Adults ages 75 and older should get a single dose of an adult RSV vaccine. People ages 60 to 74 who have health complications should also get vaccinated. Photo: Getty Images.
Federal health experts have issued new guidelines for adult RSV vaccines, and some people may be confused since this years advice is a little different than last years.
So, who should get an RSV vaccine? How are the newest guidelines different from last years RSV vaccine recommendations, and how often do older adults need to get an RSV vaccine?
To better understand RSV vaccines for adults, we consulted with Dr. Michelle Barron, UCHealthssenior medical director of infection prevention and control.
Barron said its excellent that there are now RSV vaccines for at-risk older adults. The vaccines were first approved in 2023, and if youve already gotten a single dose of an RSV vaccine, you dont need to worry about getting another dose now.
You should be good. At this point in time, a single shot is considered a lifetime dose, so you should not get another one, Barron said. The new guidelines only apply to people who didnt get an RSV vaccine last year and are wondering if they would benefit from getting one this year.
Health experts are encouraging people who could get sickest from RSV to get the new vaccines. People ages 75 and older and those ages 60 and older who have serious health conditions are most at risk if they get RSV and should consider getting the vaccine, Barron said.
Its wonderful anytime we can prevent a disease from becoming severe, and preventing hospitalizations is definitely worthwhile, said Barron, who is alsoa professorat theUniversity of Colorado School of Medicineon theAnschutz Medical Campus.
For both medical providers and patients, the fine print about RSV vaccines can be confusing. So we went over the most frequently asked questions with Barron.
RSV stands for Respiratory Syncytial Virus. Parents of young children may think of RSV by its more common name: croup. Along with older adults, RSV or croup can be very dangerous for newborns and young children. And parents whove nursed sick children through a case of croup can attest to the alarming barking seal sound that children make when theyre coughing or gasping for air.
No. RSV can be very dangerous for babies, young children and some older adults. But many other people likely have had RSV and didnt realize it.
Thats because RSV in older children and healthy adults can manifest with basic cold symptoms or those of bronchitis.
For most people, this is not a big deal, Barron said. But in patients who are immunosuppressed because theyve had a transplant or are undergoing chemotherapy or have really bad underlying lung disease, RSV can get them into a trouble and put them in the hospital. So its something we have to pay attention to.
No. There is not an RSV vaccine for infants and children. Especially vulnerable newborns like those born prematurely can receive a new injected medication called nirsevimab. Its a type of monoclonal antibody that babies can receive if theyre born during RSV season. Learn more about monoclonal antibodies for RSV.
Yes. For pregnant women who are due to deliver babies during the winter months when RSV most commonly peaks medical experts recommend one dose of an RSV vaccine at 32 to 36 weeks of pregnancy.
Medical advisers to the U.S. Centers for Disease Control and Prevention (CDC) who are part of the CDCs Advisory Committee on Immunization Practices voted on June 26 to revise guidance related to adult RSV vaccines. Leaders at the CDC then adopted these new guidelines.
Here are the newest recommendations for RSV vaccines for adults:
In addition, experts encourage people who are immunocompromised, such as transplant recipients, to get the RSV vaccine. And people living in nursing homes and long-term care facilities should also get a single dose of the RSV vaccine since the virus can spread quickly and cause serious illness to people living in elder care facilities.
Older people who get RSV infections tend to end up in the hospital and can have complications once theyre hospitalized, Barron said. The new guidelines make sense in that theyre trying to target the people who are at highest risk.
People who have questions about whether they should get an RSV vaccine should talk with their doctors.
Last years guidelines for RSV vaccines encouraged shared decision making for people ages 60 and older. Those guidelines spurred confusion both for medical providers and patients who werent certain who should get an RSV vaccine.
In addition, RSV vaccines are relatively expensive. For people without insurance, they can cost about $400 per dose, and a very small percentage of people can experience a serious side effect called Guillain-Barr syndrome.
When medical experts reviewed RSV vaccines this year, they decided to focus on the people who needed them most: those ages 75 and older and those who are dealing with serious underlying health conditions.
Dr. Oliver Brooks is the chief medical officer for Watts HealthCare Corporation in Los Angeles and is a member of the CDC advisory committee for vaccines.
During a recent meeting of the advisers, Brooks said it makes sense to change guidance when new information emerges.
We shouldnt vaccinate people who dont need the vaccine, Brooks said of the new RSV guidance. Sometimes we change our minds based on data.
Barron concurred.
RSV is not going to have a big impact on everybody. So, from an economic perspective and as it relates to the potential for side effects, not offering this vaccine to the universe at large is probably the best answer for now, Barron said.
She emphasized that its normal for viruses to evolve. So, its wise for health experts and policy makers to keep evaluating and reevaluating proper recommendations for RSV and other vaccines.
We may need to change the recommendations again based on what we learn five years from now, Barron said. Well continue to evaluate as we go along.
The best time to get an RSV vaccine is in the late summer or early fall before RSV starts to spread widely during the winter respiratory virus season.
No. For now, medical experts advise people who qualify for RSV vaccines to get a single dose.
Barron said medical experts will continue to monitor the long-term effectiveness of the new RSV vaccines. If the effect of the vaccine wanes over time as is typical for other vaccines, like those for flu and COVID-19 its possible that federal health authorities will recommend booster doses of RSV sometime in the future.
No. There were no shortages of the (adult) RSV vaccine, Barron said.
There were some shortages of the monoclonal antibodies that help prevent RSV in infants and young children, and some people may have mixed up those treatments with the adult RSV vaccines.
The monoclonal antibody is not a vaccine. But since its for prevention of RSV, some people may have bunched the two together, Barron said.
People who need an RSV vaccine this fall shouldnt have any trouble getting it, Barron said.
Yes. Its safe to get multiple vaccines at the same time.
Barron is a big fan of convenience. She encourages her patients not to worry too much about the exact timing of their vaccines. If youre already seeing your doctor this fall, go ahead and get your vaccines at that time. (Learn all about the new 2024-25 COVID-19 vaccine that people should get this fall.)
RSV is probably much more common that we know. Thats because its unusual to test for RSV unless a child or adult gets so sick that they need to be hospitalized.
We know that kids are disproportionately affected by RSV, and most parents will get it if their kids get the croup, Barron said.
But if you come in to see your doctor, and you say, I have a cold or bronchitis, we might give you something for it, but were not typically going to test for RSV. So thats the end of the story, she said.
Its more common these days to test for RSV, especially for anyone who needs hospital care. But additional data in the future may provide a more complete picture of how widespread RSV infections area.
The U.S. Food and Drug Administration (FDA) approved the first RSV vaccine in May of 2023. Its called Arexvy, and the drug manufacturer is GlaxoSmithKline.
FDA officials approved a second RSV drug last year. Pfizer created a drug called Abryzvo. Its currently the only RSV vaccine which is approved for use during pregnancy.
Theres also a third vaccine aimed at fighting RSV. Its called mResvia, is made by Moderna and received FDA approval in May of 2024.
In older adults, RSV can cause serious illness, hospitalization and deaths. For people in high-risk groups, the new RSV vaccines can keep people healthy or if a person gets RSV, the symptoms likely will be milder.
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Hi, this is Will covering for Irwin for another edition of Inklings, where we explore all things aid and aid-adjacent unfolding in humanitarian hubs, on the front lines of emergency response, or in the dark corners of online aid punditry.
Its also available as an email newsletter.Subscribe here.
Today: Publication of a damning polio vaccine report is mysteriously postponed, the UKs new Labour government appears to be demoting foreign aid, and feeding the UN reform beast.
Polio switch paralysis: A report slated to shed light on how3,300 children were paralysed as a result of the Global Polio Eradication Initiative (GPEI) changing a vaccine recipe has been kicked into the long grass. The publication of the final version of an official investigation into what went wrong was due in the first week of June but has been repeatedly pushed back. A GPEI spokesperson told The New Humanitarian it was still being finalised, however another source said the final report was ready some time ago.
And now a draft version of the report, which revealed the damning findings,has disappeared from the website of the GPEI, a body made up of the biggest players in global health: the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention, UNICEF, the Bill & Melinda Gates Foundation, and Gavi (the vaccine alliance). The draft was taken down once a public consultation period was over, the spokesperson said, and the final report should eventually take its place.
Luckily, The New Humanitarian previously downloaded a copy, which can beviewed here. It found a decision to remove the type 2 poliovirus one of three polio strains from oral vaccines given to children from 2016 was an unqualified failure that went on for years. The move, dubbed the switch, was supposed to help end outbreaks of the vaccine-derived type 2 virus. But the reverse happened, the strain spread unabated as thousands of unprotected children were infected. Some of them will never walk again the precise numbers are unknown because the data has not been published.
Other key details are missing from the draft report. It took direct aim at GPEIs leadership, which it said showed an inability or unwillingness of programme leadership to recognise the seriousness of the evolving problem and take corrective action, but did not explain what happened or why.
In 1997, after a landslide UK Labour Party election victory, the government set about creating the Department for International Development (DFID), led by a Secretary of State, Clare Short. But now, the new government led by Keir Starmer has downgraded the position of the politician in charge of humanitarian issues even more than the previous Conservative government, which was no fan of aid, having closed DFID and slashed the budget.
A weekend of confusion followed the UKs 4 July election, in which NGO workers were left unsure if there would even be anyone in the new government responsible for aid. But on 8 July, former Labour Party chair Anneliese Dodds wasconfirmed as the Minister of State responsible for International Development a demotion from the titles attached to her Conservative predecessor, Andrew Mitchell (Minister for development and deputy foreign secretary). The move was a surprise to aid workers who spent 10 months building relationships with the team of Lisa Nandy, who held the role in opposition. The move makes my life harder, said one.
Worse, Dodds appears to be sharing the job with the role of Minister for Women and Equalities, at the Department for Education and the aid position formerly one of the most prominent international roles in government is not even mentioned onher official government page. This suggests that they think it is a part time role on development or a part time role on women and equalities, said one UK aid sector leader. Either way this is not a strong signal that they truly want to renew the UKs leadership on development, but rather keep the portfolio a subordinate of [Foreign Secretary David] Lammys.
The person wondered: why arent INGOs condemning this more strongly?
Perhaps because after 13 years of Conservative government, as a third aid worker noted, I think the general feeling is that it could be a lot lot worse.
A new analysis on the quality of climate finance claims its real value is much less than reported by as much as $88 billion in 2022. Concerned about how much climate finance is dominated by loans and is of dubious relevance to climate purposes, Oxfam researchers devised a new measurement: Climate-Specific Net Assistance, displayed in the graph above in green. They say this measurement more accurately represents the financial effort of rich countries on climate finance, which is always among the most sensitive issues in COP talks. Read the full methodologyhere.
10 (and counting):The number of days the UNs Office for the Coordination of Humanitarian Affairs has been without a leader. The former head of OCHA,Martin Griffiths, stepped down on 30 June but has not yet been replaced, even as humanitarian crises continue unabated. TNH enquiries to OCHA asking when the replacement will come have so far gone unanswered.
Also: Indias scorching heatwave cost the lives of 25 polling officials during the countrys recent election, which saw record temperatures envelop the country, including 47 degrees Celsius in Dehli, The Hindureported.
NCQG:NewCollectiveQuantifiedGoal. The new climate finance target that governments must agree on this November at COP29 in Baku, Azerbaijan. It will supersede the current target of $100 billion a year from Global North to South, which many experts say is insufficient for meeting the challenges of climate change.
DRFIP:DisasterRiskFinancing andInsuranceProgram. One of the ways being considered to fill the coffers of thefund for loss and damage being discussed this week at the second meeting of the board in Songdo, South Korea.
There's more comfort than there should be with the idea that we should have a UN reform process which recommends another UN reform process and so on and so on. Once this dynamic establishes itself where you have this cycle of conferences and consultations there is a small economy that builds around that, where theres work to be found as NGOs and consultants in feeding the beast.
Fred Carver, managing director at Strategy for Humanity, gives some background to the forthcoming Summit for the Future, a big UN conference, which he says is the product of a previous big UN conference, like the one before that
Have any tips, recommendations, or indecipherable acronyms to share with the Inklingsnewsletter? Get in touch: [emailprotected]
Nearly 13 million Americans, including teens and adults, become infected with Human Papillomavirus (HPV) each year. Unvaccinated individuals who are sexually active will more likely get HPV at some point in their life. Although most HPV infections go away on their own, some don't and may cause cancer.
Let's look at three truths and three myths about the HPV vaccination.
Children ages 11 and 12 should receive the vaccination. Up to age 26, you can still get vaccinated and be protected against cancers caused by HPV infections. You can get the vaccine up to age 45. However, it may not be as effective if you have already been exposed to HPV.
When vaccinating a young person, the point is not to promote sexual activity. Like other vaccinations, the HPV vaccination is given as part of the course of regular immunizations. It protects a child from contracting a serious illness in the future.
HPV is highly contagious; it spreads primarily through skin-to-skin contact. So, its extremely important for you to get vaccinated before becoming sexually active. HPV can be passed through one sexual encounter and may not show symptoms, so you may not realize you have it. Most likely, you'd learn you have it following a diagnosis of HPV-related cancer or genital warts.
HPV can cause the following types of cancer:
The fact is the HPV vaccination received strict safety testing through the Food and Drug Administration (FDA) before its approval in 2006. Since that time, with careful monitoring and research, the vaccination continues to prove its safe.
There are around 200 strains of HPV, and 13 of those can cause cancer, so the vaccination is necessary for both men and women.
Since 2006, HPV infections and cervical precancers have dropped significantly.
Like with most vaccines you receive, the side effects are mild and go away in a day or two. They could include:
Actually, not getting the vaccination could cause fertility problems. If you get cancer caused by HPV and receive treatment, such as a hysterectomy, chemotherapy or radiation you may not be able to have children. Additionally, treating cervical precancer sometimes causes preterm delivery.
Ask your primary care physicianabout the importance of the HPV vaccination for your child, as well as for yourself.
Researchers from Trinity College Dublin have taken a leap forward in understanding how we might fight back against the potentially deadly MRSAbacterium. They have shown in an animal model that targeting a key suppressive immune molecule (IL-10) during the delivery of a vaccine improves the ability of the vaccine to protect against infection.
The bacteriumStaphylococcus aureusis one of the leading causes of community- and hospital-acquired bacterial infection, and is associated with over one million deaths worldwide each year. Unfortunately, antibiotics are becoming increasingly less effective against this bacterium with the antibiotic-resistant form, MRSA,responsible for the highest number of deaths in high-income countries that are attributable to antimicrobial resistant bacterial infections.
As a result, scientists are keenly focused on finding solutions to turn the tide in fightingS. aureus-related infections. One hugely appealing option is a vaccine but, while some progress has been made on that front in recent years, a number of major hurdles remain. One of these appears to be the bacterium's ability to dampen the immune response by turning on one of the natural breaks that exists within the immune system, an important immune-suppressive molecule known as Interleukin-10 (IL-10), which acts to reduce inflammation in the body.
The interesting thing aboutS. aureusis that in addition to being a deadly pathogen, forms of this bacteria live in and on our bodies without causing harm. During these asymptomatic interactions the bacterium is, however, shaping the immune response meaning that when a vaccine against S. aureus is administered the immune system struggles to respond appropriately.
Here, in the work just published in leading journalJCI Insight,the researchers showed in the animal model that if they immunized subjects with a vaccine that primed their immune systems to respond to infection in tandem with antibodies that neutralized IL-10, the immune response (via specialized T cells) was improved and bacterial clearance was likewise improved following subsequent infection.
The research team was led byRachel McLoughlin, Professor in Immunology in Trinity College Dublin's School of Biochemistry and Immunology. Rachel, who is based in the Trinity Biomedical Sciences Institute, said: "Taken in combination, our results offer significant promise for what would be a novel strategy for improving the efficacy of vaccines developed with the aim of suppressingS. aureusinfection.
"Our work also strongly suggests that prior exposures to this bacterium may create a situation whereby our immune system no longer sees it as a threat and thus does not respond appropriately to a vaccine due to the creation of this immune-suppressed state. Again, this underlines why immunization delivered with something that helps neutralise IL-10 offers renewed hope for effective vaccines againstS. aureus."
Source:
Journal reference:
Kelly, A. M., et al. (2024). IL-10 inhibition during immunization improves vaccine-induced protection against Staphylococcus aureus infection.JCI Insight. doi.org/10.1172/jci.insight.178216.
Researchers across various universities are developing a new vaccine and delivery system to prevent bovine tuberculosis (TB) in free-roaming white-tailed deera primary reservoir for the disease. The development is a mucosal, oral, probiotic-based vaccine that may contribute to the eradication of bovine TB in any wildlife species.1
Controlling bovine TB in animals with vaccination is a primary approach to preventing or mitigating the spread of a disease across animal populations and intohuman populations, Srinand Sreevatsan, BVSc, MVSc, MPH, PhD, associate dean for research and graduate studies in the College of Veterinary Medicine at Michigan State University (MSU) and lead of the research team, said in a news release by MSU.1 Here in Michigan, the rise in bovine TB-infected deer and cattle herds has led to a state of urgency due to restrictions associated with animal trade and movement.
The mucosal vaccine was designed to withstand the intestinal mucosal barrier, which works to prevent pathogens from entering the body. Prior to the new vaccine, the development of oral vaccines had been hindered due to the inhospitable environment of the gut, according to the release.1 Sreevatsan and his teammates, Srinivas Dhandayuthapani, PhD, at the Center of Emphasis in Infectious Diseases at Texas Tech University Health Sciences Center, and Gireesh Rajashekara, DVM, PhD, at the Ohio State University, Center for Food Animal Health, used Bacillus subtilis spores, a probiotic naturally found in fermented foods and soil, as well as in the gastrointestinal tract of humans and ruminants, such as deer.1,2 B subtilis is capable of withstanding the acidic environment of the gut and its protective mucosal barrier. It can also survive the conditions of the outdoors food bait it will be left in for deer to ingest, according to the news release.1
Using probiotic spores to deliver antigens is a very exciting development, said Sreevatsan.1 We clone the bovine TB antigen encoding genes in the genetic machinery ofBacillus subtilis, and program it to express those antigens when they make spores.
The current vaccine used to protect against TBthe Bacillus Calmette-Gurin (BCG) vaccineis not effective in its prevention of illness in ruminants, including cattle, white tail deer, and other animals.1 Moreover, according to MSU, the BCG vaccine does not protect against the spread of bovine TB.1
Theres a need for a vaccine that can be delivered to deer as well as cattle, he continued.1 We require a low-cost vaccine and delivery system that will work with animals in the wild, and one that will actually provide a robust immune response.
The new bovine TB vaccine project, which received a grant from the United States Department of Agriculture, has the potential of being engineered to protect other wildlife animals against any infectious disease, such as the highly pathogenic H5N1 avian influenza, due to the flexible nature of the vaccines delivery mechanismwhich is similar to a nanoparticle delivery system.1
With this platform, we are producing a machinery of specialist suppliers that isnt limited to bovine TB antigens. Were very optimistic about its ability to deliver vaccines for any infectious disease, said Sreevatsan.1
References
(Precision Vaccinations News)
Colossal today announced that the first elephant in captivity at the Houston Zoo has been administered an experimental herpesvirus mRNA vaccine.The Houston Zoo approved the vaccine and has inoculatedTess, a 40-year-old Asian elephant.
On July 9, 2024, Colossal stated the elephant endotheliotropic herpesvirus (EEHV) is the number one killer of Asian elephant calves living under managed care in North America and Europe and significantly impacts free-ranging populations of Asian elephants as well.
Recent EEHV-related deaths in several African elephants in the U.S. have raised concerns about EEHV in this elephant species.
Following encouraging results from the initial vaccine trials, the mRNA vaccine will be offered to more facilities, especially those with vulnerable young elephants.
Colossal supported our efforts to work on an mRNA solution approach, shared Dr. Paul Ling, Professor at the Department of Microbiology and Virology at Baylor College of Medicine, in a press release.
It quickly became evident that the mRNA solution was going to be feasible, so we prioritized implementing that approach. We are much further along today than we would have been without Colossals scientific support, research teams, and funding.
In the next three to five years, Dr. Ling hopes this vaccine will be applied to the broad population of elephants under human care worldwide. Following that, the team would look to applications with animals in the wild.
This represents a massive step forward for the protection of elephants globally and a huge step forward for science.
According to the Houston Zoo, Tess, mother to Tucker (19), Tupelo (13), Tilly (6), and Teddy (3) and grandmother to Winnie (3), is currently doing well post-vaccination.
Upon the successful outcome of this first vaccination, the Houston Zoo plans to vaccinate additional animals under its care.
As of July 9, 2024, the U.S. FDA has not approved a herpes vaccine for humans.
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No matter how good immunisation programmes are, some infants fall through the net and do not receive the vaccines they need at the optimal, recommended moment. But when it comes to vaccination, its better late than never.
Following drops in immunisation coverage seen during the COVID-19 pandemic, Gavi and other partners are spearheading the Big Catch-up initiative. But more generally, catching up missed children is an important responsibility of integrated primary health care systems, both during outreaches and at the clinic. Going out into the community to provide care takes time and effort to organise, so it makes sense to provide a bundle of services, including vaccination. Meantime, when caregivers attend health facilities with their child for any reason, their visit is an opportunity to ask about immunisation status, and may offer a chance to provide deliver vaccine doses.
For the immunisation session at Teach to Reach 10, an experience-sharing event that took place on 20 June 2024, drawing participation from more than 21,000 health workers from the Global South, the Geneva Learning Foundation (TGLF) invited attendees to share their experiences of integrating services. Their responses offer insight into the nimble pragmatism of primary health care done right.
In some cases, immunisation catch-up activities piggy-back onto other community-oriented services:
During family planning activities, routine vaccination was integrated. This made it possible to catch up with several children who had not yet received their first dose of measles vaccine This activity helped reduce the incidence of measles cases in the community. This strategy also made it possible to reduce the costs of implementing the routine EPI because the agents had the possibility of thinking of several activities in a single outing.
- Anon, Sanitary Technology Engineer, Ministry of Health, Yamoussoukro Health District, Cte dIvoire
Other contributors described how activities had been planned around community events, with services provided for multiple age groups:
Vaccination days were set as days of intensification of nutritional activities. Every month in some of my health facilities, we choose the fair days as health fairs. A child can receive the care they need, such as screening for malnutrition and its management, vaccination or catch-up, deworming, nutritional advice. For adults, they can receive screening for diabetes or its control, control of blood pressure. Everyone welcomes the time-saving, money-saving benefits of integrating primary health care services.
- Fousseyni Dembele, Public Health Physician (MPH), Mali
The benefits can also work in reverse, with routine vaccination activities in the community providing an opportunity to deliver additional services:
The most memorable story of child vaccination is when we went for community outreach for child immunisation. A little girl was brought for immunisation and what she needed was a vitamin A supplement. When we asked the mother to bring her the vitamin, the little girl refused, with tears gushing out from her eyes. We had to get some sweets to give her in order to get her trust. After giving her the sweets with a smile on her face then we presented the vitamins and she received them happily.
- Esther Yusuf Yakubu, Public Health Specialist (MPH), NGO, Plateau State, Nigeria
A highly effective catch-up strategy is avoiding missed opportunities for vaccination (MOV) contacts with health services that do not lead to identification and vaccination of under-immunised infants. In many countries this is a national policy and formal part of daily practice:
This vaccination practice is common here in Cte dIvoire. During daily consultations, if a child presents to our services, whatever the cause for which they came and their state of health allows it, we vaccinate them. This practice makes it possible to catch up with those who are not up to date in the schedule and also improve vaccination coverage.
- Sopi Sess Michel, Sanitary Engineering Engineer, Ministry of Health, San Pedro, Cte dIvoire
While the strategy can be written into national or institutional policies, it is vital that it is adopted in practice. Several respondents described how, as well as providing care for a sick child, they have also taken the time to enquire about immunisation status:
One day a woman came to our health facility who was having a fever and cough. The woman had a five-month-old baby also. We attended to her complaint and gave her the medicine she deserved. After that, we asked her about the immunszation status of her baby but surprisingly, she said that the baby did not have any vaccine. She said that there was no nearby health facility providing vaccinations. On hearing that, the health worker in charge of vaccination counselled her on the need to have her baby vaccinated and that she could come to the facility on an appointed date for her baby to complete her immunisation schedule. After convincing her, the baby was administered the vaccines appropriate to her age schedule. The woman was happy and showed her appreciation.
- Abdulrahman Umar Pella, Community Health Practitioner, Gombi Local Government Area, Nigeria
This personal approach enables the causes of missed vaccinations to be approached. In the context of caregiving, people may be more receptive to messaging around vaccination:
A baby was rushed to my facility sometimes last year around Christmas. The baby was convulsed and the mother was crying thinking that the baby will not survive it as the baby is the only survivor child for her. Myself and the hospital tried to stabilise the child and when the mother calmed down to see her child had come around, I called the mother to my office confidentially to ask some vital questions about immunisation, when I got to know that the child had never been given immunisation. I asked the mother further the reason why she didnt take her child for immunisation. She confided in me that, due to a still birth, a herbalist warned her not to immunise her child. I asked her to bring her husband to convince both together and tell them about the importance of immunisation. Up till now the child is doing well because we asked her to give the child immunisation, which she did after several pleading. The procedure that made this work for me is confidentiality and trust.
- Eegunjobi Anifat Omowumi, Public Health Specialist (MPH), Ministry of Health, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, Nigeria
A failure to have a child vaccinated is not always a sign of antipathy to vaccination. Sometimes other priorities intercede, so vaccination at another contact with the health service can provide a more convenient opportunity for caregivers:
One such memorable experience involved a mother who brought her young daughter to our facility for a routine check-up due to a mild respiratory infection. As I conducted the check-up, I engaged the mother in a conversation about her childs overall health and vaccination status. Through our discussion, I discovered that her daughter had missed several key vaccinations due to the familys recent relocation and the disruptions caused by it. The mother was unaware of the importance of staying on schedule with the immunisation plan and the potential risks of missing vaccinations. Recognising the opportunity, I explained the benefits of vaccinations and addressed her concerns about vaccine safety. I informed her about the policies in place at our facility that allow for the integration of immunisation services with other health visits. Our health facility operates under a policy that promotes a holistic approach to health care, ensuring that every patient encounter is maximised for comprehensive health promotion. With the mothers consent, I was able to administer the necessary vaccines during the same visit. This not only saved her an additional trip to the facility, but also ensured that her child was up to date with her immunisation schedule.
- Fatima Ado Garba, Nurse, Gashua, Nigeria
Several respondents noted that these valuable activities are not always easy in practice but the potential benefits are great:
Integrating immunisation with other services wasnt always straightforward. I faced several challenges, such as time constraints during busy clinic hours, limited vaccine supplies, and occasional resistance from parents who were sceptical about vaccines. Additionally, the health facilitys electronic health record system, though useful, sometimes had issues with updating and retrieving vaccination histories promptly I believe that continuous training for health care staff on integrating immunisation with other health services, coupled with community outreach programmes to build trust in vaccines, could significantly reduce missed vaccination opportunities and improve overall public health outcomes.
- Claudius Mbuya, Social Worker, NGO, Kisumu, Kenya
Note: Contributor quotes in this article are their own and do not necessarily represent their employers.
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A systematic review and meta-analysis of 12 studies suggests meningococcal vaccines show moderate effectiveness against gonorrhea infection, researchers reported yesterday in the Journal of Infection.
Of the 12 studies included in the review, conducted by a team of researchers from Australia, nine evaluated the evidence of vaccine effectiveness (VE) of meningococcal B (MenB) outer membrane vesicle (OMV) vaccines against gonorrhea, and one evaluated VE of a non-OMV-based vaccine (MenB-FHbp)
While previous studies have indicated that the four-component serogroup B meningococcal vaccine (4CMenB) and other OMV-based MenB vaccines, which target Neisseria meningitides, may provide some cross-protection against Neisseria gonorrhoeae, none have synthesized and examined the evidence of the effects of all meningococcal vaccines on gonococcal infections.
Most of the included studies targeted people aged 15 to 30 years in 8 countries: Australia, Canada, Cuba, France, Italy, New Zealand, Norway, and the United States. Six of the studies evaluated the VE of the 4CMenB vaccine. The adjusted VE for OMV-based vaccines against gonorrhea ranged from 22% to 46%. The pooled VE estimates of OMV vaccines against any gonorrhea infection following the full vaccine series were 33% to 34%. The observed vaccine impact (VI) ranged from a 30% reduction in gonorrhea incidence in South Australia to a 59% reduction in Quebec, Canada.
The MenB-FHbp vaccine showed no protection against gonorrhea.
The study authors say that while the variation in VE and VI could be attributed to differences in vaccination programs, target age-groups, and the regional epidemiology of gonococcal infections, the findings "provide reassurance regarding the cross-protection provided by MenB vaccines." And with the prevalence of N gonorrhoeae strains with resistance to most commonly used antibiotics on the rise worldwide, and no highly effective, gonorrhea-specific vaccine on the horizon, they suggest vaccines like 4CMenB are "the most favorable approach" to combat the increasing incidence of gonorrhea.
These findings emphasise the potential value of incorporating meningococcal vaccination into strategies aimed at controlling gonococcal infections.
"These findings emphasise the potential value of incorporating meningococcal vaccination into strategies aimed at controlling gonococcal infections, particularly in regions with high incidence rates and limited treatment options due to antibiotic resistance," they wrote.
