Showing papers on "Vaccination published in 1984"
TL;DR: An age-structured epidemiologic model is investigated here, which also pays attention to the fact that children are promoted grade-wise into and out of school, and is shown to perform better than previous global mass-action models.
Abstract: An infection like measles does not spread uniformly in populations from Europe and North America. Of special importance is a pronounced age-dependency in the contact rates, because of increased infection transmission within schools. Therefore an age-structured epidemiologic model is investigated here, which also pays attention to the fact that children are promoted grade-wise into and out of school. Simulation results are contrasted with pre- and post-vaccination measles data from England and Wales and the model is shown to perform better than previous global mass-action models.
435 citations
TL;DR: This study did not demonstrate the efficacy of the vaccine in a population of patients receiving dialysis in whom both the rate of antibody response to hepatitis B vaccine and the viral attack rate were low, and other measures to control transmission of hepatitis B virus in dialysis units must be continued.
Abstract: We evaluated the immunogenicity and efficacy of hepatitis B vaccine (Heptavax-B) in a randomized, double-blind, placebo-controlled trial involving 1311 patients receiving hemodialysis in the United States. After three doses of vaccine (40 micrograms each) had been administered, 63 per cent of the patients were antibody-positive. After correction for possible passive transfer of antibodies by blood transfusion, only 50 per cent of vaccine recipients were considered vaccine responders. The incidence of hepatitis B viral infection during the 25 months of the trial was much lower than had been anticipated and was virtually the same in the vaccine and placebo recipients (6.4 and 5.4 per cent, respectively). Four cases of hepatitis B occurred in patients who had an apparent antibody response to the vaccine, but in each case either antibody had reached low or undetectable levels before hepatitis B surface antigen was detected or the patient had been receiving immunosuppressive therapy. This study did not demonstrate the efficacy of the vaccine in a population of patients receiving dialysis in whom both the rate of antibody response to hepatitis B vaccine and the viral attack rate were low. Other measures to control transmission of hepatitis B virus in dialysis units, including surveillance for hepatitis B surface antigen and isolation of patients who are positive for the antigen, must be continued.
426 citations
TL;DR: The first set of injections was given within 1 h after birth and 96-100% of the infants in the three treatment groups were anti-HBs positive; the geometric mean titres of antiHBs did not differ significantly as mentioned in this paper.
415 citations
TL;DR: The live attenuated Oka/Merck varicella vaccine produced few clinical reactions and was well tolerated, and there was no clinical evidence of viral spread from vaccinated children to sibling controls.
Abstract: We conducted a double-blind, placebo-controlled efficacy trial of the live attenuated Oka/Merck varicella vaccine among 956 children between the ages of 1 and 14 years, with a negative clinical history of varicella. Of the 914 children who were serologically confirmed to be susceptible to varicella, 468 received vaccine and 446 received placebo. The vaccine produced few clinical reactions and was well tolerated. There was no clinical evidence of viral spread from vaccinated children to sibling controls. Approximately eight weeks after vaccination, 94 per cent of the initially seronegative children who received vaccine had detectable antibody to varicella. During the nine-month surveillance period, 39 clinically diagnosed cases of varicella, 38 of which were confirmed by laboratory tests, occurred among study participants. All 39 cases occurred in placebo recipients; no child who received vaccine contracted varicella. The vaccine was 100 per cent efficacious in preventing varicella in this population of healthy children (P less than 10(-9).
408 citations
TL;DR: An epidemiological study of parkinsonism over a 13-year period is presented, updating previous reports on incidence and trend in the population of Rochester, Minnesota, which revealed no remarkable change following the 1976 swine flu vaccination program.
Abstract: An epidemiological study of parkinsonism over a 13-year period (1967 through 1979) is presented, updating previous reports on incidence and trend in the population of Rochester, Minnesota. The overall average annual incidence of parkinsonism per 100,000 population was 20.5, adjusted to the 1970 total United States population, which is virtually unchanged from previous observations. Incidences calculated for each calendar year (1967 through 1979) revealed no remarkable change following the 1976 swine flu vaccination program. There was no sex difference and the peak incidence occurred between ages 75 and 84 years. Idiopathic Parkinson's disease was the most common variant (86%), followed by drug-induced parkinsonism (7%). There were no new cases of postencephalitic parkinsonism diagnosed during the study period. Relative frequency of other types of Parkinson's disease as identified by practicing neurologists is presented. For each case two age- and sex-matched controls were selected from the Rochester population. The survival rates in the controls were comparable to the general population of the west north central region of the United States. The mortalities in the patients were significantly higher (p = 0.001) than the controls and were unchanged from previous rates reported from the same community. In the 69 (50%) patients treated with levodopa, the mortality was comparable to that in controls. The favorable outcome in these cases is attributed to bias resulting from selection of healthier patients for treatment.
341 citations
TL;DR: Analysis of paired serum samples from 514 vaccinated children showed that effective immunization with this vaccine could be performed after but not before the age of 16 to 20 months, and 60 per cent of infections occurring in Finland over a period of five years are potentially preventable with the capsular polysaccharide vaccine.
Abstract: A long-term follow-up of approximately 50,000 children who received the Hemophilus influenzae type b capsular polysaccharide vaccine in 1974 at three months to five years of age has shown good protective efficacy in those who received the vaccine at 18 months or older. No adverse effects were observed. Analysis of paired serum samples from 514 vaccinated children showed that effective immunization with this vaccine could be performed after but not before the age of 16 to 20 months. An analysis of 956 bacteremic H. influenzae infections occurring in Finland over a period of five years showed that 94 per cent of all cases were in children under 10 years of age. Of these, 40 per cent occurred in children under 18 months, and 60 per cent in children between the ages of 1 1/2 and 9 years. These 60 per cent are potentially preventable with the capsular polysaccharide vaccine.
335 citations
TL;DR: Vaccine prepared from RIT 4237 strain of attenuated bovine rotavirus thus seems to protect children against heterologous subgroup 2 rotav virus diarrhoea.
323 citations
TL;DR: It is shown that the design of case-control studies to measure vaccine efficacy is dependent upon which model is considered appropriate and, under the second model, individuals who have already had the disease under study should not be excluded from the control group.
Abstract: Case-control and cohort studies may be employed to assess the protective efficacy of vaccines. The appropriate measure of vaccine efficacy is shown to depend upon the mode of action of the vaccination. Two models of vaccine action are considered. In the first, vaccination is assumed to reduce the instantaneous disease-rate in the total vaccinated population by a constant proportion and, in the second, vaccination is assumed to render a constant proportion of individuals totally immune from the disease. The implications of these two models on the behaviour of different measures of vaccine efficacy in cohort studies is explored. It is shown that the design of case-control studies to measure vaccine efficacy is dependent upon which model is considered appropriate. In particular, under the second model, individuals who have already had the disease under study should not be excluded from the control group.
293 citations
TL;DR: It is reported that subline A2b, which bore a marker of helper/delayed hypersensitivity T lymphocytes, was strongly arthritogenic, but could not vaccinate against arthritis, and reactivity to collagen type II is not a requisite for arthritis.
Abstract: We have been studying the pathogenesis of adjuvant arthritis in rats using a long-term cell line of T lymphocytes, the A2 line, which can induce polyarthritis and can also be used to vaccinate rats against adjuvant arthritis. Although line A2 was selected for its proliferative response to mycobacteria, it also responded to collagen type II. To elucidate its role of responsiveness to collagen type II and the relationship between arthritogenicity and vaccination, we cloned A2 and selected a subline A2b. We now report that subline A2b, which bore a marker of helper/delayed hypersensitivity T lymphocytes, was strongly arthritogenic, but could not vaccinate against arthritis. Moreover, A2b showed no response to collagen type II. Therefore, reactivity to collagen type II is not a requisite for arthritogenicity, and mediation of arthritis and vaccination can be distinct properties of different populations of T lymphocytes.
291 citations
TL;DR: Evidence is presented that chimpanzees vaccinated with a live recombinant vaccinia virus were protected against hepatitis following challenge with HBV, a continuation of the earlier study.
Abstract: Hepatitis B virus (HBV) is an important human pathogen responsible for over 200 million cases of chronic infection, many of which progress to hepatocellular carcinoma. Although HBV cannot be propagated in tissue culture, highly effective subunit vaccines obtained from the plasma of chronically infected patients have been developed and licensed1–3. Such vaccines are safe but their expense and limited quantities make them unavailable to most Third World countries. Other approaches to vaccine construction, including purification of the HBV surface antigen (HBsAg) from genetically engineered eukaryotic cells4–13 and the synthesis of peptides predicted from the nucleotide sequence of the HBsAg gene14–19, are still under evaluation. Another potential application of recombinant DNA technology to vaccine development is the use of live virus vectors to express foreign genes20–25. An infectious vaccinia virus recombinant that expressed the HBsAg in animal cells and which stimulated the production of antibody to HBsAg (anti-HBs) in rabbits represented a novel candidate vaccine of this class22,23. As a continuation of our earlier study, we now present evidence that chimpanzees vaccinated with a live recombinant vaccinia virus were protected against hepatitis following challenge with HBV.
268 citations
TL;DR: Pneumococcal vaccine confers substantial protection against systemic pneumococcal infections on the elderly and patients with illnesses associated with a moderately increased risk of pneumitiscal infections.
Abstract: The protective efficacy of pneumococcal vaccine against systemic pneumococcal infections in adults with the current indications for the vaccine was evaluated in a case-control study. Six (7%) of the 90 cases and 16 (18%) of the matched controls had received pneumococcal vaccine for an odds ratio of 0.33 (p less than 0.05). The vaccine's protective efficacy was 67%, which remained virtually unchanged after adjusting for potential confounding variables. The vaccine's efficacy was 77% for patients at moderately increased risk of pneumococcal infections, but 0% for patients who were severely immunocompromised. The vaccine's protective efficacy was 70% (p less than 0.05) for all patients 55 years or older after controlling for indications for the vaccine in addition to age. Pneumococcal vaccine confers substantial protection against systemic pneumococcal infections on the elderly and patients with illnesses associated with a moderately increased risk of pneumococcal infections.
TL;DR: The results suggest that B subunit-whole cell vaccine, when given in at least two oral doses, may be a good candidate for use in cholera prophylaxis.
Abstract: Mucosal and systemic immune responses to a new oral cholera vaccine, consisting of the B subunit plus killed vibrios, were studied in Bangladeshi volunteers and compared with those to clinical cholera. A single peroral dose of vaccine induced a local IgA antitoxin response in intestinal-lavage fluid of seven of eight vaccinees; the response closely mimicked that of patients convalescing from cholera, and evidence of the induction of local immunologic memory was found as well. Two peroral doses were needed for stimulation of an intestinal IgA immune response to the lipopolysaccharide of Vibrio cholerae that was comparable to the response obtained after clinical cholera. This response to peroral immunization was considerably stronger than that to parenteral vaccination, although the intramuscular route gave rise to the strongest IgG antitoxin and antilipolysaccharide responses in serum. The results suggest that B subunit-whole cell vaccine, when given in at least two oral doses, may be a good candidate for use in cholera prophylaxis.
TL;DR: In the recombinant vaccine group the immune response developed more slowly during the early phase and seroconversion rates and mean anti-HBs levels were slightly lower in males; this probably reflects use of a lower dose of recombinant vaccines.
TL;DR: Computerized summaries of approximately 1,300 cases reported as Guillain-Barré syndrome by state health departments to the Centers for Disease Control during the intensive national surveillance instituted following the swine influenza vaccination program in 1976-1977 became available for further study.
Abstract: As a result of a court order, computerized summaries of approximately 1,300 cases reported as Guillain-Barre syndrome by state health departments to the Centers for Disease Control during the intensive national surveillance instituted following the swine influenza vaccination program in 1976-1977 became available for further study. Although the data were not uniformly adequate to confirm the diagnosis of Guillain-Barre syndrome, they were sufficient to enable classification according to extent of motor involvement. Vaccinated cases with "extensive" paresis or paralysis occurred in a characteristic epidemiologic pattern closely approximated by a lognormal curve, suggesting a causal relationship between the disease and the vaccine. Cases with "limited" motor involvement showed no such pattern, suggesting that this group included a substantial proportion of cases which were unrelated to the vaccine. The effect attributed to the vaccine lasted for at least six weeks and possibly for eight weeks but not longer. The relative risk of acquiring "extensive" disease over a six-week period following vaccination ranged from 3.96 to 7.75 depending on the particular baseline estimate of expected normal or endemic incidence that was chosen. Correspondingly, the number of cases that could be attributed to the vaccine over the six-week period ranged from 211 to 246, or very slightly higher over an eight-week period if the lowest baseline estimate was used. The total rate of Guillain-Barre syndrome cases attributed to prior use of the vaccine was 4.9 to 5.9 per million vaccinees.
TL;DR: Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukemia and completely effective in protecting against severe varICElla in this high-risk group of children.
Abstract: One hundred ninety-one varicella-susceptible children with leukemia in remission were immunized with live attenuated varicella vaccine. There was serological evidence of an immune response in approximately 80% after one dose and in more than 90% after two doses. The major side effect was mild to moderate rash, seen especially in children with maintenance chemotherapy suspended for one week before and one week after vaccination. Children with rash had higher antibody titers than those without rash, but those with rash were also at risk (10%) to transmit vaccine virus to others. Twenty-two vaccinees subsequently had household exposures to varicella or zoster. The attack rate of clinical varicella in these vaccinees was 18%, significantly lower than the attack rate of approximately 90% in varicella-susceptible persons with household exposures. All cases of clinical illness were extremely mild, with an average of about 50 vesicles. The mild character of the illness was clearly different than varicella in unimmunized children receiving chemotherapy for leukemia. Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukemia and completely effective in preventing severe varicella in this high-risk group. (JAMA1984;252:355-362)
TL;DR: V infection occurred in most of the seronegative vaccine-treated or placebo-treated patients who received kidneys from seropositive donors, but the illnesses were less severe in the vaccines than those in similarly exposed placebo- treated patients.
TL;DR: Since it is not only the malnourished children who die of measles, vaccination may have a greater importance for survival patterns than has previously been assumed.
Abstract: Data from a 1979 measles epidemic in an urban district of Guinea- Bissau indicate that state of nutrition is not a major determinant of outcome of infection. However, overcrowding increases the risk of early infection and the severity of disease. In instances in which several children have measles simultaneously, the case fatality rate is significantly higher than for isolated cases. This tendency is apparently a result of intensity of exposure; within the same house, secondary cases have a much higher age-specific case fatality rate than index cases. It is suggested that the association between intensive exposure and severity of infection may be due to increase rates of intercurrent infection and/or a greater dose of infection. Since it is not only the malnourished children who die of measles, vaccination may have a greater importance for survival patterns than has previously been assumed.
TL;DR: Measurement of the median lethal dose of the bacteria indicated that anti-idiotope immunization significantly increased the resistance of BALB/c mice to the bacterial challenge.
Abstract: A monoclonal anti-idiotope antibody coupled to a carrier protein was used to immunize BALB/c mice against a lethal Streptococcus pneumoniae infection. Vaccinated mice developed a high titer of antibody to phosphorylcholine, which is known to protect against infection with Streptococcus pneumoniae. Measurement of the median lethal dose of the bacteria indicated that anti-idiotope immunization significantly increased the resistance of BALB/c mice to the bacterial challenge. Antibody to an idiotope can thus be used as an antigen substitute for the induction of protective immunity.
TL;DR: In dialysis patients who fail to develop anti-HBs after three doses of vaccine, a fourth vaccination is recommended after 12 months and a fifth vaccination only led to seroconversion, when brief or borderline anti- HBs could already be demonstrated previously.
TL;DR: A vaccine formulated from hepatitis B surface antigen (HBsAg) produced by a recombinant strain of the yeast Saccharomyces cerevisiae was administered to two groups of human volunteers composed of 37 healthy, low-risk adults, the first reported use in man of a vaccine prepared by recombinant DNA technology.
Abstract: A vaccine formulated from hepatitis B surface antigen (HBsAg) produced by a recombinant strain of the yeast Saccharomyces cerevisiae was administered to two groups of human volunteers composed of 37 healthy, low-risk adults. Each subject received a 10-μg dose of HBsAg at 0, 1, and 6 months. By one month, 27% to 40% of the vaccinees had antibody to HBsAg, and by three months 80% to 100% were antibody positive. Large boosts in titer followed the third dose at six months. The antibody formed is predominantly specific for the a determinant of HBsAg. There have been no serious reactions attributable to the vaccine. The most frequent complaint has been transient soreness at the injection site. As far as we know, this is the first reported use in man of a vaccine prepared by recombinant DNA technology. ( JAMA 1984;251:2812-2815)
TL;DR: Probably the most effective prophylaxis against pneumococcal infection requires penicillin beyond the age of 3, but the age at which pneumococCal vaccine should be given must await further data on antibody response and clinical efficacy in these patients.
Abstract: The efficacy of prophylactic penicillin and of 14 valent pneumococcal vaccine in preventing pneumococcal infection in homozygous sickle cell (SS) disease was investigated in 242 children aged 6 months to 3 years at entry. In the first five years of the trial there were 11 pneumococcal infections in the pneumococcal vaccine treated group, 10 by serotypes present in the vaccine. Type 23 accounted for five of these, and there was evidence of higher infection rates in those given the vaccine before age 1. No pneumococcal isolations occurred in the penicillin group while receiving penicillin, although four isolations occurred within one year of stopping penicillin. Probably the most effective prophylaxis against pneumococcal infection requires penicillin beyond the age of 3. The age at which pneumococcal vaccine should be given must await further data on antibody response and clinical efficacy in these patients.
TL;DR: Ability to protect was not closely related to the capacity of the mice to make either agglutinating or anti-O antibody in response to a particular vaccine, suggesting that reported discrepancies in vaccine efficacy among laboratories may be attributable to differences in the mouse strains used.
Abstract: Three mouse strains in the C3H lineage--C3H/HeJ, C3HeB/FeJ, and C3H/HeNCr1BR--were tested for their ability to be protected against infection with Salmonella typhimurium by a panel of nonviable vaccines and by passive transfer of hyperimmune serum. These strains differ in their innate susceptibilities to infection with S. typhimurium, but all are histocompatible. The same vaccines showed a widely different ability to protect different mouse strains. Ability to protect was not closely related to the capacity of the mice to make either agglutinating or anti-O antibody (as shown by ELISA) in response to a particular vaccine. Passive transfer of antibody was shown to protect inherently resistant mice but not inherently susceptible strains. These observations suggest that reported discrepancies in vaccine efficacy among laboratories may be attributable to differences in the mouse strains used and raise the question as to what might be an appropriate mouse model for human infections with Salmonella species.
TL;DR: A striking reduction in virus shedding suggests that influenza transmission may be more efficiently interrupted with live than with inactivated virus vaccination.
TL;DR: Data from diaries and medical and hospital case notes failed to reveal consistent or significant benefits in those who received the vaccine, and recipients of vaccine had no consistent reduction in days of respiratory morbidity, antibiotic consumption, hospitalization, or visits to a physician.
Abstract: A double-blind, randomized, controlled trial of a 14-valent Streptococcus pneumoniae polysaccharide vaccine, with saline as placebo, was performed on 1,273 healthy children six to 54 months of age. Different dosage regimens were used for children younger and older than two years of age. The vaccine was well tolerated. Follow-up continued for two years, during which time 95% of mothers submitted diaries of their children's respiratory-tract and otic symptoms. Data from diaries and medical and hospital case notes failed to reveal consistent or significant benefits in those who received the vaccine. In the first 16 months after immunization, recipients of placebo experienced an average of 0.69 episodes of otitis media per child, compared with 0.63 in recipients of vaccine (P = .6). Recipients of vaccine had no consistent reduction in days of respiratory morbidity, antibiotic consumption, hospitalization, or visits to a physician, when compared with recipients of placebo.
TL;DR: In areas where the case fatality rate is high, vaccination against measles should be made an indispensable part of primary health care.
TL;DR: Until improved vaccines are available, continued use of the present vaccines, with careful attention to possible contraindications, seems the only prudent course to follow.
Abstract: Using recently published information, we examined the experience of a hypothetical cohort of 1 million children followed up from birth to 6 years of age without and with a pertussis vaccination program. Costs associated with death or lost wages were not estimated. A vaccination program reaching 90% of children would reduce disease incidence and disease-related costs by 90%. Taking into account costs associated with vaccine and vaccine reactions, the costs are reduced 82%. The ratio of overall costs without a program to those with a program is 5.7:1. The benefit-cost ratio is 11.1:1. Because we did not include indirect costs, this is a conservative estimate. Until improved vaccines are available, continued use of our present vaccines, with careful attention to possible contraindications, seems the only prudent course to follow. (JAMA1984;251:3109-3113)
Journal Article•
TL;DR: A vaccine containing serotypes 1 through 6 was fully protective against serotypes 2 and 3 and also against serotype 8, which shares antigenic determinants with serotypes 3 and 6, indicating that the protection obtained by parenteral immunization is serotype-specific.
Abstract: Pigs vaccinated with a killed 6-hour culture of Haemophilus pleuropneumoniae serotype 2 with Freund's incomplete adjuvant were not protected against challenge with serotypes 1, 5, 6 or 8. Equivalent results were obtained when pigs were vaccinated with serotypes 4 or 5 and challenged with serotype 2. In earlier studies of immunity induced by intranasal immunization with live H. pleuropneumoniae organisms, it was clearly shown that intranasal inoculation with one serotype of H. pleuropneumoniae would induce a strong immunity to both homologous and heterologous serotypes (Nielsen 1979). The present study has shown that cross immunity is not obtained with parenteral immunization. The results strongly suggest that the immune response of the pig to parenteral vaccination is different from the response seen after natural infection, and indicate that an important part of the defence mechanism against H. pleuropneumoniae infection is a local immune-barrier which is effective in preventing the bacterium from penetrating the mucosa. In earlier vaccination experiments 90 per cent of vaccinates were protected against homologous challenge (Nielsen 1976). In the present work a vaccine containing serotypes 1 through 6 was fully protective against serotypes 2 and 3 and also against serotype 8, which shares antigenic determinants with serotypes 3 and 6. These results indicate that the protection obtained by parenteral immunization is serotype-specific. Vaccines must therefore contain the serotypes existing in the swine population.
TL;DR: The probability that a parish in Åland was affected by a smallpox epidemic is shown to be highly correlated with migration patterns and parish population sizes, and the periodicity of the prevaccination time series demonstrates a strong seven-year periodicity.
Abstract: We analyze a 140-year series of smallpox deaths in the Aland Islands, Finland. Vaccination, introduced in 1805, dramatically reduced the annual number of smallpox deaths. It also influenced the age distribution of smallpox deaths, changing smallpox from a childhood disease before 1805 to one which affected both adults and children after 1805. This appears to be due to the fact that Alanders were usually vaccinated only once during childhood and often lost their immunity during adulthood. Spectral analysis of the prevaccination time series of smallpox deaths demonstrates a strong seven-year periodicity, reflecting the amount of time necessary to build up a cohort of nonimmune individuals. After the introduction of vaccination, the periodicity changes to eight years. The probability that a parish in Aland was affected by a smallpox epidemic is shown to be highly correlated with migration patterns and parish population sizes.
TL;DR: Vaccination of susceptible individuals with a purified C burneti phase 1 vaccine appears to be safe and effective in preventing Q fever in the abattoir.