Special Issue "Vaccination and Vaccine Effectiveness"

A special issue of Vaccines (ISSN 2076-393X).

Deadline for manuscript submissions: closed (31 December 2019).

Special Issue Editors

Prof. Dr. Alessandra Casuccio
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Guest Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
Interests: public health; preventive medicine; communicable disease prevention; health promotion; palliative care epidemiology; health determinants
Special Issues and Collections in MDPI journals
Dr. Vincenzo Restivo
Website
Guest Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
Interests: Non-communicable disease; Vaccine safety; Screening; Epidemiology; HPV; MPRV, Gynecological cancer; Health Belief Model
Special Issues and Collections in MDPI journals
Dr. Claudio Costantino
Website
Guest Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
Interests: vaccination strategies; health communication; counselling; smoking habit; nutrition; food hygiene; influenza
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

Vaccination is universally recognized as one of the best strategies that have increased duration and quality of life during the last centuries. However, vaccination coverages are often below the recommended levels to reduce the circulation of and extinguish vaccine-preventable diseases. In several countries, vaccination acceptance is low because of misconceptions or doubts about the effectiveness and safety of vaccines. Vaccine hesitancy involves at least 15% of the general population, and even healthcare workers sometimes express doubts on vaccination effectiveness and safety.

This Special Issue will contribute to the enhancement of international literature data on vaccine effectiveness and safety and on strategies that could help reduce vaccine hesitancy and improve vaccination coverage.

Manuscripts reporting on vaccines administered to infants, adolescents, adults, elderly people, at-risk populations (susceptible to comorbidities and presenting personal risk factors), and healthcare workers and on strategies adopted to promote vaccination adherence by these categories are welcomed for this Special Issue.

This Special Issue encourages the submission of original articles, systematic reviews, meta-analyses, short communications, and other types of article that can improve our knowledge on vaccine effectiveness and related topics, such as vaccine safety and strategies to increase vaccination acceptance.

Prof. Alessandra Casuccio
Dr. Vincenzo Restivo
Dr. Claudio Costantino
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vaccination
  • Vaccine effectiveness
  • Vaccination Safety
  • Neonatal immunization
  • Adult vaccination
  • Elderly vaccination
  • At risk categories
  • Vaccine hesitancy

Published Papers (16 papers)

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Research

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Open AccessArticle
Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination
Vaccines 2020, 8(2), 156; https://doi.org/10.3390/vaccines8020156 - 30 Mar 2020
Abstract
Background: Hepatitis B still represents a health concern, although safe and effective vaccines have been available since 1982. Italy introduced a program of universal vaccination against hepatitis B in 1991. The aim of this study was to assess the immunity levels towards hepatitis [...] Read more.
Background: Hepatitis B still represents a health concern, although safe and effective vaccines have been available since 1982. Italy introduced a program of universal vaccination against hepatitis B in 1991. The aim of this study was to assess the immunity levels towards hepatitis B in a sample of sera from the pediatric and adolescent population in the province of Florence, Central Italy, twenty-seven years after the implementation of universal vaccination. Methods: A total of 165 sera samples were collected from the resident population of Florence aged 1–18 years. The anti-HBs and anti-HBc enzyme-linked immunosorbent Assay (ELISA) tests were performed on all samples. The anamnestic and vaccination status data were also collected. Results: Seroprevalence of anti-HBs was approximately 60%, with children aged 1–5 years having the highest positivity rate (81.6%), and decreasing trends in the older age groups. The zero prevalence of anti-HBc shows that the detected protective immunity is mainly due to vaccination, and natural infection was not reported in the studied population. Conclusions: The seroprevalence of anti-HBs and the lack of anti-HBc in this study highlights that immunity levels have been derived mainly from immunization. This confirms how vaccination dramatically reduced circulation of the hepatitis B virus in Italy in the pediatric and adolescent population twenty-seven years after implementation of the mandatory universal program. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Influenza Vaccination in Italian Healthcare Workers (2018–2019 Season): Strengths and Weaknesses. Results of a Cohort Study in Two Large Italian Hospitals
Vaccines 2020, 8(1), 119; https://doi.org/10.3390/vaccines8010119 - 05 Mar 2020
Cited by 2
Abstract
Background: Annual vaccination is the most effective way to combat influenza. As influenza viruses evolve, seasonal vaccines are updated annually. Within the European project Development of Robust and Innovative Vaccine Effectiveness (DRIVE), a cohort study involving Italian healthcare workers (HCWs) was carried out [...] Read more.
Background: Annual vaccination is the most effective way to combat influenza. As influenza viruses evolve, seasonal vaccines are updated annually. Within the European project Development of Robust and Innovative Vaccine Effectiveness (DRIVE), a cohort study involving Italian healthcare workers (HCWs) was carried out during the 2018-2019 season. Two aims were defined: to measure influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza cases and to conduct an awareness-raising campaign to increase vaccination coverage. Methods: Each subject enrolled was followed up from enrollment to the end of the study. Each HCW who developed ILI was swabbed for laboratory confirmation of influenza. Influenza viruses were identified by molecular assays. A Cox regression analysis, crude and adjusted for confounding variables, was performed to estimate the IVE. Results: Among the 4483 HCWs enrolled, vaccination coverage was 32.5%, and 308 ILI cases were collected: 23.4% were positive for influenza (54.2% A(H1N1) pdm09; 45.8% A(H3N2)). No influenza B viruses were detected. No overall IVE was observed. Analyzing the subtypes of influenza A viruses, the IVE was estimated as 45% (95% CI: -59 to 81) for A(H1N1) pdm09. Conclusions: Vaccination coverage among HCWs increased. Study difficulties and the circulation of drifted variants of A(H3N2) could partly explain the observed IVE. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Strategies to Increase Flu Vaccination Coverage among Healthcare Workers: A 4 Years Study in a Large Italian Teaching Hospital
Vaccines 2020, 8(1), 85; https://doi.org/10.3390/vaccines8010085 - 13 Feb 2020
Abstract
Flu vaccination is recommended among healthcare workers (HCWs). The low vaccination coverage registered in our hospital among HCWs called for new engaging approaches to improve flu vaccination coverage. The aim of this study was to evaluate the efficacy of different strategies implemented during [...] Read more.
Flu vaccination is recommended among healthcare workers (HCWs). The low vaccination coverage registered in our hospital among HCWs called for new engaging approaches to improve flu vaccination coverage. The aim of this study was to evaluate the efficacy of different strategies implemented during the last four years (2015–2019). A quasi-experimental study was conducted, involving almost 4000 HCWs each year. Starting from the 2015–2016 campaign, new evidence-based strategies were progressively implemented. At the end of each campaign, an evaluation of the vaccination coverage rate reached was performed. Moreover, during the last three campaigns, differences in coverage among job category, wards involved or not in on-site vaccination (OSV) intervention, age classes and gender were analyzed. An increasing flu vaccination coverage rate was registered, from 6% in 2015–2016 to almost 22% at the end of 2018–2019. The overall number of vaccinated HCWs increased, especially at younger ages. OSV strategy always leads to better results, and physicians always show a higher vaccination coverage than nurses and other HCWs. The implemented strategies were effective in achieving higher flu vaccination coverage among HCWs in our hospital and therefore can be considered valuable examples of good prevention practices in hospital settings. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Predominance of a Drifted Influenza A (H3N2) Clade and Its Association with Age-Specific Influenza Vaccine Effectiveness Variations, Influenza Season 2018–2019
Vaccines 2020, 8(1), 78; https://doi.org/10.3390/vaccines8010078 - 09 Feb 2020
Abstract
Background: Influenza A (H3N2) clade 3C.3a was the predominant influenza virus in Israel throughout the 2018-2019 season, constituting a drift from the influenza A (H3N2) vaccine. We estimated the end-of season vaccine effectiveness (VE) by age, among community patients with influenza-like illness (ILI), [...] Read more.
Background: Influenza A (H3N2) clade 3C.3a was the predominant influenza virus in Israel throughout the 2018-2019 season, constituting a drift from the influenza A (H3N2) vaccine. We estimated the end-of season vaccine effectiveness (VE) by age, among community patients with influenza-like illness (ILI), considering the hemagglutinin (HA) gene mutations and amino acid substitutions of influenza A (H3N2) viruses detected. Methods: Nose-throat samples were analyzed for the presence of influenza virus, type/subtype, and HA gene sequence. HA gene sequences and amino acid substitutions were compared to the influenza A/Singapore/INFIMH-16-0019/2016 (H3N2)-like 2018-2019 vaccine virus, and a phylogenetic tree was generated. Influenza VE against influenza A (H3N2) was estimated using the test-negative design. VE was estimated by age group and by 15 year moving age intervals. Results: In total, 90% of the influenza A (H3N2) viruses belonged to the 3C.3a clade, constituting a unique situation in the northern hemisphere. Adjusted all-age influenza A (H3N2) VE was −3.5% (95% CI: −51.2 to 29.1). Although adjusted VEs were very low among infants, children, and young adults, a VE of 45% (95% CI: −19.2 to 74.6) was estimated among adults aged ≥45 years old. Conclusions: The higher VE point estimates among older adults may be related to previous exposure to similar influenza viruses. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Assessment of Knowledge, Attitudes, and Propensity towards HPV Vaccine of Young Adult Students in Italy
Vaccines 2020, 8(1), 74; https://doi.org/10.3390/vaccines8010074 - 07 Feb 2020
Abstract
Background: Human Papillomavirus (HPV) is a common sexually transmitted infection (STI), representing the main cause of genital warts and cervical cancer. This cross-sectional study evaluated knowledge and attitudes about HPV infection, related diseases, and prevention and propensity towards HPV vaccine among undergraduate students. [...] Read more.
Background: Human Papillomavirus (HPV) is a common sexually transmitted infection (STI), representing the main cause of genital warts and cervical cancer. This cross-sectional study evaluated knowledge and attitudes about HPV infection, related diseases, and prevention and propensity towards HPV vaccine among undergraduate students. Methods: An online and written survey about HPV and its prevention, targeted to young adults of both genders, was addressed to students attending health sciences and other schools at Universities of Genoa and Bari. Results: The overall median knowledge and attitude scores were 56.3% (25–75 p = 40–68.8%) and four out of five (25–75 p = 4–5), respectively. In the multivariate analysis, attending a health sciences university, using social networks ≤2 h a day, a history of STI, having heard about HPV and HPV vaccine previously resulted as predictors of higher knowledge scores. Having heard about HPV previously also predicted a high attitude score, together with a perceived economic status as good. Having Italian and healthcare worker parents, being employed, and following a specific diet, instead, predicted lower attitude score. Conclusions: Poor knowledge and good attitudes were found among undergraduates about HPV. In order to increase HPV vaccine compliance and the counselling skills of future healthcare workers, the improvement of training on HPV is needed. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
Open AccessArticle
Assessment of the Clinical and Economic Impact of Different Immunization Protocols of Measles, Mumps, Rubella and Varicella in Internationally Adopted Children
Vaccines 2020, 8(1), 60; https://doi.org/10.3390/vaccines8010060 - 01 Feb 2020
Abstract
The appropriate immunization of internationally adopted children (IAC) is currently under debate and different approaches have been suggested. The aim of this study is to evaluate the clinical and economic impact of different strategies of measles, mumps, rubella, and varicella (MMRV) immunization in [...] Read more.
The appropriate immunization of internationally adopted children (IAC) is currently under debate and different approaches have been suggested. The aim of this study is to evaluate the clinical and economic impact of different strategies of measles, mumps, rubella, and varicella (MMRV) immunization in IAC in Italy. A decision analysis model was developed to compare three strategies: presumptive immunization, pre-vaccination serotesting and vaccination based on documentation of previous immunization. Main outcomes were the cost of strategy, number of protected IAC, and cost per child protected against MMRV. Moreover, the incremental cost-effectiveness ratio (ICER) was calculated. The strategy currently recommended in Italy (immunize based on documentation) is less expensive. On the other hand, the pre-vaccination serotesting strategy against MMRV together, improves outcomes with a minimum cost increase, compared with the presumptive immunization strategy and compared with the comparator strategy. From a cost-effectiveness point of view, vaccination based on serotesting results in being the most advantageous strategy compared to presumptive vaccination. By applying a chemiluminescent immunoassay test, the serology strategy resulted to be clinically and economically advantageous. Similar results were obtained excluding children aged <1 year for both serology methods. In conclusion, based on our analyses, considering MMRV vaccine, serotesting strategy appears to be the preferred option in IAC. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
The Impact of Mandatory Vaccination Law in Italy on MMR Coverage Rates in Two of the Largest Italian Regions (Emilia-Romagna and Sicily): An Effective Strategy to Contrast Vaccine Hesitancy
Vaccines 2020, 8(1), 57; https://doi.org/10.3390/vaccines8010057 - 30 Jan 2020
Abstract
Background: Vaccine hesitancy has increased worldwide, leading to reduction in vaccination coverage rates. In particular, reduction in the coverage for the trivalent Measles-Mumps-Rubella vaccine has led to an increase of measles cases. The aim of this study is to analyze the coverage [...] Read more.
Background: Vaccine hesitancy has increased worldwide, leading to reduction in vaccination coverage rates. In particular, reduction in the coverage for the trivalent Measles-Mumps-Rubella vaccine has led to an increase of measles cases. The aim of this study is to analyze the coverage rates for the MMR vaccine in the Emilia-Romagna Region (RER) and Sicily Region (SR) between 2009 and 2018, and to correlate any significant change to index events which could have modified the trend of vaccination rates. Methods: Official aggregate data on vaccination coverage at 24 months provided by the RER and the SR were analyzed through trend analysis and related to important index events. Results: The two regions showed similar results; both achieved the lowest coverage rates in 2015 and both showed an increase in the rates after the introduction of mandatory vaccinations for access to schools. In 2018, both reached the starting point before the decrease. Conclusions: Our results confirm the effectiveness of legislative coercive measures in favor of vaccination. A potential decrease in the coverage rates may be observed as a result of an attenuation of the positive effects of coercive measures over time. It is thus necessary to combine these measures together with information campaigns and political initiatives at different levels (i.e., national, regional). Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
The Impact of School and After-School Friendship Networks on Adolescent Vaccination Behavior
Vaccines 2020, 8(1), 55; https://doi.org/10.3390/vaccines8010055 - 29 Jan 2020
Abstract
Psychological and social characteristics of individuals are important determinants of their health choices and behaviors. Social networks represent “pipes” through which information and opinions circulate and spread out in the social circle surrounding individuals, influencing their propensity toward important health care interventions. This [...] Read more.
Psychological and social characteristics of individuals are important determinants of their health choices and behaviors. Social networks represent “pipes” through which information and opinions circulate and spread out in the social circle surrounding individuals, influencing their propensity toward important health care interventions. This paper aims to explore the relationship between students’ vaccination health choices and their social networks. We administered a questionnaire to students to collect data on individual students’ demographics, knowledge, and attitudes about vaccinations, as well as their social networks. Forty-nine pupils belonging to 4 classrooms in an Italian secondary school were enrolled in the study. We applied a logistic regression quadratic assignment procedure (LR-QAP) by regressing students’ positive responsive behavior similarity as a dependent variable. LRQAP findings indicate that students’ vaccination behavior similarity is significantly associated with after-school social ties and related social mechanisms, suggesting that pupils are more likely to share information and knowledge about health behaviors through social relationships maintained after school hours rather than through those established during the school day. Moreover, we found that vaccination behaviors are more similar for those students having the same ethnicity as well as for those belonging to the same class. Our findings may help policymakers in implementing effective vaccination strategies. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Immunization Status against Measles, Mumps, Rubella and Varicella in a Large Population of Internationally Adopted Children Referred to Meyer Children’s University Hospital from 2009 to 2018
Vaccines 2020, 8(1), 51; https://doi.org/10.3390/vaccines8010051 - 28 Jan 2020
Cited by 1
Abstract
Control of vaccine preventable diseases (VPDs) is a challenge for healthcare systems. Different studies highlighted the suboptimal immunization of internationally adopted children (IAC). To evaluate the immunization status against measles, mumps, rubella (MMR), and varicella (V) in a large cohort of IAC, data [...] Read more.
Control of vaccine preventable diseases (VPDs) is a challenge for healthcare systems. Different studies highlighted the suboptimal immunization of internationally adopted children (IAC). To evaluate the immunization status against measles, mumps, rubella (MMR), and varicella (V) in a large cohort of IAC, data at first screening visit of all IAC (<18 years) consecutively referred to Meyer Children’s University Hospital (Florence, Italy) from 2009 to 2018 were collected and analyzed. In total, 1927 children (median age: 5.99 years, interquartile range: 3.33–8.21) were enrolled. More than half of IAC were unprotected against MMR-V. The reliability of the vaccination documentation of the country of origin was poor, since more than a quarter of the IAC serologically tested were not protected against MMR-V, despite the vaccination documentation attesting previous vaccination. This was significantly more pronounced in children aged 15–18 years and in those originating from Africa. High rate of discordant serological results/documentation brings up questions regarding the optimal management of IACs, and suggests a rapid, careful, and complete assessment of immunization status timely after IAC’s arrival. Serological testing of IAC of all ages followed by vaccination of seronegative children should be provided. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Evaluation of the Burden of HPV-Related Hospitalizations as a Useful Tool to Increase Awareness: 2007–2017 Data from the Sicilian Hospital Discharge Records
Vaccines 2020, 8(1), 47; https://doi.org/10.3390/vaccines8010047 - 26 Jan 2020
Abstract
In light of the implementation of human papillomavirus (HPV) prevention strategies, epidemiological studies in different geographical areas are required in order to assess the impact of HPV-related diseases. The purpose of the present study was to describe the burden of HPV-related hospitalizations in [...] Read more.
In light of the implementation of human papillomavirus (HPV) prevention strategies, epidemiological studies in different geographical areas are required in order to assess the impact of HPV-related diseases. The purpose of the present study was to describe the burden of HPV-related hospitalizations in Sicily. A retrospective observational study estimated 43,531 hospitalizations attributable to HPV from 2007 to 2017. During the observed period, there was a decrease for all HPV-related conditions with a higher reduction, among neoplasms, for cervical cancer (annual percent change (APC) = −9.9%, p < 0.001). The median age for cervical cancer was 45 years old, with an increasing value from 43 to 47 years (p < 0.001). The age classes with greater decreases in hospital admissions for invasive cancers were women aged 35 years or more (APC range from −5.5 to −9.86) and 25–34 years old (APC = −11.87, p < 0.001) for women with cervical carcinoma in situ. After ten years for vaccine introduction and sixteen years for cervical cancer screening availability, a relatively large decrease in hospital admissions for cervical cancer and other HPV-related diseases in Sicily was observed. Some clinical characteristics of hospitalization, such as increasing age, are suggestive clues for the impact of preventive strategies, but further research is needed to confirm this relationship. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Vaccination Programs for Adults in Europe, 2019
Vaccines 2020, 8(1), 34; https://doi.org/10.3390/vaccines8010034 - 20 Jan 2020
Cited by 2
Abstract
Background: While all European countries implement vaccination programs for children, there are gaps in terms of vaccination programs for adults. Methods: We studied the 2019 vaccination policies for adults in 42 European countries. Results: Vaccination programs for adults were in place in all [...] Read more.
Background: While all European countries implement vaccination programs for children, there are gaps in terms of vaccination programs for adults. Methods: We studied the 2019 vaccination policies for adults in 42 European countries. Results: Vaccination programs for adults were in place in all countries. However, there were considerable differences between countries in terms of number of vaccinations, target populations and frame of implementation (recommended or mandatory vaccinations). In particular the following vaccination policies were in place: influenza (42 countries), tetanus (31), diphtheria (30), pneumococcus (29), hepatitis B (20), pertussis (18), measles (14), human papilloma virus (14), meningococcus tetravalent A,C,W,Y (14), rubella (13), hepatitis A (11), mumps (11), poliomyelitis (10), herpes zoster (9), varicella (8), tick-born encephalitis (8), meningococcus B (6), rabies (6), Haemophilus influenzae type b (5), tuberculosis (3), typhoid fever (3), meningococcus C (2), and yellow fever (1). Seventeen countries implement mandatory vaccinations, mainly against diphtheria, tetanus and hepatitis B. Conclusions: There are significant differences in vaccination programs for adults in Europe. Routine vaccination programs for adults need to be strengthened. A consensus-based vaccination program is needed. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
Open AccessArticle
HPV-Specific Systemic Antibody Responses and Memory B Cells are Independently Maintained up to 6 Years and in a Vaccine-Specific Manner Following Immunization with Cervarix and Gardasil in Adolescent and Young Adult Women in Vaccination Programs in Italy
Vaccines 2020, 8(1), 26; https://doi.org/10.3390/vaccines8010026 - 14 Jan 2020
Cited by 1
Abstract
Human papillomavirus (HPV) persistent infections are associated with cervical cancer and other HPV-related diseases and tumors. Thus, the characterization of long lasting immunity to currently available HPV vaccines is important. A total of 149 female subjects vaccinated with Cervarix or Gardasil participated to [...] Read more.
Human papillomavirus (HPV) persistent infections are associated with cervical cancer and other HPV-related diseases and tumors. Thus, the characterization of long lasting immunity to currently available HPV vaccines is important. A total of 149 female subjects vaccinated with Cervarix or Gardasil participated to the study and they were stratified according to age (10–12-year-old and 16–20-year-old). Humoral immune responses (IgG and neutralizing antibody titers, antibody avidity) and circulating memory B cells were analyzed after an average of 4–6 years from the third immunization. The humoral responses against HPV-16 and HPV-18 (and HPV-6 and HPV-11 for Gardasil) were high in both age groups and vaccines up to six years from the third dose. However, Cervarix induced significantly higher and more persistent antibody responses, while the two vaccines were rather equivalent in inducing memory B cells against HPV-16 and HPV-18. Moreover, the percentage of subjects with vaccine-specific memory B cells was even superior among Gardasil vaccinees and, conversely, Cervarix vaccinated individuals with circulating antibodies, but undetectable memory B cells were found. Finally, a higher proportion of Cervarix-vaccinated subjects displayed cross-neutralizing responses against non-vaccine types HPV-31 and HPV-45. Gardasil and Cervarix may, thus, differently affect long-lasting humoral immunity from both the quantitative and qualitative point of view. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
The Unknown Health Burden of Herpes Zoster Hospitalizations: The Effect on Chronic Disease Course in Adult Patients ≥50 Years
Vaccines 2020, 8(1), 20; https://doi.org/10.3390/vaccines8010020 - 10 Jan 2020
Abstract
The effect of severe Herpes Zoster (HZ) on chronic diseases is a component of the real burden of this vaccine-preventable disease that is not commonly considered. A retrospective cohort study was conducted to assess the health burden of severe HZ in adults ≥50 [...] Read more.
The effect of severe Herpes Zoster (HZ) on chronic diseases is a component of the real burden of this vaccine-preventable disease that is not commonly considered. A retrospective cohort study was conducted to assess the health burden of severe HZ in adults ≥50 years residing in Liguria Region from 2015 to 2017. Subjects hospitalized with and without HZ were matched (1:6 ratio). 437 subjects in the HZ cohort and 2622 subjects in the non-HZ cohort were enrolled. Previous immunodeficiency, autoimmune, and rare diseases are identified as main chronic conditions related to HZ hospitalization. Higher incidences of autoimmune (1.4% vs. 0.22%, p = 0.002) and gastrointestinal (7.04% vs. 3.62%, p = 0.015) diseases after hospitalization were observed in the HZ cohort compared to the non-HZ cohort. Significantly higher incidences were found after hospitalization versus the previous period for cardiovascular diseases (11.17% vs. 2.09%, p < 0.001), cerebral vasculopathy (6.13% vs. 0.60%, p < 0.001), non-arrhythmic myocardiopathy (4.31% vs. 0.59%, p = 0.002), and neuropathy (2.62% vs. 0.56%, p = 0.033). The HZ cohort showed a relative risk 10-fold higher for cerebral vasculopathy, 5-fold higher for cardiovascular diseases, and 7-fold higher for non-arrhythmic myocardiopathy. HZ causes a substantial impact on the chronic conditions. These data could suggest an implementation of HZ vaccination programs in the elderly and in high-risk groups. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Impact of Communicative and Informative Strategies on Influenza Vaccination Adherence and Absenteeism from Work of Health Care Professionals Working at the University Hospital of Palermo, Italy: A Quasi-Experimental Field Trial on Twelve Influenza Seasons
Vaccines 2020, 8(1), 5; https://doi.org/10.3390/vaccines8010005 - 24 Dec 2019
Cited by 3
Abstract
Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of [...] Read more.
Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs’ awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p < 0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7–50.5) to 35.9 years (95% CI: 35.0–36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Open AccessArticle
Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting
Vaccines 2019, 7(4), 199; https://doi.org/10.3390/vaccines7040199 - 28 Nov 2019
Cited by 2
Abstract
Despite efforts to improve surveillance and vaccination coverage, measles virus (MeV) continues to cause outbreaks also in high-income countries. As the reference laboratory of the Veneto Region, Italy, we analyzed changes in population immunity, described measles outbreaks, investigated MeV genetic diversity, and evaluated [...] Read more.
Despite efforts to improve surveillance and vaccination coverage, measles virus (MeV) continues to cause outbreaks also in high-income countries. As the reference laboratory of the Veneto Region, Italy, we analyzed changes in population immunity, described measles outbreaks, investigated MeV genetic diversity, and evaluated cross-protection of measles vaccination against MeV epidemic strains. Like most European areas, the Veneto Region has suboptimal measles vaccination coverage and is facing a growing public mistrust of vaccination. A progressive decline of measles vaccine uptake was observed during the last decade in the Veneto Region, leading to immunity gaps in children and young adults. Measles outbreaks were caused by the same MeV genotype B3, D4, and D8 strains that were circulating in other European countries. Eleven cases of measles were observed in immunized subjects. These cases were not associated with particular MeV genotypes nor with mutations in epitopes recognized by neutralizing antibodies. Accordingly, sera from fully vaccinated subjects cross-neutralized epidemic MeV strains, including the genotypes B3, D4, and D8, with the same high efficiency demonstrated against the vaccine strain. In fully vaccinated subjects, high MeV IgG antibody titers persisted up to 30 years following vaccination. These results support the use of the current measles-containing vaccines and strategies to strengthen vaccination. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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Review

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Open AccessReview
Discrepancies Between Protocols of Immunization Targeting Internationally Adopted Children in Western Countries
Vaccines 2020, 8(1), 75; https://doi.org/10.3390/vaccines8010075 - 07 Feb 2020
Abstract
The immunization status of Internationally Adopted Children (IAC) newly arrived in the adoptive country require a timely assessment and completion of necessary vaccinations. In fact, due to their frequent suboptimal immunization status, IAC are at high risk for vaccine preventable diseases (VPDs). Comparative [...] Read more.
The immunization status of Internationally Adopted Children (IAC) newly arrived in the adoptive country require a timely assessment and completion of necessary vaccinations. In fact, due to their frequent suboptimal immunization status, IAC are at high risk for vaccine preventable diseases (VPDs). Comparative analysis of immunization protocols adopted in European countries, United States, and Canada disclosed different approaches to the immunization of these children. In order to guarantee the continuity of paediatric immunization schedules that may have been interrupted in countries of origin, a homogeneous and internationally shared standard of immunization in the management of IAC should be provided. Full article
(This article belongs to the Special Issue Vaccination and Vaccine Effectiveness)
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