Posts filed under ‘Inmunizaciones’

A systems biology approach to the effect of aging, immunosenescence and vaccine response.

Current Opinion in Immunology August 2014 V.29 P.62-8.

Poland GA1, Ovsyannikova IG2, Kennedy RB2, Lambert ND2, Kirkland JL3.

Author information

1 Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA. Electronic address:

2 Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA.

3 Robert & Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA.


Aging can lead to immunosenescence, which dramatically impairs the hosts’ ability to develop protective immune responses to vaccine antigens. Reasons for this are not well understood.

This topic’s importance is reflected in the increases in morbidity and mortality due to infectious diseases among elderly persons, a population growing in size globally, and the significantly lower adaptive immune responses generated to vaccines in this population.

Here, we endeavor to summarize the existing data on the genetic and immunologic correlates of immunosenescence with respect to vaccine response.

We cover how the application of systems biology can advance our understanding of vaccine immunosenescence, with a view toward how such information could lead to strategies to overcome the lower immunogenicity of vaccines in the elderly.



February 19, 2018 at 9:12 am

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–2015

Emerg Infect Dis. 2018 V.24 N.2 P.201-209

Adriana E. KajonComments to Author , Daryl M. Lamson, Camden R. Bair, Xiaoyan Lu, Marie L. Landry, Marilyn Menegus2, Dean D. Erdman, and Kirsten St. George

Author affiliations: Lovelace Respiratory Research Institute, Albuquerque, New Mexico, USA (A.E. Kajon, C.R. Bair); New York State Department of Health, Albany, New York, USA (D.M. Lamson, K. St. George); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (X. Lu, D.D. Erdman); Yale University School of Medicine, New Haven, Connecticut, USA (M.L. Landry); University of Rochester Medical Center, Rochester, New York, USA (M. Menegus)


Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011–2015.

Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities.

HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases.

Two novel a-like variants were recovered from students enrolled at a college in Tompkins County, New York, USA, and a prototype-like variant distinguishable from the vaccine strain was isolated from an 18-year-old woman visiting a physician’s office in Ulster County, New York, USA, with symptoms of influenza-like illness. Our data suggest that HAdV-4 might be an underestimated causative agent of ARD among civilian adults.





February 9, 2018 at 6:47 pm

Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community.

Proc Natl Acad Sci U S A 2018 Jan; 115:1081.

Yan J et al


Lack of human data on influenza virus aerosol shedding fuels debate over the importance of airborne transmission. We provide overwhelming evidence that humans generate infectious aerosols and quantitative data to improve mathematical models of transmission and public health interventions. We show that sneezing is rare and not important for—and that coughing is not required for—influenza virus aerosolization. Our findings, that upper and lower airway infection are independent and that fine-particle exhaled aerosols reflect infection in the lung, opened a pathway for a deeper understanding of the human biology of influenza infection and transmission. Our observation of an association between repeated vaccination and increased viral aerosol generation demonstrated the power of our method, but needs confirmation.


Little is known about the amount and infectiousness of influenza virus shed into exhaled breath. This contributes to uncertainty about the importance of airborne influenza transmission. We screened 355 symptomatic volunteers with acute respiratory illness and report 142 cases with confirmed influenza infection who provided 218 paired nasopharyngeal (NP) and 30-minute breath samples (coarse >5-µm and fine ≤5-µm fractions) on days 1–3 after symptom onset. We assessed viral RNA copy number for all samples and cultured NP swabs and fine aerosols. We recovered infectious virus from 52 (39%) of the fine aerosols and 150 (89%) of the NP swabs with valid cultures. The geometric mean RNA copy numbers were 3.8 × 104/30-minutes fine-, 1.2 × 104/30-minutes coarse-aerosol sample, and 8.2 × 108 per NP swab. Fine- and coarse-aerosol viral RNA were positively associated with body mass index and number of coughs and negatively associated with increasing days since symptom onset in adjusted models. Fine-aerosol viral RNA was also positively associated with having influenza vaccination for both the current and prior season. NP swab viral RNA was positively associated with upper respiratory symptoms and negatively associated with age but was not significantly associated with fine- or coarse-aerosol viral RNA or their predictors. Sneezing was rare, and sneezing and coughing were not necessary for infectious aerosol generation. Our observations suggest that influenza infection in the upper and lower airways are compartmentalized and independent.



February 8, 2018 at 8:40 pm

Primary Care Physicians’ Struggle with Current Adult Pneumococcal Vaccine Recommendations

Journal of American Board of Family Medicine January-February 2018 V.31 N.1 P.94-104

Laura P. Hurley, MD, MPH, Mandy A. Allison, MD, MSPH, Tamara Pilishvili, MPH, Sean T. O’Leary, MD, MPH, Lori A. Crane, PhD, MPH, Michaela Brtnikova, PhD, MPH, Brenda L. Beaty, MSPH, Megan C. Lindley, MPH, Carolyn B. Bridges, MD and Allison Kempe, MD, MPH

From the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.


In 2012, the Advisory Committee on Immunization Practices recommended 13-valent pneumococcal conjugate vaccine (PCV13) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for at-risk adults ≥19; in 2014, it expanded this recommendation to adults ≥65. Primary care physicians’ practice, knowledge, attitudes, and beliefs regarding these recommendations are unknown.


Primary care physicians throughout the U.S. were surveyed by E-mail and post from December 2015 to January 2016.


Response rate was 66% (617 of 935). Over 95% of respondents reported routinely assessing adults’ vaccination status and recommending both vaccines. A majority found the current recommendations to be clear (50% “very clear,” 38% “somewhat clear”). Twenty percent found the upfront cost of purchasing PCV13, lack of insurance coverage, inadequate reimbursement, and difficulty determining vaccination history to be “major barriers” to giving these vaccines. Knowledge of recommendations varied, with 83% identifying the PCV13 recommendation for adults ≥65 and only 21% identifying the recommended interval between PCV13 and PPSV23 in an individual <65 at increased risk.


Almost all surveyed physicians reported recommending both pneumococcal vaccines, but a disconnect seems to exist between perceived clarity and knowledge of the recommendations. Optimal implementation of these recommendations will require addressing knowledge gaps and reported barriers.



February 3, 2018 at 8:59 am

Pneumococcal conjugate vaccine 13 delivered as one primary and one booster dose (1 + 1) compared with two primary doses and a booster (2 + 1) in UK infants: a multicentre, parallel group randomised controlled trial



Prof David Goldblatt, MBChB†,Jo Southern, PhD†, Nick J Andrews, PhD, Polly Burbidge, BSc, Jo Partington, BSc, Lucy Roalfe, BSc, Marta Valente Pinto, MD, Vasilli Thalasselis, Emma Plested, Hayley Richardson, BSc, Matthew D Snape, MBChB, Prof Elizabeth Miller, FRCPath



Infants in the UK were first offered a pneumococcal conjugate vaccine (PCV7) in 2006, given at 2 and 4 months of age and a booster dose at 13 months (2 + 1 schedule). A 13-valent vaccine (PCV13) replaced PCV7 in 2010. We aimed to compare the post-booster antibody response in UK infants given a reduced priming schedule of PCV13 (ie, a 1 + 1 schedule) versus the current 2 + 1 schedule and to assess the potential effect on population protection.


In this multicentre, parallel group, randomised controlled trial, we recuited infants due to receive their primary immunisations aged up to 13 weeks on first vaccinations by information booklets mailed out via the NHS Child Health Information Service and the UK National Health Application and Infrastructure Services. Eligible infants were randomly assigned (1:1) to receive PCV13 at 2, 4, and 12 months (2 + 1 schedule) or 3 and 12 months of age (1 + 1 schedule) delivered with other routine vaccinations. Randomisation was done by computer-generated permuted block randomisation, with a block size of six. Participants and clinical trial staff were not masked to treatment allocation. The primary endpoint was serotype-specific immunoglobulin G concentrations values (geometric mean concentrations [GMC] in μg/mL) measured in blood samples collected at 13 months of age. Analysis was by modified intention to treat with all individuals included by randomised group if they had a laboratory result. This trial is registered on the EudraCT clinical trial database, number 2015-000817-32, and, number NCT02482636.


Between September, 2015, and June, 2016, 376 infants were assessed for eligibility. 81 infants were excluded for not meeting the inclusion criteria (n=50) or for other reasons (n=31). 213 eligible infants were enrolled and randomly allocated to group 1 (n=106; 2 + 1 schedule) or to group 2 (n=107; 1 + 1 schedule). In group 1, 91 serum samples were available for analysis 1 month after booster immunisation versus 86 in group 2. At month 13, post-booster, GMCs were equivalent between schedules for serotypes 3 (0·61 μg/mL in group 1 vs 0·62 μg/mL in group 2), 5 (1·74 μg/mL vs 2·11 μg/mL), 7F (3·98 μg/mL vs 3·36 μg/mL), 9V (2·34 μg/mL vs 2·50 μg/mL), and 19A (8·38 μg/mL vs 8·83 μg/mL). Infants given the 1 + 1 schedule had significantly greater immunogenicity post-booster than those given the 2 + 1 schedule for serotypes 1 (8·92 μg/mL vs 3·07 μg/mL), 4 (3·43 μg/mL vs 2·55 μg/mL), 14 (16·9 μg/mL vs 10·49 μg/mL), and 19F (14·76 μg/mL vs 11·12 μg/mL; adjusted p value range <0·001 to 0·047). The 2 + 1 schedule was superior for serotypes 6A, 6B, 18C and 23F (adjusted p value range <0·0001 to 0·017). In a predefined numerical subset of all of the infants recruited to the study (n=40 [20%]), functional serotype-specific antibody was similar between schedules. 26 serious adverse events were recorded in 21 (10%) infants across the study period; 18 (n=13) were in the 2 + 1 group and eight (n=8) in the 1 + 1 group. Only one serious adverse event, a high temperature and refusal to feed after the first vaccination visit in a child on the 2+1 schedule was considered related to vaccine.


Our findings show that for nine of the 13 serotypes in PCV13, post-booster responses in infants primed with a single dose are equivalent or superior to those seen following the standard UK 2 + 1 schedule. Introducing a 1 + 1 schedule in countries with a mature PCV programme and established herd immunity is likely to maintain population control of vaccine-type pneumococcal disease.


NIHR and the Bill & Melinda Gates Foundation.






When less is more: how many doses of PCV are enough?

Katherine L O’Brien

Pneumococcal conjugate vaccine (PCV) is an incredibly important, lifesaving vaccine, first licensed in 2000,1 and recommended for infant routine use in the UK in 2006.2 Since 2007 WHO has recommended it for inclusion in the routine infant immunisation schedule of all countries.3, 4 Up to now, it has been rolled out in the national immunisation programmes of 141 countries (figure), has saved hundreds of thousands of lives,5 and is projected to save millions in the decades to come as country introductions continue and coverage increases….




January 26, 2018 at 6:15 pm

Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines

MMWR  January 26, 2018  V.67 N.3 P.103–108

Kathleen L. Dooling, MD1; Angela Guo, MPH1; Manisha Patel, MD1; Grace M. Lee, MD2; Kelly Moore, MD3; Edward A. Belongia, MD4; Rafael Harpaz, MD1


On October 20, 2017, Zoster Vaccine Recombinant, Adjuvanted (Shingrix, GlaxoSmithKline, [GSK] Research Triangle Park, North Carolina), a 2-dose, subunit vaccine containing recombinant glycoprotein E in combination with a novel adjuvant (AS01B), was approved by the Food and Drug Administration for the prevention of herpes zoster in adults aged ≥50 years.

The vaccine consists of 2 doses (0.5 mL each), administered intramuscularly, 2–6 months apart (1).

On October 25, 2017, the Advisory Committee on Immunization Practices (ACIP) recommended the recombinant zoster vaccine (RZV) for use in immunocompetent adults aged ≥50 years…..


January 26, 2018 at 8:42 am

ESCMID guideline: diagnosis and treatment of acute bacterial meningitis.

Clin Microbiol Infect. 2016 May;22 Suppl 3:S37-62.

van de Beek D1, Cabellos C2, Dzupova O3, Esposito S4, Klein M5, Kloek AT1, Leib SL6, Mourvillier B7, Ostergaard C8, Pagliano P9, Pfister HW5, Read RC10, Sipahi OR11, Brouwer MC12; ESCMID Study Group for Infections of the Brain (ESGIB).

Author information

1 Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.

2 Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain.

3 Department of Infectious Diseases, Charles University, Third Faculty of Medicine, Prague, Czech Republic.

4 Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.

5 Department of Neurology, Klinikum Großhadern, Munich, Germany.

6 Institute for Infectious Diseases, University of Bern, Bern, Switzerland.

7 Department of Intensive Care Medicine, Groupe Hospitalier Bichat-Claude Bernard, Paris, France.

8 Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.

9 Department of Infectious Diseases, “D. Cotugno” Hospital, Naples, Italy.

10 Department of Infectious Diseases, Southampton General Hospital, Southampton, United Kingdom.

11 Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey.

12 Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address:



November 22, 2017 at 11:58 am

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