Finlay Institute Research Articles

Which roads lead to access? A global landscape of six COVID-19 vaccine innovation models

BackgroundUnequal and inequitable access to Covid-19 vaccines in low- and middle-income countries (L&MICs) was a major political, ethical and public health failure in the pandemic. However, vaccine developers’ practices were not monolithic, but rather, took diverse approaches to supplying different countries, with important implications for global access.ResultsUsing data on R&D investments, regulatory approvals, manufacturing and purchase agreements, and vaccine deliveries, we identified six distinct innovation models that apply across the 14 COVID-19 vaccines with more international presence from 2020–2022. “Western Early Arrivers” Pfizer/BioNTech and Moderna supplied the largest volumes quickly and prioritized high-income countries (HICs) from registration to vaccine delivery. “Western Latecomers” Janssen and Novavax supplied intermediate volumes later, also prioritizing HICs but with a greater proportion to L&MICs. “Major Chinese Developers” Sinopharm and Sinovac supplied intermediate volumes early, primarily to middle-income countries (MICs). “Russian Developer” Gamaleya completed development early but ultimately supplied small volumes, primarily to middle-income countries (MICs). “Cosmopolitan Developer” Oxford/AstraZeneca supplied large volumes early to HICs and MICs at the lowest prices. Finally, “Small MIC Developers” CanSino, Bharat Biotech, Medigen, Finlay Institute and the Center for Genetic Engineering and Biotechnology (CGEB), exported relatively small volumes to a few MICs. Low-income countries (LICs) were not targeted by any developer, and received far fewer doses, later, than any other income group. Almost all developers received public funding and other forms of support, but we found little evidence that such support was leveraged to expand global access.ConclusionsEach of the six innovation models has different implications for which countries get access to which vaccines, how quickly, and at which prices. Each offers different strengths and weaknesses for achieving equitable access. Our findings also suggest that Western firms had the greatest capacity to develop and deliver vaccines quickly during the pandemic, but such capacity is rapidly becoming more globally distributed with MICs playing a significant role, especially in supplying other MICs. Given the critical role of public support in enabling pandemic vaccine development and supply, governments have both the capacity and responsibility to craft international rules that will make responses to future pandemics more equitable and effective.

Homeoprophylaxis in Cuba: The End of an Era?

From 2004 to 2015 some of the largest homeoprophylactic interventions were executed in Cuba. However, significant changes occurred in early 2015 at the Finlay Institute where the interventions were planned and delivered. In addition, Cuba's borders are now open to multinational pharmaceutical companies. This raises concerns regarding the effects this will have on natural medicine.

Comparative cytotoxicity, antifungal and immunomodulatory effects of free and AFCo3-amphotericin B against Sporothrix brasiliensis

Event Abstract Back to Event Comparative cytotoxicity, antifungal and immunomodulatory effects of free and AFCo3-amphotericin B against Sporothrix brasiliensis Alexander Batista-Duharte1*, Belkis Romeu2, Miriam Lastre2, Deivys Portuondo3, Damiana Téllez Martínez3, Oliver Pérez4 and Iracilda Zeppone Carlos3 1 Centro de Toxicología y Biomedicina. Universidad de Ciencias Médicas. Santiago de Cuba, Lab Inmunotoxicología, Cuba 2 Finlay Institute, Cuba 3 Pharmaceutical Science Faculty, Universidade Estadual Paulista Julho Mesquita Filho (UNESP, Laboratorio de Imunología Clínica, Brazil 4 Universidad de Ciencias Médicas La Habana, Dpto Inmunología, Cuba It was evaluated the antifungal and immunomodulatory activity of AFCo3, a novel cochleate associated with amphotericin B (AmB) against Sporothrix brasiliensis, a pathogenic fungus causing sporotrichosis in Brazil. The minimum inhibitory concentrations (MICs) of AFCo3-AmB and AmB were determined by the M27-A3 microdilution method and by the Alamarblue test. It was also evaluated the minimum lethal concentration (MLC), the ability to form biofilms in ELISA microplates and the antifungal effect against phagocyted yeast by murine peritoneal macrophages. The cytotoxicity over peritoneal macrophages was analysed using a MTT assay and their immunomodulatory effect was evaluated by the production of IL-1β, and TNF-α, NO in the supernatant of these cells stimulated with different concentrations of AFCo3-AmB and AmB. All the studies were performed using a range of concentration of 16 to 0.078 µg/mL. The MIC of AmB and AFCo3-AmB was of 2 and 0.50 µg/mL respectively, while the MFC was of 2 for AMB and 1 µg/mL for AFCo3-AmB. Both formulations were effective reducing the biofilm formation. AFCo3-AmB was less cytotoxic, caused more intracellular yeast killing and induced more IL-1β, TNF-α and NO than free AmB. Finally either oral AFCo3-AmB and intraperitoneal AmB were similarly effective reducing spleen fungal burden in a Balb/model of sporothrichosis. Overall, these data evidences that AFCo3 improve the antifungal effects, reduce the toxicity of AmB and exhibited an immunomodulator effect, being a promissory AmB delivery for sporotrichosis treatment Acknowledgements This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior (CAPES, Brazil): Foreigner Visiting Professor Program (Grant BEX 07610/13-0), and the Bioscience and Biotechnology Applied to Pharmacy Pos-graduate Program from Pharmaceutical Sciences Faculty, UNESP, Araraquara, SP, Brazil. Keywords: AFCo3, Cochleates, Sporothrix brasiliensis, Antifungal, Immunomodulation, Amphotericin B Conference: IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología, Medellin, Colombia, 13 Oct - 16 Oct, 2015. Presentation Type: Poster Presentation Topic: Infectious and parasitic diseases Citation: Batista-Duharte A, Romeu B, Lastre M, Portuondo D, Téllez Martínez D, Pérez O and Zeppone Carlos I (2015). Comparative cytotoxicity, antifungal and immunomodulatory effects of free and AFCo3-amphotericin B against Sporothrix brasiliensis. Front. Immunol. Conference Abstract: IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología. doi: 10.3389/conf.fimmu.2015.05.00195 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 27 May 2015; Published Online: 14 Sep 2015. * Correspondence: MD, PhD. Alexander Batista-Duharte, Centro de Toxicología y Biomedicina. Universidad de Ciencias Médicas. Santiago de Cuba, Lab Inmunotoxicología, Santiago de Cuba, Cuba, batista.duharte@unesp.br Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Alexander Batista-Duharte Belkis Romeu Miriam Lastre Deivys Portuondo Damiana Téllez Martínez Oliver Pérez Iracilda Zeppone Carlos Google Alexander Batista-Duharte Belkis Romeu Miriam Lastre Deivys Portuondo Damiana Téllez Martínez Oliver Pérez Iracilda Zeppone Carlos Google Scholar Alexander Batista-Duharte Belkis Romeu Miriam Lastre Deivys Portuondo Damiana Téllez Martínez Oliver Pérez Iracilda Zeppone Carlos PubMed Alexander Batista-Duharte Belkis Romeu Miriam Lastre Deivys Portuondo Damiana Téllez Martínez Oliver Pérez Iracilda Zeppone Carlos Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Bacterial Outer Membrane Vesicles and Vaccine Applications

Vaccines based on outer membrane vesicles (OMV) were developed more than 20 years ago against Neisseria meningitidis serogroup B. These nano-sized structures exhibit remarkable potential for immunomodulation of immune responses and delivery of meningococcal antigens or unrelated antigens incorporated into the vesicle structure. This paper reviews different applications in OMV Research and Development (R&D) and provides examples of OMV developed and evaluated at the Finlay Institute in Cuba. A Good Manufacturing Practice (GMP) process was developed at the Finlay Institute to produce OMV from N. meningitidis serogroup B (dOMVB) using detergent extraction. Subsequently, OMV from N. meningitidis, serogroup A (dOMVA), serogroup W (dOMVW), and serogroup X (dOMVX) were obtained using this process. More recently, the extraction process has also been applied effectively for obtaining OMV on a research scale from Vibrio cholerae (dOMVC), Bordetella pertussis (dOMVBP), Mycobacterium smegmatis (dOMVSM), and BCG (dOMVBCG). The immunogenicity of the OMV has been evaluated for specific antibody induction, and together with functional bactericidal and challenge assays in mice has shown their protective potential. dOMVB has been evaluated with non-neisserial antigens, including with a herpes virus type 2 glycoprotein, ovalbumin, and allergens. In conclusion, OMV are proving to be more versatile than first conceived and remain an important technology for development of vaccine candidates.

Adjuvants as possible solution to polysaccharide unconjugated vaccines

Event Abstract Back to Event Adjuvants as possible solution to polysaccharide unconjugated vaccines Belkis Romeu1*, Miriam Lastre1, Osmir Cabrera1, Elizabeth Gonzalez1, Aleida Mandariote1, Luis García1, Daniel Cardoso1 and Oliver Pérez1 1 Finlay Institute, Immunology Department, Cuba Background. Plain polysaccharide (Ps) vaccines were the first meningococcal vaccines developed. Nevertheless, they neither function in new born / infant nor induce memory response and could induce antibody hyporesponsiveness. Therefore, covalent conjugated vaccines offer a particular type of stimulation where the carrier gives the T cell help. However, adjuvants in the restricted sense never were considered as an alternative solution. Therefore, we developed a proprietary adjuvant Finlay platform derived from Neisseria meningitidis. Aims. To determine if adjuvants could be use as an alternative solution to covalent conjugated Ps vaccines. Results. The Ps used were: PsVi from Salmonella Typhi and PsA from N. meningitidis serogroups A, respectively. The adjuvants used were: Outer membrane vesicles from N. meningitidis serogroups A, W and AFCo (Cochleate) 1 derived from PL. MenAfricVac™ as well as unconjugated plain Ps were use as controls. Anti Ps IgG class and IgG1, IgG2a, and IgG3 subclasses were evaluated after two parenteral or three mucosal doses. The conventional memory response was evaluated after a booster dose. Non-conventional T and B memory response was also evaluated. OMV and AFCo1 overcome the T-independence of Ps inducing a Th1 typical pattern. They induce memory response at B and T cell levels. Conclusion. Adjuvants could be an alternative to covalent conjugated vaccines. The mechanism of T cell memory induction needs to be fully explored. Acknowledgements We thank the Finlay Institute for supporting this work. Keywords: adjuvant, Vaccine, Protoliposome, Cochleate, OMV Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Adaptive Immunity Citation: Romeu B, Lastre M, Cabrera O, Gonzalez E, Mandariote A, García L, Cardoso D and Pérez O (2013). Adjuvants as possible solution to polysaccharide unconjugated vaccines. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.01074 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 28 Jun 2013; Published Online: 22 Aug 2013. * Correspondence: Dr. Belkis Romeu, Finlay Institute, Immunology Department, Havana, Havana, Cuba, bromeu@finlay.edu.cu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Belkis Romeu Miriam Lastre Osmir Cabrera Elizabeth Gonzalez Aleida Mandariote Luis García Daniel Cardoso Oliver Pérez Google Belkis Romeu Miriam Lastre Osmir Cabrera Elizabeth Gonzalez Aleida Mandariote Luis García Daniel Cardoso Oliver Pérez Google Scholar Belkis Romeu Miriam Lastre Osmir Cabrera Elizabeth Gonzalez Aleida Mandariote Luis García Daniel Cardoso Oliver Pérez PubMed Belkis Romeu Miriam Lastre Osmir Cabrera Elizabeth Gonzalez Aleida Mandariote Luis García Daniel Cardoso Oliver Pérez Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

The mouse as biomodel in genotoxicity assays, two years of experience, Finlay institute, Cuba

The mouse as biomodel in genotoxicity assays, two years of experience, Finlay institute, Cuba

Randomized, double-blind, placebo-controlled trial to evaluate the safety and immunogenicity of live oral cholera vaccine 638 in Cuban adults

A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the safety, reactogenicity and the immunogenicity of a 2 × 10 9 CFU dose of the 638 lyophilized live attenuated cholera vaccine for oral administration, formulated and produced at Finlay Institute, City of Havana, Cuba. Thirty-six healthy female and male adult volunteers from 18 to 40 years old were involved, clinically examined and laboratory tested after the informed consent signature. Adverse events were monitored and seroconversion rates and geometrical mean titer (GMT) of vibriocidal antibodies were tested in volunteer's sera samples. Neither serious adverse events nor other damages to the volunteers due to vaccine or placebo feeding were reported during the clinical follow-up period of this study; none of the adverse events registered within the first 72 h after inoculation were life-threatening for volunteers. Neither severe nor moderate adverse events were reported. Sixty-one percent of subjects showed mild expected adverse events in an interval lower than 24 h up to the first 72 h, 75% of these in the vaccinated group and 18% in the placebo group. Fourteen days after inoculation the GMT of vibriocidal antibodies in the vaccine group significantly increased in comparison to the placebo group. All subjects in the vaccine group (24) seroconverted (100%). Results show that this vaccine is safe, well tolerated and immunogenic in healthy female and male volunteers.

Proteomic study via a non-gel based approach of meningococcal outer membrane vesicle vaccine obtained from strain CU385: A road map for discovering new antigens

This work presents the results from a study of the protein composition of outer membrane vesicles from VA-MENGOC-BC® (Finlay Institute, Cuba), an available vaccine against serogroup B Neisseria meningitidis. Proteins were identified by means of SCAPE, a 2DE-free method for proteome studies. More than one hundred proteins were detected by tandem liquid chromatography-mass spectrometry analysis of fractions enriched in peptides devoid of histidine or arginine residues, providing a detailed description of the vaccine. A bioinformatic analysis of the identified components resulted in the identification of 31 outer membrane proteins and three conserved hypothetical proteins, allowing the cloning, expression, purification and immunological study of two of them (NMB0088 and NMB1796) as new antigens.

The Adaptability of Homeoprophylaxis in Endemic, Epidemic and Stable Background Conditions

NOSODES 2008, the International Meeting on Homeoprophylaxis, Homeopathic Immunisation and Nosodes Against Epidemics was held in Havana, Cuba, from 10th to 12th December, 2008. It was hosted by Dr Concepcion Campa Huergo, President and Director General of the Carlos J Finlay Institute in Cuba. Speakers from ten countries on five continents presented papers relating to all aspects of homeoprophylaxis (HP). Leo van Gelder presented a short report on the conference in LINKS issue June 2009. In this paper some of the presentations will be discussed in more detail and the usefulness of homeoprophylaxis in a variety of endemic, epidemic and stable conditions described.

Cuban Health Professionals: Will Publishing Perish?

Cuba is a small country with one of the highest physician-percapita ratios in the world (1:155 in 2007). Since the 1980s, all new MDs are required to complete a family medicine residency, and many go on to pursue a second medical specialty or an advanced degree in public health, medical education or medical sciences. The numbers of other university-level health professionals are impressive. Cuba is also home to globally-respected biotechnology and medical research institutions, such as the Finlay Institute and the Pedro Kour� Institute of Tropical Medicine. Yet, the number and frequency of articles by Cuban authors published in national and international journals does not reflect the breadth and depth of Cuban medical research and practice. The most frequently cited articles in international journals of impact are in the fields of genetics, neurosciences, immunology, pharmacology and oncology, and almost 80% of these are co-authored by non-Cubans. While it is certain that many of these articles reflect public health applications, you will find scant citations of articles on other important topics at the forefront of Cuban public health-such as primary health care, infectious disease control, human resource development, sexual and reproductive health, and social determinants of health and wellness.

Epidemiology of pathogenic Neisseria meningitidis serogroup B serosubtypes in Malta: Implications for introducing PorA based vaccines

Objective To describe the epidemiology of the serosubtypes of Neisseria meningitidis serogroup B (MenB) in the most densely populated area in Europe and to review the MenB Porin A (PorA) based outer membrane vesicle (OMV) vaccines that could provide the broadest protection. Study design and setting Active surveillance of invasive meningococcal disease in a population of 400,000 inhabitants in Malta from 1999 to 2006. Serogroup B isolates were serosubtyped and analysed by age and year. The suitability of OMV vaccines was then assessed. Results Laboratory confirmation of invasive meningococcal disease was obtained in 48% (79/163) of notified cases. Serogroup B caused the majority of invasive meningococcal disease (76%, 60/79) with the greatest disease burden occurring in 0–14-year-old children (73%, 44/60). MenC caused 14% (11/79) of cases. The most prevalent MenB serotype:serosubtype combination was B:4:P1.19,15 which constituted 59% (34/58) of all phenotypeable MenB isolates. The PorA epitopes P1.15 and P1.19, detected in 74% (43/58) of isolates, were significantly more prevalent than serosubtypes with other PorA epitopes ( χ 2: 7.18, P < 0.01). Conclusion An assessment of the usefulness of a MenB OMV vaccine in Malta requires further research. The wild-type OMV vaccine developed by the Finlay Institute (FI) in Cuba could potentially be used to control an outbreak with a MenB P1.19,15 clone. A multivalent OMV vaccine would however be needed for broader protection against the endemic heterogenous MenB strains. A serogroup B vaccine incorporating more conserved proteins than PorA would be more suitable for comprehensive control of meningococcal B disease.

New Vaccines Require Potent Adjuvants like AFPL1 and AFCo1

Neisseria meningitidis B proteoliposome (AFPL1 when used as adjuvant) and its derivative-Cochleate (AFCo1) contain immunopotentiating and immunomodulating properties and delivery system capacities required for a good adjuvant. Additionally, they contain meningococcal protective antigens and permit packaging of other antigens and pathogen-associated molecular patterns (PAMP). Consequently, we hypothesized that they would function as good vaccine adjuvants for their own antigens and also for non-related antigens. AFPL1 is a detergent-extracted outer membrane vesicle of N. meningitidis B transformed into AFCo1 in calcium environment. Both are produced at Finlay Institute under good manufacture practices (GMP) conditions. We show their exceptional characteristics: combining in the same structure, the potentiator activity, polarizing agents and delivery system capacities; presenting multimeric protein copies; containing multiprotein composition and multi and synergistic PAMP components; acting with incorporated or co-administrated antigens; inducing type I IFN-gamma and IL-12 cytokines suggesting the stimulation of human plasmocytoid precursor and conventional dendritic cells, respectively, inducing a preferential Th1 immune response with TCD4(+), TCD8(+), cross-presentation and cytotoxic T-lymphocyte (CTL) in vivo responses; and functioning by parenteral and mucosal routes. AFPL1-AFCo1 protective protein constitutions permit per se their function as a vaccine. In addition to Phase IV Men BC vaccine, AFPL1 has ended the preclinical stage in an allergy vaccine and is concluding the preclinical stage of a nasal meningococcal vaccine. In conclusion, AFPL1 and AFCo1 induced signal 1, 2 and 3 polarizing to a Th1 (including CTL) response when they acted directly as vaccines or were used as adjuvants with incorporated or co-administered antigens by parenteral or mucosal routes. Both are very promising adjuvants.

Concepción Campa Huergo, President &amp; General Director, Finlay Institute

Pharmacist, biochemist, and lead scientist of the Cuban team that developed the meningitis B vaccine, Concepción Campa has been internationally recognized for her scientific contributions to children's health; this vaccine, patented as VA-MENGOC-BC®, was awarded the World Intellectual Property Organization's Gold Medal in 1989. Currently, Campa is President and General Director of the Finlay Institute, the Cuban scientific center dedicated to research, development, production, and marketing of vaccines for human use. Among many other distinctions, Concepci�n Campa is: Senior Member of the Cuban Academy of Sciences; World Health Organization Temporary Consultant & Scientific Advisor; Pan American Health Organization Temporary Advisor; Member of the Scientific Council of the Cuban Ministry of Public Health; and Member of the Cuban Expert Committee on Vaccines. She received an honorary PhD from the University of Havana in 1996. Dr Campa sat down with MEDICC Review to discuss Cuba's vaccine research approach, development of the meningitis B vaccine, what it's like to lead an internationally-renowned scientific institution, and more.

Cuban Meningococcal BC Vaccine: Experiences &amp; Contributions from 20 Years of Application

This paper reviews 20 years of experience and scientific contributions of the Cuban meningococcal BC vaccine (VA-MENGOC-BC®) obtained by the Finlay Institute in Havana, Cuba. The vaccine is the first of its type in the world that is safe, effective, and commercially available for preventing meningococcal disease caused by serogroup B meningococcus; it is also effective against serogroup C. VA-MENGOC-BC® has shown satisfactory results, with no serious adverse events, after application of approximately 55 million doses in some 15 countries. Also included is background information on meningococcal disease, as well as the main characteristics of VA-MENGOC-BC®, the strategy used for controlling meningococcal disease and its prevention in Cuba, and a summary of the main scientific results obtained in basic research, development, clinical evaluation, and post-marketing results (safety, efficacy-effectiveness, post-vaccination adverse events, etc.) in Cuba and elsewhere.

Outer membrane vesicles of the VA‐MENGOC‐BC® vaccine against serogroup B of Neisseria meningitidis: Analysis of protein components by two‐dimensional gel electrophoresis and mass spectrometry

Neisseria meningitidis is a Gram-negative bacterium responsible for significant mortality worldwide. While effective polysaccharides-based vaccines exist against serogroups A, C, W135, and Y, no similar vaccine is suitable for children under 4 years against disease caused by serogroup B strains. Therefore, major vaccine efforts against this serogroup are based on outer membrane vesicles (OMVs), containing major outer membrane proteins. The OMV-based vaccine produced by the Finlay Institute in Cuba (VA-MENGOC-BC) contributed to the rapid decline of the epidemic in this Caribbean island. While the content of major proteins in this vaccine has been discussed, no detailed work of an outer membrane proteomic map of this, or any other, commercially available OMV-derived product has been published so far. Since OMVs exhibit a large bias toward a few major proteins and usually contain a high content of lipids, establishing the adequate conditions for high resolution, 2-DE of this kind of preparation was definitely a technical challenge. In this work, 2-DE and MS have been used to generate a proteomic map of this product, detailing the presence of 31 different proteins, and it allows the identification of new putative protective protein components it contains.

Epidemiology of meningococcal disease in the city of Rio de Janeiro: changes after vaccination against B and C serogroups

Meningococcal disease has been a serious public health problem in the city of Rio de Janeiro, with high attack rates among younger children, high case fatality rates, and predominance of serogroup B. In December 1994 the second vaccination drive against B and C meningococcal disease was performed with the objective of protecting children ages 6 months to 13 years. A total of 950 thousand children received 2 doses of vaccine produced by the Finlay Institute of Cuba. In 1995 a change was observed in the disease pattern with a predominance of serogroup C and a higher global attack rate, particularly among children under 1 year of age, teenagers, and young adults. In vaccinated groups the attack rate was lower than in 1994, due to a decrease in serogroup B. No change was observed in the case fatality rate.

Radiation and Climatic Therapy of Chronic Pulmonary Diseases, with Special Reference to Natural and Artificial Heliotherapy, X-Ray Therapy, and Climatic Therapy of Chronic Pulmonary Diseases and All Forms of TuberculosisRadiation and Climatic Therapy of Chronic Pulmonary Diseases, with Special Reference to Natural and Artificial Heliotherapy, X-Ray Therapy, and Climatic Therapy of Chronic Pulmonary Diseases and All Forms of Tuberculosis. Edited

Radiation and Climatic Therapy of Chronic Pulmonary Diseases, with Special Reference to Natural and Artificial Heliotherapy, X-Ray Therapy, and Climatic Therapy of Chronic Pulmonary Diseases and All Forms of Tuberculosis<scp>Radiation and Climatic Therapy of Chronic Pulmonary Diseases, with Special Reference to Natural and Artificial Heliotherapy, X-Ray Therapy, and Climatic Therapy of Chronic Pulmonary Diseases and All Forms of Tuberculosis</scp>. Edited

Radiation and Climatic Therapy of Chronic Pulmonary Diseases, Including all Forms of Tuberculosis

Journal Article Radiation and Climatic Therapy of Chronic Pulmonary Diseases, Including all Forms of Tuberculosis Get access Radiation and Climatic Therapy of Chronic Pulmonary Diseases, Including all Forms of Tuberculosis. Edited by Edgar Mayer, M.D., F.A.C.P., F.A.C.C.P., Assistant Professor of Clinical Medicine, Cornell University Medical College; Attending Physician, New York and Memorial Hospitals; Special Pulmonary Consultant, New York State Department of Labor; Formerly Member Faculty, Trudeau School for Tuberculosis; Director (ex urbe) Northwoods and Will Rogers Tuberculosis Sanatoria, Saranac Lake, New York; Consultant on Tuberculosis to the Government of Cuba; Board Member of the Finlay Institute of America. With the collaboration of 22 contributors. Cloth. Price, $5. Pp. 393, with 46 illustrations. Baltimore: Williams and Wilkins Company, 1944. Physical Therapy, Volume 24, Issue 5, September-October 1944, Page 227, https://doi.org/10.1093/ptj/24.5.227b Published: 01 September 1944

Finlay Institute of the Americas

In the current comment on the Finlay Institute of the Americas inThe Journal, January 17, page 230, the name of Morton Kahn, a member of the Scientific Advisory Committee, was inadvertently omitted.