pH1N1 Vaccine Research Articles

Pandemic influenza vaccination: Will the health care system take its own medicine?

To identify factors associated with acceptance of the pandemic Influenza A H1N1 California 7/09 vaccine (pH1N1 vaccine) in rural hospital staff. Cross-sectional group administered survey. A 58-bed rural Queensland hospital, over a 10-day period starting five days after commencement of the pH1N1 vaccination program. Hospital staff and students. Intention to receive pandemic influenza vaccination, seasonal influenza vaccination. The survey was completed by 252 staff and students (full response rate 76.1%, cooperation rate 98.4%). The majority of respondents had already decided whether or not to receive the pH1N1 vaccine: 111 (44.0%) intended to be vaccinated, 63 (25.0%) intended not to be vaccinated and 78 (31.0%) were undecided. Of 125 staff who had received the seasonal influenza vaccine, 86 (68.8%) intended to receive the pandemic vaccine. Respondents were less likely to state acceptance of the pH1N1 vaccine if they identified concern about vaccine adverse reactions (odds ratio (OR) 0.29; 95% confidence interval (CI), 0.11-0.78), vaccine safety (OR 0.20; 95% CI, 0.09-0.46), vaccine efficacy (OR 0.20; 95% CI, 0.04-0.87) or perceived limitations of vaccine trials (OR 0.08; 95% CI, 0.01-0.99) as primary reasons discouraging pandemic influenza vaccination. There is considerable concern among rural hospital staff regarding pH1N1 vaccine adverse reactions, safety, efficacy and the adequacy of clinical trials on its use. Education specifically addressing these concerns might increase pandemic vaccine acceptability.

Experiences of the Department of Anesthesiology and Intensive Therapy of Semmelweis University during the 2009 pandemic H1N1 (pH1N1) influenza outbreak

Abstract Introduction: The 2009 pandemic 2009 H1N1 (pH1N1) influenza A virus shows a markedly different disease pattern than seasonal strains, causing critical illness in relatively young, female, pregnant individuals as well as in comorbid patients. Materials and methods: The Department of Anesthesiology and Intensive Therapy of Semmelweis University served as a regional influenza center for the adult critically ill during the winter of pH1N1 outbreak. We analyzed data collected from 26 suspected pH1N1 critically ill patients treated in our unit during this period. Results: Sixteen cases were confirmed as pH1N1 infection with RT-PCR, while the other 10 patients with influenza like illness showed tendency to a different age and comorbidity, as well as outcome characteristics, suggesting a different pathogenesis. Confirmed pH1N1 patients showed a mean age of 50.5 years (median: 44; range: 20–85), with female predominancy (69%). Comorbidity was present in 69% of cases (chronic heart conditions, chronic pulmonary disease, previous history of malignancy present in 31; 25 and 19%, respectively). Twenty-five percent of the patients were pregnant women. Nineteen percent of the cases received previous pH1N1 vaccination. But two patients were later readmitted for worsening chronic conditions that led to death, which resulted in a total mortality rate of 31%. Mean APACHE II and SOFA scores on admittance were 12.2 and 5.3, respectively. Average length of treatment was 11.5 days (median: 6.5; range 2–50 days). All patients received ventilatory assistance, 69% of patients received invasive, while 31% of patients received non-invasive ventilatory assistance. The average number of days of invasive ventilation was 10.5 days (median: 5.5; range: 2–45). Forty-five percent of ventilated patients required rescue ARDS therapy. Complications included hemodynamic instability (56%); acute renal failure (13%) and pneumothorax (13%). Superinfection with other microbes were observed in 56% of the patients. Conclusions: In our study, pH1N1 infected critically ill patients had a wide age range, but were more commonly female, pregnant, or had a previously described underlying disease. Mortality, length of treatment, need for invasive mechanical ventilation, length of mechanical ventilation, major complication rates were similar to those previously described. A previously not reported relatively high occurrence of pneumothorax was noted, which is possibly a long-term complication of severe viral pneumonitis.

Administration of the Adjuvanted Ph1N1 Vaccine in Egg Allergic Children at High Risk for H1N1 Disease

Administration of the Adjuvanted Ph1N1 Vaccine in Egg Allergic Children at High Risk for H1N1 Disease

Influenza vaccines provide diminished protection but are cost‐saving in older adults

Influenza is associated with substantial morbidity and mortality in adults aged over 65 years. Although vaccination remains the most effective method of preventing influenza and its sequellae, current vaccination strategies provide less protection to older adults than to younger persons. Influenza vaccination in community-dwelling older adults is cost-effective, though there is room for improvement. Newer vaccine strategies considered for use in older adults include alternate routes of administration (intradermal or intranasal), addition of adjuvant, and novel methods of antigen presentation. Measuring cell-mediated immune response to new vaccines in addition to antibody response may correlate better with vaccine efficacy in this population. Whilst pandemic influenza A/H1N1 2009 (pH1N1) has largely spared older adults, the impact of pH1N1 vaccination has yet to be determined.

Preliminary population‐based epidemiological and clinical data on 2009 pandemic H1N1 influenza A (pH1N1) from Lima, Peru

Preliminary population‐based epidemiological and clinical data on 2009 pandemic H1N1 influenza A (pH1N1) from Lima, Peru