Vaccine最新文献

{"title":"Report from the World Health Organization's immunization and vaccines-related implementation research advisory committee (IVIR-AC) ad hoc meeting, 28 June – 1 July 2024","authors":"","doi":"10.1016/j.vaccine.2024.126307","DOIUrl":"10.1016/j.vaccine.2024.126307","url":null,"abstract":"<div><p>The World Health Organization's Immunization and Vaccines-related Implementation Research Advisory Committee (IVIR-AC) serves to independently review and evaluate vaccine-related research to maximize the potential impact of vaccination programs. From 28 June – 1 July 2024, IVIR-AC was convened for an ad hoc meeting to discuss new evidence on criteria for rubella vaccine introduction and the risk of congenital rubella syndrome. This report summarizes background information on rubella virus transmission and the burden of congenital rubella syndrome, meeting structure and presentations, proceedings, and recommendations.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009897/pdfft?md5=6bc828b0f5e447cfc80490f49f2861b0&pid=1-s2.0-S0264410X24009897-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-genome sequencing of Neisseria meningitidis collected in Chile from pediatric patients during 2016–2019 and coverage vaccine prediction","authors":"","doi":"10.1016/j.vaccine.2024.126311","DOIUrl":"10.1016/j.vaccine.2024.126311","url":null,"abstract":"<div><h3>Background</h3><p>Over the past few years, whole-genome sequencing (WGS) has become a valuable tool for global meningococcal surveillance. The objective of this study was to genetically characterize <em>Neisseria meningitidis</em> strains isolated from children in Chile through WGS and predicting potential vaccine coverage using gMATS and MenDeVAR.</p></div><div><h3>Methods</h3><p>WGS of 42 <em>N.meningitidis</em> from pediatric patients were processed and assembled using different software. We analyzed genomes with BIGSdb platform hosted at <span><span>PubMLST.org</span><svg><path></path></svg></span>, and predicted vaccine coverage using MenDeVAR and gMATS tools.</p></div><div><h3>Results</h3><p>Among 42 strains, 25 were MenB, 16 MenW, and 1 MenC. The cc11 and cc 41/44 were the most frequents. The main frequent deduced peptide sequence for PorA was P1.5,2 (40 %), peptide P1.4 was present in one MenB strain; NHBA-29 (64 %), none having peptide 2; fHbp-2 (76 %), one strain had peptide-1, and two had peptide 45; NadA was detected in 52 %, peptide-6 was present in 84 %, none had peptide 8. The MenDeVAR index predicted a coverage in MenB strains for 4CMenB 8 % <em>exact matches</em>, 12 % <em>cross-reactivity</em>, 8 % <em>not coverage</em> and 64 % had <em>insufficient data</em>. gMATS predicted 16 % was <em>covered</em>, 8 % <em>not covered</em> and 76 % <em>unpredictable,</em> and overall coverage of 54 %. For rLP2086-fHbp, the MenDeVAR index predicted <em>exact match</em> in 8 %, <em>cross-reactivity</em> in 64 %, and <em>insufficient data</em> in 28 % and an overall coverage of 72 %. In non-MenB strains, the MenDeVAR index predicted for 4CMenB vaccine: <em>cross-reactivity</em> 88 %, 6 % for <em>not covered</em> and <em>insufficient data</em>. For rLP2086-fHbp, predicted <em>cross-reactivity</em> 12 % and insufficient data in 88 %. gMATS predicted an overall coverage of 50 % for Non-MenB.</p></div><div><h3>Conclusion</h3><p>genetic variability of the Chilean strains that its different from other countries, and until now limit the coverage prediction of vaccine with the available tools like gMATS and MenDeVAR.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durability for 12 months of antibody response to a booster dose of monovalent BNT162b2 in adults who had initially received 2 doses of inactivated vaccine","authors":"","doi":"10.1016/j.vaccine.2024.126317","DOIUrl":"10.1016/j.vaccine.2024.126317","url":null,"abstract":"<div><p>This study examined the strength and durability of antibody responses in 277 adults who received a heterologous third dose of the BNT162b2 vaccine, following two doses of an inactivated vaccine. Neutralizing antibody levels against both the ancestral virus and Omicron BA.2 subvariant decreased from one month to 6 months after the third dose, and were then maintained at 12 months. Participants who received both a fourth dose and reported a SARS-CoV-2 infection had the highest antibody titers at 365 days after the third dose. Individuals with chronic medical conditions had lower antibody levels against the Omicron BA.2 subvariant at 12 months after the third dose. The results suggest that the heterologous third dose provides durable neutralizing antibody responses, which may be influenced by subsequent infection or vaccination and pre-existing medical conditions. These findings may help explain the differences in immune protection between vaccination and natural infection.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity and safety of different dose levels of Ad26.RSV.preF/RSV preF protein vaccine in adults aged 60 years and older: A randomized, double-blind, placebo-controlled, phase 2a study","authors":"","doi":"10.1016/j.vaccine.2024.126273","DOIUrl":"10.1016/j.vaccine.2024.126273","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory syncytial virus (RSV) can cause severe illness in older adults. A combination vaccine containing Ad26.RSV.preF and purified recombinant RSV preF protein has previously demonstrated efficacy and tolerability in older adults. We report results of a dose-ranging study to determine immunogenicity and safety of different doses of the Ad26.RSV.preF component in the combined Ad26.RSV.preF/RSV preF protein vaccine to support Ad26.RSV.preF drug product release and stability specifications.</p></div><div><h3>Methods</h3><p>In this randomized, double-blind, placebo-controlled, phase 2a study, adults aged ≥60 years in good or stable health were randomly assigned within 1 of 3 cohorts to receive either placebo or Ad26.RSV.preF/RSV preF protein, composed of different doses of Ad26.RSV.preF with a fixed dose of RSV preF protein (150 μg). Ad26.RSV.preF doses in Cohort 1 (4 dose-down groups) ranged from 3.7 × 10⁹ to 1.0 × 10¹¹ viral particles (vp). Doses in Cohorts 2 and 3 (2 dose-up groups, each) ranged from 1.0 to 1.6 × 10¹¹ vp. Primary endpoints were immunogenicity (RSV preF protein antibody titers) for Cohort 1 and safety (solicited local and systemic adverse events [AEs] and unsolicited AEs) for Cohorts 2 and 3. Immunogenicity analyses (RSV preF protein antibody titers, RSV A2 neutralizing antibodies, and RSV-F–specific interferon-γ enzyme-linked immunosorbent spot) were performed on the day of vaccination and 14 days, 3 months, and 6 months postvaccination. Safety was monitored from vaccination until study end.</p></div><div><h3>Results</h3><p>Overall, 454 participants were enrolled and received 1 dose of study vaccine or placebo (Cohort 1, <em>n</em> = 226; Cohort 2, <em>n</em> = 124; Cohort 3, <em>n</em> = 104). No substantial differences in measured immune responses were observed between lower or higher Ad26.RSV.preF doses compared with Ad26.RSV.preF 1.0 × 10¹¹ vp across all postvaccination time points. All Ad26.RSV.preF doses between 3.7 × 10⁹ vp and 1.6 × 10¹¹ vp were well tolerated, with no safety issues identified.</p></div><div><h3>Conclusions</h3><p>Results of this dose-ranging study may be used to inform the refinement of Ad26.RSV.preF drug product release and stability specifications.</p><p><strong>Clinical Trial Registration:</strong> <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: <span><span>NCT04453202</span><svg><path></path></svg></span></p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009551/pdfft?md5=197b57c1fb3d7e4b12fe489543013453&pid=1-s2.0-S0264410X24009551-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of commercial quadrivalent foot-and-mouth disease vaccines against east African virus strains reveals limited immunogenicity and duration of protection","authors":"","doi":"10.1016/j.vaccine.2024.126325","DOIUrl":"10.1016/j.vaccine.2024.126325","url":null,"abstract":"<div><p>Foot-and-mouth disease virus (FMDV) causes a contagious disease (FMD) in cloven-hoofed animals. For FMD-endemic countries, vaccination is critical for controlling disease but is rarely monitored, despite substantial funds spent on vaccine purchases. We evaluated antibody responses in cattle to two commercial vaccines each containing antigens of four FMDV serotypes. Sampling was done over 360 days, with serology for each serotype performed using commercially available solid phase competition ELISAs (SPCE) and with virus neutralization tests (VNT) employing regionally relevant test viruses. A primary course of each vaccine was administered to 37 calves, some of which received a second dose after 28 days. Using new production batches of vaccines, all calves received a booster vaccination 180 days post vaccination, while 10 additional naïve calves were also vaccinated using the new batches and followed up for ∼180 days. Simple and general linear models were used to compare antibody responses which varied substantially according to vaccine, dose regime, serotype, and test, but were mostly insufficient to ensure a high likelihood of adequate or sustained probable protection. One of the vaccines administered as a two-dose primary course of vaccination was superior to other options, but even then, data trajectories from VNT responses suggested probable protection of 75 % of calves for 6 months for only one virus serotype. Calves administered with the other vaccine and those given a single primary dose developed low levels of antibodies, offering predicted likely protection lasting less than two months. Individual SPCE results were weakly correlated (r² = 0.48) to neutralization and associated likelihoods of protection but SPCE and VNT agreed on which vaccine and dose regime performed best. Our findings highlight gaps in immunogenicity of FMD vaccines used in East Africa and reinforce the importance of independent quality control studies to evaluate and improve commercial FMD vaccines and vaccination regimes.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24010077/pdfft?md5=99e42016e19bbba139c5ac8ef55d450d&pid=1-s2.0-S0264410X24010077-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of health claims data on vaccination coverage in older adults in Bavaria, Germany: Influenza, pneumococcus and herpes zoster","authors":"","doi":"10.1016/j.vaccine.2024.126354","DOIUrl":"10.1016/j.vaccine.2024.126354","url":null,"abstract":"<div><h3>Background</h3><p>Vaccination is essential, especially in older adults whose immune system function declines with age. The COVID-19 pandemic and its associated lockdowns temporarily disrupted routine vaccination services. We aimed to assess vaccination coverage for Influenza, Pneumococcus, and Herpes zoster among older adults in Bavaria over time and investigate potential pandemic effects on these rates.</p></div><div><h3>Methods</h3><p>Based on health claims data from the Bavarian Association of Statutory Health Insurance Physicians (KVB), we estimated the percentage of adults aged 60 years and older vaccinated following the German Standing Committee on Vaccinations (STIKO) recommendation for Influenza (2012−2021), Pneumococcus (2017–2021) and Herpes zoster (2019–2021), stratified by sex and 10-year age groups. Using time series regression analysis, we estimated the effect of the pandemic period (2020−2021) on quarterly Influenza and Pneumococcal vaccination rates.</p></div><div><h3>Results</h3><p>In the first year of the pandemic (2020), Influenza, Pneumococcus and Herpes zoster coverage in both sexes increased by 9.9, 8.7, and 2.5 percentage points (pp), respectively. In 2021, Influenza coverage decreased by 4.7 pp., while Pneumococcus and Herpes zoster coverage increased by 2.7 and 3.8 pp., respectively. Influenza and Pneumococcal vaccinations showed a seasonal pattern, with vaccinations occurring mainly in the fourth quarter; this pattern was distorted for Pneumococcus during the pandemic. Per the time series regression analysis, Influenza vaccination rates in the fourth quarters of 2020 and 2021 were 7.86 (95 %CI: 5.10–10.62) and 8.87 (95 %CI: 5.80–11.54) pp. higher for males and females, respectively, compared to that of the pre-pandemic period. During the pandemic, the quarterly Pneumococcal vaccination rates increased by 0.68 (95 %CI: 0.19–1.18) pp. in males and 0.80 (95 %CI: 0.30–1.30) pp. in females.</p></div><div><h3>Conclusion</h3><p>The heightened increase in vaccination rates observed in 2020 may have resulted from increased vaccination awareness during the pandemic. As the pandemic effect wanes, more efforts are needed to sustain and increase these vaccination rates.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24010363/pdfft?md5=ac50a0341383451cb2b690605f467a71&pid=1-s2.0-S0264410X24010363-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Governance matters: Exploring the impact of governance on routine immunization performance in 54 African countries: A 10-year (2012−2021) analysis using linear mixed models","authors":"","doi":"10.1016/j.vaccine.2024.126293","DOIUrl":"10.1016/j.vaccine.2024.126293","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Immunization coverage across numerous African nations has, unfortunately, shown little improvement and, in some cases, has even decreased over the past decade, leaving millions of children vulnerable to vaccine-preventable diseases. While efforts to improve immunization performance have primarily focused on the health system, effective delivery of immunization services is intricately linked to a country's governance, which, in this context, reflects a government's ability to provide comprehensive services to its citizens. This study investigated the relationship between governance, measured using the Mo Ibrahim Index for African Governance, and the trajectory of immunization coverage for three vaccines in 54 African countries from 2012 to 2021.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We conducted an ecological study utilizing publicly available datasets, the WHO/UNICEF estimates of National Immunization Coverage and the Ibrahim Index of African Governance score (IIAG). We described the trends in routine immunization performance, evaluated and assessed the impact of governance on immunization coverage across 54 African countries for the period 2012 to 2021, using linear mixed models and focusing on three vaccines provided through the Expanded Program on Immunization (DTPCV1, DTPCV3, and MCV1).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Among the 54 African countries studied, 32 (59.3 %) witnessed an overall decrease (slope of change in immunization coverage over time &lt; 0) in immunization coverage, with 16 (29.6 %) experiencing a significant decline (slope of change significantly different from zero (&lt;em&gt;P&lt;/em&gt; &lt; 0.05)) in coverage. For DTPCV3, 31 countries (57.4 %) demonstrated a decline in coverage, with 12 (22.2 %) being significant declines. Thirty-two countries (59.2 %) reported a decrease in MCV1 coverage over the analysis period, with 17 (31.5 %) significant. Across all three antigens, the IIAG overall score was positively associated with immunization coverage over time. One unit increase in the IIAG score correlated with an average annual increase of 0.64 (95 % CI: 0.35–0.93) percentage points in DTPCV1 coverage, 0.74 percentage points (95 % CI: 0.42–1.07) in DTPCV3 coverage, and 0.60 (95 % CI: 0.30–0.91) percentage points in MCV1 coverage. These findings suggest that an African country with an average IIAG score just one unit higher than their observed average value over the study period, would have achieved a 6.4 %, 7.4 %, and 6.0 % coverage for DTPCV1, DTPCV3, and MCV1, respectively, above its 2021 coverage levels.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The Expanded Program on Immunization aspires to reach all eligible populations with life-saving vaccines, regardless of the context. We found that country governance may be an important determinant of immunization performance, potentially explaining the observed stagnation or decline in immunization performance and the heightened vulnerability of immunization programs to exte","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling conjugate vaccine and natural induced antibody correlates of protection for pneumococcal colonization and acute otitis media infection in young children","authors":"","doi":"10.1016/j.vaccine.2024.126295","DOIUrl":"10.1016/j.vaccine.2024.126295","url":null,"abstract":"<div><p>We measured anti-pneumococcal serotype 19A vaccine-induced antibodies in 160 children (611 sera) after introduction of 13-valent pneumococcal conjugate vaccine and naturally-induced antibodies in 59 children (185 sera) after colonization and acute otitis media (AOM) episodes caused by strains expressing serotype 19A. Correlate of protection (COP) models were constructed using results from multiple prospectively-collected observations in individual children. Generalized estimating equations followed by logistic-regression was used. The COP derived from vaccine-induced antibody levels for prevention of colonization was 5 μg/mL and for AOM was 2.3 μg/mL. A COP for naturally-induced antibody levels for prevention of colonization or AOM could not be derived because an age gradient was not observed. Combining natural- and vaccine-induced antibody levels did not provide biologically plausible COP estimates. We conclude derivation of a COP for prevention of colonization and AOM using individual multi-point child data for pneumococcal serotype 19A can be estimated when an age-gradient is observed.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine uptake in a predominantly minoritized cohort hospitalized during the early pandemic in New York City","authors":"","doi":"10.1016/j.vaccine.2024.126260","DOIUrl":"10.1016/j.vaccine.2024.126260","url":null,"abstract":"<div><h3>Background</h3><p>Minoritized communities in the United States have had higher COVID-19 mortality and lower vaccine uptake. The influence of previous SARS-CoV-2 infection, initial disease severity, and persistent symptoms on COVID-19 vaccine uptake in Black and Latinx communities has not been examined.</p></div><div><h3>Objective</h3><p>To investigate whether initial COVID-19 severity, persistent symptoms, and other correlates affected vaccine uptake in a predominantly minoritized cohort hospitalized for COVID-19 during the early pandemic in New York City.</p></div><div><h3>Design</h3><p>In this historical cohort study, we abstracted electronic health record data on demographics, comorbidities, hospital oxygen requirements, symptoms at 3 and 6 months post-admission, COVID-19 vaccinations through November 2022, and influenza vaccinations during the 2018–2019 through 2021–2022 seasons. Unadjusted and adjusted odds ratios were estimated through logistic regression analyses of correlates of COVID-19 vaccination, on-time vaccination, and boosting.</p></div><div><h3>Participants</h3><p>Survivors among the first 1186 adult patients hospitalized for COVID-19 between March 1 and April 8, 2020 at a large quaternary care medical center in Northern Manhattan.</p></div><div><h3>Main Measures</h3><p>Uptake of at least one COVID-19 vaccine dose, uptake of at least one booster, and on-time vaccination.</p></div><div><h3>Key Results</h3><p>The 890 surviving individuals were predominantly Latinx (54%) and Non-Hispanic Black (15%). Most had one or more comorbidities (67%), and received at least one COVID-19 vaccine dose (78%). Among those vaccinated, 57% received at least one booster, and 31% delayed vaccination. 67% experienced persistent symptoms. Multiple logistic regression showed no association between vaccine uptake and disease severity or symptom persistence. However, older age and influenza vaccination during the COVID-19 era were associated with increased vaccination, booster uptake, and on-time vaccination.</p></div><div><h3>Conclusions</h3><p>Pinpointing drivers of vaccine uptake and hesitancy is critical to increasing and sustaining COVID-19 vaccination as the field transitions to annual boosters. The association between influenza vaccination and increased vaccine uptake suggests that bundling vaccines for adults may be an effective delivery strategy.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal influenza vaccination and associated risk of fetal loss: A claims-based prospective cohort study","authors":"","doi":"10.1016/j.vaccine.2024.126256","DOIUrl":"10.1016/j.vaccine.2024.126256","url":null,"abstract":"<div><h3>Background</h3><p>Although numerous studies support the safety of influenza vaccination during pregnancy, fewer studies have evaluated the risk of miscarriage or considered the effect of prior immunization.</p></div><div><h3>Methods</h3><p>Using national de-identified administrative claims data from the Optum Labs Data Warehouse, we conducted a claims-based cohort study of 117,626 pregnancies between January 2009 and December 2018. We identified pandemic A(H1N1)pdm09 and seasonal influenza vaccinations using CPT codes. Fetal loss was defined as miscarriage, medical termination, or stillbirth as identified by ICD-10-CM diagnostic codes. Cox proportional hazard models treating influenza vaccination as a time-varying exposure, weighted for loss-to-follow-up and stratified by baseline probability of vaccination, were used to model the risk of fetal loss by exposure to influenza vaccine.</p></div><div><h3>Results</h3><p>About 31.4 % of the cohort had a record of influenza vaccination; 10.0 % were vaccinated before pregnancy only, 17.8 % during pregnancy only, and 3.6 % before and during pregnancy. The risk of miscarriage was 39 % lower among those vaccinated during pregnancy compared to unvaccinated (adjusted hazard ratio, aHR 0.61; 95 % CI 0.50, 0.74) and was similar for medical termination or stillbirth (HR 0.69; 95 % CI 0.45, 1.03 and aHR 0.99; 95 % CI 0.76, 1.30, respectively). Similar results were observed for women who received the vaccine before and during pregnancy. We observed little to no association between vaccination before pregnancy and risk of miscarriage (HR 0.98; 95 % CI 0.76, 1.26), medical termination (HR 1.02; 95 % CI 0.46, 2.24), or stillbirth (HR 1.14, 95 % CI 0.77, 1.69).</p></div><div><h3>Discussion</h3><p>Influenza vaccination was not associated with an increased risk of fetal loss. These results support the safety of influenza vaccine administration even when administered before or early during pregnancy.</p></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0264410X24009381/pdfft?md5=b6dfe73ba1c5c08cfe680ae8233b0868&pid=1-s2.0-S0264410X24009381-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}