THE GREAT DEBATE

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Are you getting 'proper and informed consent' before vaccinations?

Please note - this is not an 'anti-vaccination' position.

Questions are being constantly raised - is there a link?​

 
Autism, Delayed Development Syndrome, Behavioral and Learning Difficulties, Cerebral Palsy Disorders, Compulsive Obsessive Disorders, Motor Skill Delay ...

Consumer Medicine Information (CMI)

Who are the 'at risk' children?

"You have/your child has lowered immunity. This can occur in persons :

 - with inherited (or family history of) immune deficiency conditions

 - with abnormal blood conditions or blood protein (immunoglobulin) disorders - glycoproteins - cytokines.

 - with cancer

 - receiving or who have received certain drugs (i.e. cyclosporin, corticosteroids, and cancer medicines)

 - receiving or who have received radiation therapy"

Maternal Immune Issues

Is YOUR child at risk because of underlying maternal immune issues?

 

Mol Psychiatry. 2016 May 24. doi: 10.1038/mp.2016.77. [Epub ahead of print]

Autism with intellectual disability is associated with increased levels of maternal cytokines and chemokines during gestation.

Jones KL1,2, Croen LA3, Yoshida CK3, Heuer L1,2, Hansen R2,4, Zerbo O3, DeLorenze GN3, Kharrazi M5, Yolken R6, Ashwood P2,7, Van de Water J1,2.

Author information

Abstract

Immune abnormalities have been described in some individuals with autism spectrum disorders (ASDs) as well as their family members. However, few studies have directly investigated the role of prenatal cytokine and chemokine profiles on neurodevelopmental outcomes in humans. In the current study, we characterized mid-gestational serum profiles of 22 cytokines and chemokines in mothers of children with ASD (N=415), developmental delay (DD) without ASD (N=188), and general population (GP) controls (N=428) using a bead-based multiplex technology. The ASD group was further divided into those with intellectual disabilities (developmental/cognitive and adaptive composite score<70) (ASD+ID, N=184) and those without (composite score⩾70) (ASD-noID, N=201). Levels of cytokines and chemokines were compared between groups using multivariate logistic regression analyses, adjusting for maternal age, ethnicity, birth country and weight, as well as infant gender, birth year and birth month.

  • Mothers of children with ASD+ID had significantly elevated mid-gestational levels of numerous cytokines and chemokines, such as granulocyte macrophage colony-stimulating factor (GM-CSF), interferon-γ, interleukin-1α (IL-1α) and IL-6, compared with mothers of children with either ASD-noID, those with DD, or GP controls. Conversely, mothers of children with either ASD-noID or with DD had significantly lower levels of the chemokines IL-8 and monocyte chemotactic protein-1 compared with mothers of GP controls. This observed immunologic distinction between mothers of children with ASD+ID from mothers of children with ASD-noID or DD suggests that the intellectual disability associated with ASD might be etiologically distinct from DD without ASD.

  • These findings contribute to the ongoing efforts toward identification of early biological markers specific to subphenotypes of ASD. Molecular Psychiatry advance online publication, 24 May 2016; doi:10.1038/mp.2016.77.

Is YOUR pre-vaccination child already in a heightened 'inflammatory' Cytokine State?

Why is the vaccination schedule in contrast to the manufactures CMI?

The manufacturer CMI (CONSUMER MEDICINE INFORMATION LEAFLET) recommends only two (2)  MMR (Measles_Mumps_Rubella live vaccines) doses.

  • The CMI states that the FIRST MMR to be at 12-months and the SECOND MMR dose NOT UNTIL between the ages of 4-6 years.

 MMR Priorix_CMI_AU_005_Approved.pdf  (CMI Priorix page 2)

  • There is NO recommendation for an extra vaccination of MMR at 18-months of age - THIRD DOSE  MMR

  • What happens with an additional MMR (live vaccine strains) together with Varilrix (Chicken Pox) live vaccine, at 18-months of age when the child is still recovering (adapting) from the first MMR at 12-months of age?

  • Does your doctor INFORM you as to the possible side-effects when combining multiple Live Vaccine strains and extra vaccinations?

  • What are the 'reported side effects' of MMR?

  • What are the 'reported side effects' of Chicken Pox?

  • What are the side effects of the combination of MMR and Chicken Pox?

  • What are the 'un-reported side effects' of MMR or Chicken Pox and when given together?

Australia Vaccination Schedule

Cytokine Storm Reaction - 'Over Expression'

Drug Saf. 2015 Sep;38(9):781-7. doi: 10.1007/s40264-015-0330-8.

Vaccine-Drug Interactions: Cytokines, Cytochromes, and Molecular Mechanisms.

Pellegrino P1, Perrotta CClementi ERadice S.

Author information

Abstract

Vaccinations are recommended throughout life to reduce the risk of vaccine-preventable diseases and their sequelae. Vaccines are often administered in patients with chronic diseases who are likely to be treated with several drugs. A growing number of clinical observations have indicated the possibility of interactions between vaccines and drugs, leading to changes in drug metabolism after vaccination. These interactions represent a significant concern because of the increasing use of vaccines in older patients who are likely to be treated with several drugs. Because of the possible implications of adverse reactions in terms of public health, several studies were performed to verify the risk posed by these interactions and to clarify the biologic mechanisms that drive these events. Of the several mechanisms proposed to be at the basis of vaccine-drug interactions, the most convincing evidence suggests a role of inflammatory cytokines on the regulation of specific cytochrome P450 enzymes in the liver. Differences in the cytochrome P450 enzymes involved in the metabolism of these drugs could explain these contrasting results and provide important insights to fully understand the clinical importance of these events. Further studies are required to verify whether vaccine-drug interactions may occur in other clinical settings, especially the ones for which patients are required to be vaccinated against specific diseases.

Vaccine. 2014 Jun 24;32(30):3861-8. doi: 10.1016/j.vaccine.2014.03.032.

Evaluation of the bioactivity of influenza vaccine strains in vitro suggests that the introduction of new strains in the 2010 Southern Hemisphere trivalent influenza vaccine is associated with adverse events.

Rockman S1, Dyson A2, Koernig S2, Becher D2, Ng M2, Morelli AB2, Barnden M2, Tang ML3, Pearse M2, Maraskovsky E4.

Author information

Abstract

In Australia, during the 2010 Southern Hemisphere (SH) influenza season, there was an unexpected increase in post-marketing adverse event reports of febrile seizures (FS) in children under 5 years of age shortly after vaccination with the CSL trivalent influenza vaccine (CSL 2010 SH TIV) compared to previous CSL TIVs and other licensed 2010 SH TIVs. The present study describes the outcomes of a series of in vitro experiments directed at elucidating the root cause. The scientific investigations found that a subset of paediatric donors displayed elevated cytokine/chemokine responses to the CSL 2010 SH TIV but not to previous CSL TIVs nor other 2010 SH TIVs.

The induction of elevated cytokines/chemokines in paediatric whole blood correlated with elevated NF-κB activation in a HEK293 cell reporter assay. The data indicate that the introduction of the B/Brisbane/60/2008 strain within the CSL manufacturing process (such as occurred in the preceding 2009/10 NH season) appears to have raised the pyrogenic potential of the CSL 2009/10 NH TIV but that this was insufficient to elicit FS in children <5 years. The 2010 SH season coincided with the first introduction of the H1N1 A/California/07/2009 in combination with the B/Brisbane/60/2008 strain. Our data demonstrates that the introduction of the H1N1 A/California/07/2009 (and to a much lesser degree, H3N2 A/Wisconsin/15/2009) in combination with B/Brisbane/60/2008 (as expressed through the CSL method of manufacture) combined and likely compounded the bioactivity of the CSL 2010 SH TIV. This was associated with stronger immune responses, which in a proportion of children <5 years were associated with FS. The assays and systems developed during these investigations should greatly assist in determining the bioactivity of new influenza strains, and thus aid with the manufacture of CSL TIVs indicated for use in the paediatric population.

 

 

Case Study Reactions

  • note the elevated over expression of pro-inflammatory cytokines

IL1 in Stroke - Bench to Bedside

Caused a severe reduction in cerebral blood flow and increase in infarct volume. Blockade of endothelin-1 receptors reversed this hypoperfusion, reduced tissue damage, and improved functional outcome. 

Chemokine Interleukin-8 (IL-8) in Alzheimer’s and Other Neurodegenerative Diseases

Neuroinflammation is a critical component in the pathogenesis of neurodegenerative diseases. Evidence suggests that IL8 activated microglia serve as a primary source for a host of inflammatory mediators which in assemblage can lead to neurotoxicity in inflamed brain.

IL8 & Cardiovascular Disease

A Neurologist Guide to TNF biology and to the principles behind the therapeutic removal of excess TNF in disease​

Tumor necrosis factor (TNF)is an ancient and widespread cytokine required in small amounts for much physiological function. Higher concentrations are central to innate immunity, but if unchecked this cytokine orchestrates much chronic and acute disease, both infectious and noninfectious.

Over expression of GMCSF associated with influenza viruses (IVs) and are a common cause of respiratory infections in pediatric and adult patients. Additionally, recurrent pandemics cause massive morbidity and mortality worldwide. Infection may result in rapid progressive viral pneumonia with fatal outcome.

Granulocyte Colony-Stimulating Factor Protects Mice during Respiratory Virus Infections

Lung Epithelial GMCSF Host Defense Function and Epithelial Repair in Influenza Virus Pneumonia

Pivotal Role of GMCSF in Autoimmunity and Inflammation​

GMCSF as a therapeutic target in autoimmune diseases

Case Study EO - Autism Spectrum Disorder age 3.5 years

Pre-HBOT (left) and Post HBOT at 53 hours and 100-hours 

Note the cytokine  'wash-out' at 50 hours 'Oxygen in - garbage out'

Case Study EO - Post HBOT at 100-hours 

  • significant reduction of the pro-inflammatory cytokines at 100-hours.

  • significant elevation of Brain Derived Neurotrophic Factor (BDNF) associated with neurologic growth and repair.

Cytokines drive autoimmune illness and recovery

Oxygen In - Garbage OUT ('Wash-out')

Adv Drug Deliv Rev. 2017 Feb 15. pii: S0169-409X(17)30028-5. doi: 10.1016/j.addr.2017.02.001. [Epub ahead of print]

Mimicking Oxygen delivery and waste removal functions of blood.

Zhang H1, Barralet JE2.

Author information

Abstract

In addition to immunological and wound healing cell and platelet delivery, ion stasis and nutrient supply, blood delivers oxygen to cells and tissues and removes metabolic wastes. For decades researchers have been trying to develop approaches that mimic these two immediately vital functions of blood. Oxygen is crucial for the long-term survival of tissues and cells in vertebrates. Hypoxia (oxygen deficiency) and even at times anoxia (absence of oxygen) can occur during organ preservation, organ and cell transplantation, wound healing, in tumors and engineering of tissues. Different approaches have been developed to deliver oxygen to tissues and cells, including hyperbaric oxygen therapy (HBOT), normobaric hyperoxia therapy (NBOT), using biochemical reactions and electrolysis, employing liquids with high oxygen solubility, administering hemoglobin, myoglobin and red blood cells (RBCs), introducing oxygen-generating agents, using oxygen-carrying microparticles, persufflation, and peritoneal oxygenation. Metabolic waste accumulation is another issue in biological systems when blood flow is insufficient.

Metabolic wastes change the microenvironment of cells and tissues, influence the metabolic activities of cells, and ultimately cause cell death. This review examines advances in blood mimicking systems in the field of biomedical engineering in terms of oxygen delivery and metabolic waste removal.

Case Study AH - Autism Spectrum Disorder age 4.5 years

If there is no controversy - then why the controversy?
Vaccination Reactions

Vaccine. 2017 Sep 9. pii: S0264-410X(17)31222-7. doi: 10.1016/j.vaccine.2017.09.007. [Epub ahead of print]

What is 'confidence' and what could affect it?: A qualitative study of mothers who are hesitant about vaccines.

Mendel-Van Alstyne JA1, Nowak GJ2, Aikin AL3.

Author information

Abstract

BACKGROUND:

Public confidence in immunization is critical to maintaining high vaccine-coverage rates needed to protect individuals and communities from vaccine-preventable diseases. Recent attention has been placed on factors influencing confidence in vaccination in the US and globally, but comprehensive understanding of what drives or hinders confidence in childhood vaccination is yet to be reached. As such, assessing parents' confidence in childhood vaccination and the ways in which educational materials affect confidence is needed.

OBJECTIVE:

We sought to (1) learn how mothers who are hesitant about vaccination characterize confidence in health-related products for young children, including the recommended vaccines; (2) gain insights on what influences vaccine confidence beliefs; and (3) assess whether short, education materials affect parental confidence in childhood vaccinations.

METHODS:

Eight moderator-lead focus groups (n=61), stratified by socioeconomic status, were undertaken with mothers of children 5years of age of less who are hesitant about vaccines. Four of the groups were held in the Philadelphia, PA area and four were held in the San Francisco/Oakland, CA area. Three educational material pairs, each consisting of a 2-3min video and an infographic poster about an immunization-related topic, were reviewed and assessed for influence on confidence.

RESULTS:

Qualitative data analysis was used to identify overarching themes across the focus groups. Themes, insights, and illustrative quotes were identified and provided for each of the major discussion areas: primary health concerns for young children; confidence beliefs and perceptions, including for recommended vaccines; facilitators and barriers to confidence; and reactions to the educational materials.

CONCLUSIONS:

Results provide helpful insights into how mothers who are hesitant about vaccines perceive confidence in childhood vaccines and health-related products, suggestions for how to improve confidence, and support for the value and use of short videos as part of vaccination education efforts. Findings can aid those developing vaccination education materials and resources designed to foster vaccine confidence.

Vaccine. 2017 Sep 5. pii: S0264-410X(17)31135-0. doi: 10.1016/j.vaccine.2017.08.047. [Epub ahead of print]

Postmarketing safety surveillance of trivalent recombinant influenza vaccine: Reports to the Vaccine Adverse Event Reporting System.

Woo EJ1, Moro PL2, Cano M2, Jankosky C3.

Author information

Abstract

On January 16, 2013, the Food and Drug Administration approved recombinant hemagglutinin influenza vaccine (RIV3) (Spodoptera frugiperda cell line; Flublok), which is the first completely egg-free flu vaccine licensed in the United States. To improve our understanding of the safety profile of this vaccine, we reviewed and summarized reports to the Vaccine Adverse Event Reporting System (VAERS) following RIV3. Through June 30, 2016, VAERS received 88 reports. Allergic reactions, including anaphylaxis, were the most common type of adverse event. Based on medical review, 10 cases met the Brighton Collaboration case definition of anaphylaxis, 21 reports described allergic reactions other than anaphylaxis, and 11 reports described signs and symptoms that suggested hypersensitivity. Other adverse events included injection site reactions, fatigue, myalgia, headache, and fever. The occurrence of anaphylaxis and other allergic reactions in some individuals may reflect an underlying predisposition to atopy that may manifest itself after an exposure to any drug or vaccine, and it does not necessarily suggest a causal relationship with the unique constituents that are specific to the vaccine product administered. Further research may elucidate the mechanism of allergic reactions following influenza vaccination: it is possible that egg proteins and influenza hemagglutinin play little or no role. Vaccination remains the single best defense against influenza and its complications. The information summarized here may enable policy makers, health officials, clinicians, and patients to make a more informed decision regarding vaccination strategies.

Child Care Health Dev. 2017 Jan 19. doi: 10.1111/cch.12442. [Epub ahead of print]

What do popular YouTubeTM videos say about vaccines?

Basch CH1, Zybert P2, Reeves R1, Basch CE2.

Author information

Abstract

BACKGROUND:

The unregulated social network YouTubeTM has become an increasingly popular source of information on health topics such as vaccine safety. With a reach of over one billion users per month, the potential for misinformation is significant.

METHODS:

Using the keywords 'vaccine safety' and 'vaccines and children', 87 of the most widely viewed YouTubeTM videos were identified and analyzed for content, author status and view count.

RESULTS:

The range of view counts was 25 532 to 6 229 835, with a median of 62 075 views per video. Most videos (n = 74, 85.1%) were devoted exclusively to the topic of vaccination. The three most common sources of these YouTubeTM videos were consumers (27.6%), TV-based or Internet-based news (26.4%) and individual health professionals (25.3%). Top topics covered were autism causality (47.1% of videos), undisclosed or poorly understood risks (42.5%), adverse reactions (40.2%) and thimerosol or mercury in vaccines (36.8%). The majority of videos (65.5%) discouraged the use of vaccines.

CONCLUSION:

Health professionals should be aware of the widely disseminated vaccination information available on the Internet and should appreciate its possible effect on the public.

Vaccine. 2017 Jan 23;35(4):619-625. doi: 10.1016/j.vaccine.2016.12.017. Epub 2016 Dec 23.

Extensive swelling of the limb and systemic symptoms after a fourth dose of acellular pertussis containing vaccines in England in children aged 3-6years.

Southern J1, Waight PA2, Andrews N3, Miller E2.

Author information

Abstract

Extensive limb swelling (ESL) after a booster dose of acellular pertussis (aP) containing vaccine can cause concern and has the potential to be confused with cellulitis. In the United Kingdom aP-containing vaccine was introduced for primary immunisation at 2, 3 and 4months of age in 2004, with the first cohorts eligible to receive a fourth dose in 2007 at school entry. We assessed the frequency of ESL (here defined as swelling >100mms diameter) in 973 children receiving a fourth dose of one of four aP vaccines given combined with inactivated polio, tetanus and either low dose diphtheria (TdaP/IPV) or high dose diphtheria (DTaP/IPV) vaccine; 2 of the 3 DTaP/IPV vaccines also contained Haemophilus influenza b conjugate vaccine (Hib). Post-vaccination symptoms and local reactions were recorded in 7-day diaries or by a telephone follow up if no diary was returned. Local swellings >50mm diameter were reported by 2.2% TdaP/IPV recipients compared with 6.6-11.1% of DTaP/IPV recipients; the corresponding proportions for redness >50mms was 7.0% for TdaP/IPV and 13.3-17.7% for DTaP/IPV recipients. Among the latter, the addition of Hib did not affect the frequency or size of local reactions. Pain at the injection site and systemic symptoms did not differ between the four vaccine groups. A history of atopy was not associated with development of local swelling or redness. A total of 13 children (1.3%) experienced an ESL, three after TdaP/IPV. ESLs resolved without systemic upset within a few days and were usually painless; medical advice was only sought for two children. Parents should be informed about the possible occurrence of an ESL with the pre-school aP-containing booster vaccine but can be reassured that it is a benign and transient condition.

Pediatrics. 2017 Feb 7. pii: e20162536. doi: 10.1542/peds.2016-2536. [Epub ahead of print]

Safety of Second-Dose Single-Antigen Varicella Vaccine.

Su JR1, Leroy Z2, Lewis PW3, Haber P3, Marin M4, Leung J4, Woo EJ5, Shimabukuro TT3.

Author information

Abstract

BACKGROUND AND OBJECTIVE:

In 2006, routine 2-dose varicella vaccination for children was recommended to improve control of varicella. We assessed the safety of second-dose varicella vaccination.

METHODS:

We identified second-dose single-antigen varicella vaccine reports in the Vaccine Adverse Event Reporting System during 2006 to 2014 among children aged 4 to 18 years. We analyzed reports by age group (4-6 and 7-18 years), sex, serious or nonserious status, most common adverse events (AEs), and whether other vaccines were administered concomitantly with varicella vaccine. We reviewed serious reports of selected AEs and conducted empirical Bayesian data mining to detect disproportional reporting of AEs.

RESULTS:

We identified 14 641 Vaccine Adverse Event Reporting System reports after second-dose varicella vaccination, with 494 (3%) classified as serious. Among nonserious reports, injection site reactions were most common (48% of children aged 4-6 years, 38% of children aged 7-18 years). The most common AEs among serious reports were pyrexia (31%) for children aged 4 to 6 years and headache (28%) and vomiting (27%) for children aged 7 to 18 years. Serious reports of selected AEs included anaphylaxis (83), meningitis (5), encephalitis (16), cellulitis (52), varicella (6), herpes zoster (6), and deaths (7). One immunosuppressed adolescent was reported with vaccine-strain herpes zoster. Only previously known AEs were reported more frequently after second-dose varicella vaccination compared with other vaccines.

CONCLUSIONS:

We identified no new or unexpected safety concerns for second-dose varicella vaccination. Robust safety monitoring remains an important component of the national varicella vaccination program.

Vaccine. 2017 Mar 1;35(9):1238-1245. doi: 10.1016/j.vaccine.2017.01.056. Epub 2017 Feb 3.

Metabolites as biomarkers of adverse reactions following vaccination: A pilot study using nuclear magnetic resonance metabolomics.

McClenathan BM1, Stewart DA2, Spooner CE3, Pathmasiri WW4, Burgess JP5, McRitchie SL6, Choi YS7, Sumner SC8.

Author information

Abstract

An Adverse Event Following Immunization (AEFI) is an adverse reaction to a vaccination that goes above and beyond the usual side effects associated with vaccinations. One serious AEFI related to the smallpox vaccine is myopericarditis. Metabolomics involves the study of the low molecular weight metabolite profile of cells, tissues, and biological fluids, and provides a functional readout of the phenotype. Metabolomics may help identify a particular metabolic signature in serum of subjects who are predisposed to developing AEFIs. The goal of this study was to identify metabolic markers that may predict the development of adverse events following smallpox vaccination. Serum samples were collected from military personnel prior to and following receipt of smallpox vaccine. The study population included five subjects who were clinically diagnosed with myopericarditis, 30 subjects with asymptomatic elevation of troponins, and 31 subjects with systemic symptoms following immunization, and 34 subjects with no AEFI, serving as controls. Two-hundred pre- and post-smallpox vaccination sera were analyzed by untargeted metabolomics using 1H nuclear magnetic resonance (NMR) spectroscopy. Baseline (pre-) and post-vaccination samples from individuals who experienced clinically verified myocarditis or asymptomatic elevation of troponins were more metabolically distinguishable pre- and post-vaccination compared to individuals who only experienced systemic symptoms, or controls. Metabolomics profiles pre- and post-receipt of vaccine differed substantially when an AEFI resulted. This study is the first to describe pre- and post-vaccination metabolic profiles of subjects who developed an adverse event following immunization. The study demonstrates the promise of metabolites for determining mechanisms associated with subjects who develop AEFI and the potential to develop predictive biomarkers.

Front Endocrinol (Lausanne). 2017 Jan 24;7:150. doi: 10.3389/fendo.2016.00150. eCollection 2016.

Autoimmune/Inflammatory Syndrome Induced by Adjuvants and Thyroid Autoimmunity.

Watad A1, David P2, Brown S3, Shoenfeld Y4.

Author information

Abstract

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA), presented by Shoenfeld and Agmon-Levin in 2011, is an entity that incorporates diverse autoimmune conditions induced by the exposure to various adjuvants. Adjuvants are agents that entail the capability to induce immune reactions. Adjuvants are found in many vaccines and used mainly to increase the response to vaccination in the general population. Silicone has also been reported to be able to induce diverse immune reactions. Clinical cases and series of heterogeneous autoimmune conditions including systemic sclerosis, systemic lupus erythematosus, and rheumatoid arthritis have been reported to be induced by several adjuvants. However, only a small number of cases of autoimmune thyroid disorder have been included under the umbrella of ASIA syndrome. Indeed, clinical cases of Hashimoto's thyroiditis and/or subacute thyroiditis were observed after the exposure to vaccines as well as silicone implantation. In our review, we aimed to summarize the current knowledge on ASIA syndrome presented as endocrinopathies, focusing on autoimmune thyroid disorders associated with the various adjuvants.

Clin Exp Vaccine Res. 2017 Jan;6(1):38-44. doi: 10.7774/cevr.2017.6.1.38. Epub 2017 Jan 25.

Comparison of immunogenicity and safety of an influenza vaccine administered concomitantly with a 13-valent pneumococcal conjugate vaccine or 23-valent polysaccharide pneumococcal vaccine in the elderly.

Seo YB1, Choi WS2, Lee J1, Song JY3, Cheong HJ3, Kim WJ3.

Author information

Abstract

PURPOSE:

Previous studies have demonstrated the immunogenicity and safety of the co-administration of the trivalent inactivated influenza vaccine (IIV3) with the polysaccharide pneumococcal vaccine (PPV) or pneumococcal conjugate vaccine (PCV). However, there is no direct comparison study that evaluates the immunogenicity and safety of IIV3 given concomitantly with PCV13 or PPV23 in the elderly.

MATERIALS AND METHODS:

During the 2012-2013 influenza vaccination period, 224 healthy elderly volunteers aged 65 years and older randomly received IIV3 given concomitantly with either PCV13 (PCV13+IIV3) or PPV23 (PPV23+IIV3) in a 1:1 ratio. Serum hemagglutination-inhibiting antibodies for IIV3 were measured at the time of vaccination and 1 month after vaccination. Adverse events were recorded prospectively in a clinical diary during a 7-day period.

RESULTS:

A total of 220 participants blood samples for analysis of immunogenicity and kept a clinical diary for safety analysis (PCV13+IIV3, n=110; PPV23+IIV3, n=110). One month after vaccination, both groups satisfied the Committee for Medical Products for Human Use criteria for A/H1N1, A/H3N2 and B strains, showing comparable seroprotection rates, seroconversion rates and geometric mean titer fold. The assessments of immunogenicity were similar in both groups. The most common local and systemic reactions were pain at the injection site and generalized myalgia. They were generally mild or moderate in intensity. The adverse events were not statistically different between the two groups.

CONCLUSION:

PCV13+IIV3 and PPV23+IIV3 demonstrated similar immunogenicity and safety in the elderly.

JMIR Public Health Surveill. 2016 Nov 22;2(2):e166.

"Mommy Blogs" and the Vaccination Exemption Narrative: Results From A Machine-Learning Approach for Story Aggregation on Parenting Social Media Sites.

Tangherlini TR1, Roychowdhury V2, Glenn B3, Crespi CM3, Bandari R2, Wadia A2, Falahi M2, Ebrahimzadeh E2, Bastani R3.

Author information

Abstract

BACKGROUND:

Social media offer an unprecedented opportunity to explore how people talk about health care at a very large scale. Numerous studies have shown the importance of websites with user forums for people seeking information related to health. Parents turn to some of these sites, colloquially referred to as "mommy blogs," to share concerns about children's health care, including vaccination. Although substantial work has considered the role of social media, particularly Twitter, in discussions of vaccination and other health care-related issues, there has been little work on describing the underlying structure of these discussions and the role of persuasive storytelling, particularly on sites with no limits on post length. Understanding the role of persuasive storytelling at Internet scale provides useful insight into how people discuss vaccinations, including exemption-seeking behavior, which has been tied to a recent diminution of herd immunity in some communities.

OBJECTIVE:

To develop an automated and scalable machine-learning method for story aggregation on social media sites dedicated to discussions of parenting. We wanted to discover the aggregate narrative frameworks to which individuals, through their exchange of experiences and commentary, contribute over time in a particular topic domain. We also wanted to characterize temporal trends in these narrative frameworks on the sites over the study period.

METHODS:

To ensure that our data capture long-term discussions and not short-term reactions to recent events, we developed a dataset of 1.99 million posts contributed by 40,056 users and viewed 20.12 million times indexed from 2 parenting sites over a period of 105 months. Using probabilistic methods, we determined the topics of discussion on these parenting sites. We developed a generative statistical-mechanical narrative model to automatically extract the underlying stories and story fragments from millions of posts. We aggregated the stories into an overarching narrative framework graph. In our model, stories were represented as network graphs with actants as nodes and their various relationships as edges. We estimated the latent stories circulating on these sites by modeling the posts as a sampling of the hidden narrative framework graph. Temporal trends were examined based on monthly user-poststatistics.

RESULTS:

We discovered that discussions of exemption from vaccination requirements are highly represented. We found a strong narrative framework related to exemption seeking and a culture of distrust of government and medical institutions. Various posts reinforced part of the narrative framework graph in which parents, medical professionals, and religious institutions emerged as key nodes, and exemption seeking emerged as an important edge. In the aggregate story, parents used religion or belief to acquire exemptions to protect their children from vaccines that are required by schools or government institutions, but (allegedly) cause adverse reactions such as autism, pain, compromised immunity, and even death. Although parents joined and left the discussion forums over time, discussions and stories about exemptions were persistent and robust to these membership changes.

CONCLUSIONS:

Analyzing parent forums about health care using an automated analytic approach, such as the one presented here, allows the detection of widespread narrative frameworks that structure and inform discussions. In most vaccination stories from the sites we analyzed, it is taken for granted that vaccines and not vaccine preventable diseases (VPDs) pose a threat to children. Because vaccines are seen as a threat, parents focus on sharing successful strategies for avoiding them, with exemption being the foremost among these strategies. When new parents join such sites, they may be exposed to this endemic narrative framework in the threads they read and to which they contribute, which may influence their health care decision making.

Acta Reumatol Port. 2016 Nov 9. [Epub ahead of print]

Efficacy and Safety of Vaccination in Pediatric Patients with Systemic Inflammatory Rheumatic Diseases: a systematic review of the literature.

Sousa S1, Duarte AC1, Cordeiro I1, Ferreira J2, Gonçalves MJ3, Meirinhos T4, Rocha TM5, Romão VC3, Santos MJ1.

Author information

Abstract

INTRODUCTION:

Children and adolescents with systemic rheumatic diseases have an increased risk of infections. Although some infections are vaccine-preventable, immunization among patients with juvenile rheumatic diseases is suboptimal, partly due to some doubts that still persist regarding its efficacy and safety in this patient population.

OBJECTIVES:

To review the available evidence regarding the immunological response and the safety of vaccination in children and adolescents with systemic inflammatory rheumatic diseases (SIRD).

METHODS:

A systematic review of the current literature until December 2014 using MEDLINE, EMBASE and abstracts from the American College of Rheumatology and European League Against Rheumatism congresses (2011-2014), complemented by hand search was performed. Eligible studies were identified and efficacy (seroprotection and/or seroconversion) and safety (reactions to vaccine and relapse of rheumatic disease) outcomes were extracted and summarized according to the type of vaccine.

RESULTS:

Twenty-eight articles concerning vaccination in pediatric patients with SIRDs were found, that included almost 2100 children and adolescents, comprising nearly all standard vaccinations of the recommended immunization schedule. Children with SIRDs generally achieved seroprotection and seroconversion; nevertheless, the antibody levels were often lower when compared with healthy children. Glucocorticoids and conventional disease-modifying anti-rheumatic drugs do not seem to significantly hamper the immune responses, whereas TNF inhibitors may reduce antibody production, particularly in response to pneumococcal conjugate, influenza, meningococcal C and hepatitis A vaccine. There were no serious adverse events, nor evidence of a relevant worsening of the underlying rheumatic disease. Concerning live attenuated vaccines, the evidence is scarce, but no episodes of overt disease were reported, even in patients under biological therapy.

CONCLUSIONS:

Existing literature demonstrates that vaccines are generally well tolerated and effective in stable SIRD patients, yet antibody titers are frequently lower than in healthy controls. There is some evidence that biological therapy could hamper the immune response. Data on safety of live attenuated vaccines is limited. Although the available literature covers most vaccines included in the national immunization plan, there is a need for more information regarding new vaccines and new anti-rheumatic therapies.

Clin Psychopharmacol Neurosci. 2016 Nov 30;14(4):396-398. doi: 10.9758/cpn.2016.14.4.396.

Recurrence of Panic Attacks after Influenza Vaccination: Two Case Reports.

Kim HJ1, Jeon SW1, Yoon HK1.

Author information

Abstract

Human influenza is a contagious respiratory illness caused by the influenza virus. The influenza vaccination is recommended annually, but several adverse effects related to allergic reactions have been reported. Panic attacks are also known to occur, but no case of a panic attack adverse effect has been reported in South Korea. We present two cases of panic disorder patients whose symptoms were aggravated by the influenza vaccination. We assumed that dysregulation of T-lymphocytes in panic disorder patients could have a role in activating various kinds of cytokines and chemokines, which then can lead to panic attack aggravation.

Clin Vaccine Immunol. 2016 Aug 5;23(8):664-71. doi: 10.1128/CVI.00092-16. Print 2016 Aug.

Unique Inflammatory Mediators and Specific IgE Levels Distinguish Local from Systemic Reactions after Anthrax Vaccine Adsorbed Vaccination.

Garman L1, Smith K2, Muns EE2, Velte CA2, Spooner CE3, Munroe ME2, Farris AD1, Nelson MR3, Engler RJ3, James JA4.

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Abstract

Although the U.S. National Academy of Sciences concluded that anthrax vaccine adsorbed (AVA) has an adverse event (AE) profile similar to those of other adult vaccines, 30 to 70% of queried AVA vaccinees report AEs. AEs appear to be correlated with certain demographic factors, but the underlying immunologic pathways are poorly understood. We evaluated a cohort of 2,421 AVA vaccinees and found 153 (6.3%) reported an AE. Females were more likely to experience AEs (odds ratio [OR] = 6.0 [95% confidence interval {CI} = 4.2 to 8.7]; P < 0.0001). Individuals 18 to 29 years of age were less likely to report an AE than individuals aged 30 years or older (OR = 0.31 [95% CI = 0.22 to 0.43]; P < 0.0001). No significant effects were observed for African, European, Hispanic, American Indian, or Asian ancestry after correcting for age and sex. Additionally, 103 AEs were large local reactions (LLRs), whereas 53 AEs were systemic reactions (SRs). In a subset of our cohort vaccinated 2 to 12 months prior to plasma sample collection (n = 75), individuals with LLRs (n = 33) had higher protective-antigen (PA)-specific IgE levels than matched, unaffected vaccinated individuals (n = 50; P < 0.01). Anti-PA IgE was not associated with total plasma IgE, hepatitis B-specific IgE, or anti-PA IgG in individuals who reported an AE or in matched, unaffected AVA-vaccinated individuals. IP-10 was also elevated in sera of individuals who developed LLRs (P < 0.05). Individuals reporting SRs had higher levels of systemic inflammation as measured from C-reactive protein (P < 0.01). Thus, LLRs and SRs are mediated by distinct pathways. LLRs are associated with a vaccine-specific IgE response and IP-10, whereas SRs demonstrate increased systemic inflammation without a skewed cytokine profile.

Vaccine. 2014 Jun 24;32(30):3861-8. doi: 10.1016/j.vaccine.2014.03.032.

Evaluation of the bioactivity of influenza vaccine strains in vitro suggests that the introduction of new strains in the 2010 Southern Hemisphere trivalent influenza vaccine is associated with adverse events.

Rockman S1, Dyson A2, Koernig S2, Becher D2, Ng M2, Morelli AB2, Barnden M2, Tang ML3, Pearse M2, Maraskovsky E4.

Author information

Abstract

In Australia, during the 2010 Southern Hemisphere (SH) influenza season, there was an unexpected increase in post-marketing adverse event reports of febrile seizures (FS) in children under 5 years of age shortly after vaccination with the CSL trivalent influenza vaccine (CSL 2010 SH TIV) compared to previous CSL TIVs and other licensed 2010 SH TIVs. The present study describes the outcomes of a series of in vitro experiments directed at elucidating the root cause. The scientific investigations found that a subset of paediatric donors displayed elevated cytokine/chemokine responses to the CSL 2010 SH TIV but not to previous CSL TIVs nor other 2010 SH TIVs. The induction of elevated cytokines/chemokines in paediatric whole blood correlated with elevated NF-κB activation in a HEK293 cell reporter assay. The data indicate that the introduction of the B/Brisbane/60/2008 strain within the CSL manufacturing process (such as occurred in the preceding 2009/10 NH season) appears to have raised the pyrogenic potential of the CSL 2009/10 NH TIV but that this was insufficient to elicit FS in children <5 years. The 2010 SH season coincided with the first introduction of the H1N1 A/California/07/2009 in combination with the B/Brisbane/60/2008 strain. Our data demonstrates that the introduction of the H1N1 A/California/07/2009 (and to a much lesser degree, H3N2 A/Wisconsin/15/2009) in combination with B/Brisbane/60/2008 (as expressed through the CSL method of manufacture) combined and likely compounded the bioactivity of the CSL 2010 SH TIV. This was associated with stronger immune responses, which in a proportion of children <5 years were associated with FS. The assays and systems developed during these investigations should greatly assist in determining the bioactivity of new influenza strains, and thus aid with the manufacture of CSL TIVs indicated for use in the paediatric population.

MMWR Morb Mortal Wkly Rep. 2010 Aug 13;59(31):989-92.

Update: Recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding use of CSL seasonal influenza vaccine (Afluria) in the United States during 2010-11.

Centers for Disease Control and Prevention (CDC).

Abstract

During the 2010 influenza season in Australia, administration of a 2010 Southern Hemisphere seasonal influenza trivalent inactivated vaccine (TIV) (Fluvax Junior and Fluvax) manufactured by CSL Biotherapies was associated with increased frequency of fever and febrile seizures in children aged 6 months through 4 years. Postmarketing surveillance indicated increased reports of fever in children aged 5-8 years after vaccination with Fluvax compared to previous seasons. An antigenically equivalent 2010-11 Northern Hemisphere seasonal influenza TIV (Afluria) manufactured by CSL Biotherapies is approved by the Food and Drug Administration (FDA) for persons aged >or=6 months in the United States. Prescribing information for the 2010-11 Afluria formulation includes a warning that "Administration of CSL's Southern Hemisphere influenza vaccine has been associated with increased postmarketing reports of fever and febrile seizures in children predominantly below the age of 5 years as compared to previous years". In the United States, annual influenza vaccination is recommended for all persons aged >or=6 months. On August 5, 2010, the Advisory Committee on Immunization Practices (ACIP) recommended that the 2010-11 Afluria vaccine not be administered to children aged 6 months through 8 years. Other age-appropriate, licensed seasonal influenza vaccine formulations should be used for prevention of influenza in these children. If no other age-appropriate, licensed inactivated seasonal influenza vaccine is available for a child aged 5-8 years who has a medical condition that increases their risk for influenza complications, Afluria can be used; however, providers should discuss with the parents or caregivers the benefits and risks of Afluria use before administering this vaccine to children aged 5-8 years.