Administration Of Influenza Vaccine Research Articles

Influenza Vaccine Uptake in the Year After Concurrent vs Separate Influenza and Zoster Immunization

Fewer than half of US adults receive the influenza vaccine each year; many cite concerns about side effects, which occur infrequently. By contrast, the recombinant zoster vaccine causes systemic side effects in a large proportion of patients. To determine whether concurrent administration of the influenza and zoster vaccines was associated with a reduced likelihood of influenza vaccination in the subsequent year. This cohort study included patients aged 50 years or older who received the influenza vaccine between August 1, 2018, and March 31, 2019, and received the zoster vaccine on the same day or separately (within the prior 180 days). Data were gathered from a national claims database of patients with commercial insurance and Medicare Advantage plans. Logistic regression analysis was used to adjust for baseline demographic characteristics, comorbidities, influenza vaccine month and location (pharmacy vs medical office), and health care use (including influenza vaccination in the prior year). Concurrent vs separate influenza and zoster vaccine administration. Receipt of the influenza vaccine in the subsequent year (August 1, 2019, to March 31, 2020). Among 89 237 individuals included in this study, the median age was 72 years (IQR, 67-77 years), 58.3% were women, 70.1% were White, and 85.7% had at least 1 comorbidity. Influenza vaccine uptake in 2019-2020 was lower among 27 161 individuals who received concurrent influenza and zoster vaccines compared with the 62 076 individuals who received the vaccines on separate days (87.3% vs 91.3%; adjusted odds ratio, 0.74; 95% CI, 0.71-0.78; P < .001). Results were similar across subgroups. Results of this cohort study suggest that concurrent administration of influenza and zoster vaccines was associated with a reduction in receipt of the influenza vaccine the following year. One possible explanation is that some patients could have misattributed systemic side effects caused by the zoster vaccine to the influenza vaccine. It may be preferable to administer these 2 vaccines separately or enhance patient counseling about expected vaccine side effects.

Influenza Vaccinations During the COVID-19 Pandemic - 11 U.S. Jurisdictions, September-December 2020.

Influenza causes considerable morbidity and mortality in the United States. Between 2010 and 2020, an estimated 9-41 million cases resulted in 140,000-710,000 hospitalizations and 12,000-52,000 deaths annually (1). As the United States enters the 2021-22 influenza season, the potential impact of influenza illnesses is of concern given that influenza season will again coincide with the ongoing COVID-19 pandemic, which could further strain overburdened health care systems. The Advisory Committee on Immunization Practices (ACIP) recommends routine annual influenza vaccination for the 2021-22 influenza season for all persons aged ≥6 months who have no contraindications (2). To assess the potential impact of the COVID-19 pandemic on influenza vaccination coverage, the percentage change between administration of at least 1 dose of influenza vaccine during September-December 2020 was compared with the average administered in the corresponding periods in 2018 and 2019. The data analyzed were reported from 11 U.S. jurisdictions with high-performing state immunization information systems.* Overall, influenza vaccine administration was 9.0% higher in 2020 compared with the average in 2018 and 2019, combined. However, in 2020, the number of influenza vaccine doses administered to children aged 6-23 months and children aged 2-4 years, was 13.9% and 11.9% lower, respectively than the average for each age group in 2018 and 2019. Strategic efforts are needed to ensure high influenza vaccination coverage among all age groups, especially children aged 6 months-4 years who are not yet eligible to receive a COVID-19 vaccine. Administration of influenza vaccine and a COVID-19 vaccine among eligible populations is especially important to reduce the potential strain that influenza and COVID-19 cases could place on health care systems already overburdened by COVID-19.

Safety and immunogenicity of concomitant administration of COVID-19 vaccines (ChAdOx1 or BNT162b2) with seasonal influenza vaccines in adults in the UK (ComFluCOV): a multicentre, randomised, controlled, phase 4 trial

SummaryBackgroundConcomitant administration of COVID-19 and influenza vaccines could reduce burden on health-care systems. We aimed to assess the safety of concomitant administration of ChAdOx1 or BNT162b2 plus an age-appropriate influenza vaccine.MethodsIn this multicentre, randomised, controlled, phase 4 trial, adults in receipt of a single dose of ChAdOx1 or BNT162b2 were enrolled at 12 UK sites and randomly assigned (1:1) to receive concomitant administration of either an age-appropriate influenza vaccine or placebo alongside their second dose of COVID-19 vaccine. 3 weeks later the group who received placebo received the influenza vaccine, and vice versa. Participants were followed up for 6 weeks. The influenza vaccines were three seasonal, inactivated vaccines (trivalent, MF59C adjuvanted or a cellular or recombinant quadrivalent vaccine). Participants and investigators were masked to the allocation. The primary endpoint was one or more participant-reported solicited systemic reactions in the 7 days after first trial vaccination(s), with a difference of less than 25% considered non-inferior. Analyses were done on an intention-to-treat basis. Local and unsolicited systemic reactions and humoral responses were also assessed. The trial is registered with ISRCTN, ISRCTN14391248.FindingsBetween April 1 and June 26, 2021, 679 participants were recruited to one of six cohorts, as follows: 129 ChAdOx1 plus cellular quadrivalent influenza vaccine, 139 BNT162b2 plus cellular quadrivalent influenza vaccine, 146 ChAdOx1 plus MF59C adjuvanted, trivalent influenza vaccine, 79 BNT162b2 plus MF59C adjuvanted, trivalent influenza vaccine, 128 ChAdOx1 plus recombinant quadrivalent influenza vaccine, and 58 BNT162b2 plus recombinant quadrivalent influenza vaccine. 340 participants were assigned to concomitant administration of influenza and a second dose of COVID-19 vaccine at day 0 followed by placebo at day 21, and 339 participants were randomly assigned to concomitant administration of placebo and a second dose of COVID-19 vaccine at day 0 followed by influenza vaccine at day 21. Non-inferiority was indicated in four cohorts, as follows: ChAdOx1 plus cellular quadrivalent influenza vaccine (risk difference for influenza vaccine minus placebos −1·29%, 95% CI −14·7 to 12·1), BNT162b2 plus cellular quadrivalent influenza vaccine (6·17%, −6·27 to 18·6), BNT162b2 plus MF59C adjuvanted, trivalent influenza vaccine (–12·9%, −34·2 to 8·37), and ChAdOx1 plus recombinant quadrivalent influenza vaccine (2·53%, −13·3 to 18·3). In the other two cohorts, the upper limit of the 95% CI exceeded the 0·25 non-inferiority margin (ChAdOx1 plus MF59C adjuvanted, trivalent influenza vaccine 10·3%, −5·44 to 26·0; BNT162b2 plus recombinant quadrivalent influenza vaccine 6·75%, −11·8 to 25·3). Most systemic reactions to vaccination were mild or moderate. Rates of local and unsolicited systemic reactions were similar between the randomly assigned groups. One serious adverse event, hospitalisation with severe headache, was considered related to the trial intervention. Immune responses were not adversely affected.InterpretationConcomitant vaccination with ChAdOx1 or BNT162b2 plus an age-appropriate influenza vaccine raises no safety concerns and preserves antibody responses to both vaccines. Concomitant vaccination with both COVID-19 and influenza vaccines over the next immunisation season should reduce the burden on health-care services for vaccine delivery, allowing for timely vaccine administration and protection from COVID-19 and influenza for those in need.FundingNational Institute for Health Research Policy Research Programme

Clinical and immunological changes in patients with chronic inflammatory diseases of the upper respiratory tract at different periods after administration of influenza vaccine. Message 1. The influence of parenteral influenza vaccination on the clinical condition and indicators of systemic humoral immunity in patients with chronic inflammatory diseases of the upper respiratory tract

Topicality: Today, as an assessment of the effectiveness of vaccination against influenza infection is to determine the level of antibodies against influenza virus hemagglutinin, which is determined by the reaction of inhibition of hemagglutination. It is known that the effect of vaccination with modern drugs is short-lived, compared with what remains after the disease. Therefore, there is a need for further vaccinations, which are carried out without taking into account the state of immunity in those who will be vaccinated. This raises the question of the appropriateness of this approach in individuals who, according to this indicator, can already be considered protected from influenza infection and how often such patients occur in clinical practice. Material and methods: From the autumn-winter period of 2019 to November 2020, 32 donors and 32 patients with chronic inflammatory diseases of the upper respiratory tract chronic inflammatory diseases of the upper respiratory tract of both sexes who were not vaccinated for 1 year before the study were examined. Among these patients, 11 were diagnosed with chronic rhinosinusitis, 9 with chronic tonsillitis, and 12 with chronic pharyngitis. All patients with chronic inflammatory diseases of the upper respiratory tract underwent a complete otolaryngological examination prior to influenza vaccination and were monitored for another 36 weeks thereafter. Attention was paid to their general clinical condition, cases of exacerbations of chronic inflammatory diseases of the upper respiratory tract and the number of episodes of acute respiratory viral infections during the year before vaccination according to the anamnesis and for the observation period during the post-vaccination period. Samples of serum venous blood of donors, as well as persons with chronic inflammatory diseases of the upper respiratory tract were obtained at the initial examination, and in vaccinated patients 3, 12 and 36 weeks after vaccination and stored at -20°C (Ardo, Italy) until the simultaneous detection of antibodies (Ab) to influenza A and B viruses by hemagglutination inhibition reaction with human erythrocytes 0 group. Trivalent influenza inactivated split vaccine Vaxigrip (France) was used both for vaccination and in the determination of Ab in the blood for influenza viruses. In all examinations, the titer of anti-influenza Ab and the content of immune complexes were determined in the sera of patients, and the content of total IgE was measured in patients with chronic inflammatory diseases of the upper respiratory tract before and after 12 and 36 weeks. Statistical processing of the obtained results was performed in accordance with the recommendations of Glantz. Results: In 41% of those examined protectively significant titers of antibodies to hemagglutinins of vaccine strains of influenza virus vaccine Vaxigrip were detected in the blood. Parenteral vaccination of patients with chronic inflammatory diseases of the upper respiratory tract against influenza helped to improve the course of their underlying clinical disease and reduce their incidence of acute respiratory viral infections within 36 weeks after vaccination. The effect of increasing the level of antibodies to hemagglutinins of influenza virus remained at the limit of 3 months and decreased. Influenza vaccination in patients with chronic inflammatory diseases of the upper respiratory tract with the presence of most of them at the time of vaccination of clinically significant protective titers of antibodies to hemagglutinins vaccine strains of viruses led to an increase in blood in the long term of the vaccination process levels of immune complex and total IgE relative to their initial level, while these indicators did not exceed the limits of their physiological values. Conclusion: Single parenteral influenza vaccination leads to a short-term increase in the blood of specific projective antibodies, improving the clinical condition of patients with inflammatory diseases of the upper respiratory tract, increasing the level of immune complexes and total IgE.

Perceptions of Glove Use During Vaccination: A Cross-Sectional Study.

To better understand clinic attendees' perceptions of nonsterile glove (NSG) use during vaccination and their concern for the environment. This was a cross-sectional, self-administered, in-person survey. A nonrandom volunteer sample of vaccination clinic attendees (n = 789) completed a survey assessing their perception of NSG use during influenza vaccination administration and their concern for the environment. Nearly all respondents equated NSG use with increased safety and professionalism. More than half of respondents reported feeling concerned about environmental waste associated with NSG use. NSG are not indicated for routine vaccination. Adherence to evidence-based practices on NSG use during vaccination can substantially reduce associated medical waste. Nurses can lead by example by only using NSG when indicated.

Similar inflammatory response and conduit artery vascular function between sexes following induced inflammation

What is the central question of this study? Are there sex differences in vascular function following induced inflammation when oestrogen is typically similar between sexes? What is the main finding and its importance? The present study suggests no sex differences in conduit artery vascular responses to acutely induced inflammation during the low-oestrogen phase of the menstrual cycle in premenopausal women. However, women exhibit lower microvascular function than men. Overall, the results underpin the role of oestrogen in previously observed sex differences and the importance of reporting the phase in the hormonal cycle when women are studied. Sex differences in cardiovascular disease incidence in premenopausal women and age-matched men have been attributed to the cardioprotective influence of oestrogen. However, limited knowledge exists regarding sex differences following acute inflammation when oestrogen concentrations are lower in women. We evaluated sex differences in vascular responses to induced inflammation when oestrogen concentrations are typically lower in women (early follicular phase or placebo phase of hormonal contraception). In 15 women and 14 men, interleukin-6 (IL-6) concentrations and vascular function [via brachial artery flow-mediated dilatation (FMD)] were assessed at baseline (BL) and 24 (24H) and 48hours (48H) after administration of influenza vaccine. After induction of inflammation, both sexes exhibited an increase in IL-6 concentrations at 24H [mean (SD) BL vs. 24H: women, 0.563 (0.50) vs. 1.141 (0.65) pg/ml; men, 0.385 (0.17) vs. 1.113 (0.69) pg/ml; P<0.05] that returned to near-baseline concentrations by 48H (BL vs. 48H, P>0.05). There were no sex differences in FMD, allometrically scaled FMD or IL-6 concentrations at any time point (P>0.05). Notably, women exhibited significantly lower microvascular function than men at every time point [P<0.05; reactive hyperaemic area under the curve (in arbitrary units): women, BL 35,512 (14,916), 24H 34,428 (14,292) and 48H 39,467 (13,936); men, BL 61,748 (27,324), 24H 75,028 (29,051) and 48H 59,532 (13,960)]. When oestrogen concentrations are typically lower in women, women exhibit a similar inflammatory response and conduit artery function, but lower microvascular response to reactive hyperaemia, in comparison to age-matched men.

Standard-Setting for Continuing Education Assessment of Select New Competencies.

Completion of continuing education hours might not guarantee the achievement of new competencies. Influenza vaccination training was provided to pharmacists in the United Arab Emirates (UAE), who had no similar training in their pharmacy degree. The training was developed and conducted at Gulf Medical University, UAE. Influenza vaccine administration is not yet a privilege for pharmacists in the UAE. This study focuses on determining whether a defensible cut score for the influenza vaccination training multiple-choice questions examination is feasible. Influenza vaccination training and assessment happened on the same day. The Angoff (modified), Beuk, and Hofstee methods were used for standard-setting. Six subject matter experts who were involved in developing and conducting the first influenza vaccination training in the UAE evaluated the cut score using the Angoff method with the Delphi technique. The criterion-based cut score was 34.23 of 46 questions, with mean 74% and SD 2.24. Inter-rater reliability was 0.92 with standard errors of judgment 0.29 (0.63%). The modified Angoff is a credible method to set cut scores, reassured with Beuk and Hofstee methods for assessment of influenza continuing education. It is feasible and perhaps essential to determine a formal cut score for the continuing education assessment of health professionals on select new competencies.

Interferon-λ Improves the Efficacy of Intranasally or Rectally Administered Influenza Subunit Vaccines by a Thymic Stromal Lymphopoietin-Dependent Mechanism.

Previous work showed that interferon-λ (IFN-λ) can trigger the synthesis of thymic stromal lymphopoietin (TSLP) by specialized epithelial cells in the upper airways of mice, thereby improving the performance of intranasally administered influenza vaccines. Here we demonstrate that protein-only influenza vaccines containing either IFN-λ or TSLP boosted antigen-specific IgG1 and IgA responses and enhanced the resistance of mice to influenza virus challenge, irrespective of whether the vaccines were applied via the intranasal or the rectal route. TSLP receptor deficiency negatively influenced vaccine-induced antiviral immunity by impairing the migration of dendritic cells from the airways to the draining lymph nodes of immunized mice, thereby restraining follicular helper T cell and germinal center B cell responses. As previously observed during intranasal vaccination, the adjuvant effect of IFN-λ on a rectally administered influenza vaccine was no longer observed when TSLP receptor-deficient mice were used for immunization, highlighting the central role of the IFN-λ/TSLP axis for vaccine-induced antiviral immunity in the mucosa.

Exploring determinants of community pharmacist-led influenza vaccination in a Middle Eastern country: a national web-based cross-sectional study

BackgroundUtilizing community pharmacists (CPs) as immunizers has being adopted in various countries as approach to boost influenza vaccination coverage. Our study aims to explore the Lebanese CPs’ willingness to administer influenza vaccine, and to identify factors associated with this willingness.MethodsThis is a web-based, cross-sectional study, conducted over 2 months, from the 1st of November to the end of December 2020. Self-reported data were collected electronically from Lebanese CPs through an anonymous, questionnaire using google form. The collected data were analyzed using the statistical software SPSS (Statistical Package for Social Sciences). Bivariate and multivariable analyses were performed to examine factors associated with the willingness of CPs to administer influenza vaccine.ResultsA total of 412 CPs participated in this survey of which 76.9% are willing to administer influenza vaccines. More than 90% of them had a good overall knowledge score and 88.8% of CPs showed a positive overall attitude score, particularly towards involvement of CPs in influenza vaccine provision. Their willingness to administer vaccine was positively associated with the younger age (aOR = 3.12 with 95% CI (1.597–4.040)), higher education level (aOR = 2.02 with 95% CI (1.093–3.741)), previous experience in immunization (aOR = 2.72 with 95% CI (1.320–5.627)) and urbanicity of pharmacy (aOR = 1.542 with 95% CI (1.219–4.627)). Extensive working hours (aOR = 2.34 with 95% CI (1.131–4.845)), working in pharmacies that are operating round-the-clock, showing positive attitude towards immunization (aOR = 3.01 with 95% CI (1.872–6.422)) and towards provision of influenza vaccines (aOR = 13.72 with 95% CI (13.721–38.507)) were also positively associated to this willingness. Conversely, patient privacy (aOR = 0.55 with 95% CI (0.079–0.983)), time and cost for professional development (aOR = 0.55 with 95% CI (0.172–0.918)), limited patient’s trust (aOR = 0.39 with 95% CI (0.203–0.784)), financial remuneration (aOR = 0.18 with 95% CI (0.088–0.377)), and requirement of formal certification in vaccine administration (aOR = 0.07 with 95% CI (0.020–0.279)) were negatively associated to this willingness.ConclusionAddressing the unearthed concerns related to utilizing CPs as influenza immunizers through a concerted effort is a key to success in any future implementation of vaccination services in pharmacies.

Associations between Combined Influenza and Pneumococcal Pneumonia Vaccination and Cardiovascular Outcomes

Background: In 2017, the CDC listed heart disease as the leading cause of death, with pneumonia and influenza being the eighth cause of death. Several studies have suggested the protective effects of influenza vaccination on myocardial infarction (MI). Available evidence supports the use of influenza vaccination in decreasing cardiovascular events, and the Joint Commission considers influenza vaccination a metric of quality care for hospitalized patients. Our specific aim was to evaluate the combined use of pneumococcal pneumonia vaccine (PPV) and influenza vaccine on cardiovascular outcomes and mortality. Methods: A retrospective observational study was conducted using the 2012–2015 US National Inpatient Sample (NIS) database, to compare cardiovascular events in adult patients who did and did not receive vaccination during their hospitalization. ICD-9 codes were used to extract data for specific variables. The outcomes included MI, transient ischemic attacks, cardiac arrest, stroke, heart failure, and death. Adjusted relative risks (RR) were calculated using survey-weighted generalized linear models after adjusting for gender, race, socioeconomic status, diabetes, hypertension, hyperlipidemia, smoking status, prior coronary artery disease, and cerebrovascular disease. The effect of vaccination on in-hospital mortality was assessed in each subgroup of cardiovascular events using RR regressions. Results: This study included 22,634,643 hospitalizations, of which 21,929,592 did not receive immunization. Vaccination solely against influenza was associated with lower MI (RR = 0.84, 95% CI: 0.82–0.87, p < 0.001), TIA (RR = 0.93, 95% CI: 0.9–0.96, p < 0.001), cardiac arrest (RR = 0.36, 95% CI: 0.33–0.39, p < 0.001), stroke (RR = 0.94, 95% CI: 0.91–0.97, p < 0.001), and mortality (RR = 0.38, 95% CI: 0.36–0.4, p < 0.001). Vaccination with PPV alone was associated with MI (RR = 1.13, 95% CI: 1.11–1.16, p < 0.001), TIA (RR = 1.28, 95% CI: 1.26–1.31, p < 0.001), stroke (RR = 1.21, 95% CI: 1.18–1.24, p < 0.001), and lower mortality (RR = 0.47, 95% CI: 0.45–0.49, p < 0.001). Combined PPV and influenza vaccine was associated with lower mortality (2.21% vs. 1.03%, p < 0.001) and lower cardiac arrest (0.61% vs. 0.51%, p < 0.001). In the adjusted analysis, the RR was 0.46 (95% CI: 0.43, 0.49) for mortality in the combined vaccinated cohort. The combined vaccination group also had a significantly reduced risk of mortality among those admitted with MI (RR = 0.46), transient ischemic attacks (RR = 0.58), and stroke (RR = 0.42) compared to the nonvaccinated group. Conclusions: Our study shows a significantly reduced risk of mortality with influenza vaccine and PPV and with combined pneumococcal and influenza vaccination. These data suggest that in-hospital administration of pneumonia and influenza vaccines appears safe and supports the use of combined vaccination during hospitalization due to their cardiovascular benefits.

Safety and effectiveness of dose-sparing strategies for intramuscular seasonal influenza vaccine: a rapid scoping review

BackgroundThe objective of this rapid scoping review was to identify studies of dose-sparing strategies for administration of intramuscular seasonal influenza vaccines in healthy individuals of all ages.MethodsComprehensive literature searches were...

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021–22 Influenza Season

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021–22 Influenza Season

Pre-Solid-Organ-Transplant COVID-19 Vaccination

Vaccine such as influenza vaccine, is administered in stable transplant recipients, although live attenuated virus vaccines are contraindicated, generally due to risk of disseminated infection [1, 2]. Neither efficacy, safety, nor durability are well known in transplant recipients due to exclusion of them from recent COVID-19 vaccine trials [1, 2]. Currently, there are no SARS-CoV-2 vaccine platforms using attenuated live virus approved in phase III trials. Nevertheless, if they are approved for use, concerns, including potential decrease in efficacy in immunocompromised patients, potential for vaccine-related allograft rejection, unknown durability of the immune response, and long-term safety data still exist. Due to experience with neither the influenza vaccine nor the adjuvant recombinant zoster vaccine having been related to allograft rejection, successful administration of influenza and adjuvanted recombinant zoster vaccines to stable transplant recipients, and unanticipated vaccine-related adverse events to the allograft having not borne out, the influenza and adjuvanted recombinant zoster vaccines are able to be extrapolated to COVID-19 vaccines [2, 3]. In immunocompromised host, concerns for adenoviral vector vaccines are focused on a viral infection, but these concerns have no scientific evidence. Although newly approved adenoviral-vector use for vaccination, this vaccine platform has been used for decades for gene therapy for cancer and other rare diseases. Inactivated virus and protein subunit vaccine platforms that have been used in transplant recipients for other infections, such as human papilloma virus, pertussis, and hepatitis A and B, are currently under investigation for SARS-CoV-2 (COVID-19) infection in transplant recipients [2].

Vaccination contre la COVID-19 dans les officines en région Auvergne-Rhône-Alpes. Étude menée trois mois après le début de la vaccination

IntroductionLe développement de vaccins contre le SARS-Cov-2 a permis le déploiement de la vaccination notamment par l’intermédiaire des pharmaciens officinaux, déjà autorisés à la vaccination anti-grippale en France.MéthodologieNous avons interrogé les pharmaciens d’officine de la région Auvergne-Rhône-Alpes pour un état des lieux de la pratique vaccinale anti-COVID-19 dans la région. Un questionnaire leur a été transmis ; l’analyse a été réalisée conjointement avec l’URPS-Pharmaciens.RésultatsAu total, 739 officines ont participé à notre enquête, et nous ont fait part de leurs impressions pour l’organisation de la vaccination anti-COVID 19 et des informations à transmettre aux patients.ConclusionsL’engagement des pharmaciens d’officine à la vaccination anti-COVID-19 témoigne de l’attachement des pharmaciens à leur patientèle, et de leur place privilégiée dans la prévention en France. L’élargissement de leurs compétences à la vaccination générale de la population attend une légitimité des pouvoirs décisionnels.

Analysis of School-Day Disruption of Administering School-Located Vaccination to Children in Three Local Areas, 2012–2013 School Year

The purpose of this study was to determine the amount of time elementary and middle-school students spend away from the classroom and clinic time required to administer vaccines in school-located vaccination (SLV) clinics. We conducted a time study and estimated average time away from class and time to administer vaccine by health department (HD), student grade level, vaccine type, and vaccination process for SLV clinics during the 2012-2013 school year. Average time away from classroom was 10 min (sample: 688 students, 15 schools, three participating HD districts). Overall, time to administer intranasally administered influenza vaccine was nearly half the time to administer injected vaccine (52.5 vs. 101.7 s) (sample: 330 students, two HDs). SLV administration requires minimal time outside of class for elementary and middle-school students. SLV clinics may be an efficient way to administer catch-up vaccines to children who missed routine vaccinations during the coronavirus disease-2019 pandemic.

Enhancing influenza vaccine immunogenicity and efficacy through infection mimicry using silk microneedles

Traditional bolus vaccine administration leads to rapid clearance of vaccine from lymphoid tissue. However, there is increasing evidence suggesting that the kinetics of antigen delivery can impact immune responses to vaccines, particularly when tailored to mimic natural infections. Here, we present the specific enhancements sustained release immunization confers to seasonal influenza vaccine, including the magnitude, durability, and breadth of humoral responses. To achieve sustained vaccine delivery kinetics, we have developed a microneedle array patch (MIMIX), with silk fibroin-formulated vaccine tips designed to embed in the dermis after a short application to the skin and release antigen over 1–2 weeks, mimicking the time course of a natural influenza infection. In a preclinical murine model, a single influenza vaccine administration via MIMIX led to faster seroconversion, response-equivalence to prime-boost bolus immunization, higher HAI titers against drifted influenza strains, and improved protective efficacy upon lethal influenza challenge when compared with intramuscular injection. These results highlight infection mimicry, achieved through sustained release silk microneedles, as a powerful approach to improve existing seasonal influenza vaccines, while also suggesting the broader potential of this platform technology to enable more efficacious next-generation vaccines and vaccine combinations.

Evaluation of immunization status in patients with cerebral palsy: a multicenter CP-VACC study.

Children with chronic neurological diseases, including cerebral palsy (CP), are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease. This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey, wherein outpatient children with CP were included in the study. Data on patient and CP characteristics, concomitant disorders, vaccination status included in the National Immunization Program (NIP), administration, and influenza vaccine recommendation were collected at a single visit. A total of 1194 patients were enrolled. Regarding immunization records, the most frequently administrated and schedule completed vaccines were BCG (90.8%), hepatitis B (88.9%), and oral poliovirus vaccine (88.5%). MMR was administered to 77.3%, and DTaP-IPV-HiB was administered to 60.5% of patients. For the pneumococcal vaccines, 54.1% of children received PCV in the scope of the NIP, and 15.2% of children were not fully vaccinated for their age. The influenza vaccine was administered only to 3.4% of the patients at any time and was never recommended to 1122 parents (93.9%). In the patients with severe (grades 4 and 5) motor dysfunction, the frequency of incomplete/none vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically more common than mild to moderate (grades 1-3) motor dysfunction (p = 0.003, p < 0.001, p < 0.001, p < 0.00, and p < 0.001, respectively). Physicians' influenza vaccine recommendation was higher in the severe motor dysfunction group, and the difference was statistically significant (p = 0.029).Conclusion: Children with CP had lower immunization rates and incomplete immunization programs. Clinicians must ensure children with CP receive the same preventative health measures as healthy children, including vaccines. What is Known: • Health authorities have defined chronic neurological diseases as high-risk conditions for influenza and pneumococcal infections, and they recommend vaccines against these infections. • Children with CP have a high risk of incomplete and delayed immunization, a significant concern given to their increased healthcare needs and vulnerability to infectious diseases. What is New: • Influenza vaccination was recommended for patients hospitalized due to pneumonia at a higher rate, and patients were administered influenza vaccine more commonly. • Children with CP who had higher levels of motor dysfunction (levels 4 and 5) were more likely to be overdue immunizations.

Pharmacy, workplace or primary care? Where Australian adults get their influenza vaccines

ObjectiveTo estimate the proportion of influenza vaccines administered in non‐medical settings in Australia in 2019 and identify factors associated with vaccination site. MethodsWe surveyed 1,444 Australian adults online in October 2019. To identify factors associated with vaccination site, we used Pearson's chi‐square test. We used thematic analysis to describe responses to the question, ‘Please explain why you chose to get vaccinated there’. ResultsMost participants (73%) received the influenza vaccine in a medical setting, while 13% received it at a pharmacy and 14% at their workplace. Being vaccinated in pharmacy was associated with being under 65 years of age (p<0.01), marital status (p=0.01), and not having a high‐risk comorbidity (p<0.01). Workplace vaccination was associated with being under 65 (p<0.01), household income (p<0.01), not having a regular general physician/practice (p=0.01), having private insurance (p<0.01), and not having a high‐risk comorbidity (p<0.01). There was no association between site of vaccination and first‐time vaccination (p=0.71, p=0.22). ConclusionsDespite new policies allowing pharmacists to administer influenza vaccines, most Australian adults are still vaccinated in medical settings. Pharmacy and workplace vaccination settings were more common among younger adults without high‐risk comorbidities. Implications for public healthWorkplaces, pharmacies and other non‐medical settings may provide an opportunity to increase influenza vaccination among healthy, working‐age adults who might otherwise forego annual vaccination. Pharmacies may also provide a convenient location for the rollout of the COVID‐19 vaccine, particularly in medically underserved areas.

Reduction in self-reported influenza-like-illness in school children and household members following influenza vaccine administration \u2013 a cohort study, Israel, 2016\u20137

BackgroundSecond-grade pupils in Israel have been vaccinated against influenza since the winter of 2016–2017. This study aims to appraise the rate reduction of seasonal influenza vaccine among vaccinated children and their household members, and that of the vaccinated cohort and their household members.MethodsThis retrospective cohort study was performed in winter 2016–2017 in Tel-Aviv District, Israel and compared second-grade pupils who were vaccinated at school, with third-grade pupils- who were not vaccinated at school. Parents in nine schools were asked to report prior vaccination against influenza and influenza-like illness (ILI) of their children and other household members. Rate reduction was defined as [(ILI among unvaccinated) – (ILI among vaccinated)] / (ILI among vaccinated) (%).ResultsOf 527 participants, 359 (68.1%) were unvaccinated and 168 (31.9%) vaccinated. Unvaccinated children reported more ILI compared with vaccinated children (19.5% vs. 7.7%), yielding a rate reduction of 60.5%. Unvaccinated children also had a greater number of physicians’ visits and missed school days (35.7% vs. 14.9 and 42.9% vs. 25.6%, respectively). The rate of ILI among household members of unvaccinated children was 34.5%, compared with 25.0% among household members of vaccinated children.The vaccinated cohort (defined as all children in second grade) reported less ILI compared with the unvaccinated cohort (defined as all children in third grade), with a rate reduction of 44.6%. Pupils of the unvaccinated cohort were more likely to miss school days (42.1% vs. 32.0%, respectively), and a higher rate of ILI was reported among household members of the unvaccinated cohort (35.4% vs. 27.3%, respectively).ConclusionInfluenza vaccine administered in school setting reduced ILI among the vaccinated cohort and their household members by 60.5 and 27.5%, respectively, compared with the unvaccinated cohort. Expansion of the vaccination program in a school setting increased the public health benefit of influenza vaccines among both school children and their household members.

Targeting the Host Response: Can We Manipulate Extracellular Matrix Metalloproteinase Activity to Improve Influenza Virus Infection Outcomes?

Each year, hundreds of thousands of individuals succumb to influenza virus infection and its associated complications. Several preventative and therapeutic options may be applied in order to preserve life. These traditional approaches include administration of seasonal influenza vaccines, pharmacological interventions in the form of antiviral drug therapy and supportive clinical approaches including mechanical ventilation and extracorporeal membrane oxygenation. While these measures have shown varying degrees of success, antiviral therapies and vaccination are constrained due to ongoing antigenic drift. Moreover, clinical approaches can also be associated with complications and drawbacks. These factors have led to the exploration and development of more sophisticated and nuanced therapeutic approaches involving host proteins. Advances in immunotherapy in the cancer field or administration of steroids following virus infection have highlighted the therapeutic potential of targeting host immune responses. We have now reached a point where we can consider the contribution of other “non-traditional” host components such as the extracellular matrix in immunity. Herein, we will review current, established therapeutic interventions and consider novel therapeutic approaches involving the extracellular matrix.