Open AccessArticle

Immune Response after Vaccination against Tick-Borne Encephalitis Virus (TBEV) in Horses

by Dana Kälin, Angela Becsek, Helen Stürmer, Claudia Bachofen, Denise Siegrist, Hulda R. Jonsdottir and Angelika Schoster

Vaccines 2024, 12(9), 1074; https://doi.org/10.3390/vaccines12091074 - 19 Sep 2024

Abstract

(1) Background: Horses infected by a tick-borne encephalitis virus (TBEV) can develop clinically apparent infections. In humans, vaccination is the most effective preventive measure, while a vaccine is not available for horses. The objective of this study was to describe the immune response [...] Read more.

(1) Background: Horses infected by a tick-borne encephalitis virus (TBEV) can develop clinically apparent infections. In humans, vaccination is the most effective preventive measure, while a vaccine is not available for horses. The objective of this study was to describe the immune response in horses after a TBEV vaccination with a human vaccine. (2) Materials and Methods: Seven healthy horses were randomised to a treatment or a control group in a stratified fashion based on TBEV–IgG concentrations on day −4. The treatment group (n = 4) was intramuscularly vaccinated using an inactivated human TBEV vaccine on days 0 and 28; the control group (n = 3) did not receive an injection. A clinical examination and blood sampling were performed on day –4, 0, 2, 4, 6, 8, 10, 14, 28, 30, 32, 34, 36, 38, 43, 56, 84, and 373. A linear mixed model analysis was used to compare IgG and IgM concentrations, neutralising antibody (nAb) titres, leucocyte count, serum amyloid A (SAA), and fibrinogen and globulin concentrations between the groups and time points. (3) Results: The clinical examination was normal in all horses at all time points. There were no significant changes in SAA, globulin, and fibrinogen concentrations and leucocyte count between the groups or time points (all p > 0.05). There was no significant increase in IgG, IgM, or nAb titres in the control group over time (all p > 0.05). In the vaccination group, there was a significant increase in IgG concentration and nAb titres after the second vaccination (p < 0.0001). There was no significant increase in IgM antibodies after the TBEV vaccination (all p > 0.05). One horse in the vaccination group had an IgM concentration above the laboratory reference on day 10. (4) Conclusions: The human TBEV vaccine did not have side effects when used in healthy horses in this study. A significant rise in TBEV-specific IgG antibodies and nAbs after the second vaccination was observed. However, IgG and nAb titres have been shown to decrease within 1 year after vaccination. The results of this study indicate that a vaccination with a human vaccine only induces a mild rise in IgM antibodies and only in previously naive horses. With no significant changes to inflammatory parameters in the vaccinated horses, it remains unclear whether vaccination with the human vaccine leads to protective immunity. Full article

(This article belongs to the Section Veterinary Vaccines)

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13 pages, 547 KiB

Open AccessArticle

Are HPV Vaccines Well Accepted among Parents of Adolescent Girls in China? Trends, Obstacles, and Practical Implications for Further Interventions: A Five-Year Follow-Up Study

by Yu Huang, Jie Ling, Xiang Zhao, Qiaohong Lv, Lei Wang, Qingqing Wu, Shuiyang Xu and Xuehai Zhang

Vaccines 2024, 12(9), 1073; https://doi.org/10.3390/vaccines12091073 - 19 Sep 2024

Abstract

Background: In 2020, the WHO proposed the global strategic goal of accelerating the elimination of cervical cancer (CC). One of the key strategies is that, by 2030, 90% of girls will complete HPV vaccination by age 15. In 2017, HPV vaccines were first [...] Read more.

Background: In 2020, the WHO proposed the global strategic goal of accelerating the elimination of cervical cancer (CC). One of the key strategies is that, by 2030, 90% of girls will complete HPV vaccination by age 15. In 2017, HPV vaccines were first marketed in China. Objectives: This study aimed to explore the changes in parents’ knowledge about CC, HPV, HPV vaccines, and acceptance of HPV vaccination 5 years after the introduction of HPV vaccines into China. Associated factors and reasons for refusal by parents were also explored. Methods: A school-based follow-up study was conducted among parents in China from May 2018 to May 2023. Comparison using Chi-square tests was performed to measure the changes. Univariate and multivariate analyses were used to explore factors associated with HPV vaccination among teenage girls. Results: The overall cognitive level in terms of CC- and HPV-related knowledge among parents increased, and they expressed more willingness to vaccinate their daughter (35.4% in 2018 vs. 56.6% in 2023). The HPV vaccination rate among teenage girls remained at a low level (4.4% in 2018, 9.8% in 2023). The main obstacles reported by parents were limited knowledge (42.0%), scarcity of the HPV vaccine (29.2%), waiting until their daughter was older (27.5%), safety concerns (14.7%), high cost (9.0%), and effectiveness concerns (4.6%). Parents who are elderly, local residents, have received HPV vaccines themselves, have had experience of vaccinating their children with influenza vaccines, and have a higher knowledge level of CC, HPV and HPV vaccines are more likely to vaccinate their children with HPV vaccines. Conclusions: Although we observed an increment in parents’ knowledge level in terms of CC, HPV, HPV vaccines, and HPV vaccine uptake over the past 5 years, the HPV vaccine coverage among girls still falls short of the WHO’s 2030 target. Comprehensive intervention strategies, including tailored health education among adolescents and their parents, doctor recommendations, and providing financial subsidies or free HPV vaccines are needed in China. Full article

(This article belongs to the Special Issue Advancing the Science on Vaccine Hesitancy to Inform Interventions)

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18 pages, 1975 KiB

Open AccessReview

Navigating the Evolving Landscape of COVID-19: Strategies to Increase Vaccine Confidence and Improve Vaccination Rates in the United States

by James A. Mansi, Heather R. Hensler, Rachel Dawson, Reed Tuckson and Todd Wolynn

Vaccines 2024, 12(9), 1072; https://doi.org/10.3390/vaccines12091072 - 19 Sep 2024

Abstract

The COVID-19 pandemic has had a significant impact on every individual in the United States. The launch of the COVID-19 vaccines is estimated to have averted millions of deaths and reduced over 18 million COVID-19-related hospitalizations. In September 2023, the updated 2023–2024 COVID-19 [...] Read more.

The COVID-19 pandemic has had a significant impact on every individual in the United States. The launch of the COVID-19 vaccines is estimated to have averted millions of deaths and reduced over 18 million COVID-19-related hospitalizations. In September 2023, the updated 2023–2024 COVID-19 vaccine, which includes a monovalent component that corresponds to the omicron variant XBB.1.5, reflecting the predominant circulating variant at the time of strain selection, was approved and was recommended for use in all people ≥ 6 months of age. Despite this recommendation, the US uptake of the updated COVID-19 vaccines over the 2023–2024 season has been far from optimal, placing many people at unnecessary risk of severe COVID-19 outcomes. This paper provides an overview of the current state of COVID-19 in 2023–2024 and barriers to vaccine uptake. With the continued evolution of the virus, the potential for more virulent variants, reduced public acceptance of vaccination, and the potential barriers that contributed to low vaccine uptake are explored to provide solutions for improving COVID-19 protection for future seasons. Full article

(This article belongs to the Special Issue Advance Public Health through Vaccination)

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29 pages, 1137 KiB

Open AccessReview

Virulence and Immune Evasion Strategies of FMDV: Implications for Vaccine Design

by Gisselle N. Medina and Fayna Diaz San Segundo

Vaccines 2024, 12(9), 1071; https://doi.org/10.3390/vaccines12091071 - 19 Sep 2024

Abstract

Foot-and-mouth disease (FMD) is globally recognized as a highly economically devastating and prioritized viral disease affecting livestock. Vaccination remains a crucial preventive measure against FMD. The improvement of current vaccine platforms could help control outbreaks, leading to the potential eradication of the disease. [...] Read more.

Foot-and-mouth disease (FMD) is globally recognized as a highly economically devastating and prioritized viral disease affecting livestock. Vaccination remains a crucial preventive measure against FMD. The improvement of current vaccine platforms could help control outbreaks, leading to the potential eradication of the disease. In this review, we describe the variances in virulence and immune responses among FMD-susceptible host species, specifically bovines and pigs, highlighting the details of host–pathogen interactions and their impact on the severity of the disease. This knowledge serves as an important foundation for translating our insights into the rational design of vaccines and countermeasure strategies, including the use of interferon as a biotherapeutic agent. Ultimately, in this review, we aim to bridge the gap between our understanding of FMDV biology and the practical approaches to control and potentially eradicate FMD. Full article

(This article belongs to the Special Issue Interplay between Host and Pathogen: Effects of Infection and Immune Responses)

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12 pages, 1475 KiB

Open AccessArticle

Humoral Immunity and Antibody Responses against Diphtheria, Tetanus, and Pneumococcus after Immune Effector Cell Therapies: A Prospective Study

by Georgios Angelidakis, Roy F. Chemaly, Pranoti V. Sahasrabhojane, Oscar Morado-Aramburo, Ying Jiang, Micah M. Bhatti, Elizabeth Shpall, Chitra Hosing, Preetesh Jain, Kris Michael Mahadeo, Fareed Khawaja, Peter Elhajj, Jennifer A. Wargo, Robert R. Jenq, Nadim J. Ajami, Partow Kebriaei and Ella J. Ariza-Heredia

Vaccines 2024, 12(9), 1070; https://doi.org/10.3390/vaccines12091070 - 19 Sep 2024

Abstract

Patients undergoing immune effector cell therapy (IECT) are at high risk for infections. We assessed seropositivity against pneumococcus, tetanus, and diphtheria in patients before and after IECT and the patients’ response to vaccination. We enrolled patients who underwent IECT from January 2020 to [...] Read more.

Patients undergoing immune effector cell therapy (IECT) are at high risk for infections. We assessed seropositivity against pneumococcus, tetanus, and diphtheria in patients before and after IECT and the patients’ response to vaccination. We enrolled patients who underwent IECT from January 2020 to March 2022. Antibody levels for diphtheria, tetanus, and pneumococcus were measured before IECT, at 1 month, and 3–6 months after. Eligible patients were vaccinated after IECT. In non-seroprotected patients, we discontinued testing. Before IECT, most patients had seroprotective antibody levels against tetanus (68/69, 99%) and diphtheria (65/69, 94%), but fewer did against pneumococcus (24/67, 36%). After IECT, all patients had seroprotective antibody levels for tetanus at 1 month (68/68) and 3–6 months (56/56). For diphtheria, 65/65 patients (100%) had seroprotective antibody levels at 1 month, and 48/53 (91%) did at 3–6 months. For pneumococcus, seroprotective antibody levels were identified in 91% (21/23) of patients at 1 month and 79% (15/19) at 3–6 months following IECT. Fifteen patients received a pneumococcal vaccine after IECT, but none achieved seroprotective response. One patient received the tetanus-diphtheria vaccine and had a seroprotective antibody response. Because some patients experience loss of immunity after IECT, studies evaluating vaccination strategies post-IECT are needed. Full article

(This article belongs to the Special Issue Advances in Vaccines against Infectious Diseases)

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10 pages, 386 KiB

Open AccessArticle

Progress with the Second Dose Measles Vaccine Introduction and Coverage in the WHO African Region

by Balcha G. Masresha, Messeret E. Shibeshi, Gavin B. Grant, Cynthia Hatcher and Charles S. Wiysonge

Vaccines 2024, 12(9), 1069; https://doi.org/10.3390/vaccines12091069 - 18 Sep 2024

Abstract

Introduction: To achieve global and regional measles elimination objectives, the World Health Organization (WHO) recommends coverage of 95% or higher with two doses of measles-containing vaccine. A second dose of measles-containing vaccine (MCV) is typically administered in the second year of life after [...] Read more.

Introduction: To achieve global and regional measles elimination objectives, the World Health Organization (WHO) recommends coverage of 95% or higher with two doses of measles-containing vaccine. A second dose of measles-containing vaccine (MCV) is typically administered in the second year of life after 12 months of age. Methods: We reviewed WHO-UNICEF estimates of national coverage (WUENIC) for the first and second doses of MCV (MCV1 and MCV2, respectively) and calculated drop-out rates between MCV1 and MCV2 for countries in the WHO African Region. Results: From 2013 to 2023, estimated regional MCV2 coverage increased from 7% to 49%, and at the end of 2023, 43 (91%) countries had introduced MCV2 into their routine immunization programs. Countries with more antigens provided in the second year of life had higher mean and median MCV2 coverage levels, and lower drop-out rates between MCV1 and MCV2, as compared to countries providing only MCV2. Discussion: Despite substantial progress, MCV2 coverage remains below the required levels to achieve and sustain elimination, and many countries have high drop-out rates between MCV1 and MCV2 coverage, indicating challenges in reaching children over 12 months of age. Increasing coverage of MCV2 and other vaccines in the second year of life is essential to achieving higher and equitable routine immunization coverage. This will require continued efforts to understand and mitigate barriers to reaching children after 12 months of age and accelerated implementation of available tools. Full article

(This article belongs to the Special Issue A World without Measles and Rubella: Meeting the Regional Elimination Targets on the Path to Global Eradication)

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23 pages, 6419 KiB

Open AccessArticle

Adjuvant Use of the Invariant-Natural-Killer-T-Cell Agonist α-Galactosylceramide Leads to Vaccine-Associated Enhanced Respiratory Disease in Influenza-Vaccinated Pigs

by Bianca L. Artiaga, Daniel Madden, Taeyong Kwon, Chester McDowell, Cassidy Keating, Velmurugan Balaraman, Darling Melany de Carvahlo Madrid, Laurie Touchard, Jamie Henningson, Philip Meade, Florian Krammer, Igor Morozov, Juergen A. Richt and John P. Driver

Vaccines 2024, 12(9), 1068; https://doi.org/10.3390/vaccines12091068 - 18 Sep 2024

Abstract

Invariant natural killer T (iNKT) cells are glycolipid-reactive T cells with potent immunoregulatory properties. iNKT cells activated with the marine-sponge-derived glycolipid, α-galactosylceramide (αGC), provide a universal source of T-cell help that has shown considerable promise for a wide array of therapeutic applications. This [...] Read more.

Invariant natural killer T (iNKT) cells are glycolipid-reactive T cells with potent immunoregulatory properties. iNKT cells activated with the marine-sponge-derived glycolipid, α-galactosylceramide (αGC), provide a universal source of T-cell help that has shown considerable promise for a wide array of therapeutic applications. This includes harnessing iNKT-cell-mediated immune responses to adjuvant whole inactivated influenza virus (WIV) vaccines. An important concern with WIV vaccines is that under certain circumstances, they are capable of triggering vaccine-associated enhanced respiratory disease (VAERD). This immunopathological phenomenon can arise after immunization with an oil-in-water (OIW) adjuvanted WIV vaccine, followed by infection with a hemagglutinin and neuraminidase mismatched challenge virus. This elicits antibodies (Abs) that bind immunodominant epitopes in the HA2 region of the heterologous virus, which purportedly causes enhanced virus fusion activity to the host cell and increased infection. Here, we show that αGC can induce severe VAERD in pigs. However, instead of stimulating high concentrations of HA2 Abs, αGC elicits high concentrations of interferon (IFN)-γ-secreting cells both in the lungs and systemically. Additionally, we found that VAERD mediated by iNKT cells results in distinct cytokine profiles and altered adaptation of the challenge virus following infection compared to an OIW adjuvant. Overall, these results provide a cautionary note about considering the formulation of WIV vaccines with iNKT-cell agonists as a potential strategy to modulate antigen-specific immunity. Full article

(This article belongs to the Special Issue Immunity to Influenza Viruses and Vaccines)

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18 pages, 1729 KiB

Open AccessSystematic Review

The Evolution of Vaccines Development across Salmonella Serovars among Animal Hosts: A Systematic Review

by Abubakar Siddique, Zining Wang, Haiyang Zhou, Linlin Huang, Chenghao Jia, Baikui Wang, Abdelaziz Ed-Dra, Lin Teng, Yan Li and Min Yue

Vaccines 2024, 12(9), 1067; https://doi.org/10.3390/vaccines12091067 - 18 Sep 2024

Abstract

Salmonella is a significant zoonotic foodborne pathogen, and the global spread of multidrug-resistant (MDR) strains poses substantial challenges, necessitating alternatives to antibiotics. Among these alternatives, vaccines protect the community against infectious diseases effectively. This review aims to summarize the efficacy of developed Salmonella [...] Read more.

Salmonella is a significant zoonotic foodborne pathogen, and the global spread of multidrug-resistant (MDR) strains poses substantial challenges, necessitating alternatives to antibiotics. Among these alternatives, vaccines protect the community against infectious diseases effectively. This review aims to summarize the efficacy of developed Salmonella vaccines evaluated in various animal hosts and highlight key transitions for future vaccine studies. A total of 3221 studies retrieved from Web of Science, Google Scholar, and PubMed/Medline databases between 1970 and 2023 were evaluated. One hundred twenty-seven qualified studies discussed the vaccine efficacy against typhoidal and nontyphoidal serovars, including live-attenuated vaccines, killed inactivated vaccines, outer membrane vesicles, outer membrane complexes, conjugate vaccines, subunit vaccines, and the reverse vaccinology approach in different animal hosts. The most efficacious vaccine antigen candidate found was recombinant heat shock protein (rHsp60) with an incomplete Freund’s adjuvant evaluated in a murine model. Overall, bacterial ghost vaccine candidates demonstrated the highest efficacy at 91.25% (95% CI = 83.69–96.67), followed by the reverse vaccinology approach at 83.46% (95% CI = 68.21–94.1) across animal hosts. More than 70% of vaccine studies showed significant production of immune responses, including humoral and cellular, against Salmonella infection. Collectively, the use of innovative methods rather than traditional approaches for the development of new effective vaccines is crucial and warrants in-depth studies. Full article

(This article belongs to the Special Issue Animal Vaccines)

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