Mwanza/Geneva, 22 April 2024 The Ministry of Health of the United Republic of Tanzania, in partnership with Gavi, the Vaccine Alliance (Gavi), UNICEF and the World Health Organization (WHO), today launched the national multi-age cohort (MAC) vaccination campaign against the human papillomavirus (HPV) the leading cause of cervical cancer. The campaign, which is targeting over 5 million girls aged 914 years, will run from Monday, 22 April, to Friday, 26 April 2024.
While cervical cancer remains a significant cause of death among women in Tanzania, with more than 10,800 cases and 6,800 deaths in 2022 alone, it is vaccine preventable. The HPV vaccine is safe and highly effective in preventing infections. During the campaign, eligible girls will have the opportunity to receive a single dose of the HPV vaccine at no cost.
Efforts to increase access to the HPV vaccine across Tanzania have made substantial progress. In 2018, the two-dose vaccine was integrated into the national routine immunization programme for 14-year-old girls, demonstrating the government's commitment to safeguarding the health and well-being of future generations.
To date, coverage of the first dose of the HPV vaccine has reached 79%, and the second dose is at 60%. Combined efforts are needed to ensure every girl in Tanzania receives crucial protection against this deadly yet preventable disease. Following the MAC campaign, the vaccine will continue to be provided routinely as a single dose to nine-year-old girls. It will go a long way towards increasing girls protection.
Tanzanias progress in administering the HPV vaccine is a critical part of a broader global initiative supported by the Vaccine Alliance, which has committed additional funding and resources towards reaching 86 million girls worldwide with the HPV vaccine by 2025.
The campaign will leverage African Vaccination Week, synchronized with World Immunization Week (24 to 30 April), during which routine childhood vaccinations along with health education will be provided for girls in schools, health facilities and community centres countrywide.
Throughout this week, the Ministry of Health, Gavi, UNICEF and WHO are urging communities to encourage girls to get vaccinated against cervical cancer and to aim for a future where no girl is burdened by this disease.
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Posted: April 23, 2024 Last Updated: April 23, 2024
Peel Region has a massive childhood vaccination backlog, with more than half of children missing at least one mandated vaccine dose.
That's the warning fromPeel's acting medical officer of health, who says the lack of school immunizations is spelling trouble for communicable diseases.
"Without significant dedicated resources, we estimate it will take seven years to complete screening catch up and achieve pre-pandemic coverage rates," said Dr. Katherine Binghamina presentation to Peel council on April 11.
She says low immunization coverage among students significantly increases the risk for the re-emergence of vaccine-preventable diseases such as measles.
Unless children have a valid exception, the following vaccines are mandatory for Ontario school children: diphtheria, tetanus, polio, measles, mumps, rubella, meningitis, whooping cough and chicken pox. Several other vaccines are strongly recommended by public health units and doctors.
Advocates, doctors and Peel public health are advocating for more attention to the issue, more money from the province for public health and the formation of an action plan to quickly address the currently low vaccination rates.
Peel stacks lower than the provincial average on a number of vaccinations.For example, just over 37 per cent of seven-year-olds had been vaccinated against measles compared to more than 52 per cent province-wideas ofAugust 31, 2022.
Peel Public Health says many children missed vaccinations they would have received at school or a doctor's offices. Reporting of vaccines and enforcement also fell behind in the pandemic. To tackle the backlog more quickly, Peel Public Health opened public clinics for mandatory vaccines as of April 1 of this year.
Jill Promoli, a Mississauga mother,lost her son, Jude, to a school flu outbreak eight years ago even though he was vaccinated. She's now an illness prevention advocate championing immunizations and said the low vaccination rates in Peel children are "very concerning."
"We never thought it would be us, but it is going to be someone," said Promoli, who's alsoa Peel District School Board Trustee, but did not speak to CBCTorontoin that capacity.
"The reason that we do vaccinate against these diseases is not because they're inconvenient or uncomfortable, but it's because people do die from them," she said.
Promolisays she's also concerned about children who are vaccinated being exposed, given vaccines do not provide complete immunity.
Pediatric and infectious disease specialist, Dr. Anna Banerji, called the proportion of Peel students missing a mandated dose "very high."
"It needs to be addressed," she said.
She says part of the problem in the region is access, including to family doctors, but the region also has a diverse population, which can mean additional challenges.
"I think that language and cultural support and trying to get these kids vaccinated will be very important," she said.
Banerji also pointed to vaccine hesitancy being higher for some coming out of the pandemic.
She says seven years is far too long to have school-aged children not protected against such concerning diseases.
The public health unit says they have less money than several nearby health units to try and tackle the issue, receiving one of the lowest provincial per capita funding rates in the province.
For cost-shared programs, in Peel, public health was funded by the province at approximately $34 per capita in 2022, while Toronto and Hamilton each received $49 per capita, according to the health authority's report.
Caledon Mayor Annette Groves says the funding needs to change now to address problems that will continue to climb for Peel Public Health.
"Peel is a growing region and there will be greater need for funding as our resident population increases," she saidin a statement.
Asked why Peel Public Health gets fewer dollars per capita,Ministry of Health spokesperson Hannah Jensen didn't disputeToronto and Hamilton received more funding per capita.
"Since 2018, our government has increased our investment into Peel Public Health by nearly 20 per cent," she said in a statement.
Jensen said that'sin addition to the $100 million the provincial government invested into public health units across the province to provide support throughout the COVID-19 pandemic.
The government has restored a funding model where the province pays 75 percent of cost sharing for public health units and municipalities including Peel pay 25 percent, she said, noting the provincehad been paying 70per cent for sometime, so this represented an increase.
The province also increased base funding by oneper cent per year, over the next three years, starting this year for public health units and municipalities including Peel, she added.
Asked why Peel would still receivea lower per capita rate that some of its neighbours,the province did not respond directly.
She says the government is working closely with its partners to get children caught up on vaccines.
Promoli says the per capita discrepancy in funding between regions is "shocking"and diverse populations need more, not less.
"It's always important to try to meet people where they are," she said. "To hear those questions, to hear the reasons why people are hesitant or even refusing and to try to understandand then find the best ways to help people make decisions that will best protect their families."
Peel Public Health says it plans to return to council soon with more details about the challenges and its plans to address them.
Clara Pasieka is a CBC journalist in Toronto. She has also worked in CBC's national bureau and as a reporter in the Northwest Territories, Ontario and New Brunswick. Her investigative work following the Nova Scotia Mass Shooting was a finalist for a CAJ Award. She holds a Masters degree in Public Policy, Law and Public Administration from York University.
On the heels of a multi-state outbreak of highly pathogenic avian influenza A (H5N1) in dairy cows, experts told MedPage Today that a trio of H5N1 vaccines for humans has already been developed and approved in the U.S.
While there hasn't been an outbreak among people to put them to the test, human-to-human transmission would "drive the need" for H5N1 vaccines, Aaron Glatt, MD, of Mount Sinai South Nassau in Oceanside, New York and a fellow of the Infectious Diseases Society of America, told MedPage Today.
If infections among humans who work with animals become more common, this could be a subgroup of people to vaccinate, he added. So far, only one human case in the U.S. has been reported this year.
Nahid Bhadelia, MD, of the Boston University Center on Emerging Infectious Diseases, noted that it is "important to be talking about vaccines," including the current stockpile, the capacity to manufacture new doses if need be, and the designs of the current vaccines.
A spokesperson for the Administration for Strategic Preparedness and Response (ASPR) told MedPage Today in an emailed statement that it is monitoring the situation closely, along with partners from the CDC, FDA, Department of Agriculture, and White House.
ASPR's National Pre-Pandemic Influenza Vaccine Stockpile (NPIVS) program "enables rapid response to influenza strains as they evolve," the spokesperson said, adding that the program "works closely with industry partners to make and test updated vaccines that match new strains of influenza viruses with pandemic potential as they emerge, while at the same time, supporting manufacturing capacity to allow for large-scale vaccine production if needed."
NPIVS is "continually generating antigens that are matched to virus strains of interest, and we have two antigens that are well-matched to the currently circulating strain of H5N1," the spokesperson added. "Hundreds of thousands of doses could be deployed within weeks pending regulatory action, and over 100 million doses could be deployed in the coming months."
Vaccine Makers Stand Ready
ASPR's industry partners include CSL Seqirus, GSK, and Sanofi, which have H5N1 vaccines licensed for use in the U.S.
Sanofi developed egg-based A/H5N1 vaccines as early as 2004 and received the first U.S. license for such a vaccine in 2007, a spokesperson for the company told MedPage Today.
"Our egg-based vaccine supply would well contribute to support a global influenza pandemic response should it arise either from A/H5N1 or any other influenza strain," the spokesperson said, adding that in December 2019, Sanofi entered into an agreement with the Biomedical Advanced Research and Development Authority (BARDA) to "establish sustainable production of a recombinant vaccine for use in the event of a pandemic."
That would allow the company "to leverage the technology used for one of our approved seasonal flu vaccines to deliver a pandemic vaccine," the spokesperson said.
A spokesperson for GSK said the company is also monitoring the situation, along with the evolving epidemiology: "We are directly connected with our contractual partners to deliver on our commitments in the event that an influenza pandemic is declared."
However, "GSK is not planning to disrupt seasonal flu production plans while there is no global health emergency," the spokesperson added.
In 2022, the company was awarded multi-year contracts with the U.S., Canada, the European Union, and the WHO to supply its pandemic preparedness vaccine if the WHO declared an influenza pandemic, the spokesperson said. "These contracts will support the ready production and supply of this vaccine, and together could provide at least 200 million doses of pandemic influenza vaccine around the world."
As for what may be currently available for use, the spokesperson said that the company's pandemic vaccine is "developed to be updated with the latest circulating strains, and this follows the process for seasonal flu, where strains are identified by the WHO and vaccines are updated every season."
"The timeline for this depends on several factors, including the licensing processes, which would be determined when a pandemic is declared," the spokesperson noted.
For its part, CSL Seqirus said in a statement that it is able to "make a vaccine in response to government orders for use in a disease outbreak, for people who could be occupationally exposed to sick animals, or full-scale production of pandemic influenza vaccine should a pandemic be declared."
The company's manufacturing facility in Holly Springs, North Carolina, which was built through a public-private partnership with BARDA, "utilizes a highly scalable method of production and is positioned to deliver up to 150 million pandemic influenza vaccine doses to support a pandemic response if needed," the statement said, "in addition to its annual routine seasonal influenza vaccine production."
What Else Is Important?
At this point, stockpiling H5N1 vaccines for a specific clade is "just not practical," Glatt said.
However, if a different situation emerges, the time from when a vaccine may be needed to when a vaccine would be available would likely be shorter than historical cases, given the trio of already approved H5N1 vaccines and their safety data, he noted.
In the meantime, it is important to continue to recognize and address cases in poultry and other animal populations, Glatt added.
Bhadelia also expressed concern regarding the potential for more infections among animals and any significant spread among humans, which would increase the chances for evolution of the virus farther away from the current vaccines.
As for the ongoing development of vaccines, she pointed to potential interest in vaccines that are not egg-based, especially in the event of an outbreak affecting the egg supply, as well as vaccines that are not monovalent, such as universal influenza shots.
It is also crucial to think beyond vaccines alone, she added, especially when it comes to immunocompromised people and other more vulnerable individuals, including ensuring that an H5N1 vaccine strategy is backed up by the availability of antiviral treatments.
Jennifer Henderson joined MedPage Today as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.
Its true that the recent spread of bird flu among dairy cows is an enormous concern, as Jeremy Farrar, the World Health Organizations chief scientist, described it last week. While only two people in the United States have contracted this H5N1 strain of the avian flu (one last year and one this month), wider spread could be catastrophic, given that, in past outbreaks, the disease has killed one of every two people who are infected.
But before anyone panics, lets take a step back and look at the facts. Health officials have a plan in the event avian flu becomes the next pandemic. In fact, as Dawn OConnell, the assistant secretary for preparedness and response at the Department of Health and Human Services, told me, the federal government is much better prepared to respond to pandemic influenza than it was for covid-19.
To start, its much easier today to access personal protective equipment such as masks, gowns and goggles through commercial markets than it was before the coronavirus hit. But even if those supply chains are pinched, OConnell said, the Strategic National Stockpile has plenty to provide for farms, health-care systems and other affected entities.
The stockpile also contains the antiviral medication Tamiflu, which works against seasonal flu and is expected to work well against H5N1. Like antivirals for covid, Tamiflu reduces the chance of an influenza infection becoming severe when taken soon after symptoms emerge. Unlike covid treatments, however, Tamiflu can also be given to close contacts of infected individuals to prevent them from falling ill.
OConnell explained there are tens of millions of courses of Tamiflu available in the national stockpile. The federal government has also funded states to build their own stockpiles, which means tens of millions more treatments are available. And this is on top of commercially available Tamiflu, which people can buy at pharmacies with a prescription from their doctors.
Another key preventive measure is vaccines. OConnell, who also oversees vaccine-preparedness efforts, explained that the federal government contracts with three manufacturers that can make avian flu vaccines. Each uses the three platforms approved by the Food and Drug Administration to develop the vaccines: egg-based, cell-based and recombinant. That means if one platform doesnt work, or if one company encounters production problems, there are other options.
Moreover, because quite a few influenza strains have already been identified, the federal government keeps a library of antigens, which are used in vaccines to trigger an immune response to flu viruses. Every year, for the seasonal flu shot, scientists try to predict which strains will be dominant that fall. They then analyze existing antigens, test them against the strains, and select the closest-matching antigens to make that years flu vaccine.
Two antigens in the library appear to match H5N1, OConnell said. The federal government also has adjuvants, the component of vaccines needed to help enhance the bodys immune response to the shot, ready for the bird-flu shot as well.
In fact, the federal government has already developed hundreds of thousands of vaccine doses that are ready to be deployed against the avian H5N1 strain. In addition, they have 10 million doses that need finishing touches, which could be completed within weeks.
If more are needed, there are two options. The first is to make more vaccines using the same technology as seasonal vaccines. OConnell estimates that manufacturers could produce 125 million doses within 130 days. Because the vaccine is a two-dose vaccine, this would only cover a fraction of the U.S. population.
The second option would be to pursue mRNA vaccines, which could be made much faster than the traditional platforms. Even if these vaccines end up not being as effective or as durable as traditional ones, they could be a useful first shot that buys time for additional vaccines to be made.
Of course, there is a third option, which is to scale up vaccine production now. OConnell has a good answer as to why this isnt happening: To make hundreds of millions of doses of avian flu vaccines, manufacturers would have to stop producing seasonal flu shots. This would also takes a lot of extra funding from Congress. Wed have to be sure that we were in a position that it warrants that, she said.
With no evidence of human-to-human transmission, the Centers for Disease Control and Prevention has assessed that the risk to humans is low. Therefore, we have not yet reached the point where ramping up vaccine production is necessary. But if we did, it is reassuring to know that the United States would be in a better place to respond compared with the start of the covid pandemic.
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LAWRENCE Anti-vaccine sentiments are not new. But in recent years, attitudes toward vaccines have increasingly become more politicized along partisan lines. Accompanying such hesitancy is escalating distrust of China, which is where the COVID-19 epidemic originated.
A new study titled The politics of flu vaccines: international collaboration and political partisanship examines the influence of international collaboration and vaccine developments on peoples attitudes toward vaccines.
Interestingly, it was the collaboration between the U.S. and China that resulted in our annual flu vaccines, said John James Kennedy, a professor of political science at the University of Kansas.
Despite the previously successful and effective U.S.-China collaboration in developing vaccines, Kennedys study finds that respondents are much less likely to receive a U.S.-China flu vaccine than ones created by a U.S.-Japan collaboration or U.S. alone. It appears in the Japanese Journal of Political Science.
Co-written with KU assistant professor of political science Jack Zhang, KU doctoral student Riago Liu and former KU doctoral students Haruka Nagao and William Hatungimana (currently of the University of Oklahoma), the surveys results further suggest that Republicans are significantly less likely to accept an FDA-approved flu vaccine developed through U.S.-China collaboration than a flu vaccine developed through U.S.-Japan collaboration or the U.S. alone.
Historically, international collaboration has been critical to vaccine development, even with the general public being largely unaware of foreign involvement in the process.
U.S.-China relations with medicine goes back to the 1900s, said Kennedy, who also is chair of KUs political science department.
Theyve been collaborating specifically on vaccines for nearly 20 years. And it was through the World Health Organization (WHO) that theyve been sharing the actual flu viruses -- because you have to share the virus to get a piece of that virus in order to create the vaccine.
Kennedys team set up an experimental design that introduced four scenarios testing for vaccine nationalism, country-specific hypothesis and partisan hypothesis. More than 1,200 respondents were surveyed.
We knew there would be resistance in the U.S. to vaccines from China. We also assumed we would likely see Democrat and Republican differences, in terms of the Republicans being much more anti-China. But the surprise was there was greater support for the Japanese collaboration. In fact, more people would rather take a U.S.-Japan vaccine than one made solely by the U.S., he said.
This surprising result wasnt merely because of the eroding trust in the FDA coming from partisan influences.
Its also because of overall trust in Japanese products, Kennedy said.
Many cars driven in the U.S. are made by Japanese countries: Honda, Subaru, Toyota. Sony is a huge product, both in entertainment and things like headphones. Anime is extremely popular. And US-Japan relations together against China have been also prevalent. I think the trust in Japanese products over time has contributed to a trust in the vaccine.
Kennedy revealed that the impetus for this study was the conflux of seeing news reports about the anti-China legislation in Kansas coupled with advertisements touting the flu vaccine.
I was thinking, Well, I wonder if people would take the flu vaccine if they really knew that China has been engaged with helping create it? Because we asked people in the survey, Did you ever get a flu shot in the last 10 years? Almost everybody said yes which means theyve all been affected by this collaboration. But I thought the difference between knowing and not knowing would make an interesting survey experiment, he said.
A Los Angeles native who has taught at KU since 2003, Kennedy is fluent in Mandarin and conducts research on Chinese local governance. His first book, Lost and Found: The Missing Girls in Rural China, was published by Oxford in 2019.
The politics of vaccines could have a real influence on our public health, Kennedy said.
If people are refusing to take vaccines for political reasons, rather than medical reasons, that is unusual. Distrust in the FDA plays a role in some of that. Pandemics are not going away we were losing 30,000 to 50,000 people a year due to flu-related deaths before the pandemic. So Im hoping the biggest takeaway of this research is that people will be less political when it comes to vaccine choices.
The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) last night announced that it has shared 239 recent genetic sequences of the H5N1 avian flu virus from poultry, wild birds, and dairy cows, which will help scientists look for new clues about the spread of the virus.
In related developments over the past 3 days, APHIS reported four more H5N1 detections in dairy herds, along with more positive findings in wild birds and poultry. Also, the Centers for Disease Control and Prevention (CDC) posted a recent update on its actions to look for new human infections.
As the outbreak nears the 1-month mark, it's still not known how the 2.3.4.4b H5N1 clade is now able to infect cows and exactly how it is spreading in dairy herds. With the virus still spreading across multiple world regions, veterinary experts are looking for answers to protect dairy cows and human health.
Some scientists have voiced frustration with the slow pace of sharing genetic sequences and other investigation details. Until yesterday, only a few genetic sequences were available from the recent outbreaks, including those from a few cows and cats that were detailed in a recent preprint paper from a team at Iowa State University.
In its statement, APHIS said it usually publishes sequences on GISAID, the Global Initiative on Sharing All Influenza Data, but for transparency and to speed research, it shared raw sequence data via the National Institutes of Health National Center for Biotechnology Information. It added that the sequences are from cattle, cats, chickens, skunk, racoon, grackle, blackbird, and goose and that it will continue to make the data available on a rolling basis.
Louise Moncla, PhD, assistant professor of pathobiology at the University of Pennsylvania School of Veterinary Medicine, today on X welcomed the posting of the raw genetic sequencing, but said analysis steps such as downloading and mapping will take time, and it will take a while before scientists can show how the viruses are related to each other.
Meanwhile, in updates over the last few days, APHIS reported 4 more H5N1 detections in dairy herds, which raise the total to 32. The latest positive samples were from cows in Kansas, Michigan, and Texas.
Also, APHIS reported two more H5N1 detections in poultry flocks, including an earlier announced outbreak at a commercial turkey farm in Michigan's Newaygo County and a third hatchery in New Mexico's Roosevelt County. The agency also reported about 30 more H5N1 detections in wild birds, including waterfowl, shorebirds, crows, and raptors. Most were from the eastern part of the country.
In other related developments, the CDC on April 19 posted an update in its response, which includes lab studies to better clarify the impact of antiviral drugs and candidate vaccine viruses.
The agency said it just completed susceptibility testing for seasonal flu antivirals. Tests on the H5N1 virus from the recent human case in Texas confirm that it is susceptible to all commercially available neuraminidase inhibitors. "Testing to confirm susceptibility to baloxavir marboxil, a different antiviral medication, takes longer and is ongoing," it said.
Testing to confirm susceptibility to baloxavir marboxil, a different antiviral medication, takes longer.
The CDC said it is studying blood samples from people to have been vaccinated against H5 avian flu to confirm that existing candidate vaccine viruses (CVV) protect against the H5N1 virus isolated from the patient in Texas. Earlier genetic analysis suggested that the CDC's two existing CVVs would protect against the subtype found in the Texas patient.
Among other actions, the CDC said it is designing an epidemiologic field study to better understand the outbreak. So far, its monitoring of emergency department and flu testing data in areas where H5N1 has been found in dairy cattle or other animals shows no unusual trends.
Metabolic health (normal blood pressure, blood sugar and cholesterol levels, among other factors) influences the effectiveness of influenza vaccinations. Vaccination is known to be less effective in people with obesity compared to those with a healthier body mass index (BMI), but St. Jude Children's Research Hospital scientists have found it is not obesity itself, but instead metabolic dysfunction, which makes the difference. In a study published today in Nature Microbiology, the researchers found switching obese mice to a healthy diet before flu vaccination, but not after, completely protected the models from a lethal dose of flu, despite BMI.
We found that the vaccines worked effectively if at the time of vaccination an animal is metabolically healthy. And the opposite was also true: Regardless of what the mice looked like on the outside, if they had metabolic dysfunction, the vaccines did not work as well."
Stacey Schultz-Cherry, PhD, corresponding author, St. JudeDepartment of Host-Microbe InteractionsandCenter of Excellence for Influenza Research and Responseco-director
Prior research has shown that when exposed to influenza virus, even after vaccination, 100% of obese mice succumbed to disease. Contrary to the scientists' original expectations, when mice who were vaccinated while obese returned to a healthy weight, outcomes did not improve. These now outwardly healthy mice still all succumbed to disease when exposed to the real virus. Only switching to a healthy diet four weeks before vaccination improved survival, with drastic effect, despite high BMI.
"We were excited to see this effect because mice with obesity are so susceptible to severe disease and succumbing to the infection," Schultz-Cherry said. "Getting 100% survival with the vaccine where we had only seen 0% survival was impressive." The improved survival suggests the researchers have discovered a greater underlying principle determining influenza vaccine efficacy.
While studying how metabolic function influences influenza vaccine responses, the scientists found that poor metabolic health causes immune system dysfunction. T cells, the primary immune cells involved in anti-viral responses, failed to act in animals that had been in an unhealthy metabolic state at the time of vaccination, even during later viral exposure. Even when the animals ate a healthy diet after vaccination and maintained a normal BMI, the anti-flu T cells were "frozen" in that dysfunctional state.
However, a healthy diet before vaccination improved T-cell function, which resulted in a robust anti-flu response during later exposure.
"The T cells were better able to do their job in the metabolically healthy mice at the time of vaccination," Schultz-Cherry said. "It wasn't a matter of the numbers of them or the types of them. It was their functional activity. There were plenty of them in the lungs, not working. The healthy diet switched them from not working to functioning properly, but only if the switch occurred before vaccination."
The earlier healthy diet also improved inflammation. Pro-inflammatory cytokines are upregulated in obese animals. Schultz-Cherry's team found that models also returned to a lower basal cytokine level when switched to a healthy diet before vaccination.
"A healthy diet lowered some of the systemic meta-inflammation in these animals, and they regained some of the epithelial innate immune responses," said Schultz-Cherry. "We started seeing better signaling of things like interferons, which we know is problematic in obesity and in general saw the immune system starting to function the way that it should."
"What we found and are emphasizing is that it's not the phenotype of obesity that matters; it's really about metabolic health," Schultz-Cherry said. "It's metabolic health at that moment of vaccination that really makes a difference."
The study was restricted to mice, but it does open research opportunities to improve influenza vaccine efficacy in humans. The findings suggest methods of improving metabolic health may also improve subsequent influenza vaccinations. Given the recent introduction of metabolic improvement drugs, especially glucagon-like peptide 1 (GLP-1) agonists, there may be potential for a cooperative effect.
"We don't know for sure, but if the outcome of using GLP-1 drugs is weight loss and improved metabolic health, we would hypothesize that it will help," Schultz-Cherry said. "But we do know that we can do better protecting our vulnerable populations, and this study is a start for understanding how."
The study's co-first authors are Rebekah Honce, formerly of St. Jude, and Ana Vazquez-Pagan, formerly of the St. Jude Graduate School of Biomedical Sciences.
The study's other authors are R. Chris Skinner, University of Vermont, Brandi Livingston, Alexandra Mandarano, Benjamin Wilander, Sean Cherry, Virginia Hargest, Bridgett Sharp, Pamela Brigleb, Ericka Kirkpatrick Roubidoux, Lee-Ann Van de Velde, Maureen McGargill and Paul Thomas, St. Jude.
The study was supported by grants and contracts from the National Institute of Allergy and Infectious Diseases (HHSN27220140006C, 75N93019C00052, 75N93021C00016, F31AI161986, R01 AI140766-03 and 32AI106700-07) and ALSAC, the fundraising and awareness organization of St. Jude.
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Journal reference:
Honce, R., et al. (2024). Diet switch pre-vaccination improves immune response and metabolic status in formerly obese mice.Nature Microbiology. doi.org/10.1038/s41564-024-01677-y.
Researchers from St Georges, University of London have identified key barriers to vaccine uptake for whooping cough, flu and Covid-19 in pregnant women, and outline recommendations for addressing vaccine hesitancy. The results are from the first review of its kind and published today in the journalPLOS ONE.
Pregnant women are at increased risk of viral infections due to changes in their immune system during pregnancy. Vaccinations particularly for influenza (flu), pertussis (whooping cough) and Covid-19 are therefore highly recommended. If pregnant women choose not to have these vaccines, they not only put themselves at increased risk of disease, hospitalization and death, but also prevent their baby from having increased protection from birth.
Despite the NHS and the WHO strongly recommending these vaccines in pregnancy, uptake remains low in the UK with only 51% of pregnant women having two doses of Covid-19 vaccine, 60% having the whooping cough vaccine and just 30% taking the flu jab.
To better identify the main barriers and facilitators for vaccine uptake in pregnant women, researchers carried out the first systematic review of qualitative interview-based studies published between 2012 and 2022 in high-income countries with established vaccination programmes throughout pregnancy. Countries included the UK, Australia, New Zealand and the USA.
Their search identified 2,681 relevant articles, of which 28 peer-reviewed articles covering 1,573 women were included in the review. The majority of studies (78%) focused on flu and whooping cough.
The review revealed that the main barriers to vaccine uptake in pregnant women included concerns about vaccine safety and efficacy, a lack of knowledge about the benefits and necessity of vaccines, fear of adverse effects to themselves and their baby, poor understanding in how severe these diseases can be without vaccination, lack of endorsement by healthcare professionals and barriers to physically accessing vaccines whilst juggling other health appointments and priorities.
Now, Dr Mohammad Razai and his team have laid out key recommendations they hope will be embedded into public health strategies. They centre on five Cs confidence, complacency, convenience, communication and context. More specifically, their calls include [1]:
Vaccine hesitancy remains very high among pregnant women, but vaccination against whooping cough, flu and Covid-19 in pregnancy is crucial. In this day and age, people should not be hospitalized or even die from diseases that are preventable by safe and effective vaccines.
Our work has collated the views of over 1,000 pregnant women, and we hope that the key recommendations weve set-out will be applied to public health strategies in the UK and further afield. We believe these are vital to tackle vaccine hesitancy and increase protection of mothers-to-be and their children.
Dr Mohammad Razai, Lead researcher and Clinical Academic GP, Population Health Research Institute atSt Georges, University of London
The team are now developing community interventions to boost vaccination rates among women with low uptake. This involves training midwives to counsel pregnant women on vaccinations and sharing real-life stories to empower informed decision-making.
Dr Razais In-practice Fellowship was funded by the National Institute for Health and Care Research (NIHR).
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Posted: April 18, 2024
The World Health Organization (WHO) and around 500 experts have agreed for the first time what it means for a disease to spread through the air, in a bid to avoid the confusion early in the COVID-19 pandemic that some scientists have said cost lives.
The Geneva-based U.N. health agency released a technical document on the topic on Thursday. It said it was the first step towardworking out how to better prevent this kind of transmission, both for existing diseases like measles and for future pandemic threats.
The document concludes that the descriptor "through the air" can be used for infectious diseases where the main type of transmission involves the pathogen travelling through the air or being suspended in the air, in line with other terms such as "waterborne" diseases, which are understood across disciplines and by the public.
Almost 500 experts contributed to the definition, including physicists, public health professionals and engineers, many of whom disagreed bitterly over the topic in the past.
Agencies have historically required high levels of proof before calling diseases airborne, which required very stringent containment measures; the new definition says the risk of exposure and severity of disease should also be considered.
WATCH | Airborne transmission and COVID-19:
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Past disagreements also centred on whether infectious particles were "droplets" or "aerosols" based on size, which the new definition moves away from.
During the early days of COVID in 2020, around 200 aerosol scientists publicly complained that the WHO had failed to warn people of the risk that the virus could spread through the air. This led to an overemphasis on measures like handwashing to stop the virus, rather than focusing on ventilation, they said.
By July 2020, the agency said there was "evidence emerging" of airborne spread, but its then chief scientist Soumya Swaminathan,who began the process to get a definition, later said the WHO should have been more forceful "much earlier."
Her successor, Jeremy Farrar, said in an interview that the new definition was about more than COVID, but he added that at the beginning of the pandemic there was a lack of evidence available and experts including the WHO acted in "good faith." At that time, he was head of the Wellcome Trust charity and advised the British government on the pandemic.
Farrar said getting the definition agreed upon among experts from all disciplines would allow discussions to begin about issues such as ventilation in many different settings, from hospitals to schools.
He compared it to the realization that blood-borne viruses like HIV or hepatitis B could be spread by medics not wearing gloves during procedures.
"When I started out, medical students, nurses, doctors, none of us wore gloves to take blood," he told Reuters. "Now it is unthinkable that you wouldn'twear gloves. But that came because everyone agreed on what the issue was, they agreed on the terminology.[The change in practice] came later."
