KYIV, 12 March 2024 From December 2023 to February 2024, the United Nations Childrens Fund (UNICEF) has delivered nearly 1,400 specialized refrigerators ensuring effective vaccine storage in 23 regions across Ukraine.
Today, thanks to UNICEF and USAID efforts, alongside the World Bank and the COVAX initiative, approximately 95 per cent of health care facilities and around 80 percent of vaccination points are equipped with quality cold-chain equipment and temperature loggers.
A prerequisite for ensuring high-quality vaccines for immunization is their proper storage, using cold-chain equipment that meets global standards, says Munir Mammadzade, UNICEF Representative to Ukraine. With this impressive new batch of refrigerators brought to Ukraine with USAIDs support, we are taking another significant step towards properly equipping vaccination points around the country. Importantly, with this new equipment, health facilities in Ukraine are better prepared for possible power outages.
The new specialised cold-chain equipment ensures continuous storage temperatures for up to three days in the event of an electrical failure. This is particularly important amid the ongoing war in Ukraine, where attacks on the electricity grid have impacted healthcare power systems.
UNICEF has been supporting Ukraine with its update of vaccine storage refrigerators to meet global standards. The World Health Organization (WHO), UNICEF, and other expert bodies specialized in immunization recommend using standard equipment for the storage of vaccines to ensure effectiveness.
Preventive healthcare among the population is an ongoing priority for the healthcare sector, says Ihor Kuzin, Deputy Minister, Chief State Sanitary Doctor. At the national level, a comprehensive programme of re-equipment in line with the highest cold chain standards is underway 95 per cent of the cold-chain equipment has been already replaced. This includes refrigerators and freezers, specifically used for the vaccination cycle, starting from national-level warehouses to the establishment or upgrading of cold rooms at the level of regional centers for disease control and prevention.
Despite the full-scale war, the Ministry of Health, in cooperation with international partners, ensures the uninterrupted availability of vaccines for routine immunization at the level of each region, so that newborns can receive all mandatory vaccinations while at the maternity ward, and children and adults can receive them at the family doctor or vaccination point, adds Mr. Kuzin. These services are high quality, affordable and free of charge for patients.
To support this initiative, UNICEF is training health care and transportation on the use of the new equipment. In total, in 2022-2023, UNICEF has conducted 139 training workshops, organized with the support of the World Bank, the United States Agency for International Development (USAID) and the COVAX initiative. Approximately 5,000 health workers across Ukraine have benefited from this training on vaccine and cold chain management.
Background
UNICEF has been working with the World Bank, GAVI and USAID to update and enhance the cold-chain infrastructure in Ukraine. Almost 6,600 vaccine refrigerators and freezers have already been procured and delivered that will support effective vaccine storage at storage and vaccination points. UNICEF, with its own funds and USAID funds, also procured 36 refrigerator vans for vaccine transportation from national and regional levels to vaccination points.
In 2023 and early 2024, UNICEF delivered nearly 3 million doses of vaccines (polio, diphtheria-tetanus, measles-mumps-rubella, Haemophilus influenzae type b (Hib), COVID-19, hepatitis A) procured with support from USAID, the governments of Japan, the Netherlands and France, and the international COVAX initiative. In addition, UNICEF provided nearly 6.2 million syringes for vaccination.
Media contacts
Damian Rance
Chief Advocacy and Communications
UNICEF Ukraine
Email: drance@unicef.org
Key Takeaways
Adults 65 and older should get an additional dose of the updated COVID-19 vaccine this spring, according to the Centers for Disease Control and Prevention (CDC).
The agency gave its recommendation soon after a panel of advisors to the CDC met to discuss the vaccine strategy.
The committee agreed that older adults would benefit from another booster shot if it has been at least four months since their last vaccine dose. People older than 65 made up two-thirds of the COVID-related hospitalizations since March 2020.
People with compromised immune systems may also get additional vaccine doses two months after their last dose. The CDC didnt approve any new recommendations for those individuals but said they should ask their health providers about when to get their next booster shot.
People receiving a dose this spring will get the updated vaccine that rolled out in September. That vaccine is designed to target the XBB.1.5 Omicron subvariant. According to CDC data, it appears to protect against JN.1, the COVID variant that makes up about 92% of U.S. cases.
About 70% of U.S. adults have not received the most recent monovalent vaccine nor the bivalent vaccine that preceded it. Only 4% of adults have gotten a dose of the most recent vaccine formulation. Vaccine uptake was lower in rural areas and among Native Americans and Alaska Natives.
The CDC said they hope the latest recommendation will encourage older adults to get a shot of the updated vaccine to tide them over until the next generation of COVID vaccine is available.
A Food and Drug Administration advisory panel will meet in May to discuss the formulation of the vaccine for the fall. The CDC panel will then meet in June to provide clinical recommendations for the new vaccine.
Four years into the pandemic, the virus still does not follow a clear seasonal pattern. There may be an uptick in cases this summer, which is part of the reason the CDC recommended a top-up dose for older adults this spring.
We all feel that things with COVID are still unpredictable, particularly as new variants arise. I hope that we are moving in the direction of getting more flu-like where there is a really clear season, but I dont think that we are there yet, Megan Wallace, DrPH, MPH, an epidemiologist at the CDC, told the committee.
During Wednesdays meeting, the CDC committee deliberated whether to say that older adults should get a booster shot or if they may do so. Some panelists argued that a strongly worded recommendation may further vaccine fatigue.
The group settled on saying older adults should get the vaccine to emphasize the importance of an extra dose of protection for this age group.
From my perspective as an active clinician in the field, many people did not even know that they should have had an updated vaccine since September. If we say may, for me, thats too soft, said Camille Kotton, MD, a physician at Massachusetts General Hospital and a member of the scientific advisory panel.
The CDC shared data showing the vaccine lowered the odds of COVID hospitalization by 54% in otherwise healthy people 65 years and older.
When the COVID vaccines were first approved, they had an efficacy of 90% or more. Now that nearly every American has vaccine- or infection-induced immunity, the vaccines provide a relatively smaller boost to immune protection, explained Ruth Link-Gelles, PhD, MPH, vaccine effectiveness program lead for COVID-19 and other respiratory viruses at CDC.
Older adults can expect the vaccines to reduce their risk of hospitalization by about 50%.
Whether you were infected or vaccinated multiple times, your protection will decrease, and the vaccines can then provide really important extra protection, Link-Gelles said. Thats important for all people in the United States, but especially important for those that are the highest risk.
It can be tough to know if youre up-to-date on your COVID vaccines. If you havent yet received a dose of the updated COVID vaccine released in September or if you are unvaccinated, the CDC recommends getting one shot as soon as possible. If you are an older adult or immunocompromised, you can check with a health care provider about your vaccination strategy.
By Claire Bugos Claire Bugos is a senior news reporter at Verywell Health.
Thanks for your feedback!
What is your feedback?
Levi, L. I. & Vignuzzi, M. Arthritogenic Alphaviruses: A Worldwide Emerging Threat? Microorganisms 7, 133 (2019).
Article CAS PubMed PubMed Central Google Scholar
Organization, W. H. Chikungunya Fact Sheet, (2021).
PAHO. (World Health Organization, Pan American Health Organization, 2015).
Chikungunya Cases by Country or Territory. (2023).
Shocket, M. S., Ryan, S. J. & Mordecai, E. A. Temperature explains broad patterns of Ross River virus transmission. Elife 7, e37762 (2018).
Article PubMed PubMed Central Google Scholar
Murphy, A. K. et al. Spatial and temporal patterns of Ross River virus in south east Queensland, Australia: identification of hot spots at the rural-urban interface. BMC Infect. Dis. 20, 722 (2020).
Article PubMed PubMed Central Google Scholar
Serra, O. P., Cardoso, B. F., Ribeiro, A. L., Santos, F. A. & Slhessarenko, R. D. Mayaro virus and dengue virus 1 and 4 natural infection in culicids from Cuiaba, state of Mato Grosso, Brazil. Mem. Inst. Oswaldo Cruz 111, 2029 (2016).
Article CAS PubMed PubMed Central Google Scholar
Vieira, C. J. et al. Detection of Mayaro virus infections during a dengue outbreak in Mato Grosso, Brazil. Acta Trop. 147, 1216 (2015).
Article PubMed Google Scholar
Caicedo, E. Y. et al. Correction: The epidemiology of Mayaro virus in the Americas: A systematic review and key parameter estimates for outbreak modelling. PLoS Negl. Trop. Dis. 17, e0011034 (2023).
Article PubMed PubMed Central Google Scholar
Larrieu, S. et al. Factors associated with persistence of arthralgia among Chikungunya virus-infected travellers: report of 42 French cases. J. Clin. Virol. 47, 8588 (2010).
Article PubMed Google Scholar
Borgherini, G. et al. Persistent arthralgia associated with chikungunya virus: a study of 88 adult patients on reunion island. Clin. Infect. Dis. 47, 469475 (2008).
Article PubMed Google Scholar
Soumahoro, M. K. et al. Impact of Chikungunya virus infection on health status and quality of life: a retrospective cohort study. PLoS One 4, e7800 (2009).
Article ADS PubMed PubMed Central Google Scholar
Sissoko, D. et al. Post-epidemic Chikungunya disease on Reunion Island: course of rheumatic manifestations and associated factors over a 15-month period. PLoS Negl. Trop. Dis. 3, e389 (2009).
Article PubMed PubMed Central Google Scholar
Couturier, E. et al. Impaired quality of life after chikungunya virus infection: a 2-year follow-up study. Rheumatol. (Oxf.) 51, 13151322 (2012).
Article Google Scholar
Soumahoro, M. K. et al. The Chikungunya epidemic on La Reunion Island in 2005-2006: a cost-of-illness study. PLoS Negl. Trop. Dis. 5, e1197 (2011).
Article PubMed PubMed Central Google Scholar
Alvis-Zakzuk, N. J. et al. Economic Costs of Chikungunya Virus in Colombia. Value Health Reg. Issues 17, 3237 (2018).
Article PubMed Google Scholar
Staikowsky, F. et al. Retrospective survey of Chikungunya disease in Reunion Island hospital staff. Epidemiol. Infect. 136, 196206 (2008).
Article CAS PubMed Google Scholar
Harrison, V. R., Eckels, K. H., Bartelloni, P. J. & Hampton, C. Production and Evaluation of a Formalin-Killed CHIKV vaccine. J. Immunol. 107, 643647 (1971).
Article CAS PubMed Google Scholar
Metz, S. W. & Pijlman, G. P. Production of Chikungunya Virus-Like Particles and Subunit Vaccines in Insect Cells. Methods Mol. Biol. 1426, 297309 (2016).
Article CAS PubMed Google Scholar
Khan, M., Dhanwani, R., Rao, P. V. & Parida, M. Subunit vaccine formulations based on recombinant envelope proteins of Chikungunya virus elicit balanced Th1/Th2 response and virus-neutralizing antibodies in mice. Virus Res. 167, 236246 (2012).
Article CAS PubMed Google Scholar
Chang, L. J. et al. Safety and tolerability of chikungunya virus-like particle vaccine in healthy adults: a phase 1 dose-escalation trial. Lancet 384, 20462052 (2014).
Article CAS PubMed Google Scholar
Chen, G. L. et al. Effect of a Chikungunya Virus-Like Particle Vaccine on Safety and Tolerability Outcomes: A Randomized Clinical Trial. JAMA 323, 13691377 (2020).
Article CAS PubMed PubMed Central Google Scholar
Ramsauer, K. et al. Immunogenicity, safety, and tolerability of a recombinant measles-virus-based chikungunya vaccine: a randomised, double-blind, placebo-controlled, active-comparator, first-in-man trial. Lancet Infect. Dis. 15, 519527 (2015).
Article CAS PubMed Google Scholar
Folegatti, P. M. et al. A single dose of ChAdOx1 Chik vaccine induces neutralizing antibodies against four chikungunya virus lineages in a phase 1 clinical trial. Nat. Commun. 12, 4636 (2021).
Article ADS CAS PubMed PubMed Central Google Scholar
August, A. et al. A phase 1 trial of lipid-encapsulated mRNA encoding a monoclonal antibody with neutralizing activity against Chikungunya virus. Nat. Med. 27, 22242233 (2021).
Article CAS PubMed PubMed Central Google Scholar
Norrby, E. Yellow fever and Max Theiler: the only Nobel Prize for a virus vaccine. J. Exp. Med. 204, 27792784 (2007).
Article CAS PubMed PubMed Central Google Scholar
Matrajt, L., Britton, T., Halloran, M. E. & Longini, I. M. Jr One versus two doses: What is the best use of vaccine in an influenza pandemic? Epidemics 13, 1727 (2015).
Article PubMed PubMed Central Google Scholar
Barnabas, R. V. & Wald, A. A Public Health COVID-19 Vaccination Strategy to Maximize the Health Gains for Every Single Vaccine Dose. Ann. Intern. Med. 174, 552553 (2021).
Article PubMed Google Scholar
Burger, E. A., Campos, N. G., Sy, S., Regan, C. & Kim, J. J. Health and economic benefits of single-dose HPV vaccination in a Gavi-eligible country. Vaccine 36, 48234829 (2018).
Article PubMed PubMed Central Google Scholar
Levitt, N. H. et al. Development of an attenuated strain of chikungunya virus for use in vaccine production. Vaccine 4, 157162 (1986).
Article CAS PubMed Google Scholar
Gorchakov, R. et al. Attenuation of Chikungunya virus vaccine strain 181/clone 25 is determined by two amino acid substitutions in the E2 envelope glycoprotein. J. Virol. 86, 60846096 (2012).
Article CAS PubMed PubMed Central Google Scholar
Ly H. Ixchiq (VLA1553): The first FDA-approved vaccine to prevent disease caused by Chikungunya virus infection. Virulence. 15, 2301573 (2024)
Hallengard, D. et al. Novel attenuated Chikungunya vaccine candidates elicit protective immunity in C57BL/6 mice. J. Virol. 88, 28582866 (2014).
Article PubMed PubMed Central Google Scholar
Roques, P. et al. Attenuated and vectored vaccines protect nonhuman primates against Chikungunya virus. JCI Insight 2, e83527 (2017).
Article PubMed PubMed Central Google Scholar
Wressnigg, N. et al. Single-shot live-attenuated chikungunya vaccine in healthy adults: a phase 1, randomised controlled trial. Lancet Infect. Dis. 20, 11931203 (2020).
Article PubMed Google Scholar
Valneva. (ed Valneva Austria GmbH) (2021).
McMahon, R. et al. A randomized, double-blinded phase 3 study to demonstrate lot-to-lot consistency and to confirm immunogenicity and safety of the live-attenuated chikungunya virus vaccine candidate VLA1553 in healthy adults. J. Travel Med. 13, taad156 (2023).
Google Scholar
Weger-Lucarelli, J., Aliota, M. T., Kamlangdee, A. & Osorio, J. E. Identifying the Role of E2 Domains on Alphavirus Neutralization and Protective Immune Responses. PLoS Negl. Trop. Dis. 9, e0004163 (2015).
Article PubMed PubMed Central Google Scholar
Weger-Lucarelli, J. et al. Dissecting the Role of E2 Protein Domains in Alphavirus Pathogenicity. J. Virol. 90, 24182433 (2015).
Article PubMed Google Scholar
Capitini, C. M., Fry, T. J. & Mackall, C. L. Cytokines as Adjuvants for Vaccine and Cellular Therapies for Cancer. Am. J. Immunol. 5, 6583 (2009).
Article CAS PubMed PubMed Central Google Scholar
Pennslyvania, U. o. PENNVAX-B With or Without IL-12 or IL-15 as a DNA Vaccine for HIV Infection. (2016).
NIAID. Safety of and Immune Response to an HIV Preventive Vaccine (HIV-1 Gag DNA Alone or With IL-15 DNA) Given With or Without Different Booster Vaccinations in HIV Uninfected Adults. (2021).
Chen, T. et al. IL-21 arming potentiates the anti-tumor activity of an oncolytic vaccinia virus in monotherapy and combination therapy. J. Immunother. Cancer 9, e001647 (2021).
Article PubMed PubMed Central Google Scholar
Li, M. Safety of Recombinant Human IL-21 Oncolytic Vaccinia Virus Injection (hV01) in Advanced Tumors. (2023).
Nordisk, N. Efficacy Study of IL-21 to Treat Metastatic Melanoma. (2004).
Squibb, B. M. (2015).
Clinic, M. Interferon-gamma or Aldesleukin and Vaccine Therapy in Treating Patients with Multiple Myeloma. (2011).
Inc, B. IMLYGIC, https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/imlygic. (2021).
Gherardi, M. M. et al. IL-12 Delivery from Recombinant Vaccinia Virus Attenuates the Vector and Enhances the Cellular Immune Response Against HIV-1 Env in a Dose-Dependent Manner. J. Immunol. 162, 67246733 (1999).
Article CAS PubMed Google Scholar
Abaitua, F., Rodriguez, J. R., Garzon, A., Rodriguez, D. & Esteban, M. Improving recombinant MVA immune responses: potentiation of the immune responses to HIV-1 with MVA and DNA vectors expressing Env and the cytokines IL-12 and IFN-gamma. Virus Res. 116, 1120 (2006).
Article CAS PubMed Google Scholar
Jarasch, N. et al. Interferon-gamma-induced activation of nitric oxide-mediated antiviral activity of macrophages caused by a recombinant coxsackievirus B3. Viral Immunol. 18, 355364 (2005).
Article CAS PubMed Google Scholar
Spolski, R. & Leonard, W. J. Interleukin-21: a double-edged sword with therapeutic potential. Nat. Rev. Drug Discov. 13, 379395 (2014).
Article CAS PubMed Google Scholar
Lee, A. J. & Ashkar, A. A. The Dual Nature of Type I and Type II Interferons. Front Immunol. 9, 2061 (2018).
Article PubMed PubMed Central Google Scholar
Gardner, J. et al. Chikungunya virus arthritis in adult wild-type mice. J. Virol. 84, 80218032 (2010).
Article CAS PubMed PubMed Central Google Scholar
Morrison, T. E. et al. A mouse model of chikungunya virus-induced musculoskeletal inflammatory disease: evidence of arthritis, tenosynovitis, myositis, and persistence. Am. J. Pathol. 178, 3240 (2011).
Article CAS PubMed PubMed Central Google Scholar
Lentscher, A. J. et al. Chikungunya virus replication in skeletal muscle cells is required for disease development. J. Clin. Invest. 130, 14661478 (2020).
Article CAS PubMed PubMed Central Google Scholar
Announcing a new publication for Acta Materia Medica journal. Vaccines have an essential role in preventing infectious diseases and reducing the burden of disease. In this article the differences in vaccine lists and prices, and the National Immunization Program (NIP) and vaccine development between China and the United States (US) in conjunction with epidemiologic data on infectious diseases were systematically compared.
The epidemiologic data of infectious diseases in 2019 were extracted from the China National Health Commission and the US Centers for Disease Control and Prevention (CDC). The vaccine list was identified from the China National Medical Products Administration and US Food and Drug Administration databases. Vaccine prices were obtained via the China government procurement platform and the US CDC. The NIP vaccines for China and the US were obtained from the China and US CDCs. Vaccine candidates investigated in 2015-2022 were identified from the China Clinical Trial Registry Platform and the US clinicaltrials.gov database. Differences in the incidence of infectious diseases between China and the US were detected with both countries facing a lack of available vaccines for prevention of many diseases. The number of listed vaccines and preventable diseases in China was 59 and 36, respectively, which was higher than the US (45 and 31, respectively).
The median price of NIP vaccines in China was significantly lower than the price in the US (median: $3.8 vs. $20; P<0.001); however, there was no significant difference in the price of non-NIP vaccines (median: $68 vs. $86; P=0.498). Vaccines developed by local manufacturers were less expensive than imported products despite the absence of significant differences (median: $16 vs. $31; P=0.180). The number and types of NIP vaccines used to prevent infectious diseases in China were lower than the US. The majority of vaccine candidates in China were not novel compared to the US. Vaccines marketed in China for infectious diseases were comparable to the US.
These findings suggest that China should further expand NIP vaccines and incentive research and development on novel vaccines to improve accessibility based on infectious disease epidemiology.
Source:
Journal reference:
Luo, X., et al. (2024). A comparative analysis of vaccine lists, prices, and candidates, and the national immunization program between China and the United States.Acta Materia Medica. doi.org/10.15212/amm-2023-0033.
Right-wing conspiracy theorist Alex Jones threatened to go on a warpath against Donald Trump after the former president bragged about COVID-19 vaccines on his platform Truth Social.
In a critique of President Joe Bidens State of the Union address, Trump boasted about getting COVID-19 vaccines distributed to the public in less than a year, claiming it would have taken Biden a dozen years to do so.
Despite being a well-known supporter of Trump, Jones was angered by Trumps response. He called Trump's post bulls**t and vaccines a biological weapon in a post on X, formerly Twitter.
Jones took things a step further when he threatened Trump on his show InfoWars.
"If I see any more of this from Trump ... I'm gonna have to go on the warpath," Jones warned. "I just cannot take this I cannot put my head down on the pillow at night and say that I'm a true person to everybody when I've already held my nose because of the overwhelming good he's doing and all the persecution, and put up with stuff like this."
Later in the show Jones claimed COVID-19 was actually cooked up by Dr Anthony Fauci, the former Chief Medical Advisor to the president, and that vaccines had already been developed for release. Jones also said Trumps post made him physically sick.
Though he confirmed his support for Trumps re-election, he urged voters to take the former presidents words with a grain of salt.
We cant put all of our faith in one man. We all get sucked into this Trump thing and it becomes everything. Thats kind of black-pilled though, Jones said. No, its an important fight, we need to get him in there, my gut tells me its the right thing to do, but God also the Holy Spirit also tells me, dont be a Trump follower, be a Trump backer so we have a guy in there that we can put pressure on.
According to the researchers, intramuscular vaccines induce a systemic immune response in the body, but do not induce a strong immune response in mucus membranes, like in the nose and airways. Protection in the bodys mucus membranes, where the virus is first encountered, is essential to preventing infection and limiting transmission of respiratory viruses.
An effective vaccine administered via the nose has the potential to induce a mucosal immune response as well as a systemic response, said Troy Sutton, assistant professor of veterinary and biomedical sciences at Penn State and a leader of the research team. We are developing and testing the SpyCage vaccine delivery system to try to create vaccines that do just that. If we can induce a robust immune response in the respiratory tract, thereby blocking infection and transmission, we may be able to slow the spread of airborne viruses and potentially end, or even prevent, a pandemic.
According to the researchers, candidate nasal vaccines that have been developed to date have used viral vectors or live-attenuated viruses and continue to have safety concerns, especially for the most vulnerable populations.
The SpyCage protein scaffold looks similar enough to a virus to trick the immune system into mounting a response, but none of it is actually derived from a virus, Lindner said. We make portions of the SARS-CoV-2 spike protein in the lab and permanently attach them to the surface of the SpyCage. The result is a nanoparticle that resembles the virus in size, shape and symmetry that can induce an immune response in our pre-clinical animal testing.
In their tests, when the SpyCage was loaded with the spike protein and administered via the nose, it induced an immune response helping to clear an infection more quickly than in unvaccinated animals or if the spike protein was administered on its own. If the two components the SpyCage scaffold and the spike proteins were administered together but not bound to each other, the researchers did not see an immune response or reduction of infection. They also tested the vaccine in conjunction with an adjuvant a substance designed to enhance the efficacy of nasal vaccines but did not see any significant improvement.
Its clear that the SpyCage must be decorated with spike proteins to train the bodys immune system, so that when it is exposed to the actual virus, it can quickly respond and more rapidly eliminate the virus, Lindner said. The SpyCage vaccine platform must still be optimized to achieve the goal of preventing infections and transmission, and we are working to improve its efficacy.
The researchers explained that the SpyCage vaccine platform continues to be developed and is the subject of several patents and pending patent applications.
More testing is required to confirm its safety and optimize its effectiveness, Sutton said. However, because of its modular design and assembly, SpyCage can be easily adapted to make vaccines against other respiratory viruses and could provide a platform for rapid response vaccines for novel viruses in the future.
In addition to Lindner and Sutton, the research team includes Devanshi Patel, Allen Minns, Derek Gordon Sim, Cassandra Field, Abigail Kerr, Talia Heinly, Erin Luley, Randy Rossi, Carol Bator, Ibrahim Moustafa and Susan Hafenstein at Penn State and Elizabeth Norton at Tulane University. Funding from the U.S. National Institute of General Medical Science, Penn State, a Huck Institutes of Life Sciences COVID Seed Grant and the U.S. Department of Agricultures National Institute of Food and Agriculture supported the research.
CHARLESTON, W.Va. Health Officer at the Kanawha-Charleston Health Department, Dr. Steven Eshenaur, says the passage of a bill allowing parents to choose whether they vaccinate their children against infectious diseases is very much a concern.
HB5105, or the vaccine bill, pertaining to the elimination of requirements to prevent and control diseases such as measles, mumps, tetanus, meningitis, and polio, and the compulsory immunization of school children, passed during the 60-day legislative session that just wrapped up at the state capitol.
Eshenaur told MetroNews that he testified against the bill in both the House of Delegates and the state Senate, because, up until this point, West Virginias immunization regulations for students have proven to be both safe and effective at keeping those diseases out of schools.
That system, those laws have kept our children safe, Eshenaur said. This bill weakens those laws.
Eshenaur said the bill specifically allows for parents of children attending private and parochial schools in the state to sign a religious exemption form to prevent their child from getting vaccinations that were once mandatory for all students.
He said this still allows those children deemed exempt from getting immunizations to interact with other children and potentially expose them to such diseases, as well.
Eshenaur said this poses a potential risk for the entire population, because, in order to keep herd immunity in place and infectious diseases at bay, a 95% immunization rate across the state must be maintained. He said while that 95% immunization rate can still be maintained when taking into account of those who are legitimately medically-exempt from getting vaccines, this bill creates the risk of decreasing that rate by exempting those who may otherwise safely receive immunizations.
When we drop below that threshold, then we will become like our neighbors in Ohio, Pennsylvania, Virginia, Maryland, etc. that have now had measles outbreaks just this year, he said.
Eshenaur said while it wont happen immediately, the lower immunization rates this policy change could lead to could even open the door up to a relatively longtime dormant disease in the country polio. He said West Virginia hasnt had a case of polio since 1970.
Eshenaur said a polio case was, however, reported for the first time in many years in the U.S. in New York back in 2022 from someone who was unimmunized.
He said if it could break out there again, it could just as easily spark an outbreak here.
Polio still exists in the world, it has never gone away, but we have been able to keep it from infecting our population, because weve had strong immunization programs to prevent polio from infecting our children, he said.
He said as an emergency physician who has been all over the world treating these diseases in first-world countries, he saw the affects of what the lack of accessibility of vaccinations can do.
Eshenaur urges parents to continue to protect their children by getting them these safe and effective vaccines which doctors have been utilizing in West Virginia for many years.
Our immunization laws are almost 90 years old, they have evolved overtime with new immunization that we have developed and we have now effectively eliminated as a scourge a number of childhood diseases that our grandparents and great-grandparents had to experience, said Eshenaur.
Eshenaur is now submitting a letter to Governor Jim Justice urging him to veto HB5105 immediately. He said if Justice decides not to veto the bill, the legislation will turn the clock back nearly 100 years in immunization protection.
March 12, 2024
2 min read
Add topic to email alerts
Receive an email when new articles are posted on
Back to Healio
A rapid response to hepatitis A exposure helped minimize the risk for transmission and prevent an HAV outbreak among incarcerated persons in a Los Angeles County jail, according to an investigation in Morbidity and Mortality Weekly Report.
On May 30, 2023, the countys Correctional Health Services (CHS) department was notified that an incarcerated person, who had been assigned to food preparation in the jail kitchen, tested positive for acute HAV. Within 48 hours, CHS identified individuals who had been housed in the jail during the infectious period and offered postexposure prophylactic HAV vaccination to more than 2,700 people.
The prompt vaccine rollout likely helped reduce transmission and prevent an outbreak among the LA County Jail population, and the enhanced surveillance, which included the monitoring of emergency hospital transfers made because of suspicion of acute hepatitis A, helped identify possible secondary cases or clusters needing further investigation, Nazia S. Qureshi, MPH, of the Los Angeles County Department of Health Services, and colleagues wrote.
According to the report, a 41-year-old incarcerated man with a history of homelessness, injection drug use and alcohol use disorder sought care on May 25 for vomiting, received antacids and reported feeling better. Three days later, the man returned to an urgent care facility for inappetence, abdominal pain, nausea and vomiting. He also had jaundice.
Health care providers reported elevated liver enzymes and reactive anti-HAV immunoglobin M; a stool sample collected May 28 also tested positive for HAV via polymerase chain reaction. The man remained hospitalized until June 2.
Based on the symptoms, CHS determined that May 9 to 28 was the patients infectious period, with the potential incubation period of his contacts to extend through July 17. CHS staff members identified 5,830 people who had been housed in the jail during the infectious period and offered HAV vaccination as postexposure prophylaxis to 2,766 who did not have a documented history of HAV serology or vaccination. Of these, 1,510 (54.6%) accepted and were vaccinated.
In addition, CHS noted that any HAV-related signs or symptoms were reason for emergency hospital transfer. No additional cases of HAV had been reported or identified as of Oct. 16, the report noted.
This exposure response highlights the importance of initiating a rapid response to hepatitis A exposure in a jail setting to minimize risk for transmission and help prevent an outbreak, Qureshi and colleagues wrote. Having relevant laboratory results for reportable communicable diseases consistently and seamlessly communicated electronically across different health systems with mutual patients and using serology and vaccination records from electronic health records and state immunization registries can facilitate and optimize the response to a potential exposure by ensuring the timely administration of postexposure prophylaxis to those who are at greatest risk.
Add topic to email alerts
Receive an email when new articles are posted on
Back to Healio
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Puerto Rico US Virgin Islands Armed Forces Americas Armed Forces Pacific Armed Forces Europe Northern Mariana Islands Marshall Islands American Samoa Federated States of Micronesia Guam Palau Alberta, Canada British Columbia, Canada Manitoba, Canada New Brunswick, Canada Newfoundland, Canada Nova Scotia, Canada Northwest Territories, Canada Nunavut, Canada Ontario, Canada Prince Edward Island, Canada Quebec, Canada Saskatchewan, Canada Yukon Territory, Canada
Zip Code
Country United States of America US Virgin Islands United States Minor Outlying Islands Canada Mexico, United Mexican States Bahamas, Commonwealth of the Cuba, Republic of Dominican Republic Haiti, Republic of Jamaica Afghanistan Albania, People's Socialist Republic of Algeria, People's Democratic Republic of American Samoa Andorra, Principality of Angola, Republic of Anguilla Antarctica (the territory South of 60 deg S) Antigua and Barbuda Argentina, Argentine Republic Armenia Aruba Australia, Commonwealth of Austria, Republic of Azerbaijan, Republic of Bahrain, Kingdom of Bangladesh, People's Republic of Barbados Belarus Belgium, Kingdom of Belize Benin, People's Republic of Bermuda Bhutan, Kingdom of Bolivia, Republic of Bosnia and Herzegovina Botswana, Republic of Bouvet Island (Bouvetoya) Brazil, Federative Republic of British Indian Ocean Territory (Chagos Archipelago) British Virgin Islands Brunei Darussalam Bulgaria, People's Republic of Burkina Faso Burundi, Republic of Cambodia, Kingdom of Cameroon, United Republic of Cape Verde, Republic of Cayman Islands Central African Republic Chad, Republic of Chile, Republic of China, People's Republic of Christmas Island Cocos (Keeling) Islands Colombia, Republic of Comoros, Union of the Congo, Democratic Republic of Congo, People's Republic of Cook Islands Costa Rica, Republic of Cote D'Ivoire, Ivory Coast, Republic of the Cyprus, Republic of Czech Republic Denmark, Kingdom of Djibouti, Republic of Dominica, Commonwealth of Ecuador, Republic of Egypt, Arab Republic of El Salvador, Republic of Equatorial Guinea, Republic of Eritrea Estonia Ethiopia Faeroe Islands Falkland Islands (Malvinas) Fiji, Republic of the Fiji Islands Finland, Republic of France, French Republic French Guiana French Polynesia French Southern Territories Gabon, Gabonese Republic Gambia, Republic of the Georgia Germany Ghana, Republic of Gibraltar Greece, Hellenic Republic Greenland Grenada Guadaloupe Guam Guatemala, Republic of Guinea, Revolutionary People's Rep'c of Guinea-Bissau, Republic of Guyana, Republic of Heard and McDonald Islands Holy See (Vatican City State) Honduras, Republic of Hong Kong, Special Administrative Region of China Hrvatska (Croatia) Hungary, Hungarian People's Republic Iceland, Republic of India, Republic of Indonesia, Republic of Iran, Islamic Republic of Iraq, Republic of Ireland Israel, State of Italy, Italian Republic Japan Jordan, Hashemite Kingdom of Kazakhstan, Republic of Kenya, Republic of Kiribati, Republic of Korea, Democratic People's Republic of Korea, Republic of Kuwait, State of Kyrgyz Republic Lao People's Democratic Republic Latvia Lebanon, Lebanese Republic Lesotho, Kingdom of Liberia, Republic of Libyan Arab Jamahiriya Liechtenstein, Principality of Lithuania Luxembourg, Grand Duchy of Macao, Special Administrative Region of China Macedonia, the former Yugoslav Republic of Madagascar, Republic of Malawi, Republic of Malaysia Maldives, Republic of Mali, Republic of Malta, Republic of Marshall Islands Martinique Mauritania, Islamic Republic of Mauritius Mayotte Micronesia, Federated States of Moldova, Republic of Monaco, Principality of Mongolia, Mongolian People's Republic Montserrat Morocco, Kingdom of Mozambique, People's Republic of Myanmar Namibia Nauru, Republic of Nepal, Kingdom of Netherlands Antilles Netherlands, Kingdom of the New Caledonia New Zealand Nicaragua, Republic of Niger, Republic of the Nigeria, Federal Republic of Niue, Republic of Norfolk Island Northern Mariana Islands Norway, Kingdom of Oman, Sultanate of Pakistan, Islamic Republic of Palau Palestinian Territory, Occupied Panama, Republic of Papua New Guinea Paraguay, Republic of Peru, Republic of Philippines, Republic of the Pitcairn Island Poland, Polish People's Republic Portugal, Portuguese Republic Puerto Rico Qatar, State of Reunion Romania, Socialist Republic of Russian Federation Rwanda, Rwandese Republic Samoa, Independent State of San Marino, Republic of Sao Tome and Principe, Democratic Republic of Saudi Arabia, Kingdom of Senegal, Republic of Serbia and Montenegro Seychelles, Republic of Sierra Leone, Republic of Singapore, Republic of Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia, Somali Republic South Africa, Republic of South Georgia and the South Sandwich Islands Spain, Spanish State Sri Lanka, Democratic Socialist Republic of St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan, Democratic Republic of the Suriname, Republic of Svalbard & Jan Mayen Islands Swaziland, Kingdom of Sweden, Kingdom of Switzerland, Swiss Confederation Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand, Kingdom of Timor-Leste, Democratic Republic of Togo, Togolese Republic Tokelau (Tokelau Islands) Tonga, Kingdom of Trinidad and Tobago, Republic of Tunisia, Republic of Turkey, Republic of Turkmenistan Turks and Caicos Islands Tuvalu Uganda, Republic of Ukraine United Arab Emirates United Kingdom of Great Britain & N. Ireland Uruguay, Eastern Republic of Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam, Socialist Republic of Wallis and Futuna Islands Western Sahara Yemen Zambia, Republic of Zimbabwe
The early identification of thrombocytopenia and thrombosis (VITT) and immune thrombocytopenia (ITP) after vaccination against COVID-19 were crucial for successfully caring for patients presenting with thrombocytopenia, according to a recent study published in Research and Practice in Thrombosis and Haemostasis.1
Blood Clot Model | image credit: Matthieu - stock.adobe.com
The study authors reflected on emerging evidence of thrombocytopenic and thrombotic events in some patients after receiving a COVID-19 vaccination. While rare, VITT and ITP following vaccination require urgent evaluation and therapy initiation.2
Despite emerging data on the occurrence of VITT and ITP following vaccination, there is insufficient information available pertaining to the long-term management of these events, the authors explained.1
To better understand these adverse hemolytic events, treatment approaches, the diagnostic process, and to address the shortcomings in literature, the researchers reported on patients at a tertiary care center in Canada who presented with thrombocytopenia following their COVID-19 vaccine.
Nine adult patients with new-onset thrombocytopenia at The Ottawa Hospital between April 1, 2021, and May 31, 2021, were retrospectively reported on. These presentations of thrombocytopenia began between 4 and 42 days after receiving a COVID-19 vaccine, which included the Pfizer-BioNTech mRNA, Moderna mRNA, and Astra Zeneca adenovirus vector-based vaccines.
The treatment regimens for VITT and ITP included a corticosteroid approach with daily prednisone at a dose of 1 mg/kg over the initial few days before tapering over the next 2-3 months. For VITT, it was also recommended to administer non-heparin anticoagulation; some cases can necessitate intravenous immunoglobulin (IVIG).
Additionally, 4-42 days prior to patients symptom onset, heparin-induced thrombocytopenia (HIT) testing was sent for individuals with a COVID-19 vaccination record and a platelet count under 150. This testing utilized the Immucor PF4 Enhanced enzyme-linked immunosorbent assay (ELISA) to assess for anti-PF4 autoantibodies. If a patient registered a positive PF4 binding assay, the serotonin release assay (SRA) was performed as a confirmation test for VITT.
The 9 included patients had an average age of 55 years, with a close-to-equal gender distribution. The majority of patients received the Astra Zeneca vaccine (n = 7) while the others received Pfizer (n = 2). No one had been exposed to heparin and all patients were negative for COVID-19 infection.
Positive results from the HIT ELISA tests came back for 3 patients and further testing with SRA diagnosed VITT in a 4th patient. There were 5 patients who went on to develop ITP4 of whom did not have an associated thrombosis. The fifth patient had a history of ITP and was diagnosed with deep vein thrombosis.
All patients who developed VITT stayed oral anticoagulation treatment following 9 months of treatment. Three of the 4 patients with VITT were admitted to the hospital and subsequently treated with corticosteroids, non-heparin parenteral anticoagulation, and IVIG. The authors observed that patient 1 had a good response to treatment; however, this was not the case in patients 2 or 3. Patient 2 endured recurrent thrombocytopenia throughout their steroid taper and needed to be readmitted for steroids and IVIG. The third patient experienced 2 incidences of cerebral venous sinus thrombosis (CVST) progression and refractory thrombocytopenia. Their hospital stay lasted 15 days and their complications required 7 treatments of plasma exchange. While patient 4 was not admitted to the hospital, they did receive outpatient treatment with a DOAC for pulmonary emboli, to which they responded well.
Of the 5 patients who went on to develop ITP, 1 experienced success treating their condition with eltrombopag and apixaban as an outpatient, but the remaining 4 were admitted to the hospital.
Patients with VITT all continued to get their next round of the COVID-19 mRNA vaccine, whereas all patients except for 2 who had ITP continued with the next vaccine round. Of the 2 who did not have their next dose, 1 declined because of their experience with adverse hematologic events and the other was not recommended to continue because of their history of thrombocytopenia following their previous vaccine doses.
Early identification was key to the successful management of VITT and ITP events following COVID-19 vaccination. The patient cases described in our study add to the currently limited literature on long-term management of VITT and ITP, particularly in refractory cases, and provides guidance around future COVID-19 vaccinations, the authors concluded.
Reference
1. Ge M, Ladha D, Lymer J, et al. Thrombocytopenia with and without thrombosis following covid-19 vaccination: long-term management. Res Pract Thromb Haemost. Published online February 29, 2024. doi: 10.1016/j.rpth.2024.102357
2. Vaccine-induced immune thrombotic thrombocytopenia. American Society of Hematology. Updated May 9, 2022. Accessed March 12, 2024. https://www.hematology.org/covid-19/vaccine-induced-immune-thrombotic-thrombocytopenia
