Vaccines

WHAT YOU SHOULD HAVE READ BUT….2010 ,[object Object],University of Verona, Italy Attilio Boner

Ab titers against HBV mlU/mL Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine Middleman Pediatrics 2010;125:e508 ,[object Object],1-inch 1.5 inch 345.4 189.8 P=0.03 400 – 300 - 200 – 100 - 0 needle

Ab titers against HBV mlU/mL Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine Middleman Pediatrics 2010;125:e508 ,[object Object],1-inch 1.5 inch 345.4 189.8 P=0.03 400 – 300 - 200 – 100 - 0 That needle length accounts for a significant portion of the discrepancy in immune response to HBV vaccine that is seen among those with obesity. needle

The less abundant blood supply in adipose tissue results in a potential delay in vaccine antigen presentation to the B and T cells that are responsible for immune response; this delay may allow the protein antigens to be denatured by enzymes , resulting in a diminished immune response to vaccination. Effect of Needle Length When Immunizing Obese Adolescents With Hepatitis B Vaccine Middleman Pediatrics 2010;125:e508

Eff ect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Prymula Lancet 2009;374:1339 ,[object Object],[object Object],[object Object],% of children with temperature ≥ 38°C 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 42% 66% Paracetamol NO Paracetamol

Eff ect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Prymula Lancet 2009;374:1339 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Eff ect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Prymula Lancet 2009;374:1339 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced.

Impact of influenza vaccination on mortality risk among the elderly Groenwold ERJ 2009:34:56 ,[object Object],[object Object],INFLUENZA VACCINATION 0.58 Or for Mortality Risk 1.0 – 0.9 – 0.8 – 0.7 – 0.6 – 0.5 – 0.4 – 0.3 – 0.2 – 0.1 – 0

<30% >70% 2005 1995 ,[object Object],[object Object],80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 Vaccination rates against influenza in patients aged ≥ 60 years Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572.

>70% 2005 1995 ,[object Object],[object Object],80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572. Cumulative vaccination rate against pneumonia in patients aged ≥ 70 yrs 0%

0.59 0.97 1.0 – 0.5 – 0 During Outside influenza season For all-cause mortality the adjusted Relative Risks associated with influenza vaccination in patients not vaccinated against pneumonia Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572. ,[object Object],[object Object]

0.30 0.98 1.0 – 0.5 – 0 During Outside influenza season For all-cause mortality the adjusted Relative Risks associated with influenza vaccination in patients vaccinated against pneumonia Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD Schembri Thorax 2009;64:567–572. ,[object Object],[object Object]

Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 ,[object Object],[object Object],[object Object]

Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 ,[object Object],[object Object],[object Object],[object Object]

Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749 ,[object Object],[object Object],[object Object],[object Object],This was based on a single study demonstrating the safety of this approach with vaccines containing no more than 1.2 mg/mL ovalbumin in 83 children and adults with egg allergy. James J Pediatr 1998;133:624

Ovalbumin content in 2009 to 2010 seasonal and H1N1 monovalent influenza vaccines Waibel JACI 2010;125:749

Egg allergy and influenza vaccination Settipane Allergy Asthma Proc 2009;30:660 ,[object Object],[object Object],[object Object],[object Object],[object Object]

Egg allergy and influenza vaccination Settipane Allergy Asthma Proc 2009;30:660 Il pdf è a pagamento

Increased risk of serious pneumococcal disease (SPD) in patients with atopic conditions other than asthma Jung JACI 2010:125:217 Background: We reported an increased risk of serious pneumococcal disease ( SPD ) among patients with asthma. It is not known whether this is true for patients with other atopic conditions. Objective: To determine the relationship between atopic conditions other than asthma and SPD.

[object Object],ATOPIC CONDITIONS OTHER THAN ASTHMA 2.13 2.5 – 2.0 – 1.5 – 1.0 – 0.5 – 0 OR FOR SPD Increased risk of serious pneumococcal disease (SPD) in patients with atopic conditions other than asthma Jung JACI 2010:125:217 P=0.04

[object Object],ATOPIC CONDITIONS OTHER THAN ASTHMA 2.13 2.5 – 2.0 – 1.5 – 1.0 – 0.5 – 0 OR FOR SPD Like asthma, other atopic conditions, particularly atopic dermatitis , are associated with an increased risk of SPD. Increased risk of serious pneumococcal disease (SPD) in patients with atopic conditions other than asthma Jung JACI 2010:125:217 P=0.04

Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates O’Brien, Lancet 2010;375:893 ,[object Object],[object Object],[object Object]

Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates O’Brien, Lancet 2010;375:893 ,[object Object],Ten countries with the greatest number of pneumococcal deaths in children aged 1–59 months

Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478

% breakthrough cases * 21% ( * % vaccine-type infection in a child who received at least one dose of PCV7) ,[object Object],25 – 20 – 10 – 5 – 0 Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 (155/753)

% breakthrough cases * 21% ( * % vaccine-type infection in a child who received at least one dose of PCV7) ,[object Object],25 – 20 – 10 – 5 – 0 Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 (155/753) Predominantly caused by serotypes 6B (n = 50, 32%) and 19F (n = 45, 29%).

% breakthrough cases * 21% ( * % vaccine-type infection in a child who received at least one dose of PCV7) ,[object Object],25 – 20 – 10 – 5 – 0 Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 (155/753) Proportion of breakthrough cases decreased with the increasing number of PCV7 doses received (P < .001, X2 for linear trend).

% vaccine failures * 4% ,[object Object],Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 10 – 8 – 6 – 4 – 2 – 0 * Vaccine-type infection in a child who completed PCV7 vaccination

% vaccine failures * 4% ,[object Object],Invasive Pneumococcal Infections among Vaccinated Children in the United States Park J Pediatr 2010;156:478 10 – 8 – 6 – 4 – 2 – 0 * Vaccine-type infection in a child who completed PCV7 vaccination Invasive pneumococcal were primarily caused by disease resulting from serotypes not covered with PCV7.

Number of invasive pneumococcal infections (y-axis) in children among 8 children’s hospitals according to study years (x-axis) from 1994 to 2008. PCV7 was introduced in 2000. ,[object Object],Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429

Number of invasive pneumococcal isolates (y-axis) that were vaccine serotype, nonvaccine serotype, or 19A. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 ,[object Object]

Number of invasive pneumococcal isolates (y-axis) that were vaccine serotype, nonvaccine serotype, or 19A. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 ,[object Object],The number of invasive pneumococcal infections in children has increased, primarily as a result of serotype 19A isolates , one third of which were resistant to multiple antibiotics in 2007 and 2008 .

Proportion of isolates nonsusceptible (intermediate plus resistant) to clindamycin and erythromycin. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 The number of invasive pneumococcal isolates per penicillin MIC for isolates in 2007 and 2008.

Number of invasive pneumococcal isolates per ceftriaxone MIC for isolates in 2007 and 2008. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429 ,[object Object]

1) Currently, serotype 19A is the most common serotype for invasive disease in children . Serotype 19A also has become an important pneumococcal isolate causing otitis media and its complications such as mastoiditis. 2) In a multicenter study, pneumococcal pneumonia in children caused by isolates with penicillin MICs up to 4 µg/mL was treated successfully with intravenous penicillin or ampicillin. 3) For some patients with invasive infection, such as pneumonia or pleural empyema caused by a multidrug-resistant serotype 19A isolate, linezolid or perhaps a newer quinolone might be the only oral agents available for completing therapy. 4) Intravenous therapy with ceftriaxone and cefotaxime remains an appropriate treatment option for such patients as well. Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children Kaplan Pediatrics 2010;125:429

Continued Impact of Pneumococcal Conjugate Vaccine on Carriage in Young Children Susan Pediatrics 2009; 124:1 ,[object Object],CARRIAGE OF NON-PCV7 SEROTYPE 2000-01 2003-04 2006-07 30 – 20 – 10 – 0 15% 19% 29%

Continued Impact of Pneumococcal Conjugate Vaccine on Carriage in Young Children Susan Pediatrics 2009; 124:1 ,[object Object],CARRIAGE OF NON-PCV7 SEROTYPE 2000-01 2003-04 2006-07 30 – 20 – 10 – 0 15% 19% 29% The relative contribution of several non-PCV7 serotypes, including 19A , 35B, and 23A, increased across sampling periods with greater proportions of penicillin non-susceptibility.

New Vaccines Against Otitis Media: Projected Benefits and Cost-effectiveness O’ Brien Pediatrics 2009;123:1452 % acute otitis media episodes potentially prevented by ,[object Object],[object Object],[object Object],[object Object],[object Object],6.4% 27% 31% 7-valent pneumococcal conjugate vaccine pneumococcal–nontypeable H Influenzae – Moraxella 50 – 40 – 30 – 20 – 10 – 0 pneumococcal–nontypeable H influenzae vaccine

New Vaccines Against Otitis Media: Projected Benefits and Cost-effectiveness O’ Brien Pediatrics 2009;123:1452 % acute otitis media episodes potentially prevented by ,[object Object],[object Object],[object Object],[object Object],[object Object],6.4% 27% 31% 7-valent pneumococcal conjugate vaccine pneumococcal–nontypeable H Influenzae – Moraxella 50 – 40 – 30 – 20 – 10 – 0 pneumococcal–nontypeable H influenzae vaccine New candidate vaccines against otitis media have the potential to prevent millions of disease episodes in the United States annually

Pediatric parapneumonic pleural effusion:Epidemiology, clinical characteristics, and microbiological diagnosis Hernández-Bou Ped Pul 2009;44:1192 ,[object Object],40 – 30 – 20 – 10 – 0 CASES PER 100,000 19.9 35.2 2004 2006 TO P ABSTRACT ME THODS RE SULTS DI SCUSSION Su pport statement St atement of interest AC KNOWLEDGEMENTS RE FERENCES TO P ABSTRACT ME THODS RE SULTS DI SCUSSION Su pport statement St atement of interest AC KNOWLEDGEMENTS RE FERENCES

Pediatric parapneumonic pleural effusion:Epidemiology, clinical characteristics, and microbiological diagnosis Hernández-Bou Ped Pul 2009;44:1192 ,[object Object],40 – 30 – 20 – 10 – 0 CASES PER 100,000 19.9 35.2 2004 2006 ,[object Object],[object Object],[object Object], TO P ABSTRACT ME THODS RE SULTS DI SCUSSION Su pport statement St atement of interest AC KNOWLEDGEMENTS RE FERENCES TO P ABSTRACT ME THODS RE SULTS DI SCUSSION Su pport statement St atement of interest AC KNOWLEDGEMENTS RE FERENCES

[object Object],[object Object],[object Object],[object Object],Pediatric parapneumonic pleural effusion:Epidemiology, clinical characteristics, and microbiological diagnosis Hernández-Bou Ped Pul 2009;44:1192 Serotypes 1 and 19 A are the most frequent causes of PPE TO P ABSTRACT ME THODS RE SULTS DI SCUSSION Su pport statement St atement of interest AC KNOWLEDGEMENTS RE FERENCES TO P ABSTRACT ME THODS RE SULTS DI SCUSSION Su pport statement St atement of interest AC KNOWLEDGEMENTS RE FERENCES

Empyema Hospitalizations Increased in US Children Despite Pneumococcal Conjugate Vaccine Li Pediatrics 2010;125:26 ,[object Object],% increase in empyema-associated hospitalization rate from 1997 to 2006 70% 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0

Empyema Hospitalizations Increased in US Children Despite Pneumococcal Conjugate Vaccine Li Pediatrics 2010;125:26 ,[object Object],% increase in empyema-associated hospitalization rate from 1997 to 2006 70% 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 The rate of invasive pneumococcal disease (pneumonia, sepsis, or meningitis caused by Streptococcus pneumoniae) decreased 50%, and t he rate of bacterial pneumonia decreased 13%.

Il pediatra ha la possibilità di programmare e proporre la strategia preventiva.

Mothers’ Intention for Their Daughters and Themselves to Receive the Human Papillomavirus Vaccine: A National Study of Nurses Kahn Pediatrics 2009;123:1439 % of mother who intended to vaccinate a daughter ,[object Object],48% 68% 86% If she were 9 to 12 yr 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 If she were 13 to 15 yr If she were 16 to 18 yr of age

Mothers’ Intention for Their Daughters and Themselves to Receive the Human Papillomavirus Vaccine: A National Study of Nurses Kahn Pediatrics 2009;123:1439 % of mother who intended to vaccinate a daughter ,[object Object],48% 68% 86% If she were 9 to 12 yr 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 If she were 13 to 15 yr If she were 16 to 18 yr of age mothers’ intention to vaccinate a daughter <13 years of age was contrasting with national recommendations to target 11- to 12-year-old girls for vaccination

Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press VACCINE EFFICACY AGAINST incident infection with HPV 16/18 95.3% ,[object Object],[object Object],[object Object],100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0

100% ,[object Object],[object Object],[object Object],100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 VACCINE EFFICACY AGAINST 12 months persistent infection with HPV 16/18 Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press

100% YES NO 72% lesions associated with HPV-16/18 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 ,[object Object],[object Object],[object Object],VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia grade 2 and above (CIN2+) Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press

100% YES NO 72% lesions associated with HPV-16/18 100 – 90 – 80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 ,[object Object],[object Object],[object Object],VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia grade 2 and above (CIN2+) Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6·4 years The GlaxoSmithKline Vaccine HPV-007 Study Group Lancet 2010 in press Antibody concentrations remained 12-fold or more higher than after natural infection (both antigens) safety outcomes were similar

Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women Paavonen LANCET 2009;374:301 70.2% ,[object Object],[object Object],80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 In women receiving at least one vaccine dose w ith no evidence of oncogenic HPV infection at baseline VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia 2+ (CIN2+)

70.2% ,[object Object],[object Object],80 – 70 – 60 – 50 – 40 – 30 – 20 – 10 – 0 VACCINE EFFICACY AGAINST cervical intraepithelial neoplasia 2+ (CIN2+) Individual cross-protection against CIN2+ associated with HPV-31, HPV-33, and HPV-45 was seen. Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women Paavonen LANCET 2009;374:301 In women receiving at least one vaccine dose w ith no evidence of oncogenic HPV infection at baseline

Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 Cervarix ™ induced significantly higher serum neutralizing antibody titers in all age strata (p<0.0001) .

[object Object],[object Object],[object Object],Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 Specific memory B-cell frequencies were also higher after vaccination with Cervarix ™ compared with Gardasil ®.

[object Object],[object Object],[object Object],Comparison of the immunogenicity and safety of Cervarix TM and Gardasil ® human papillomavirus cervical cancer vaccines in healthy women aged 18–45 years Einstein, Human Vaccines 2009;5: 705 Geometric mean titers of serum neutralizing antibodies fold higher after vaccination with Cervarix ™ compared with Gardasil ®, across all age strata. 2.3 9.1 6.8 4.8 HPV-16 HPV-18 10 – 9 – 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0 Although the importance of differences in magnitude of immune response between these vaccines is unknown, they may represent determinants of duration of protection against HPV-16/18.

[object Object],[object Object],[object Object],AS04 -adjuvanted vaccine

% serious adverse events ,[object Object],2.8% Cervarix 3.1% Controls Safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for cervical cancer prevention Descamps Human Vaccines 2009;5:332 4 – 3 – 2 – 1 – 0

% new onset chronic autoimmune disease 0.4% Cervarix 0.3% Controls Safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine for cervical cancer prevention Descamps Human Vaccines 2009;5:332 0.5 – 0.4 – 0.3 – 0.2 – 0.1 – 0 ns ,[object Object]

Rates of autoimmune events ,[object Object],[object Object],[object Object],[object Object],[object Object],0.5% Analysis of adverse events of potential autoimmune aetiology in a large integrated safety database of AS04 adjuvanted vaccines Verstraeten Vaccine 2008;26:6630 1.0 – 0.5 – 0 And did not differ between the AS04 and control groups

Rates of autoimmune events ,[object Object],[object Object],[object Object],[object Object],[object Object],0.5% 1.0 – 0.5 – 0 And did not differ between the AS04 and control groups This integrated analysis of over 68,000 participants who received AS04 adjuvanted vaccines or controls demonstrated a low rate of autoimmune disorders, without evidence of an increase in relative risk associated with AS04 adjuvanted vaccines. Analysis of adverse events of potential autoimmune aetiology in a large integrated safety database of AS04 adjuvanted vaccines Verstraeten Vaccine 2008;26:6630

[object Object],[object Object],[object Object],[object Object],Current prophylactic HPV vaccines and gynecologic premalignancies Harper Curr Opin Obstet and Gynecol 2009, 21:457–464

[object Object],[object Object],[object Object],Human papillomavirus (HPV) vaccine: Cervarix Szarewski Expert Opin. Biol. Ther 2010 10(3):477-487

Vaccines

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Andere mochten auch

Andere mochten auch (19)

Ähnlich wie Vaccines

Ähnlich wie Vaccines (20)

Mehr von Envicon Medical Srl

Mehr von Envicon Medical Srl (20)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Vaccines