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Tobin GJ, Tobin JK, Wiggins TJ, Bushnell RV, Kozar AV, Maale MF, MacLeod DA, Meeks HN, Daly MJ, Dollery SJ. A highly immunogenic UVC inactivated Sabin based polio vaccine. NPJ Vaccines 2024; 9:217. [PMID: 39543143 PMCID: PMC11564903 DOI: 10.1038/s41541-024-00995-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 10/13/2024] [Indexed: 11/17/2024] Open
Abstract
Despite their efficacy, the currently available polio vaccines, oral polio vaccine (OPV) and inactivated polio vaccine (IPV), possess inherent flaws posing significant challenges in the global eradication of polio. OPV, which uses live Sabin attenuated strains, carries the risk of reversion to pathogenic forms and causing vaccine-associated paralytic poliomyelitis (VAPP) and vaccine-derived polio disease (VDPD) in incompletely vaccinated or immune-compromised individuals. Conventional IPVs, which are non-replicative, are more expensive to manufacture and introduce biohazard and biosecurity risks due to the use of neuropathogenic strains in production. These types of limitations have led to a call by the Global Polio Eradication Initiative and others for the development of updated polio vaccines. We are developing a novel Ultraviolet-C radiation (UVC) inactivation method that preserves immunogenicity and is compatible with attenuated strains of polio. The method incorporates an antioxidant complex, manganese-decapeptide-phosphate (MDP), derived from the radioresistant bacterium Deinococcus radiodurans. The inclusion of MDP protects the immunogenic neutralizing epitopes from damage during UVC inactivation. The novel vaccine candidate, ultraIPVTM, produced using these methods demonstrates three crucial attributes: complete inactivation, which precludes the risk of vaccine-associated disease; use of non-pathogenic strains to reduce production risks; and significantly enhanced yield of doses per milligram of input virus, which could increase vaccine supply while reducing costs. Additionally, ultraIPVTM retains antigenicity post-freeze-thaw cycles, a testament to its robustness.
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Affiliation(s)
- Gregory J Tobin
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA.
| | - John K Tobin
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA
| | | | - Ruth V Bushnell
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA
| | - Arina V Kozar
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA
| | - Matthew F Maale
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA
| | - David A MacLeod
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA
| | - Heather N Meeks
- Defense Threat Reduction Agency, 8725 John J. Kingman Rd #6201,Ft, Belvoir, VA, 22060, USA
| | - Michael J Daly
- Department of Pathology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., 20814, Bethesda, MD, USA
| | - Stephen J Dollery
- Biological Mimetics Inc., 124 Byte Drive, 21702, Frederick, MD, USA.
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2
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Denegetu AW, Birru TG, Asemahaegn EW. Improvements of acute flaccid paralysis and measles surveillance performances in response to outbreak of circulating vaccine-derived poliovirus (2021-2022): the case of Southwest Ethiopia Region, Ethiopia. Pan Afr Med J 2024; 49:23. [PMID: 39720400 PMCID: PMC11667081 DOI: 10.11604/pamj.2024.49.23.37746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/07/2024] [Indexed: 12/26/2024] Open
Abstract
Introduction following the detection of vaccine-derived poliovirus in 2019 in Ethiopia, response activities have been conducted including strengthening disease surveillance activities. Methods trend analysis study design of acute flaccid paralysis and measles surveillance data for the years 2021 and 2022 for Southwest Ethiopia Region was used. The non-polio acute flaccid paralysis (AFP) rate and stool adequacy rates were used to assess the AFP surveillance. Whereas the non-measles febrile rash rate was used to assess the measles surveillance. Results a total of 68 AFP cases in 2022 and 49 in 2021 have been reported as of week 41 and investigated for polio analysis. All cases were discarded in 2022 and 1 cVDPV was detected in 2021. The stool adequacy rate for 2022 was 96%; whereas, 94% in 2021. The annualized non-polio AFP rate was 4.8/100,000 for 2022 and 3.8/100,000 for 2021, which the former is much higher though both met the minimum expected rate in outbreak areas of 3/100,000. A total of 155 suspected measles cases in 2022 and 38 in 2021 have been investigated for IGM analysis. In 2022, 9 and 1 in 2021 Igm positive for measles were identified. The non-measles febrile rash rate for 2022 was 4.6/100,000; whereas, 1.2/100,000 for 2021. Conclusion there is an improvement in the sensitivity of AFP and measles surveillance for Southwest Ethiopia Region in 2022. Sustaining high-quality measles and AFP surveillance is suggested to maintain measles and polio-free statuses.
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Affiliation(s)
- Amenu Wesen Denegetu
- World Health Organization, Expanded Programme on Immunization, Maternal Child Health and Nutrition, Addis Ababa, Ethiopia
| | - Tadesse Gossaye Birru
- World Health Organization, Expanded Programme on Immunization, Maternal Child Health and Nutrition, Islamabad, Pakistan
| | - Eshetu Wassie Asemahaegn
- World Health Organization, Expanded Programme on Immunization, Maternal Child Health and Nutrition, Addis Ababa, Ethiopia
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3
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Opmeer L, Gazzoli I, Ballmann M, Willemsen M, Voshol GP, Grudniewska-Lawton M, Havenga M, Yallop C, Hamidi A, Gillissen G, Bakker WAM. High throughput AS LNA qPCR method for the detection of a specific mutation in poliovirus vaccine strains. Vaccine 2024; 42:2475-2484. [PMID: 38503660 PMCID: PMC11007389 DOI: 10.1016/j.vaccine.2024.01.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/21/2023] [Accepted: 01/30/2024] [Indexed: 03/21/2024]
Abstract
Sabin Inactivated Poliovirus Vaccine (sIPV) has become one of the preferred vaccination options for the last step in the Poliovirus eradication program. Sequencing of poliovirus samples is needed during the manufacturing of poliovirus vaccines to assure the safety and immunogenicity of these vaccines. Next-generation sequencing analysis is the current costly and time-consuming gold standard for monitoring the manufacturing processes. We developed a low-cost and quick, highly sensitive, and allele-specific locked nucleic acid-probe-based reverse transcription quantitative PCR alternative that can accurately detect mutations in poliovirus vaccine samples during process development, scaling up, and release. Using the frequently in vitro occurring and viral replication-impacting VP1-E295K mutation as a showcase, we show that this technology can accurately detect E295K mutations in poliovirus 2 samples to similar levels as NGS. The qPCR technology was developed employing a synthetic dsDNA fragment-based standard curve containing mixes of E295K-WT (wildtype) and Mut (mutant) synthetic dsDNA fragments ranging from 1 × 107 copies/µL to 1 × 102 copies/µL to achieve a linear correlation with R2 > 0.999, and PCR efficiencies of 95-105 %. Individual standard concentration levels achieved accuracies of ≥92 % (average 96 %) and precisions of ≤17 % (average 3.3 %) RSD. Specificity of locked nucleic acid (LNA)-probes was confirmed in the presence and absence of co-mutations in the probe-binding region. Application of the developed assay to Sabin Poliovirus type 2 production run samples, illustrated a linear relationship with an R2 of 0.994, and an average accuracy of 97.2 % of the variant (allele)-specific AS LNA qPCR result, compared to NGS. The assay showed good sensitivity for poliovirus samples, containing E295K mutation levels between 0 % and 95 % (quantification range). In conclusion, the developed AS LNA qPCR presents a valuable low-cost, and fast tool, suitable for the process development and quality control of polio vaccines.
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Affiliation(s)
- Lizet Opmeer
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Isabella Gazzoli
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Mónika Ballmann
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Marieke Willemsen
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Gerben P Voshol
- GenomeScan B.V., Plesmanlaan 1d, 2333 BZ Leiden, The Netherlands
| | | | - Menzo Havenga
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Christopher Yallop
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Ahd Hamidi
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Gert Gillissen
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands
| | - Wilfried A M Bakker
- Batavia Biosciences B.V., Bioscience Park Leiden, Zernikedreef 16, 2333CL Leiden, The Netherlands.
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Hussain I, Umer M, Khan A, Sajid M, Ahmed I, Begum K, Iqbal J, Alam MM, Safdar RM, Baig S, Voorman A, Partridge J, Soofi S. Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children. Front Public Health 2024; 12:1384410. [PMID: 38601488 PMCID: PMC11004230 DOI: 10.3389/fpubh.2024.1384410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction After trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6-11 months. Methods Three cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size. Results Seroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; <30% in Pishin, >80% in Killa Abdullah, Mardan & Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas. Conclusion The study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.
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Affiliation(s)
- Imtiaz Hussain
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Umer
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ahmad Khan
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Sajid
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Imran Ahmed
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Kehkashan Begum
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Junaid Iqbal
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Rana M. Safdar
- Polio National Emergency Operations Center, Islamabad, Pakistan
| | - Shahzad Baig
- Polio National Emergency Operations Center, Islamabad, Pakistan
| | - Arie Voorman
- Bill and Melinda Gates Foundation, Seattle, WA, United States
| | | | - Sajid Soofi
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Elbert B, Zainumi CM, Pujiastuti RAD, Yaznil MR, Yanni GN, Alona I, Lubis IND. Mothers' knowledge, attitude, and behavior regarding child immunization, and the association with child immunization status in Medan City during the COVID-19 pandemic. IJID REGIONS 2023:S2772-7076(23)00040-1. [PMID: 37363195 PMCID: PMC10157388 DOI: 10.1016/j.ijregi.2023.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic has caused disruption to healthcare access worldwide and has impacted basic childhood immunization services. A decline in immunization coverage can cause immunity gaps and lead to outbreaks of vaccine-preventable diseases. Our study evaluated the association between mothers' knowledge, attitude, and behavior regarding immunization and child immunization status during the COVID-19 pandemic in Medan, Indonesia. Methods An analytical cross-sectional study was conducted from April to November 2021. Mothers with children aged 0-12 months were interviewed about their knowledge, attitude, and behavior regarding immunization, and their child's immunization status. Results Of 196 participants, 46.5% had low knowledge on immunization, 41.3% had a negative attitude, and 20.4% had negative behavior. Only 62.8% of participants had children with a complete vaccination status, and mothers with moderate knowledge (OR 2.65, 95% CI 1.08-6.61), negative attitude (OR 5.33, 95% CI 2.71-10.59), and negative behavior (OR 7.88, 95% CI 3.36-19.47) were more likely to not vaccinate their children. Conclusion Mothers' attitude, behavior, and educational background were associated with child immunization status. Recovery efforts to improve immunization coverage are urgently needed, and should include efforts to reduce mothers' hesitancy regarding child vaccination during the pandemic.
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Affiliation(s)
- Bryant Elbert
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Cut Meliza Zainumi
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Muhammad Rizki Yaznil
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Gema Nazri Yanni
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Ivana Alona
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Inke Nadia D Lubis
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Menzies School of Health Research, Darwin, Australia
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6
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Morais A, Morais J, Felix M, Neto Z, Madaleno V, Umar AS, Panda N, Lemma F, Chivale JAL, Cavalcante DG, Davlantes E, Ghiselli M, Espinosa C, Whiteman A, Iber J, Henderson E, Bullard K, Jorba J, Burns CC, Diop O, Gumede N, Seakamela L, Howard W, Frawley A. Genetic and epidemiological description of an outbreak of circulating vaccine-derived polio-virus type 2 (cVDPV2) in Angola, 2019-2020. Vaccine 2023; 41 Suppl 1:A48-A57. [PMID: 36803869 PMCID: PMC10823914 DOI: 10.1016/j.vaccine.2023.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023]
Abstract
After six years without any detection of poliomyelitis cases, Angola reported a case of circulating vaccine-derived poliovirus type 2 (cVDPV2) with paralysis onset date of 27 March 2019. Ultimately, 141 cVDPV2 polio cases were reported in all 18 provinces in 2019-2020, with particularly large hotspots in the south-central provinces of Luanda, Cuanza Sul, and Huambo. Most cases were reported from August to December 2019, with a peak of 15 cases in October 2019. These cases were classified into five distinct genetic emergences (emergence groups) and have ties with cases identified in 2017-2018 in the Democratic Republic of Congo. From June 2019 to July 2020, the Angola Ministry of Health and partners conducted 30 supplementary immunization activity (SIA) rounds as part of 10 campaign groups, using monovalent OPV type 2 (mOPV2). There were Sabin 2 vaccine strain detections in the environmental (sewage) samples taken after mOPV2 SIAs in each province. Following the initial response, additional cVDPV2 polio cases occurred in other provinces. However, the national surveillance system did not detect any new cVDPV2 polio cases after 9 February 2020. While reporting subpar indicator performance in epidemiological surveillance, the laboratory and environmental data as of May 2021 strongly suggest that Angola successfully interrupted transmission of cVDPV2 early in 2020. Additionally, the COVID-19 pandemic did not allow a formal Outbreak Response Assessment (OBRA). Improving the sensitivity of the surveillance system and the completeness of AFP case investigations will be vital to promptly detect and interrupt viral transmission if a new case or sewage isolate are identified in Angola or central Africa.
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Affiliation(s)
- Alda Morais
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | - Joana Morais
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | - Miguel Felix
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | - Zoraima Neto
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | | | - Abubakar Sadiq Umar
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Nirakar Panda
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Fekadu Lemma
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - José Alexandre Lifande Chivale
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Danielle Graça Cavalcante
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Elizabeth Davlantes
- Global Immunization Division, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA.
| | - Margherita Ghiselli
- Global Immunization Division, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Catherine Espinosa
- Global Immunization Division, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Ari Whiteman
- Geospatial Research, Analysis, and Services Program, US Agency for Toxic Substances and Disease Registry. 4770, Buford Hwy Northeast, Atlanta, GA, USA
| | - Jane Iber
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Elizabeth Henderson
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Kelley Bullard
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Jaume Jorba
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Cara C Burns
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Ousmane Diop
- Polio Eradication Department, World Health Organization, Avenue Appia, 20, 1211, Geneva 27, Switzerland
| | - Nicksy Gumede
- World Health Organization Regional Office for Africa. Cité du Djoué, P.O. Box 06, Brazzaville, Republic of Congo
| | - Lerato Seakamela
- National Institute for Communicable Diseases, 1, Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
| | - Wayne Howard
- National Institute for Communicable Diseases, 1, Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
| | - Alean Frawley
- US Centers for Disease Control and Prevention, Angola Country Office, R. Houari Boumediene 32, Luanda, Angola
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Erdem R, De Coster I, Withanage K, Mercer LD, Marchant A, Taton M, Cools N, Lion E, Cassels F, Higgins D, Ivinson K, Locke E, Mahmood K, Wright PF, Gast C, White JA, Ackerman ME, Konopka-Anstadt JL, Mainou BA, Van Damme P. Safety, tolerability, and immunogenicity of inactivated poliovirus vaccine with or without E.coli double mutant heat-labile toxin (dmLT) adjuvant in healthy adults; a phase 1 randomized study. Vaccine 2023; 41:1657-1667. [PMID: 36746739 PMCID: PMC9996288 DOI: 10.1016/j.vaccine.2023.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/01/2023] [Accepted: 01/21/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Inactivated trivalent poliovirus vaccine (IPV) induces humoral immunity, which protects against paralytic poliomyelitis but does not induce sufficient mucosal immunity to block intestinal infection. We assessed the intestinal immunity in healthy adults in Belgium conferred by a co-formulation of IPV with the mucosal adjuvant double mutant Labile Toxin (dmLT) derived from Escherichia coli. METHODS Healthy fully IPV-vaccinated 18-45-year-olds were randomly allocated to three groups: on Day 1 two groups received one full dose of IPV (n = 30) or IPV + dmLT (n = 30) in a blinded manner, and the third received an open-label dose of bivalent live oral polio vaccine (bOPV types 1 and 3, n = 20). All groups received a challenge dose of bOPV on Day 29. Participants reported solicited and unsolicited adverse events (AE) using study diaries. Mucosal immune responses were measured by fecal neutralization and IgA on Days 29 and 43, with fecal shedding of challenge viruses measured for 28 days. Humoral responses were measured by serum neutralizing antibody (NAb). RESULTS Solicited and unsolicited AEs were mainly mild-to-moderate and transient in all groups, with no meaningful differences in rates between groups. Fecal shedding of challenge viruses in both IPV groups exceeded that of the bOPV group but was not different between IPV and IPV + dmLT groups. High serum NAb responses were observed in both IPV groups, alongside modest levels of fecal neutralization and IgA. CONCLUSIONS Addition of dmLT to IPV administered intramuscularly neither affected humoral nor intestinal immunity nor decreased fecal virus shedding following bOPV challenge. The tolerability of the dose of dmLT used in this study may allow higher doses to be investigated for impact on mucosal immunity. Registered on ClinicalTrials.gov - NCT04232943.
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Affiliation(s)
- Rahsan Erdem
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Ilse De Coster
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Edegem, Belgium.
| | - Kanchanamala Withanage
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Edegem, Belgium
| | - Laina D Mercer
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Arnaud Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, Brussels, Belgium
| | - Martin Taton
- Institute for Medical Immunology, Université libre de Bruxelles, Brussels, Belgium
| | - Nathalie Cools
- Vaccine & Infectious Disease Institute, Laboratory of Experimental Hematology, University of Antwerp, Wilrijk, Belgium
| | - Eva Lion
- Vaccine & Infectious Disease Institute, Laboratory of Experimental Hematology, University of Antwerp, Wilrijk, Belgium
| | - Fred Cassels
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Deborah Higgins
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Karen Ivinson
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Emily Locke
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Kutub Mahmood
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | | | - Chris Gast
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | - Jessica A White
- PATH, Center for Vaccine Innovation and Access, Seattle, WA, USA
| | | | | | - Bernardo A Mainou
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Van Damme
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination, University of Antwerp, Edegem, Belgium
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8
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Ong-Lim AL, Shukarev G, Trinidad-Aseron M, Caparas-Yu D, Greijer A, Duchene M, Scheper G, van Paassen V, Le Gars M, Cahill CP, Schuitemaker H, Douoguih M, Jacquet JM. Safety and immunogenicity of 3 formulations of a Sabin inactivated poliovirus vaccine produced on the PER.C6® cell line: A phase 2, double-blind, randomized, controlled study in infants vaccinated at 6, 10 and 14 weeks of age. Hum Vaccin Immunother 2022; 18:2044255. [PMID: 35344464 PMCID: PMC9196784 DOI: 10.1080/21645515.2022.2044255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An inactivated poliovirus vaccine candidate using Sabin strains (sIPV) grown on the PER.C6® cell line was assessed in infants after demonstrated immunogenicity and safety in adults. The study recruited 300 infants who were randomized (1:1:1:1) to receive one of 3 dose levels of sIPV or a conventional IPV based on Salk strains (cIPV). Poliovirus-neutralizing antibodies were measured before the first dose and 28 days after the third dose. Reactogenicity was assessed for 7 days and unsolicited adverse events (AEs) for 28 days after each vaccination. Serious AEs (SAEs) were recorded throughout the study. Solicited AEs were mostly mild to moderate. None of the SAEs reported in the study were judged vaccine related, including one fatal SAE due to aspiration of vomitus that occurred 26 days after the third dose of low-dose sIPV. After 3 sIPV vaccinations and across all dose levels, seroconversion (SC) rates were at least 92% against Sabin poliovirus types and at least 80% against Salk types, with a dose-response in neutralizing antibody geometric mean titers (GMTs) observed across the 3 sIPV groups. Compared to cIPV, the 3 sIPV groups displayed similar or higher SC rates and GMTs against the 3 Sabin types but showed a lower response against Salk types 1 and 2; this was most visible for Salk type 1. While the PER.C6® cell line-based sIPV showed an acceptable safety profile and immunogenicity in infants, lower seroprotection against type 1 warrants optimization of dose level and additional clinical evaluation.
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Affiliation(s)
- Anna Lisa Ong-Lim
- Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | | | | | - Delia Caparas-Yu
- De La Salle Medical and Health Sciences Institute, Cavite, Philippines
| | - Astrid Greijer
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Michel Duchene
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Gert Scheper
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | | | - Conor P Cahill
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
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Quarleri J. Poliomyelitis is a current challenge: long-term sequelae and circulating vaccine-derived poliovirus. GeroScience 2022; 45:707-717. [PMID: 36260265 PMCID: PMC9886775 DOI: 10.1007/s11357-022-00672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/12/2022] [Indexed: 02/03/2023] Open
Abstract
For more than 20 years, the World Health Organization Western Pacific Region (WPR) has been polio-free. However, two current challenges are still polio-related. First, around half of poliomyelitis elderly survivors suffer late poliomyelitis sequelae with a substantial impact on daily activities and quality of life, experiencing varying degrees of residual weakness as they age. The post-polio syndrome as well as accelerated aging may be involved. Second, after the worldwide Sabin oral poliovirus (OPV) vaccination, the recent reappearance of strains of vaccine-derived poliovirus (VDPV) circulating in the environment is worrisome and able to persistent person-to-person transmission. Such VDPV strains exhibit atypical genetic characteristics and reversed neurovirulence that can cause paralysis similarly to wild poliovirus, posing a significant obstacle to the elimination of polio. Immunization is essential for preventing paralysis in those who are exposed to the poliovirus. Stress the necessity of maintaining high vaccination rates because declining immunity increases the likelihood of reemergence. If mankind wants to eradicate polio in the near future, measures to raise immunization rates and living conditions in poorer nations are needed, along with strict observation. New oral polio vaccine candidates offer a promissory tool for this goal.
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Affiliation(s)
- Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina. .,Consejo de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
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10
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Miteva D, Peshevska-Sekulovska M, Snegarova V, Batselova H, Alexandrova R, Velikova T. Mucosal COVID-19 vaccines: Risks, benefits and control of the pandemic. World J Virol 2022; 11:221-236. [PMID: 36188733 PMCID: PMC9523321 DOI: 10.5501/wjv.v11.i5.221] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/14/2022] [Accepted: 08/10/2022] [Indexed: 02/05/2023] Open
Abstract
Based on mucosal immunization to promote both mucosal and systemic immune responses, next-generation coronavirus disease 2019 (COVID-19) vaccines would be administered intranasally or orally. The goal of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines is to provide adequate immune protection and avoid severe disease and death. Mucosal vaccine candidates for COVID-19 including vector vaccines, recombinant subunit vaccines and live attenuated vaccines are under development. Furthermore, subunit protein vac-cines and virus-vectored vaccines have made substantial progress in preclinical and clinical settings, resulting in SARS-CoV-2 intranasal vaccines based on the previously successfully used nasal vaccines. Additional to their ability to trigger stable, protective immune responses at the sites of pathogenic infection, the development of 'specific' mucosal vaccines targeting coronavirus antigens could be an excellent option for preventing future pandemics. However, their efficacy and safety should be confirmed.
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Affiliation(s)
- Dimitrina Miteva
- Department of Genetics, Sofia University “St. Kliment Ohridski,” Faculty of Biology, Sofia 1164, Bulgaria
| | - Monika Peshevska-Sekulovska
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
| | - Violeta Snegarova
- Clinic of Internal Diseases, Naval Hospital - Varna, Military Medical Academy, Medical Faculty, Medical University, Varna 9000, Bulgaria
| | - Hristiana Batselova
- Department of Epidemiology and Disaster Medicine, Medical University, Plovdiv, University Hospital “St George”, Plovdiv 6000, Bulgaria
| | - Radostina Alexandrova
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia 1000, Bulgaria
| | - Tsvetelina Velikova
- Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
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11
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Rachlin A, Patel JC, Burns CC, Jorba J, Tallis G, O’Leary A, Wassilak SG, Vertefeuille JF. Progress Toward Polio Eradication — Worldwide, January 2020–April 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:650-655. [PMID: 35552352 PMCID: PMC9098249 DOI: 10.15585/mmwr.mm7119a2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Lockhart A, Mucida D, Parsa R. Immunity to enteric viruses. Immunity 2022; 55:800-818. [PMID: 35545029 PMCID: PMC9257994 DOI: 10.1016/j.immuni.2022.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022]
Abstract
Pathogenic enteric viruses are a major cause of morbidity and mortality, particularly among children in developing countries. The host response to enteric viruses occurs primarily within the mucosa, where the intestinal immune system must balance protection against pathogens with tissue protection and tolerance to harmless commensal bacteria and food. Here, we summarize current knowledge in natural immunity to enteric viruses, highlighting specialized features of the intestinal immune system. We further discuss how knowledge of intestinal anti-viral mechanisms can be translated into vaccine development with particular focus on immunization in the oral route. Research reveals that the intestine is a complex interface between enteric viruses and the host where environmental factors influence susceptibility and immunity to infection, while viral infections can have lasting implications for host health. A deeper mechanistic understanding of enteric anti-viral immunity with this broader context can ultimately lead to better vaccines for existing and emerging viruses.
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Affiliation(s)
- Ainsley Lockhart
- Laboratory of Mucosal Immunology, The Rockefeller University, New York, NY 10065, USA
| | - Daniel Mucida
- Laboratory of Mucosal Immunology, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, The Rockefeller University, New York, NY, USA.
| | - Roham Parsa
- Laboratory of Mucosal Immunology, The Rockefeller University, New York, NY 10065, USA.
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13
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Wiesen E, Dankoli R, Musa M, Higgins J, Forbi J, Idris J, Waziri N, Ogunbodede O, Mohammed K, Bolu O, WaNganda G, Adamu U, Pinsker E. Conducting public health surveillance in areas of armed conflict and restricted population access: a qualitative case study of polio surveillance in conflict-affected areas of Borno State, Nigeria. Confl Health 2022; 16:20. [PMID: 35526017 PMCID: PMC9077905 DOI: 10.1186/s13031-022-00452-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/14/2022] [Indexed: 01/13/2023] Open
Abstract
This study examined the impact of armed conflict on public health surveillance systems, the limitations of traditional surveillance in this context, and innovative strategies to overcome these limitations. A qualitative case study was conducted to examine the factors affecting the functioning of poliovirus surveillance in conflict-affected areas of Borno state, Nigeria using semi-structured interviews of a purposeful sample of participants. The main inhibitors of surveillance were inaccessibility, the destroyed health infrastructure, and the destroyed communication network. These three challenges created a situation in which the traditional polio surveillance system could not function. Three strategies to overcome these challenges were viewed by respondents as the most impactful. First, local community informants were recruited to conduct surveillance for acute flaccid paralysis in children in the inaccessible areas. Second, the informants engaged in local-level negotiation with the insurgency groups to bring children with paralysis to accessible areas for investigation and sample collection. Third, GIS technology was used to track the places reached for surveillance and vaccination and to estimate the size and location of the inaccessible population. A modified monitoring system tracked tailored indicators including the number of places reached for surveillance and the number of acute flaccid paralysis cases detected and investigated, and utilized GIS technology to map the reach of the program. The surveillance strategies used in Borno were successful in increasing surveillance sensitivity in an area of protracted conflict and inaccessibility. This approach and some of the specific strategies may be useful in other areas of armed conflict.
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Affiliation(s)
- Eric Wiesen
- grid.416738.f0000 0001 2163 0069US Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Melton Musa
- National Stop Transmission of Polio, Abuja, Nigeria
| | - Jeff Higgins
- grid.416738.f0000 0001 2163 0069US Centers for Disease Control and Prevention, Atlanta, USA
| | - Joseph Forbi
- grid.416738.f0000 0001 2163 0069US Centers for Disease Control and Prevention, Atlanta, USA
| | - Jibrin Idris
- National Stop Transmission of Polio, Abuja, Nigeria
| | | | | | - Kabiru Mohammed
- grid.463521.70000 0004 6003 6865National Primary Health Care Development Agency, Abuja, Nigeria
| | - Omotayo Bolu
- grid.416738.f0000 0001 2163 0069US Centers for Disease Control and Prevention, Atlanta, USA
| | - Gatei WaNganda
- grid.416738.f0000 0001 2163 0069US Centers for Disease Control and Prevention, Atlanta, USA
| | - Usman Adamu
- grid.463521.70000 0004 6003 6865National Primary Health Care Development Agency, Abuja, Nigeria
| | - Eve Pinsker
- grid.185648.60000 0001 2175 0319University of Illinois at Chicago, Chicago, USA
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14
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SteelFisher GK, Caporello H, McIntosh R, Muhammad Safdar R, Desomer L, Chimenya D, Abdelwahab J, Ratna J, Rutter P, O'Reilly D, Gilani BI, Williams MR, Ben-Porath EN, Blendon RJ. Preventing erosion of oral polio vaccine acceptance: A role for vaccinator visits and social norms. Vaccine 2022; 40:3752-3760. [PMID: 35599038 PMCID: PMC9119726 DOI: 10.1016/j.vaccine.2022.04.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 03/02/2022] [Accepted: 04/29/2022] [Indexed: 10/28/2022]
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15
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Evaluating stability of attenuated Sabin and two novel type 2 oral poliovirus vaccines in children. NPJ Vaccines 2022; 7:19. [PMID: 35149714 PMCID: PMC8837630 DOI: 10.1038/s41541-022-00437-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
Novel oral poliovirus vaccine type 2 (nOPV2) is being developed to reduce the rare occurrence of disease and outbreaks associated with the genetic instability of the Sabin vaccine strains. Children aged 1 to 5 years were enrolled in two related clinical studies to assess safety, immunogenicity, shedding rates and properties of the shed virus following vaccination with nOPV2 (two candidates) versus traditional Sabin OPV type 2 (mOPV2). The anticipated pattern of reversion and increased virulence was observed for shed Sabin-2 virus, as assessed using a mouse model of poliovirus neurovirulence. In contrast, there were significantly reduced odds of mouse paralysis for shed virus for both nOPV2 candidates when compared to shed Sabin-2 virus. Next-generation sequencing of shed viral genomes was consistent with and further supportive of the observed neurovirulence associated with shed Sabin-2 virus, as well as the reduced reversion to virulence of shed candidate viruses. While shed Sabin-2 showed anticipated A481G reversion in the primary attenuation site in domain V in the 5’ untranslated region to be associated with increased mouse paralysis, the stabilized domain V in the candidate viruses did not show polymorphisms consistent with reversion to neurovirulence. The available data from a key target age group for outbreak response confirm the superior genetic and phenotypic stability of shed nOPV2 strains compared to shed Sabin-2 and suggest that nOPV2 should be associated with less paralytic disease and potentially a lower risk of seeding new outbreaks.
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16
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Westdijk J, Kogelman A, van der Put R, Eksteen Z, Suarez D, Kersten GFA, Metz B, Danial M. Immunochemical and Biophysical Characterization of Inactivated Sabin Poliovirus Products: Insights into Rapid Quality Assessment Tools. J Pharm Sci 2022; 111:1058-1069. [PMID: 35114211 DOI: 10.1016/j.xphs.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
The aim of this study was to demonstrate the strength of combining immunochemical and biophysical analysis tools for assessing the quality of Sabin inactivated poliovirus vaccine (Sabin-IPV) bulk products. We assessed Sabin-IPV serotypes 1, 2 and 3 from six different manufacturers and evaluated their comparability through biosensor analysis and biophysical characterization methods, including tryptophan fluorescence and asymmetrical flow field-flow fractionation - multi-angle light scattering analysis. These methods enabled us to assess antigenic as well as conformational and structural integrity profiles, respectively. Based on Sabin-IPV samples that were subjected to accelerated storage conditions, we revealed that existing immunochemical methods exhibit remarkably similar trends to the results obtained by the biophysical characterization methods. While the results underpin that the comparability of Sabin-IPV bulk products of different manufacturers is poor, information about their quality can rapidly be obtained by using both immunochemical and biophysical methods. Furthermore, the study highlights that quality assessment of Sabin-IPV can be obtained through biophysical techniques can complement the assessments performed with monoclonal antibodies and suggests that similar techniques could be employed to characterize other enteroviruses.
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Affiliation(s)
- Janny Westdijk
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands.
| | - Amy Kogelman
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Robert van der Put
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Zaskia Eksteen
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Diego Suarez
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Gideon F A Kersten
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands; Leiden Academic Centre for Drug Research, Einsteinweg 55, 2333 CC Leiden, The Netherlands
| | - Bernard Metz
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands
| | - Maarten Danial
- Intravacc BV, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands.
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17
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Sadigh KS, Akbar IE, Wadood MZ, Shukla H, Jorba J, Chaudhury S, Martinez M. Progress Toward Poliomyelitis Eradication - Afghanistan, January 2020-November 2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:85-89. [PMID: 35051135 PMCID: PMC8774155 DOI: 10.15585/mmwr.mm7103a3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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van Zyl GU. New Technological Developments in Identification and Monitoring of New and Emerging Infections. ENCYCLOPEDIA OF INFECTION AND IMMUNITY 2022. [PMCID: PMC8291697 DOI: 10.1016/b978-0-12-818731-9.00094-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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19
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Fontana S, Buttinelli G, Fiore S, Amato C, Pataracchia M, Kota M, Aćimović J, Blažević M, Mulaomerović M, Nikolaeva-Glomb L, Mentis A, Voulgari-Kokota A, Gashi L, Kaçaniku-Gunga P, Barbara C, Melillo J, Protic J, Filipović-Vignjevic S, O’Connor PM, D’Alberto A, Orioli R, Siddu A, Saxentoff E, Stefanelli P. Retrospective Analysis of Six Years of Acute Flaccid Paralysis Surveillance and Polio Vaccine Coverage Reported by Italy, Serbia, Bosnia and Herzegovina, Montenegro, Bulgaria, Kosovo, Albania, North Macedonia, Malta, and Greece. Vaccines (Basel) 2021; 10:44. [PMID: 35062705 PMCID: PMC8779529 DOI: 10.3390/vaccines10010044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Here we analyzed six years of acute flaccid paralysis (AFP) surveillance, from 2015 to 2020, of 10 countries linked to the WHO Regional Reference Laboratory, at the Istituto Superiore di Sanità, Italy. The analysis also comprises the polio vaccine coverage available (2015-2019) and enterovirus (EV) identification and typing data. Centralized Information System for Infectious Diseases and Laboratory Data Management System databases were used to obtain data on AFP indicators and laboratory performance and countries' vaccine coverage from 2015 to 2019. EV isolation, identification, and typing were performed by each country according to WHO protocols. Overall, a general AFP underreporting was observed. Non-Polio Enterovirus (NPEV) typing showed a high heterogeneity: over the years, several genotypes of coxsackievirus and echovirus have been identified. The polio vaccine coverage, for the data available, differs among countries. This evaluation allows for the collection, for the first time, of data from the countries of the Balkan area regarding AFP surveillance and polio vaccine coverage. The need, for some countries, to enhance the surveillance systems and to promote the polio vaccine uptake, in order to maintain the polio-free status, is evident.
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Affiliation(s)
- Stefano Fontana
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Gabriele Buttinelli
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Stefano Fiore
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Concetta Amato
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Marco Pataracchia
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Majlinda Kota
- Laboratory of Virology, Department of Control of Infectious Diseases, Institute of Public Health, 1001 Tirana, Albania;
| | - Jela Aćimović
- Department of Epidemiology, Public Health Institute of the Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Mia Blažević
- Institute for Public Health of Federation Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina; (M.B.); (M.M.)
| | - Mirsada Mulaomerović
- Institute for Public Health of Federation Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina; (M.B.); (M.M.)
| | - Lubomira Nikolaeva-Glomb
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria;
| | - Andreas Mentis
- National Poliovirus/Enterovirus Reference Laboratory, Diagnostic Department, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.M.); (A.V.-K.)
| | - Androniki Voulgari-Kokota
- National Poliovirus/Enterovirus Reference Laboratory, Diagnostic Department, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.M.); (A.V.-K.)
| | - Luljeta Gashi
- Department of Epidemiology, National Institute of Public Health, 10000 Pristina, Kosovo; (L.G.); (P.K.-G.)
| | - Pranvera Kaçaniku-Gunga
- Department of Epidemiology, National Institute of Public Health, 10000 Pristina, Kosovo; (L.G.); (P.K.-G.)
| | | | - Jackie Melillo
- Department for Health Regulation, Health Promotion and Disease Prevention, MSD2090 Msida, Malta;
| | - Jelena Protic
- National Reference Laboratory for ARBO Viruses and Hemorrhagic Fever, Institute of Virology, Vaccines and Sera “Torlak”, 11152 Belgrade, Serbia;
| | - Svetlana Filipović-Vignjevic
- Diagnostics and Research and Development, Institute of Virology, Vaccines and Sera “Torlak”, 11152 Belgrade, Serbia;
| | - Patrick M. O’Connor
- Global Immunization Division US Centers for Disease Control and Prevention, Atlanta, GA 30333, USA;
| | - Alessandra D’Alberto
- Prevention of Communicable Diseases and International Prophylaxis, Directorate General of Health Prevention, Ministry of Health, 00144 Rome, Italy; (A.D.); (R.O.); (A.S.)
| | - Riccardo Orioli
- Prevention of Communicable Diseases and International Prophylaxis, Directorate General of Health Prevention, Ministry of Health, 00144 Rome, Italy; (A.D.); (R.O.); (A.S.)
| | - Andrea Siddu
- Prevention of Communicable Diseases and International Prophylaxis, Directorate General of Health Prevention, Ministry of Health, 00144 Rome, Italy; (A.D.); (R.O.); (A.S.)
| | - Eugene Saxentoff
- Division of Health Emergencies and Communicable Diseases (DEC), Regional Office for Europe World Health Organization, DK-2100 Copenhagen, Denmark;
| | - Paola Stefanelli
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
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Weissenböck H, Ebinger A, Gager AM, Thaller D, Höper D, Lichtmannsperger K, Weissenbacher-Lang C, Matt J, Beer M. A novel enterovirus in lambs with poliomyelitis and brain stem encephalitis. Transbound Emerg Dis 2021; 69:227-234. [PMID: 34874614 PMCID: PMC9305294 DOI: 10.1111/tbed.14412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022]
Abstract
An Austrian organic dairy sheep farm experienced cases of recumbency and sudden deaths in 3- to 4-week-old lambs. Two animals were subjected to thorough clinical and pathological investigations. Pathohistological analysis identified severe nonsuppurative myelitis and mild nonsuppurative encephalitis. A reverse-transcription quantitative PCR (RT-qPCR) assay for the recently discovered ovine picornavirus causing comparable lesions scored negative. By next-generation sequencing-based metagenomics, a nearly complete genome of a novel enterovirus could be detected and assembled. In situ hybridization using a specifically designed probe revealed robust signals in affected motoneurons of the spinal cord suggesting a causative role of the novel virus.
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Affiliation(s)
| | - Arnt Ebinger
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Diagnostic Virology, Greifswald, Germany
| | - Anna Maria Gager
- Institute of Pathology, Department of Pathobiology, Vienna, Austria
| | - Denise Thaller
- Institute of Pathology, Department of Pathobiology, Vienna, Austria
| | - Dirk Höper
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Diagnostic Virology, Greifswald, Germany
| | | | | | - Julia Matt
- Institute of Pathology, Department of Pathobiology, Vienna, Austria
| | - Martin Beer
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Diagnostic Virology, Greifswald, Germany
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21
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Rahim S, Ahmad Z, Abdul-Ghafar J. The polio vaccination story of Pakistan. Vaccine 2021; 40:397-402. [DOI: 10.1016/j.vaccine.2021.11.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/12/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
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22
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Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2020-21) and Update on Immunization for Children Aged 0 Through 18 Years. Indian Pediatr 2021. [PMID: 33257602 PMCID: PMC7840391 DOI: 10.1007/s13312-021-2096-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Justification In view of new developments in vaccinology and the availability of new vaccines, there is a need to revise/review the existing immunization recommendations. Process Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) had a physical meeting in March, 2020 followed by online meetings (September-October, 2020), to discuss the updates and new recommendations. Opinion of each member was sought on the various recommendations and updates, following which an evidence-based consensus was reached. Objectives To review and revise the IAP recommendations for 2020–21 and issue recommendations on existing and new vaccines. Recommendations The major changes include recommendation of a booster dose of injectable polio vaccine (IPV) at 4–6 years for children who have received the initial IPV doses as per the ACVIP/IAP schedule, re-emphasis on the importance of IPV in the primary immunization schedule, preferred timing of second dose of varicella vaccine at 3–6 months after the first dose, and uniform dosing recommendation of 0.5 mL (15 µg HA) for inactivated influenza vaccines.
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23
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Vassallo A, Dunbar K, Ajuwon B, Lowbridge C, Kirk M, King C, Sheel M. Assessing the impact of polio supplementary immunisation activities on routine immunisation and health systems: a systematic review. BMJ Glob Health 2021; 6:bmjgh-2021-006568. [PMID: 34776411 PMCID: PMC8593720 DOI: 10.1136/bmjgh-2021-006568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction The Global Polio Eradication Initiative uses polio supplementary immunisation activities (SIAs) as a strategy to increase vaccine coverage and cease poliovirus transmission. Impact of polio SIAs on immunisation systems is frequently debated. We reviewed the impact of polio SIAs on routine immunisation and health systems during the modern era of polio eradication. Methods We searched nine databases for studies reporting on polio SIAs and immunisation coverage, financial investment, workforce and health services delivery. We conducted a narrative synthesis of evidence. Records prior to 1994, animal, modelling or case studies data were excluded. Results 20/1637 unique records were included. Data on vaccine coverage were included in 70% (14/20) studies, workforce in 65% (13/20) and health services delivery in 85% (17/20). SIAs positively contributed to vaccination uptake of non-polio vaccines in seven studies, neutral in three and negative in one. Some polio SIAs contributed to workforce strengthening through training and capacity building. Polio SIAs were accompanied with increased social mobilisation and community awareness building confidence in vaccination programmes. Included studies were programmatic in nature and contained variable data, thus could not be justly critically appraised. Conclusion Polio SIAs are successful at increasing polio vaccine coverage, but the resources and infrastructures were not always utilised for delivery of non-polio vaccines and integration into routine service delivery. We found a gap in standardised tools to evaluate SIAs, which can then inform service integration. Our study provides data to inform SIAs evaluations, and provides important considerations for COVID-19 vaccine roll-out to strengthen health systems. PROSPERO registration number CRD42020152195.
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Affiliation(s)
- Amy Vassallo
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kimberly Dunbar
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Busayo Ajuwon
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Christopher Lowbridge
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Martyn Kirk
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Catherine King
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
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Xiao T, Leng H, Zhang Q, Chen Q, Guo H, Qi Y. Isolation and characterization of a Sabin 3/Sabin 1 recombinant vaccine-derived poliovirus from a child with severe combined immunodeficiency. Virus Res 2021; 308:198633. [PMID: 34793871 DOI: 10.1016/j.virusres.2021.198633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
An 8-month-old child diagnosed with severe combined immunodeficiency (SCID) was found to be excreting vaccine-derived poliovirus (VDPVs). Five stool samples from the child and stool samples from 24 contacts were collected during the following 7 months. Complete genome sequence by next generation sequencing (NGS) identified 0.7 to 1.4% nucleotide substitutions in the capsid P1 region of the first and the last isolates compared with Sabin 3 strain. Simplot analysis revealed that all isolates were Sabin 3/Sabin 1 recombinants, sharing a single recombination breakpoint in the 2C region. Multiple nucleotide variants were identified in the 5'UTR (T472→C and G395→A); amino acid mutations were identified in residues at VP1-6 (Thr to Ile), VP1-105 (Met to Thr), VP1-286 (Arg to Lys), VP2-155 (Lys to Glu), VP3-59 (Ser to Asn) and VP3-91 (Phe to Ser). These variants were commonly observed in other PV strains, which may contribute to attenuation and temperature sensitivity. None of the 24 tested contacts of the patient and related transmits was found to be infected with poliovirus. Our study provides a rapid and reliable method for the characterization of VDPV research in Poliovirus infection. In post-OPV era, immunodeficient people with persistent and chronic infection remain a major challenge for polio eradication in China.
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Affiliation(s)
- Tianhe Xiao
- Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; Department of Bioengineering, University of California, San Diego, CA 92093, USA
| | - Hongying Leng
- Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Qian Zhang
- College of pharmacy, Nankai University, Tianjin 300353, China
| | - Qiang Chen
- Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Hongxiong Guo
- Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Yuhua Qi
- Key Laboratory of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
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25
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Debnath N, Thakur M, Khushboo, Negi NP, Gautam V, Kumar Yadav A, Kumar D. Insight of oral vaccines as an alternative approach to health and disease management: An innovative intuition and challenges. Biotechnol Bioeng 2021; 119:327-346. [PMID: 34755343 DOI: 10.1002/bit.27987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 12/11/2022]
Abstract
Vaccination is the most suitable and persuasive healthcare program for the prohibition of various deadly diseases. However, the higher production cost and purification strategies are out of reach for the developing nations. In this scenario, development of edible vaccine turns out to be the most promising alternative for remodeling the pharmaceutical industry with reduced production and purification costs. Generally, oral route of vaccination is mostly preferred due to its safety, compliance, low manufacturing cost and most importantly the ability to induce immunity in both systemic and mucosal sites. Genetically modified microorganisms and plants could efficiently be used as vehicles for edible vaccines. Edible vaccines are supposed to reduce the risk associated with traditional vaccines. Currently, oral vaccines are available in the market for several viral and bacterial diseases like cholera, hepatitis B, malaria, rabies etc. Herein, the review focuses on the breakthrough events in the area of edible vaccines associated with dietary microbes and plants for better control over diseases.
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Affiliation(s)
- Nabendu Debnath
- Centre for Molecular Biology, Central University of Jammu, Samba, Jammu & Kashmir (UT), India
| | - Mony Thakur
- Department of Microbiology, Central University of Haryana, Mahendergarh, Haryana, India
| | - Khushboo
- Department of Biotechnology, Central University of Haryana, Mahendergarh, Haryana, India
| | - Neelam P Negi
- Department of Biotechnology, University Institute of Biotechnology, Chandigarh University, Mohali, Punjab, India
| | - Vibhav Gautam
- Centre of Experimental Medicine & Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashok Kumar Yadav
- Centre for Molecular Biology, Central University of Jammu, Samba, Jammu & Kashmir (UT), India
| | - Deepak Kumar
- Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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26
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Sharma M, Singh SK, Sharma L, Dwiwedi MK, Agarwal D, Gupta GK, Dhiman R. Magnitude and causes of routine immunization disruptions during COVID-19 pandemic in developing countries. J Family Med Prim Care 2021; 10:3991-3997. [PMID: 35136757 PMCID: PMC8797101 DOI: 10.4103/jfmpc.jfmpc_1102_21] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022] Open
Abstract
The ongoing pandemic of COVID-19 is a threat to various routine healthcare services. India's routine immunization (RI) campaign is one of largest ever known. In this review, we discuss the magnitude of disruption of RI activities due to COVID-19 pandemic, various causes of it and recommend ways to reduce the disruptions. Prominent literature databases were searched till April 30, 2021 for articles reporting disruptions of RI due to COVID-19. One study from India and numerous from outside India reported significant declines in the vaccine coverage rates during the lockdown period, which ranged from March 2020 till August 2020 in different regions of the world. Some reported disruptions for all vaccines, while a few reported sparing of birth doses. Shortage of healthcare workers due for them being diverted to patient care services and their reduced movement due to lockdowns and non-availability of public transport were prominent causes. Parents avoided RI sessions as they feared them or their children getting infected. They also faced travel restrictions, just like the healthcare workers. Children of school entry age and those from poorer socio-demographic profile appeared to miss the doses more frequently. Ministry of Health and Family Welfare, India has issued guidelines for conducting fixed and outreach RI sessions while following COVID-appropriate behavior. Promptly identifying missed out children and scheduling catch-up sessions is required to sustain the gains made over the decades by the immunization program of India.
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Affiliation(s)
- Mohit Sharma
- Department of Community Medicine, Punjab Institute of Medical Sciences, Jalandhar City, Punjab, India
| | - Snehil K. Singh
- Santosh World Medical University, Ghaziabad, Uttar Pradesh, India
| | - Lokesh Sharma
- School of Business Management, Jaipur National University, Jaipur, Rajasthan, India
- Address for correspondence: Dr. Lokesh Sharma, Flat No. 318, Sector E, Pocket 2, Vasant Kunj, New Delhi - 110070, India. E-mail: ,
| | - Manish K. Dwiwedi
- School of Business Management, Jaipur National University, Jaipur, Rajasthan, India
| | - Deepika Agarwal
- Community Medicine Department, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Gajendra K. Gupta
- Community Medicine Department, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Ranjit Dhiman
- Immunization Specialist, UNICEF Country Office, Afghanistan
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27
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Burkholder B, Wadood Z, Kassem AM, Ehrhardt D, Zomahoun D. The immediate impact of the COVID-19 pandemic on polio immunization and surveillance activities. Vaccine 2021; 41 Suppl 1:A2-A11. [PMID: 34756614 PMCID: PMC8531002 DOI: 10.1016/j.vaccine.2021.10.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/23/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022]
Abstract
In addition to affecting individual health the COVID-19 pandemic has disrupted efforts to deliver essential health services around the world. In this article we present an overview of the immediate programmatic and epidemiologic impact of the pandemic on polio eradication as well as the adaptive strategic and operational measures taken by the Global Polio Eradication Initiative (GPEI) from March through September 2020. Shortly after the World Health Organization (WHO) declared a global pandemic on 11 March 2020, the GPEI initially redirected the programme’s assets to tackle COVID-19 and suspended house-to-house supplementary immunization activities (SIAs) while also striving to continue essential poliovirus surveillance functions. From March to May 2020, 28 countries suspended a total of 62 polio vaccine SIAs. In spite of efforts to continue poliovirus surveillance, global acute flaccid paralysis (AFP) cases reported from January-July 2020 declined by 34% compared with the same period in 2019 along with decreases in the mean number of environment samples collected per active site in the critical areas of the African and Eastern Mediterranean regions. The GPEI recommended countries should resume planning and implementation of SIAs starting in July 2020 and released guidelines to ensure these could be done safely for front line workers and communities. By the end of September 2020, a total of 14 countries had implemented circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak response vaccination campaigns and Afghanistan and Pakistan restarted SIAs to stop ongoing wild poliovirus type 1 (WPV1) transmission. The longer-term impacts of disruptions to eradication efforts remain to be determined, especially in terms of the effect on poliovirus epidemiology. Adapting to the pandemic situation has imposed new considerations on program implementation and demonstrated not only GPEI’s contribution to global health security, but also identified potential opportunities for coordinated approaches across immunization and health services.
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Affiliation(s)
- Brent Burkholder
- Global Public Health Consultant, 834 Miller Drive, Davis, CA 95616, United States.
| | - Zubair Wadood
- WHO Polio Eradication Division, Avenue Appia 20, 1211 Geneva, Switzerland.
| | - Ahmed M Kassem
- Global Immunization Division, US Centers for Disease Control and Prevention, 1600 Clifton Road, NE Atlanta, GA 30333, United States.
| | - Derek Ehrhardt
- Global Immunization Division, US Centers for Disease Control and Prevention, 1600 Clifton Road, NE Atlanta, GA 30333, United States.
| | - Delayo Zomahoun
- WHO Polio Eradication Division, Avenue Appia 20, 1211 Geneva, Switzerland.
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28
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Thakur KT, Epstein S, Bilski A, Balbi A, Boehme AK, Brannagan TH, Wesley SF, Riley CS. Neurologic Safety Monitoring of COVID-19 Vaccines: Lessons From the Past to Inform the Present. Neurology 2021; 97:767-775. [PMID: 34475124 DOI: 10.1212/wnl.0000000000012703] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022] Open
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a global effort to rapidly develop and deploy effective and safe coronavirus disease 2019 (COVID-19) vaccinations. Vaccination has been one of the most effective medical interventions in human history, although potential safety risks of novel vaccines must be monitored, identified, and quantified. Adverse events must be carefully assessed to define whether they are causally associated with vaccination or coincidence. Neurologic adverse events following immunizations are overall rare but with significant morbidity and mortality when they occur. Here, we review neurologic conditions seen in the context of prior vaccinations and the current data to date on select COVID-19 vaccines including mRNA vaccines and the adenovirus-vector COVID-19 vaccines, ChAdOx1 nCOV-19 (AstraZeneca) and Ad26.COV2.S Johnson & Johnson (Janssen/J&J).
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Affiliation(s)
- Kiran Teresa Thakur
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York.
| | - Samantha Epstein
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Amanda Bilski
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Alanna Balbi
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Amelia K Boehme
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Thomas H Brannagan
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Sarah Flanagan Wesley
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Claire S Riley
- From the Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
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29
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Mbaeyi C, Baig S, Khan Z, Young H, Kader M, Jorba J, Safdar MR, Jafari H, Franka R. Progress Toward Poliomyelitis Eradication - Pakistan, January 2020-July 2021. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1359-1364. [PMID: 34591827 PMCID: PMC8486386 DOI: 10.15585/mmwr.mm7039a1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
When the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) transmission was occurring in 125 countries; currently, only WPV type 1 (WPV1) transmission continues, and as of August 2021, WPV1 transmission persists in only two countries (1,2). This report describes Pakistan's progress toward polio eradication during January 2020-July 2021 and updates previous reports (3,4). In 2020, Pakistan reported 84 WPV1 cases, a 43% reduction from 2019; as of August 25, 2021, Pakistan has reported one WPV1 case in 2021. Circulating vaccine-derived poliovirus (cVDPV) emerges as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations and can lead to paralysis. In 2019, 22 cases of cVDPV type 2 (cVDPV2) were reported in Pakistan, 135 cases were reported in 2020, and eight cases have been reported as of August 25, 2021. Because of the COVID-19 pandemic, planned supplementary immunization activities (SIAs)* were suspended during mid-March-June 2020 (3,5). Seven SIAs were implemented during July 2020-July 2021 without substantial decreases in SIA quality. Improving the quality of polio SIAs, vaccinating immigrants from Afghanistan, and implementing changes to enhance program accountability and performance would help the Pakistan polio program achieve its goal of interrupting WPV1 transmission by the end of 2022.
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30
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Wastewater-Based Epidemiology and Long-Read Sequencing to Identify Enterovirus Circulation in Three Municipalities in Maricopa County, Arizona, Southwest United States between June and October 2020. Viruses 2021; 13:v13091803. [PMID: 34578384 PMCID: PMC8472758 DOI: 10.3390/v13091803] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
We used wastewater-based epidemiology and amplicon-based long-read high-throughput sequencing for surveillance of enteroviruses (EVs) in Maricopa County, Arizona, Southwest United States. We collected 48 samples from 13 sites in three municipalities between 18 June and 1 October 2020, and filtered (175 mL each; 0.45 µm pore size) and extracted RNA from the filter-trapped solids. The RNA was converted to cDNA and processed through two workflows (Sanger sequencing (SSW) and long-read Illumina sequencing (LRISW)) each including a nested polymerase chain reaction (nPCR) assay. We subjected the ~350 bp amplicon from SSW to Sanger sequencing and the ~1900-2400 bp amplicon from LRISW to Illumina sequencing. We identified EV contigs from 11 of the 13 sites and 41.67% (20/48) of screened samples. Using the LRISW, we detected nine EV genotypes from three species (Enterovirus A (CVA4, EV-A76, EV-A90), Enterovirus B (E14) and Enterovirus C (CVA1, CVA11, CVA13, CVA19 and CVA24)) with Enterovirus C representing approximately 90% of the variants. However, the SSW only detected the five Enterovirus C types. Similarity and phylogenetic analysis showed that multiple Enterovirus C lineages were circulating, co-infecting and recombining in the population during the season despite the SARS-CoV-2 pandemic and the non-pharmaceutical public health measures taken to curb transmission.
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31
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Bigouette JP, Wilkinson AL, Tallis G, Burns CC, Wassilak SGF, Vertefeuille JF. Progress Toward Polio Eradication - Worldwide, January 2019-June 2021. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1129-1135. [PMID: 34437527 PMCID: PMC8389387 DOI: 10.15585/mmwr.mm7034a1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ogbole OO, Akinleye TE, Nkumah AO, Awogun AO, Attah AF, Adewumi MO, Adeniji AJ. In vitro antiviral activity of peptide-rich extracts from seven Nigerian plants against three non-polio enterovirus species C serotypes. Virol J 2021; 18:161. [PMID: 34348755 PMCID: PMC8335448 DOI: 10.1186/s12985-021-01628-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/22/2021] [Indexed: 04/20/2025] Open
Abstract
Background As frequent viral outbreaks continue to pose threat to public health, the unavailability of antiviral drugs and challenges associated with vaccine development underscore the need for antiviral drugs discovery in emergent moments (endemic or pandemic). Plants in response to microbial and pest attacks are able to produce defence molecules such as antimicrobial peptides as components of their innate immunity, which can be explored for viral therapeutics. Methods In this study, partially purified peptide-rich fraction (P-PPf) were obtained from aqueous extracts of seven plants by reverse-phase solid-phase extraction and cysteine-rich peptides detected by a modified TLC method. The peptide-enriched fractions and the aqueous (crude polar) were screened for antiviral effect against three non-polio enterovirus species C members using cytopathic effect reduction assay. Results In this study, peptide fraction obtained from Euphorbia hirta leaf showed most potent antiviral effect against Coxsackievirus A13, Coxsackievirus A20, and Enterovirus C99 (EV-C99) with IC50 < 2.0 µg/mL and selective index ≥ 81. EV-C99 was susceptible to all partially purified peptide fractions except Allamanda blanchetii leaf. Conclusion These findings establish the antiviral potentials of plants antimicrobial peptides and provides evidence for the anti-infective use of E. hirta in ethnomedicine. This study provides basis for further scientific investigation geared towards the isolation, characterization and mechanistic pharmacological study of the detected cysteine-rich peptides.
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Affiliation(s)
- Omonike O Ogbole
- Department of Pharmacognosy, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria.
| | - Toluwanimi E Akinleye
- Department of Pharmacognosy, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Abraham O Nkumah
- Department of Pharmacognosy, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aminat O Awogun
- Department of Pharmacognosy, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Alfred F Attah
- Department of Pharmacognosy and Drug Development, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - Moses O Adewumi
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Adekunle J Adeniji
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.,WHO Polio National Laboratory, Department of Virology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Fischer TK, Simmonds P, Harvala H. The importance of enterovirus surveillance in a post-polio world. THE LANCET. INFECTIOUS DISEASES 2021; 22:e35-e40. [PMID: 34265258 DOI: 10.1016/s1473-3099(20)30852-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/08/2020] [Accepted: 10/21/2020] [Indexed: 12/22/2022]
Abstract
Poliovirus is known to most people in the world as the cause of polio, a devastating paralytic disease from the past. Success in polio eradication has understandably translated into stricter containment plans for poliovirus, coordinated by WHO. In this Personal View, we discuss the impact of recent biosafety level 3+ guidelines for handling potential poliovirus-containing diagnostic specimens, which has resulted in closure of many national WHO poliovirus reference laboratories. This reduction in laboratory capacity has a knock-on effect of capability to detect and characterise non-polio enteroviruses in samples obtained from patients with neurological symptoms. The development is of concern given the widespread circulation of non-polio enteroviruses, their role as the most common cause of meningitis worldwide, and their involvement in other severe neurological conditions, such as acute flaccid myelitis and encephalitis. These disease presentations have increased substantially in the past decade, and have been associated with major outbreaks of enterovirus D68 and enterovirus A71, leaving many who survived with lasting paralysis and disabilities. To address this growing gap in diagnostic and surveillance capability, we have established the European Non-Poliovirus Enterovirus Network (also known as ENPEN) as a supra-national, non-commercial, core reference consortium. Our consortium will develop, test, and implement generic surveillance platforms for non-polio enteroviruses and other emerging viral diseases.
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Affiliation(s)
- Thea K Fischer
- Department of Clinical Research, Nordsjaellands University Hospital, Hilleroed, Denmark; Department of Public Health and Department of International Health, University of Copenhagen, Copenhagen, Denmark.
| | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Heli Harvala
- National Microbiology Services, NHS Blood and Transplant, London, UK; Infection and Immunity, University College of London, London, UK
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34
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Jalloh MF, Hickler B, Parmley LE, Sutton R, Kulkarni S, Mansaray A, Eleeza O, Patel P, Wilhelm E, Conklin L, Akinjeji A, Toure M, Wolff B, Prybylski D, Wallace AS, Lahuerta M. Using immunisation caregiver journey interviews to understand and optimise vaccination uptake: lessons from Sierra Leone. BMJ Glob Health 2021; 6:bmjgh-2021-005525. [PMID: 34045184 PMCID: PMC8162096 DOI: 10.1136/bmjgh-2021-005525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
Quantitative and qualitative assessments have revealed diverse factors that influence the uptake of childhood immunisation services and shed light on reasons for vaccination delays and refusals. UNICEF and partner organisations developed the Immunisation Caregiver Journey Framework as a novel way to understand caregiver experiences in accessing and receiving immunisation services for children. This framework aims to help immunisation programmes identify vaccination barriers and opportunities to improve vaccination uptake by enhancing the overall caregiver journey in a systems-focused manner, using human-centred design principles. In this paper, we adapt the framework into a flexible qualitative inquiry approach with theoretical guidance from interpretative phenomenology. We draw from the implementation experiences in Sierra Leone to inform methodological guidance on how to design and implement the Immunisation Caregiver Journey Interviews (ICJI) to understand the lived experiences of caregivers as they navigate immunisation services for their children. Practical guidance is provided on sampling techniques, conducting interviews, data management, data analysis and the use of data to inform programmatic actions. When properly implemented, the ICJI approach generates a rich qualitative understanding of how caregivers navigate household and community dynamics, as well as primary healthcare delivery systems. We argue that understanding and improving the caregiver journey will enhance essential immunisation outcomes, such as the completion of the recommended vaccination schedule, timeliness of vaccination visits and reduction in dropouts between vaccine doses.
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Affiliation(s)
- Mohamed F Jalloh
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Lauren E Parmley
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Roberta Sutton
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Shibani Kulkarni
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Anthony Mansaray
- Sierra Leone Country Office, ICAP at Columbia University, Freetown, Sierra Leone
| | - Oliver Eleeza
- Sierra Leone Country Office, ICAP at Columbia University, Freetown, Sierra Leone
| | - Palak Patel
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Elisabeth Wilhelm
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laura Conklin
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adewale Akinjeji
- Sierra Leone Country Office, ICAP at Columbia University, Freetown, Sierra Leone
| | - Mame Toure
- Sierra Leone Country Office, ICAP at Columbia University, Freetown, Sierra Leone
| | - Brent Wolff
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Dimitri Prybylski
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aaron S Wallace
- Immunization Systems Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria Lahuerta
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, USA.,Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
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Development of a Quantitative One-Step RT-PCR Method for the Detection of Sabin 2 Virus Contamination in a Novel Oral Poliovirus Vaccine Type 2. Vaccines (Basel) 2021; 9:vaccines9070688. [PMID: 34201447 PMCID: PMC8310199 DOI: 10.3390/vaccines9070688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022] Open
Abstract
To control circulating vaccine-derived type 2 poliovirus outbreaks, a more genetically stable novel Oral Poliovirus Vaccine type 2 (nOPV2) was developed by targeted modifications of Sabin 2 genome. Since the use of OPV2 made of Sabin 2 strain has been stopped, it is important to exclude the possibility that batches of nOPV2 are contaminated with Sabin 2 virus. Here, we report the development of a simple quantitative one-step reverse-transcription polymerase chain reaction assay for the detection and quantitation of Sabin 2 virus in the presence of overwhelming amounts of nOPV2 strain. The method is specific and linear within 8 log10 range even in the presence of relevant amounts of nOPV2 virus. It is sensitive, with a lower limit of detection of 0.2 CCID50/mL (an equivalent of 198 genome copies per mL), and generates reproducible results. This assay can be used for quality control and lot release of the nOPV2.
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Berner M, Pany-Kucera D, Doneus N, Sladek V, Gamble M, Eggers S. Challenging definitions and diagnostic approaches for ancient rare diseases: The case of poliomyelitis. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 33:113-127. [PMID: 33894575 DOI: 10.1016/j.ijpp.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/22/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This paper aims to contribute to the definition of ancient rare diseases in skeletons displaying pathologies associated with paralysis. It uses a new suite of methods, which can be applied to challenging cases of possible paralysis in archaeologically-derived human skeletal material, specifically applied to the identification of poliomyelitis. MATERIALS An adult male skeleton from Roman Halbturn, Austria. METHODS Morphological and entheseal change analyses, CT scans, X-rays, cross-section morphology, and histology, alongside modern clinical, as well as historic, literature were used to discuss paralyses. RESULTS The results suggest a diagnosis of poliomyelitis; now considered a rare disease, but perhaps ubiquitous in antiquity, thus complicating the definition of 'rare disease'. CONCLUSIONS The integrated methodological procedures employed for this case constitutes a replicable and thorough approach to diagnosis, and explores the nature of ancient rare diseases. Due to the socio-environmental aspects of poliomyelitis transmission, it is likely that polio was likely not rare in the past. Therefore, the definition of 'rare diseases in the past' must include rarely occurring rarely diagnosed diseases due to biases and challenges within the archaeological and environmental record. SIGNIFICANCE The developed suite of methods has not been applied to establish a diagnosis of polio in the past. LIMITATIONS The individual considered in this study is fairly well-preserved; thus, this set of analyses may not be applicable to all remains where preservation is poor or highly fragmentary, and the discussion of rare diseases requires relatively secure diagnoses and context. SUGGESTIONS FOR FURTHER RESEARCH Large collections and series of skeletal human remains are recommended to develop definitive conclusions.
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Affiliation(s)
- Margit Berner
- Department of Anthropology, Natural History Museum Vienna, Austria.
| | | | | | - Vladimír Sladek
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University in Prague, Czech Republic
| | - Michelle Gamble
- Heritage and Archaeological Research Practice, Edinburgh, Scotland, United Kingdom
| | - Sabine Eggers
- Department of Anthropology, Natural History Museum Vienna, Austria
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Mbaeyi C, Moran T, Wadood Z, Ather F, Sykes E, Nikulin J, Al Safadi M, Stehling-Ariza T, Zomahoun L, Ismaili A, Abourshaid N, Asghar H, Korukluoglu G, Duizer E, Ehrhardt D, Burns CC, Sharaf M. Stopping a polio outbreak in the midst of war: Lessons from Syria. Vaccine 2021; 39:3717-3723. [PMID: 34053791 DOI: 10.1016/j.vaccine.2021.05.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/05/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Outbreaks of circulating vaccine-derived polioviruses (cVDPVs) pose a threat to the eventual eradication of all polioviruses. In 2017, an outbreak of cVDPV type 2 (cVDPV2) occurred in the midst of a war in Syria. We describe vaccination-based risk factors for and the successful response to the outbreak. METHODS We performed a descriptive analysis of cVDPV2 cases and key indicators of poliovirus surveillance and vaccination activities during 2016-2018. In the absence of reliable subnational coverage data, we used the caregiver-reported vaccination status of children with non-polio acute flaccid paralysis (AFP) as a proxy for vaccination coverage. We then estimated the relative odds of being unvaccinated against polio, comparing children in areas affected by the outbreak to children in other parts of Syria in order to establish the presence of poliovirus immunity gaps in outbreak affected areas. FINDINGS A total of 74 cVDPV2 cases were reported, with paralysis onset ranging from 3 March to 21 September 2017. All but three cases were reported from Deir-ez-Zor governorate and 84% had received < 3 doses of oral poliovirus vaccine (OPV). After adjusting for age and sex, non-polio AFP case-patients aged 6-59 months in outbreak-affected areas had 2.5 (95% CI: 1.1-5.7) increased odds of being unvaccinated with OPV compared with non-polio AFP case-patients in the same age group in other parts of Syria. Three outbreak response rounds of monovalent OPV type 2 (mOPV2) vaccination were conducted, with governorate-level coverage mostly exceeding 80%. INTERPRETATION Significant declines in both national and subnational polio vaccination coverage, precipitated by war and a humanitarian crisis, led to a cVDPV2 outbreak in Syria that was successfully contained following three rounds of mOPV2 vaccination.
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Affiliation(s)
- Chukwuma Mbaeyi
- United States Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA.
| | - Thomas Moran
- World Health Organization Headquarters, Avenue Appia 20, 1202 Geneva, Switzerland
| | - Zubair Wadood
- World Health Organization Headquarters, Avenue Appia 20, 1202 Geneva, Switzerland
| | - Fazal Ather
- Middle East and North Africa Office, United Nations Children's Fund, Abdulqader Al-Abed Street, Building No. 15, Tla'a Al-Ali, Amman, Jordan
| | - Emma Sykes
- World Health Organization, Regional Office for the Eastern Mediterranean, Mohammad Jamjoum Street, Ministry of Interior Circle Building No. 5, P.O. Box 811547, Amman 11181, Jordan
| | - Joanna Nikulin
- World Health Organization, Regional Office for the Eastern Mediterranean, Mohammad Jamjoum Street, Ministry of Interior Circle Building No. 5, P.O. Box 811547, Amman 11181, Jordan
| | - Mohammad Al Safadi
- World Health Organization Headquarters, Avenue Appia 20, 1202 Geneva, Switzerland
| | - Tasha Stehling-Ariza
- United States Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA
| | - Laurel Zomahoun
- World Health Organization Headquarters, Avenue Appia 20, 1202 Geneva, Switzerland
| | - Abdelkarim Ismaili
- World Health Organization, Regional Office for the Eastern Mediterranean, Mohammad Jamjoum Street, Ministry of Interior Circle Building No. 5, P.O. Box 811547, Amman 11181, Jordan
| | - Nidal Abourshaid
- Syria Country Office, United Nations Children's Fund, East Mazzeh, Al Shafiee St., Damascus, Syria
| | - Humayun Asghar
- World Health Organization, Regional Office for the Eastern Mediterranean, Mohammad Jamjoum Street, Ministry of Interior Circle Building No. 5, P.O. Box 811547, Amman 11181, Jordan
| | - Gulay Korukluoglu
- Public Health Institutions of Turkey, Adnan Saygun Cad. No. 55, F Blok 06100 Sihhiye, Ankara, Turkey
| | - Erwin Duizer
- National Polio Laboratory, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Derek Ehrhardt
- United States Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA
| | - Cara C Burns
- United States Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Atlanta, GA 30329, USA
| | - Magdi Sharaf
- World Health Organization, Regional Office for the Eastern Mediterranean, Mohammad Jamjoum Street, Ministry of Interior Circle Building No. 5, P.O. Box 811547, Amman 11181, Jordan
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BinHussain H, Elzwai E, Fox S, Langhi S. Total hip replacement in patient with residual poliomyelitis with neglected femoral neck fracture. BMJ Case Rep 2021; 14:14/5/e240221. [PMID: 34020986 DOI: 10.1136/bcr-2020-240221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 71-year-old man with residual poliomyelitis was referred to the orthopaedic surgeons with a neglected left femoral neck fracture of the paralytic limb. He had presented at another hospital with left groin pain and inability to weight bear 4 weeks earlier after a fall from standing height, but had delayed treatment due to his insistence on waiting until he returned to his home country.Successful treatment of residual poliomyelitis fractures requires early union as well as early mobilisation and rehabilitation. This patient presented to the orthopaedic surgeons with a challenging case due to the delay in treatment and the fact that the fracture was basicervical which results in an unstable fracture. Surgical expertise was required to decide on the optimum surgical option and a total hip arthroplasty was performed. The patient made a good recovery following physiotherapy as evidenced clinically and radiologically.
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Affiliation(s)
| | - Eman Elzwai
- Department of Surgery, Benghazi Medical Center, Benghazi, Benghazi, Libya
| | - Sarah Fox
- Alumna Homerton College, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Salem Langhi
- Orthopaedic, Benghazi Medical Center, Benghazi, Libya
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Abstract
Scoliosis has a very high prevalence among patients with neuromuscular disease involving the thoracic spine and truncal muscles. Physical examination and radiographs are used to screen for presence of scoliosis and monitor progression. Management includes therapy participation, optimizing equipment and orthotic use, and possible surgical intervention. Unlike idiopathic adolescent scoliosis, curves tend to progress despite orthotic use compliance. Associated pelvic obliquity creates risk for pressure sores and pain. As such, education of caregivers is a key point of optimizing management.
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Affiliation(s)
- Brian D Wishart
- Pediatric Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Mass General Hospital for Children, 2nd Floor, 300 1st Avenue, Boston, MA 02129, USA
| | - Emily Kivlehan
- Pediatric Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Mass General Brigham, 2nd Floor, 300 1st Avenue, Boston, MA 02129, USA.
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40
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Tuma JN, Wilkinson AL, Diop OM, Jorba J, Gardner T, Snider CJ, Anand A, Ahmed J. Surveillance to Track Progress Toward Polio Eradication - Worldwide, 2019-2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:667-673. [PMID: 33956779 PMCID: PMC9368747 DOI: 10.15585/mmwr.mm7018a2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Albanese CV, Reddy S. The Current State: Epidemiology and Working Toward Eradication. Phys Med Rehabil Clin N Am 2021; 32:467-476. [PMID: 34175007 DOI: 10.1016/j.pmr.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Acute polio, once epidemic and a significant source of paralysis and disability, has been dramatically reduced through global vaccination programs. Although vaccination efforts have experienced a setback because of COVID-19, resulting in increased number of vaccine-associated and wild virus infections, polio eradication is still a realistic goal that will result in significant cost savings. The secondary health issues related to aging with the residual effects of polio, including postpolio syndrome, will persist for many years posteradication. Continued education of medical professionals is essential to ensure provision of the necessary care to this population.
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Affiliation(s)
- Carol Vandenakker Albanese
- Department of Physical Medicine and Rehabilitation, UC Davis School of Medicine, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA.
| | - Shailesh Reddy
- Department of Physical Medicine and Rehabilitation, UC Davis Health, 4860 Y Street, Suite 3850, Sacramento, CA 95817, USA
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Majumdar M, Klapsa D, Wilton T, Bujaki E, Fernandez-Garcia MD, Faleye TOC, Oyero AO, Adewumi MO, Ndiaye K, Adeniji JA, Martin J. High Diversity of Human Non-Polio Enterovirus Serotypes Identified in Contaminated Water in Nigeria. Viruses 2021; 13:v13020249. [PMID: 33562806 PMCID: PMC7914538 DOI: 10.3390/v13020249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 01/06/2023] Open
Abstract
Human enteroviruses (EVs) are highly prevalent in sewage and have been associated with human diseases with complications leading to severe neurological syndromes. We have used a recently developed molecular method to investigate the presence of EVs in eight samples collected in 2017–2018 from water streams contaminated by drainage channels in three different locations in Nigeria. A total of 93 human EV strains belonging to 45 different serotypes were identified, far exceeding the number of strains and serotypes found in similar samples in previous studies. Next generation sequencing analysis retrieved whole-capsid genomic nucleotide sequences of EV strains belonging to all four A, B, C, and D species. Our results further demonstrate the value of environmental surveillance for the detection of EV transmission of both serotypes commonly associated with clinical syndromes, such as EV-A71, and those that appear to circulate silently but could eventually cause outbreaks and disease. Several uncommon serotypes, rarely reported elsewhere, were detected such as EV-A119, EV-B87, EV-C116, and EV-D111. Ten EV serotypes were detected in Nigeria for the first time and two of them, CV-A12 and EV-B86, firstly described in Africa. This method can be expanded to generate whole-genome EV sequences as we show here for one EV-D111 strain. Our data revealed phylogenetic relationships of Nigerian sewage strains with EV strains reported elsewhere, mostly from African origin, and provided new insights into the whole-genome structure of emerging serotype EV-D111 and recombination events among EV-D serotypes.
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Affiliation(s)
- Manasi Majumdar
- Division of Virology, National Institute for Biological Standards and Control (NIBSC), Potters Bar EN6 3QG, Hertfordshire, UK; (M.M.); (D.K.); (T.W.); (E.B.)
| | - Dimitra Klapsa
- Division of Virology, National Institute for Biological Standards and Control (NIBSC), Potters Bar EN6 3QG, Hertfordshire, UK; (M.M.); (D.K.); (T.W.); (E.B.)
| | - Thomas Wilton
- Division of Virology, National Institute for Biological Standards and Control (NIBSC), Potters Bar EN6 3QG, Hertfordshire, UK; (M.M.); (D.K.); (T.W.); (E.B.)
| | - Erika Bujaki
- Division of Virology, National Institute for Biological Standards and Control (NIBSC), Potters Bar EN6 3QG, Hertfordshire, UK; (M.M.); (D.K.); (T.W.); (E.B.)
| | | | - Temitope Oluwasegun Cephas Faleye
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; (T.O.C.F.); (M.O.A.); (J.A.A.)
| | | | - Moses Olubusuyi Adewumi
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; (T.O.C.F.); (M.O.A.); (J.A.A.)
| | - Kader Ndiaye
- Department of Virology, Institute Pasteur, Dakar, Senegal; (M.D.F.-G.); (K.N.)
| | - Johnson Adekunle Adeniji
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; (T.O.C.F.); (M.O.A.); (J.A.A.)
- World Health Organization National Polio Laboratory, Ibadan, Oyo State, Nigeria;
| | - Javier Martin
- Division of Virology, National Institute for Biological Standards and Control (NIBSC), Potters Bar EN6 3QG, Hertfordshire, UK; (M.M.); (D.K.); (T.W.); (E.B.)
- Correspondence:
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Wilder-Smith A. COVID-19 in comparison with other emerging viral diseases: risk of geographic spread via travel. Trop Dis Travel Med Vaccines 2021; 7:3. [PMID: 33517914 PMCID: PMC7847598 DOI: 10.1186/s40794-020-00129-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic poses a major global health threat. The rapid spread was facilitated by air travel although rigorous travel bans and lockdowns were able to slow down the spread. How does COVID-19 compare with other emerging viral diseases of the past two decades? RECENT FINDINGS Viral outbreaks differ in many ways, such as the individuals most at risk e.g. pregnant women for Zika and the elderly for COVID-19, their vectors of transmission, their fatality rate, and their transmissibility often measured as basic reproduction number. The risk of geographic spread via air travel differs significantly between emerging infectious diseases. COVID-19 is not associated with the highest case fatality rate compared with other emerging viral diseases such as SARS and Ebola, but the combination of a high reproduction number, superspreading events and a globally immunologically naïve population has led to the highest global number of deaths in the past 20 decade compared to any other pandemic.
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Affiliation(s)
- A Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
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44
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The Impact of the COVID-19 Pandemic on Immunization Campaigns and Programs: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030988. [PMID: 33499422 PMCID: PMC7908591 DOI: 10.3390/ijerph18030988] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
The COVID-19 pandemic has had an impact on health service delivery, including immunization programs, and this review assesses the impact on vaccine coverage across the globe and identifies the potential underlying factors. A systematic search strategy was employed on PubMed, Embase, MedRxiv, BioRxiv, and WHO COVID-19 databases from December 2019 till 15 September 2020. Two review authors independently assessed studies for inclusion, assessed quality, and extracted the data (PROSPERO registration #CRD42020182363). A total of 17 observational studies were included. The findings suggest that there was a reduction in the vaccination coverage and decline in total number of vaccines administered, which led to children missing out on their vaccine doses. An approximately fourfold increase was also observed in polio cases in polio endemic countries. Factors contributing to low vaccine coverage included fear of being exposed to the virus at health care facilities, restriction on city-wide movements, shortage of workers, and diversion of resources from child health to address the pandemic. As the world re-strategizes for the post-2020 era, we should not let a crisis go to waste as they provide an opportunity to establish guidelines and allocate resources for future instances. High-quality supplementary immunization activities and catch-up programs need to be established to address gaps during the pandemic era.
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Abstract
Troubled by an unstable world beset by new and emerging viruses? Virus evolution is here to help. Through detailed studies of poliovirus vaccine reversion to virulence, Valesano and colleagues remind us that some things in life can, indeed, be counted on.
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Kasi SG, Shivananda S, Marathe S, Chatterjee K, Agarwalla S, Dhir SK, Verma S, Shah AK, Srirampur S, Kalyani S, Pemde HK, Balasubramanian S, Parekh BJ, Basavaraja GV, Gupta P. Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2020-21) and Update on Immunization for Children Aged 0 Through 18 Years. Indian Pediatr 2021; 58:44-53. [PMID: 33257602 PMCID: PMC7840391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
JUSTIFICATION In view of new developments in vaccinology and the availability of new vaccines, there is a need to revise/review the existing immunization recommendations. PROCESS Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) had a physical meeting in March, 2020 followed by online meetings (September-October, 2020), to discuss the updates and new recommendations. Opinion of each member was sought on the various recommendations and updates, following which an evidence-based consensus was reached. OBJECTIVES To review and revise the IAP recommendations for 2020-21 and issue recommendations on existing and new vaccines. RECOMMENDATIONS The major changes include recommendation of a booster dose of injectable polio vaccine (IPV) at 4-6 years for children who have received the initial IPV doses as per the ACVIP/IAP schedule, re-emphasis on the importance of IPV in the primary immunization schedule, preferred timing of second dose of varicella vaccine at 3-6 months after the first dose, and uniform dosing recommendation of 0.5 mL (15 µg HA) for inactivated influenza vaccines.
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Affiliation(s)
- Srinivas G Kasi
- Kasi Clinic, Jayanagar, Bengaluru, Karnataka, India. Correspondence to: Srinivas G Kasi, Convener, ACVIP, Kasi Clinic, 2nd Cross, 3rd Block, Jayanagar, Bengaluru 560011, Karnataka, India.
| | - S Shivananda
- Fortis Hospital, Banneraghatta Road, Bengaluru, Karnataka, India
| | | | - Kripasindhu Chatterjee
- Department of Pediatrics, Gouri Devi Institute of Medical Science and Hospital, Durgapur, Paschim Bardhaman, West Bengal, India
| | - Sunil Agarwalla
- Department of Pediatrics, MKCG MCH, Berhampur, Odisha, India
| | - Shashi Kant Dhir
- Department of Pediatrics, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - Sanjay Verma
- Division of Infectious Diseases, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhay K Shah
- Dr Abhay K Shah Children Hospital, Ahmedabad, Gujarat, India
| | - Sanjay Srirampur
- Department of Pediatrics, Aditya Super speciality Hospital, Hyderabad, Telangana, India
| | - Srinivas Kalyani
- Department of Pediatrics, Niloufer Hospital, Osmania medical College, Hyderabad, India
| | - Harish Kumar Pemde
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - S Balasubramanian
- Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
| | | | - G V Basavaraja
- Department of Pediatrics, IGICH, Bengaluru, Karnataka, India
| | - Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, New Delhi; India
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Zomahoun DJ, Burman AL, Snider CJ, Chauvin C, Gardner T, Lickness JS, Ahmed JA, Diop O, Gerber S, Anand A. Impact of COVID-19 Pandemic on Global Poliovirus Surveillance. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 69:1648-1652. [PMID: 33382673 PMCID: PMC9191906 DOI: 10.15585/mmwr.mm695152a4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Din M, Ali H, Khan M, Waris A, Ullah S, Kashif M, Rahman S, Ali M. Impact of COVID-19 on polio vaccination in Pakistan: a concise overview. Rev Med Virol 2020; 31:e2190. [PMID: 33176028 DOI: 10.1002/rmv.2190] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 11/07/2022]
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) has disrupted immunization programs around the globe, potentially increasing life-threatening vaccine-preventable diseases. Pakistan and Afghanistan are the only countries, which are still struggling to eradicate wild poliovirus. All vaccination campaigns in Pakistan were suspended in April due to the COVID-19 outbreak, leading 40 million children to miss out on polio vaccination. Like the climate crisis, the COVID-19 pandemic could be regarded as a child-rights crisis because it could have life-threatening impact over children, who need immunization, now and in the long-term. Delays in polio vaccination programs might not have immediate impact but, in the long-term, the increase in polio cases in Pakistan could result in the global export of infections. Therefore, healthcare authorities must intensify their efforts to track and vaccinate unvaccinated children in countries like Pakistan and Afghanistan. Polio vaccination campaigns need to resume immediately, so we suggest applying social distancing measures along with standard operating procedure to flatten the transmission curve of COVID-19. Furthermore, the concurrent emergence of cVDPV2 means that tOPV should temporarily be used for primary immunization. In the current review, we have discussed delays in polio vaccination, surveillance of polio viruses, reported cases in Pakistan along with recommendations to overcome interrupted immunization.
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Affiliation(s)
- Misbahud Din
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Hammad Ali
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Mudassir Khan
- Department of Healthcare Biotechnology, Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Science and Technology (NUST), Islamabad, Pakistan
| | - Abdul Waris
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Sana Ullah
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Muhammad Kashif
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sidra Rahman
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Muhammad Ali
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
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Martinez M, Akbar IE, Wadood MZ, Shukla H, Jorba J, Ehrhardt D. Progress Toward Poliomyelitis Eradication - Afghanistan, January 2019-July 2020. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:1464-1468. [PMID: 33031360 PMCID: PMC7561224 DOI: 10.15585/mmwr.mm6940a3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Afifi RA, Novak N, Gilbert PA, Pauly B, Abdulrahim S, Rashid SF, Ortega F, Ferrand RA. 'Most at risk' for COVID19? The imperative to expand the definition from biological to social factors for equity. Prev Med 2020; 139:106229. [PMID: 32763263 PMCID: PMC7831462 DOI: 10.1016/j.ypmed.2020.106229] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/10/2020] [Accepted: 08/02/2020] [Indexed: 12/22/2022]
Abstract
First recognized in December 2019, the Coronavirus Disease 2019 (COVID19) was declared a global pandemic by the World Health Organization on March 11, 2020. To date, the most utilized definition of 'most at risk' for COVID19 morbidity and mortality has focused on biological susceptibility to the virus. This paper argues that this dominant biomedical definition has neglected the 'fundamental social causes' of disease, constraining the effectiveness of prevention and mitigation measures; and exacerbating COVID19 morbidity and mortality for population groups living in marginalizing circumstances. It is clear - even at this early stage of the pandemic - that inequitable social conditions lead to both more infections and worse outcomes. Expanding the definition of 'most at risk' to include social factors is critical to implementing equitable interventions and saving lives. Prioritizing populations with social conditions is necessary for more effective control of the epidemic in its next phase; and should become standard in the planning for, and prevention and mitigation of all health conditions. Reversing disparities and health inequities is only possible through an expansion of our 'most-at-risk' definition to also include social factors.
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Affiliation(s)
- Rima A Afifi
- University of Iowa College of Public Health, Department of Community and Behavioral Health, 145 N Riverside Drive, Iowa City, IA 52242, USA.
| | - Nicole Novak
- University of Iowa College of Public Health, Department of Community and Behavioral Health, 145 N Riverside Drive, Iowa City, IA 52242, USA.
| | - Paul A Gilbert
- University of Iowa College of Public Health, Department of Community and Behavioral Health, 145 N Riverside Drive, Iowa City, IA 52242, USA.
| | - Bernadette Pauly
- University of Victoria School of Nursing, Victoria, British Columbia, Canada.
| | - Sawsan Abdulrahim
- American University of Beirut, Faculty of Health Sciences, Department of Health Promotion and Community Health, Beirut, Lebanon.
| | - Sabina Faiz Rashid
- BRAC University, James P Grant School of Public Health, Dhaka, Bangladesh.
| | - Fernando Ortega
- Universidad San Francisco de Quito, College of Health Sciences, Quito, Ecuador.
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