Post-vaccination Complications Research Articles

METHODS OF INCREASING THE EFFECTIVENESS OF VACCINES IN CHILDREN AND REDUCING POST-VACCINATION COMPLICATIONS

Vaccination is essential in preventing infectious diseases, particularly in pediatric populations. However, optimizing vaccine efficacy while minimizing post-vaccination complications in children remains a significant challenge due to the developmental state of their immune systems. This article reviews current strategies for enhancing vaccine effectiveness, including the use of adjuvants, improved vaccine formulations, and personalized vaccination schedules. Additionally, it explores methods to reduce post-vaccination complications, such as pre-vaccination screening, prophylactic treatments, and minimizing antigen load. These approaches aim to provide better protection for children while ensuring safety and reducing adverse effects. The findings highlight the need for continued research into vaccine optimization tailored to pediatric needs, particularly in the era of advanced vaccine technologies.

Chronic inflammatory demyelinating polyneuropathy following COVID-19 vaccination: a case report and literature review

BackgroundSevere post-vaccination neurological complications are rare. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an immune-mediated polyneuropathy affecting the peripheral nerve roots, which is not well described as a post-vaccination side effect. Here, we present a rare complication of vaccination against SARS-CoV-2, reaching a diagnosis of CIDP.Case presentationA 67-year-old diabetic male presented with lower extremity paresthesia and weakness following the third dose of the Sinopharm (BBIBP-CorV) vaccine. Despite initial dismissal as a diabetic complication, symptoms escalated, affecting all extremities. Electromyography study revealed abnormal spontaneous activity with chronic reinnervation changes, which was more significant in the lower extremities. Based on the clinical course, radiographic imaging, and laboratory data, a diagnosis of CIDP with severe axonal demyelinating features was established. Treatment with intravenous immunoglobulin (IVIg), prednisolone, and azathioprine resulted in marked improvement of the upper extremities but limited recovery in distal lower extremity muscles.ConclusionAlthough CIDP is a rare complication following COVID-19 vaccination, it should be considered in the differential diagnosis. Timely diagnosis of vaccine-induced CIDP is challenging, and any delay can adversely affect treatment response in affected patients.

Guillain-Barré Syndrome following tissue rabies vaccination. A case report

Post-exposure prophylaxis against rabies vaccines can lead to acute neuro-paralytic complications such as Guillain-Barré syndrome. We report the case of a 13-year-old child, victim of a stray dog bite, who underwent tissue-based rabies vaccination. Thirteen days after vaccination, the child developed tetraplegia with respiratory distress, requiring tracheal intubation and mechanical ventilation. Cerebral-medullary magnetic resonance imaging showed contrast in the roots of the cauda equina, suggesting polyradiculoneuritis. The child was treated with immunoglobulin and physiotherapy. Outcome was marked by complete recovery of muscle strength with no neurological sequelae. This case highlights the potential risk of neurological complications following tissue-based rabies vaccination, suggesting a preference for cellular vaccines, where post-vaccination neurological complications are very rare.

National Concept of Development of Vaccine Prophylaxis in Russia

The article is dedicated to outlining the conceptual directions for the development of vaccination in the Russian Federation. The provisions of the concept are formulated based on the authors' years of research on vaccination issues and analysis of data from domestic and foreign scientific literature. The main provisions of the concept aim at strengthening the state policy in the field of vaccination, reconstructing and expanding enterprises for the production of domestic vaccines, developing and improving immunobiological medicinal products against current infections, refining the National Immunization Schedule and Vaccination Schedule according to epidemiological indications; further promoting the WHO's "lifelong immunization" strategy; developing regional immunization programs; implementing a risk-oriented approach in the development of immunization programs; developing a system for monitoring post-vaccination complications; implementing epidemiological surveillance of vaccination as a methodology for assessing the strategy and tactics of immunization in accordance with the epidemiological situation; ensuring commitment to vaccination among the population, healthcare workers, and legislative and executive authorities.

Recent pathogenetic aspects of hearing loss in COVID: A literature review

The World Health Organisation predicts that by 2050, up to 10% of the world's population will need rehabilitation to address disability-related hearing loss. The purpose of this study was to identify the main mechanisms of hearing loss associated with Severe Acute Respiratory Syndrome Coronavirus 2 infection. The study included modern English-language scientific publications, mainly those with a high citation index, through the professional platforms MEDLINE/PubMed and Index Medicus. A total of 48 sources were selected. Research papers devoted to the development of conductive or sensorineural hearing loss, which occurred directly as a result of a viral disease, or is associated with the processes that accompany it (treatment, concomitant pathology, vaccination, etc.), were analysed. It was found that the development of viral-induced hearing loss in COVID has a multifactorial nature. The heterogeneity of audiological changes is primarily conditioned by direct viral damage to auditory analyser cells that express membrane receptors of the angiotensin converting enzyme of the second type. In addition, there is a reactivation of latent viral infection, extravasation of exudate into the middle ear cavity, blood clotting disorders, immune-mediated cell damage, local and generalised inflammatory reactions that affect both sound conduction and sound perception in one ear or both. Some cases of audiological disorders may also be of iatrogenic origin, since post-vaccination complications and ototoxic effects of medications used in the treatment of COVID-19 are not excluded, which should be considered by clinicians at all levels of healthcare to effectively manage a specific clinical scenario

Attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders

The COVID-19 pandemic has exacerbated the increasing prevalence of non-psychotic mental disorders and the rise of antivaccination tendencies.The aim of the study was to describe the attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders, as well as in mentally healthy individuals.Materials and methods: a survey was conducted of 100 outpatient patients with psychiatric diagnoses of non-psychotic level: organic mental disorders (14), affective disorders (38), neurotic and stress-related disorders (48), as well as 30 people without mental disorders.Results and discussion. There was no association between the severity of COVID-19 and an adverse reaction to the vaccine. A high incidence of skepticism about vaccination against COVID-19 was noted in women, in the older age group, in people with higher education and highly qualified work, but poorly informed about immunoprophylaxis. Post-vaccination complications (fever, general weakness) after immunization against COVID-19 were more often detected in patients with affective disorders, however, this group of patients showed the most loyal attitude to vaccination. Patients with organic mental disorders shown the lowest degree of approval of vaccination against COVID-19, they cited fear of possible «side effects» and «lack of proven benefit» as the main reason for not being vaccinated.Conclusion. Vaccination of the population of all countries affected by COVID-19 has exacerbated such a phenomenon as doubt about the benefits of immunoprophylaxis. The results of the article can be extrapolated to the future development of new drugs in the field of immunoprophylaxis.

Vaccination of premature newborns

Premature newborns are most vulnerable to the severe infectious diseases. The timeliness of vaccination in this group of children is extremely important. Historically, however, vaccination coverage for premature newborns has been significantly reduced due to unjustified contraindications. This is due to the fear of developing post-vaccination complications and the opinion that the immune response to vaccines in preterm newborns is reduced. In addition, in our country, there are no approved federal clinical guidelines for the vaccination of premature newborns, which determines the lack of a unified approach among medical workers and raises doubts among parents.The article presents a review of Russian and foreign literature data, highlighting the state of the problem of timeliness and completeness of vaccination coverage of premature newborns. Features of the immunity of a child born prematurely and the possibility of an adequate response to vaccine antigens in various degrees of prematurity. According to the list of the National Immunization Schedule, scientific and practical data on the safety and efficacy of vaccines registered in Russia, the benefits of complying with approved schedule and the positive non-specific effects of individual vaccines are given. Data on the specific prevention of RS-virus infection are presented. It has been shown that conditions that can develop after vaccination and are characteristic of prematurity are not directly related to the vaccine and that premature newborns is able to develop a sufficient immune response. Accordingly, children born prematurely should be immunized in accordance with the passport age with the stabilization of the child’s condition and adequate weight gain.

Two versus three doses of COVID-19 vaccine and post-vaccination COVID-19 infection in hemodialysis patients

Background and aimPatients with chronic kidney disease including those undergoing hemodialysis (HD) constitute a particularly challenging group regarding COVID-19 vaccination. The present study aimed to compare the rate of reinfection after two and three doses of Sinopharm COVID-19 vaccine in HD patients. Patients and methodsThe study included 80 HD patients who received three doses of Sinopharm COVID-19 vaccine. In addition, there were another 80 patients who received only two doses of the vaccine. Patients in the latter group were selected based on propensity matching score with 1:1 ratio. Patients were monitored for post-vaccination COVID-19 infection using PCR examination of nasopharyngeal swabs. Patients were also monitored for post-vaccination complications including general complaints (headache, fever, fatigue), injection site complaints (arm pain, swelling, itching, rash), musculoskeletal complaints (muscle spasm or pain, joint pain) and others. All patients were followed for six months. ResultsThe present study included 80 patients submitted to COVID-19 vaccination with two doses of Sinopharm vaccine (GI) and other 80 patients who received three doses of the same vaccine (GII). At the end of follow up, 11 patients (13.8 %) in GI caught COVID-19 infection. In contrast, no patient in GII had infection (p<0.001). Comparison between patients who had COVID-19 infection and those without infection revealed that the former subgroup had significantly lower BMI (23.3 ± 2.3 versus 27.5 ± 8.1 Kg/m2), higher frequency of associated Hepatitis C (HCV) infection (54.6 % versus 2.9 %, p<0.001) and higher serum ferritin levels [median (IQR): 1101.0 (836.0-1564.0) versus 675.0 (467.0-767.7) ng/mL, p=0.01]. Binary logistic regression analysis identified high serum ferritin levels [OR (95% CI): 0.014 (0.001-0.15), p<0.001] and associated HCV infection [OR (95% CI): 0.99 (0.98-1.01), p=0.02] as significant predictors of post-vaccination COVID-19 infection in multivariate analysis. ConclusionsA three dose regime of Sinopharm COVID-19 vaccine associated with significantly lower rate of reinfection COVID-19 infection in HD patients. Infected patients had significantly lower BMI, higher frequency of HCV and higher ferritin levels.

Role of Xenosialylation in Post-Infectious and Post-Vaccination Complications, Including Covid-19 and Anti-SARS-CoV-2 Vaccination.

The host glycosylation mechanism, with sialic acids as a key component, is essential for synthesizing carbohydrate components in viral glycoproteins. We hypothesize a correlation between the presence of the Neu5Gc on the host tissue and the development of infectious complications, adverse vaccine reactions, and autoimmune diseases. In certain mammals, including humans, the loss of the Cytidine Monophospho-N-Acetylneuraminic Acid Hydroxylase gene (negative-CMAH) prevents the synthesis of Neu5Gc, which acts as a Mammalian-associated Carbohydrate Antigen (MCA), (XeSiAs-Neu5Gc). When negative-CMAH species consume products from positive-CMAH mammals or are exposed to non-human cell-derived medicines, Neu5Gc can be integrated into their glycocalyx through a process called xenosialylation, eliciting an inflammatory response (xenosialitis) and prompting the production of circulating anti-Neu5Gc antibodies aimed at eliminating Neu5Gc. We hypothesize that in the case of xenosialylation, neutralizing antiviral antibodies from infections or vaccinations-including those for SARS-CoV-2-may cross-react with the XeSiAs-Neu5Gc glycans, as these resemble viral envelope antigens produced by the host's glycosylation. Additionally, circulating anti-Neu5Gc antibodies may also react with other circulating antibodies, including newly formed antiviral ones with a XeSiAs-Neu5Gc-contaminated Fc region. This can lead to the serum removal of the anti-inflammatory antibodies, leaving only hyperinflammatory IgG agalactosylated antibodies. Such conditions are also seen in various inflammatory and autoimmune diseases. We hypothesize that the combination of antibody cross-reaction and the removal of the XeSiAs-Neu5Gc-contaminated Fc region anti-inflammatory antibodies may intensify severe inflammatory responses like cytokine storms and coagulopathies in COVID-19 patients and those vaccinated. Assessing serum levels of total XeSiAs-Neu5Gc antibodies could be a valuable method for identifying patients at risk of severe complications from viral infections and vaccinations, including SARS-CoV-2. This strategy may also deepen our understanding of the pathogenesis of autoimmune diseases linked to post-infectious and post-vaccination complications, particularly for viruses utilizing the host glycosylation machinery, such as SARS-CoV-2, IAV, EBV, and others.

Clinical trial results of an associated vaccine against cattle clostridiosis and escherichiosis

In veterinary practice, gastrointestinal diseases of newborn calves, caused by the association of pathogenic bacteria, in particular Clostridium perfringens and Escherichia coli, are often observed. The results of our research have shown that in the Volga Federal District of the Russian Federation, anaerobic enterotoxemia in newborn calves is most often caused by Clostridium perfringens serotypes A, C, D. For the specific prevention of this form of pathology, an associated vaccine has been developed containing inactivated antigens of Clostridium perfringens serotypes A, C, D and Escherichia coli, which produce adhesion factors K99 and A20. Clinical trials of the effectiveness of the vaccine on cattle were carried out in 3 large agricultural enterprises of the Republic of Tatarstan for the production of milk, permanently dysfunctional for clostridiosis and escherichiosis of newborn calves. Disease prevention began with the immunization of pregnant cows and heifers 60 days before the expected calving. The animals were vaccinated twice with an interval of 14 days at a dose of 10 cm3. Calves obtained from immunized cows were vaccinated twice subcutaneously at a dose of 3 cm3 at the age of 18- 20 days. A total of 3156 cows and heifers were vaccinated in three dairy complexes. It was found that the associated vaccine is harmless for deepwalled cows and heifers, does not cause post-vaccination complications. Immunization of animals in the last months of pregnancy contributes to the accumulation of specific antibodies in colostrum, the intake of which provides passive protection of the newborn calf from infection with Cl. perfringens and E. coli bacteria.

Evaluating clinical effectiveness and safety of pneumococcal immunization of infants

According to WHO, pneumococcal infection (PI) is considered one of the most dangerous of all vaccine-preventable diseases and, before vaccination, led to the death of up to 1.6 million people per year, of which from 0.7 to 1 million were children. In the prevention of PI, specific prevention occupies a special place. For the first time in 2014, vaccination against PI with pneumococcal conjugate vaccine was included in the national calendar of preventive vaccinations. International practice of using pneumococcal vaccine has shown that timely vaccination can produce positive results in the fight against PI. Under observation were 55 children who were vaccinated against PI with the pneumococcal polysaccharide conjugate vaccine (adsorbed), 13 valent according to the national calendar of preventive vaccinations of the Russian Federation. It was revealed that post-vaccination complications after vaccination did not occur in any child. General post-vaccination reactions were observed in the form of a short-term increase in temperature, loss of appetite and sleep disturbances, as well as local reactions in the form of edema, hyperemia, and hardening at the site of vaccine administration. We studied the incidence of community-acquired pneumonia (CAP), acute otitis media and acute respiratory infections among 55 children of the first year of life vaccinated at 2 months and 4.5 months (main group) and 50 children for various reasons not vaccinated against PI (comparison group). A study of the long-term results of 2-fold vaccination in the first year of life and revaccination at 15 months against PV based on observation of children for two years showed that children of the main group, compared with the comparison group, were 3.3 times less likely to suffer from PV, 2.7 times acute otitis and 1.7 times acute respiratory infections, p &lt; 0.05. The data obtained show the high efficiency and safety of vaccinating children against PI with the pneumococcal vaccine.

NEURO-COVAX: An Italian Population-Based Study of Neurological Complications after COVID-19 Vaccinations.

In this Italian population-based study, we aimed to evaluate the neurological complications after the first and/or second dose of COVID-19 vaccines and factors potentially associated with these adverse effects. Our study included adults aged 18 years and older who received two vaccine doses in the vaccination hub of Novegro (Milan, Lombardy) between 7 and 16 July 2021. The NEURO-COVAX questionnaire was able to capture the neurological events, onset and duration. That data that were digitized centrally by the Lombardy region were used to match the demographic/clinical characteristics and identify a vulnerability profile. Associations between vaccine lines and the development of complications were assessed. Digital healthcare system matching was also performed to evaluate severe neurological complications (Guillain-Barrè syndrome, Bell's palsy, transverse myelitis, encephalitis) and the incidence of hospital admissions and/or the mortality rate after two doses of the vaccines. The NEURO-COVAX-cohort included 19.108 vaccinated people: 15.368 with BNT162b2, 2077 with mRNA-1273, 1651 with ChAdOx1nCov-19, and 12 with Ad26.COV2.S who were subsequently excluded. Approximately 31.2% of our sample developed post-vaccination neurological complications, particularly with ChAdOx1nCov-19. A vulnerable clinical profile emerged, where over 40% of the symptomatic people showed comorbidities in their clinical histories. Defining the neurological risk profile, we found an increased risk for ChAdOx1nCov-19 of tremors (vs. BNT162b2, OR: 5.12, 95% CI: 3.51-7.48); insomnia (vs. mRNA-1273, OR: 1.87, 95% CI: 1.02-3.39); muscle spasms (vs. BNT162b2, OR: 1.62, 95% CI: 1.08-2.46); and headaches (vs. BNT162b2, OR: 1.49, 95% CI: 0.96-1.57). For mRNA-1273, there were increased risks of parethesia (vs. ChAdOx1nCov-19, OR: 2.37, 95% CI: 1.48-3.79); vertigo (vs. ChAdOx1nCov-19, OR: 1.68, 95% CI: 1.20-2.35); diplopia (vs. ChAdOx1nCov-19, OR: 1.55, 95% CI: 0.67-3.57); and sleepiness (vs. ChAdOx1nCov-19, OR: 1.28, 95% CI: 0.98-1.67). In the period that ranged from March to August 2021, no one was hospitalized and/or died of severe complications related to COVID-19 vaccinations. This study estimates the prevalence and risk for neurological complications potentially associated with COVID-19 vaccines, thus improving the vaccination guidelines and loading in future personalized preventive medicine.

Обізнаність майбутніх батьків щодо вакцинації

Purpose - to assess the intentions of students of different universities to vaccinate their future children and the factors that influence their decision. Materials and methods. A Google form with 20 questions was developed. The data were obtained from an online survey conducted among students who have not yet had children. The questions concerned the attitude to immunoprophylaxis, as well as information about the age, gender and occupation of the respondents (of particular interest are those who have or are obtaining a medical education). Results. A total of 145 students took part in the survey, including 79.5% from healthcare and 20.5% from non-healthcare sectors. The majority of those who took part in the survey were female, aged 18 to 30. According to the data, after giving birth to children, 77.2% of respondents expressed a desire to invest in disease prevention and enjoy a full life, while almost 8% consider it appropriate to treat diseases that have already occurred, and more than 14% are undecided about medical tactics. In general, 81% have a positive attitude towards vaccination; 16% have a reservation, more than 2% are undecided, and almost 1% have a negative attitude. According to the attitude towards vaccination of their future children, five distinct parental groups were identified among the respondents: “unquestioning acceptors” - 57% of respondents indicated that they intend to vaccinate their future children with all vaccines available in Ukraine, 43.9% - “cautious acceptors” - will choose only mandatory vaccinations; 8.8% are undecided and slightly less than 2% are “refusers” from all vaccines. The first place among the main reasons for refusing to vaccinate children is the fear of adverse reactions and post-vaccination complications; the second place is distrust of the manufacturer and the third is caution because of so-called contraindications. The survey also found that when determining contraindications to vaccinating an unborn child, respondents would most likely listen to the opinion of the following specialists: pediatrician - 87.7%; immunologist - 56.1%; family doctor - 46.5%. Conclusions. The level of awareness of vaccination among young people is generally satisfactory. There is no difference between doctors and non-physicians. To maximize protection of children from vaccine-preventable infections, pediatricians should effectively counsel parents on the benefits of vaccines and the risks of delaying or refusing vaccination. To increase understanding and benefit of vaccines among the general population and reduce vaccine hesitation/refusal, vaccine education should begin as part of a healthy lifestyle and disease prevention program long before university and continue after medical and non-medical training. Basic knowledge about vaccines should be included in the curriculum of not only medical but also non-medical universities. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. No conflict of interests was declared by the authors.

Commitment of health workers and various population groups to vaccination

Introduction. The relatively stable incidence of most controlled infections shifts the focus of public attention from the need for vaccination to the likelihood of post-vaccination complications.&#x0D; Aim. To examine the adherence of various population groups and health workers to vaccine prophylaxis and analyze the reasons for anti-vaccination scepticism.&#x0D; Materials and methods. A survey was conducted on the attitudes towards vaccination among one thousand nine hundred thirty nine respondents including 485 doctors of various specialties (163 pediatricians, 86 surgeons, 85 obstetricians-gynecologists, 76 neurologists, 75 neonatologists), 117 nurses, 295 parents, 1042 students. The significance of differences was assessed using Student’s t-test.&#x0D; Results. An insufficient level of adherence to vaccine prophylaxis has been established: 43.1% of parents vaccinate their children selectively, 35.4% according to the national calendar, 17.1% refuse categorically, and 4.4% have a medical refusal. The main reason for refusal is fear of complications (30%). Less than half receive information from health workers (45.6%), the main source being the media (49.1%). Among health workers, adherence to vaccine prophylaxis is highest among pediatricians (86.1%), significantly lower among neurologists (35.6%), surgeons (43.7%), obstetricians-gynecologists (62.6%), nurses (79.5%). The main reason for distrust of vaccination is fear of post-vaccination complications, narrow specialists more often choose the answer “better to get sick”. Among medical university students there is a significantly higher adherence among senior students in paediatrics (63.6%) compared to students in undergraduate (40.8%) and medical school (48.8%). However, 5% of those surveyed do not plan to vaccinate their children in the future. Polytechnic students have a more negative attitude towards vaccination accounted for only 36.4% vaccinated according to the National Calendar and 30% do not plan to vaccinate their children in the future.&#x0D; Conclusion. There is a clear need for additional training programs on vaccination to raise the awareness of health care workers on this issue, which will provide a strong rationale for the importance of immunization to patients and their parents.

Pediatric Vaccination: Exploring the Views of Pediatricians on the Implementation of a Feedback Module

Preventive vaccination is particularly important in children as their bodies are highly susceptible to infectious diseases. However, despite significant achievements in the field of vaccination, it is crucial to note that preventive vaccination is not without complications. This necessitates careful monitoring and evaluation of the effectiveness of used vaccines, as well as the implementation of effective feedback mechanisms to collect data on potential post-vaccination reactions and complications. Currently, the level of feedback within pediatric vaccination is limited, and healthcare professionals often face limitations in providing information and support to parents and patients. Therefore, it is essential toconduct an interview analysis to assess the current situation, identify issues, and determine the necessary measures for the development of a feedback module that meets the needs of patients, their parents, and medical professionals in terms of information, support, and timely response to post-vaccination reactions and complications.

Features of the cytokine profile under its modification with technogenic factors in conditions of experiment in vitro (on the example of benz(a)pyrene and SARS-CoV-2 vaccine antigen)

Introduction. The immune system plays the key role in the formation of adaptive responses and is the most sensitive to environmental exposures. An immune response under exposure to viruses or other factors is induced by toll-like receptors stimulating production of pro-inflammatory cytokines. Simultaneous exposure to exogenous chemical pollutants in ambient air modifies the adaptation process.&#x0D; Materials and methods. An in vitro experiment was accomplished on samples of peripheral blood. The study focused on a mixed population of immune-competent cells (n=64 samples). Effects produced by exogenous factors (benz(a)pyrene, SARS-CoV-2) and managing elements (interleukin-1β, cortisol) were considered influencing factors. All the lymphocyte cultures were incubated for 72 hours; after that, the quantitative content of cytokines in the samples was determined by the ELISA tests.&#x0D; Results. The inhibition of cytokines was experimentally demonstrated when the SARS-CoV-2 vaccine antigen was introduced into cell culture in combination with cortisol and an immunomodulator (IL-6, IL-10), and a significant decrease in the level of INF-gamma in samples with the addition of IL-1β was also noted. Benz(a)pyrene exerted a catalytic effect on the cytokine-producing function of immunocompetent cells with an increase in the production of IL-6 and IFN-gamma relative to spontaneous production. Suppression of cytokines (IL-6, IFN-gamma, and IL-10) was observed in samples containing vaccine antigens SARS-CoV-2, compared with the spontaneous level, which suggests the formation of possible mechanisms of post-vaccination complications.&#x0D; Limitations. The study has no limitations associated with the use of the selected methods or characteristics of the research objects.&#x0D; Conclusions. Experimental modelling in vitro made it possible to estimate the additive effects of the mixed action of benz(a)pyrene and SARS-CoV-2 (vaccine antigen) on protein molecules and hyperproduction of inflammatory modulators was evaluated. The study aimed to facilitate investigation of the examined mechanism and development of relevant programs for preventing risks of negative effects produced on health by chemical and biological factors.

Health professionals KAP study on rabies exposure assessment and NTV administration in Ethiopia

Background: Globally, it’s estimated 60,000 human deaths occur due to rabies with 95% of cases occurring in Africa and Asia. Annually, thousands of people are infected with rabies in Ethiopia and more than 2700 people die. In Ethiopia, the neural-based vaccine has been used since the 1950’s. Due to the old method of production, low immunogenicity and vaccine associated adverse events, WHO discourage the use of this vaccine and recommend replacing it with a safe and effective modern cell culture vaccine. There was no specific guidelines and training for this vaccine and health professional mismanage the nerve tissue vaccine (NTV) with cell culture vaccine resulting in vaccination failure. This study identifies professional knowledge, attitude and practice (KAP), vaccine related adverse events and the burden of rabies cases in humans. Methods: Data were collected from health professionals in selected health facilities using structured questionnaire to identify the level of KAP. Results: The study identified overall gaps in the professionals KAP as below standard which is not more than 25%. The majority of the respondents (97%) reported vaccine associated local adverse events followed by 20% systemic complications during vaccination. Only 2.4% of the respondents reported post-vaccine complications. Rabies cases in humans at those covered health facilities were reported to be 32 during the one-year study period with an average of two cases at each facility. Conclusions: Gaps identified in the professional KAP result indicate the need to provide specific training based on standard guidelines. Generally, the study indicates the need to strengthen rabies prevention and control efforts through inter-sectoral collaboration, and facilitating the establishment of facility-based rabies palliative care centers. In addition, it is recommended to work on technology transfer to replace old method of NTV production with safe and effective modern cell culture based anti-rabies vaccine production for effective rabies PEP.

Cardiovascular and Neurological Complications of COVID-19: A Narrative Review.

A novel coronavirus emerged in China in late 2019 as a disease named coronavirus disease 2019. This pathogen was initially identified as causing a respiratory syndrome, but later, it was found that COVID-19 could also affect other body systems, such as the neurological and cardiovascular systems. For didactic purposes, cardiovascular and neurological manifestations of SARS-CoV-2 have been classified in three different groups: acute complications, late complications, and post-vaccine complications. Therefore, the following study has the goal to summarize and disseminate the present knowledge about the cardiovascular and neurological manifestations of COVID-19 based on the latest and most up-to-date data available and, thus, promote more prepared medical care for these conditions as the medical team is updated. Based on what is brought on this revision and its understanding, the medical service becomes more aware of the causal relationship between some conditions and COVID-19 and can better prepare for the most prevalent conditions to associate and, consequently, to treat patients earlier. Therefore, there is a chance of better prognoses in this context and the need to increase the number of studies about complications related to SARS-CoV-2 infection for a better understanding of other associated conditions.

THE PROBLEM OF POST-VACCINATION IMMUNITY IN CHILDREN WITH CHRONIC HERPESVIRUS INFECTIONS

The category of children with health disorders occupies a special place in the problem of vaccination of the population and the creation of long-term strained immunity to current infections. These are children with allergic, oncological diseases, central nervous system pathology, autoimmune disorders, systemic diseases of connective and supporting tissue, and chronic infectious diseases. Among these children, a special place is occupied by children who are sick often and for a long time. In these patients, the individual scheduled vaccination schedule is often disrupted due to repeated respiratory infections. Often, paediatricians give such children unreasonably long withdrawal from vaccinations due to fear of developing post-vaccination complications in them. In addition, in many cases, vaccination is not carried out, mistakenly believing that vaccination will still be ineffective, since the child's body, which is often sick, is not capable of an adequate immune response.

EXPERIENCE OF USING THE IMMUNE-COMPLEX VACCINE PULVAK MAGNIPLEX IN THE PREVENTION OF INFECTIOUS BURSA DISEASE OF BROILERS

The article presents the results of serological control of the effectiveness of vaccination of broilers against infectious bursal disease (IBD) when the immune-complex vaccine Pulvak MagniPlex is used in the incubator.&#x0D; Immune-complex vaccines are vaccines of a new generation, the use of which completely eliminates post-vaccination complications in birds and interference phenomena. The vaccine includes a mixture of specific antibodies and the vaccine strain of the IBH virus. The main property of these vaccines is that when administered subcutaneously in day-old chicks or 18-day-old chicken embryos by the in ovo method, immunity is quickly created even in the presence of high maternal antibodies (MAB). Vaccination in the incubator using immune-complex vaccines is more accurate and provides protection to the whole bird, unlike live vaccines, the main method of which is administration with drinking water. Immuno-complex vaccines are effective even in the presence of high MAT in chickens. Due to this, they provide a much higher level of protection due to the high homogeneity of protective antibodies compared to live attenuated vaccines.&#x0D; We present the data of serological monitoring on the average titer of antibodies to the IBH virus in blood sera from 15 batches of broilers aged 45-50 days, which were immunized on the first day in the incubator with the immune-complex vaccine Pulvak MagniPlex. It was established that during a single vaccination in the incubator (15 batches), the Pulvak MagniPlex vaccine stimulates the formation of an active immune response to the IBH virus for the entire period of fattening of broilers. The average titers in the blood sera of broilers aged 45-50 days to the IBH virus ranged from 6,995 to 12,388 after a single vaccination in the incubator (15 batches). The percentage of protective antibodies to the IBH virus in 15 batches of broilers varied from 77.3 to 100, which indicates the intensity of immunity to IBH. A single application of the immune-complex vaccine Pulvak MagniPlex in the incubator stimulates the formation of an active immune response to the IBD virus for the entire period of broiler fattening and provides 100 % protection of 12 batches of broilers and 77.3 % of broilers of 3 batches to IBD. The use of Pulvak MagniPlex allows: to create stable immunity against IBD; to form immunity in each individual broiler, regardless of the level of maternal antibodies; to reduce the impact of stress (compared to mass vaccination in the poultry house by the drinking method. Constant control of the effectiveness of the Pulvak MagniPlex immune-complex vaccine by means of serological monitoring of blood sera in ELISA will allow, depending on the epizootic situation, to timely adjust the vaccination scheme of poultry against IBD.