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Many drugs are available to treat Parkinson’s disease (PD), but are limited to alleviating symptoms; no disease-modifying treatment (DMT) has been approved by any authority. There is much effort to develop remedies capable of altering the underlying neurodegenerative processes in PD. Current concepts target the deposition of pathologic α-synuclein oligomers either by immunization strategies or by small molecules that interact with the protein aggregation. Further DMT approaches modulate pathologically active intracellular processes such as the c-Abl kinase or LRRK2 pathway or aim to activate signaling pathways involved in neuroprotection, such as the GLP-1 receptor pathway (with GLP1-agonist exenatide being the most advanced DMT in the PD drug pipeline). Replacement of enzymes such as β-glucocerebrosidase, modification of the microbiome, or targeting energy metabolism or inflammation are further approaches proposed to slow down neurodegeneration. Novel symptomatic treatment approaches envisage improvement of pharmacologic properties of levodopa or dopamine agonists or target non-dopaminergic neurotransmitter systems, e.g., the glutamatergic, serotoninergic or cholinergic system.
Immunization is a global development success story, saving millions of lives yearly by reducing the risks of contracting an infectious disease and enabling the immune system within the body to build protection. The global eradication of smallpox in 1977 demonstrates the potential of well-designed immunization campaigns. Islamic teaching places attention on preserving life, encouraging Muslims to care for their bodies and overall health, because of its preventive function. However, vaccination of populations is not without challenges; for example, vaccine hesitancy or avoidance emerges for a variety of reasons in Muslim populations, increasing the risks of communicable diseases globally. Public health has a role to play in countering issues. Such issues include misinformation, acting with diplomacy when discussing immunization programs with Muslim community leaders, ensuring the availability of evidence-based accessible information, and educating populations about the necessity and protective ability of vaccines to prevent life-threatening diseases. It also has a role to play in educating non-Muslim professionals about culturally competent care.
Safe vaccines are critical for biosecurity protection, yet adverse events—rightly or wrongly attributed to immunization—potentially cause rapid loss of confidence, reduced vaccine uptake, and resurgence of preventable disease. Effective vaccine safety incident management is essential to provide assessment and lead appropriate actions to ensure vaccination programs are safe and mitigate unwarranted crisis escalation that could damage vaccine programs and the effective control of vaccine preventable disease outbreaks or pandemics. Incident management systems (IMS) are used globally to direct emergency management response, particularly for natural disasters of fire, flood, and storm. Public health is equally an emergency response and can therefore benefit from these command control constructs. While examples of IMS for outbreak response and mass immunization logistics exist, there is little to no information on their use in vaccine safety. We describe Australia’s vaccine safety Alert Advisory Group establishment in Victoria during the COVID-19 pandemic and onward embedding into routine practice, anticipant of new vaccines, and the next biosecurity threat.
Rhipicephalus microplus, the cattle fever tick, is the most important ectoparasite impacting the livestock industry worldwide. Overreliance on chemical treatments for tick control has led to the emergence of acaricide-resistant ticks and environmental contamination. An immunological strategy based on vaccines offers an alternative approach to tick control. To develop novel tick vaccines, it is crucial to identify and evaluate antigens capable of generating protection in cattle. Chitinases are enzymes that degrade older chitin at the time of moulting, therefore allowing interstadial metamorphosis. In this study, 1 R. microplus chitinase was identified and its capacity to reduce fitness in ticks fed on immunized cattle was evaluated. First, the predicted amino acid sequence was determined in 4 isolates and their similarity was analysed by bioinformatics. Four peptides containing predicted B-cell epitopes were designed. The immunogenicity of each peptide was assessed by inoculating 2 cattle, 4 times at 21 days intervals, and the antibody response was verified by indirect ELISA. A challenge experiment was conducted with those peptides that were immunogenic. The chitinase gene was successfully amplified and sequenced, enabling comparison with reference strains. Notably, a 99.32% identity and 99.84% similarity were ascertained among the sequences. Furthermore, native protein recognition was demonstrated through western blot assays. Chitinase peptide 3 reduced the weight and oviposition of engorged ticks, as well as larvae viability, exhibiting a 71% efficacy. Therefore, chitinase 3 emerges as a viable vaccine candidate, holding promise for its integration into a multiantigenic vaccine against R. microplus.
Vaccination against hepatitis B virus (HBV) is effective at preventing vertical transmission. Sierra Leone, Liberia, and Guinea are hyperendemic West African countries; yet, childhood vaccination coverage is suboptimal, and the determinants of incomplete vaccination are poorly understood. We analyzed national survey data (2018–2020) of children aged 4–35 months to assess complete HBV vaccination (receiving 3 doses of the pentavalent vaccine) and incomplete vaccination (receiving <3 doses). Statistical analysis was conducted using the complex sample command in SPSS (version 28). Multivariate logistic regression was used to identify determinants of incomplete immunization. Overall, 11,181 mothers were analyzed (4,846 from Sierra Leone, 2,788 from Liberia, and 3,547 from Guinea). Sierra Leone had the highest HBV childhood vaccination coverage (70.3%), followed by Liberia (64.6%) and Guinea (39.3%). Within countries, HBV vaccination coverage varied by socioeconomic characteristics and healthcare access. In multivariate regression analysis, factors that were significantly associated with incomplete vaccination in at least one country included sex of the child, Muslim mothers, lower household wealth index, <4 antenatal visits, home delivery, and distance to health facility vaccination (all p < 0.05). Understanding and addressing modifiable determinants of incomplete vaccination will be essential to help achieve the 2030 viral hepatitis elimination goals.
National vaccination programmes recommend the influenza vaccine for older adults, but this population group has the greatest morbidity and mortality from other preventable vaccine diseases. The aim of this article is to estimate the vaccine coverage in adults aged 65 years and older and to analyse the factors that could increase or decrease vaccination uptake probability for the three listed vaccines in the national vaccination programme (influenza, tetanus and diphtheria, and pneumococcus) and the full scheme in Mexico. We conducted an analytical cross-sectional study with 2012, 2018, and 2021 rounds from the National Health and Nutrition Survey, in which we calculated the vaccine coverage estimations and performed multivariable logistic regression models to analyse the factors related to vaccine uptake. Tetanus and diphtheria vaccines had the greatest coverage estimation in all years (59–71%), whereas the pneumococcus vaccine had the lowest (32–53%). Full scheme vaccine coverage decreased from 37.80% to 24.77% in 2012 and 2021, respectively. The National Health Card property, morbidity, being a beneficiary of any health system institution, and use of preventive services increased the probability of vaccine uptake. In conclusion, vaccine coverage in older Mexican adults decreased over time, and the Mexican health system plays a strategic role in immunisation.
During the coronavirus disease (COVID-19) pandemic, mass vaccination centers became an essential element of the public health response. This drive-through mass vaccination operation was conducted in a rural, medically underserved area of the United States, employing a civilian–military partnership. Operations were conducted without traditional electronic medical record systems or Internet at the point of vaccination. Nevertheless, the mass vaccination center (MVC) achieved throughput of 500 vaccinations per hour (7200 vaccinations in 2 days), which is comparable with the performance of other models in more ideal conditions. Here, the study describes the minimum necessary resources and operational practicalities in detail required to implement a successful mass vaccination event. This has significant implications for the generalizability of our model to other rural, underserved, and international settings.
A disproportionate share of the health impacts of COVID-19 has been borne by older adults, particularly those in long-term care facilities (LTCs). Vaccination has been critical to efforts to combat this issue, but as we begin to emerge from this pandemic, questions remain about how to protect the health of residents of LTC and assisted living facilities proactively in order to prevent such a disaster from occurring again. Vaccination, not just against COVID-19, but also against other vaccine-preventable illness, will be a key component of this effort. However, there are currently substantial gaps in the uptake of vaccines recommended for older adults. Technology offers an opportunity to assist in filling these vaccination gaps. Our experiences in Fredericton, New Brunswick suggest that a digital immunization solution would facilitate better uptake of adult vaccines for older adults in assisted and independent living facilities and would help policy and decision makers to identify coverage gaps and develop interventions to protect these individuals.
The ongoing global pandemic of Covid_19 had a huge pressure to accelerate the development process of Covid_19 vaccine. This acceleration of the vaccine appearance raised many concerns regarding the effectiveness and the adequate safety of the vaccine among general population.
Objectives
The aim of the study is to determine the reasons behind vaccine refusal among general population.
Methods
Online questionnaire with the subjects’ agreement; The study included 61 participants aged between 18 and 40 years old. The study was effectuated in October 2021.
Results
Most of the participants (n=60, 98.36%) declared that they knew some persons who have refused the Covid_19 vaccine. Moreover, a number of 29 participants (48.33%) declared that vaccine refusal among the people who refused the vaccine was due to personal believes.
Conclusions
The success of the vaccination programs mainly depends on the proportion of the population that receive the vaccine. It is crucial to implement new strategies to increase the acceptability of Covid_19 vaccine.
This chapter discusses response evaluation theories (RETs), which foreground a process of response evaluation. It zooms in on the goal-directed theory of Moors (2017a), which proposes a goal-directed cycle as the causal-mechanistic explanation of the phenomena called emotions. The cycle starts with the detection of a discrepancy between a stimulus and a first goal, which activates a second goal to reduce the discrepancy. This reduction can take the form of assimilation (of the stimulus to the goal via overt action), accommodation (of the goal to the stimulus by changing the first goal), and/or immunization (reinterpretion of the stimulus as less discrepant). Assimilation requires further selection of the action with the highest expected utility. This in turn activates a third goal to engage in the action, leading to overt somatic and motor responses and feelings. The goal-directed theory can account for continuity, a rich form of Intentionality, phenomenality, bodily aspects, heat, control precedence, and irrationality. This wide scope is combined with parsimony in that presumed emotions and non-emotional phenomena are explained by the same mechanism. The goal-directed theory does not deliver discrete emotions, but can nevertheless make sense of them. Empirical research that tests the goal-directed theory is discussed.
As the population in the United States continues to age, familiarity with the clinical presentation, diagnosis, and management of the major serious infections of elderly individuals becomes an increasingly critical component of general medicine and primary care. While modern medicine has significantly reduced early death due to infection, diseases caused by infectious pathogens remain a major cause of illness and death among elderly persons. This chapter reviews the immunology of the elder host and environmental factors that make older adults uniquely vulnerable to infectious diseases. We propose an approach to the elderly patient with suspected infectious disease and highlight the differences in clinical presentation among older and younger patients, as well as addressing diagnosis and management of common and serious infectious diseases of older adults including urinary tract infection, bacterial pneumonia, influenza, herpes zoster, and Clostridioides difficile.
In this chapter, we study risks associated with movements of interest rates in financial markets. We begin with a brief discussion of the term structure of interest rates. We then discuss commonly used interest rate sensitive securities. This is followed by the study of different measures of sensitivity to interest rates, including duration and convexity. We consider mitigating interest rate risk through hedging and immunization. Finally, we take a more in-depth look at the drivers of interest rate term structure dynamics.
Existing mass vaccination clinic guidance calls for staffing and resource requirements that may not be achievable in smaller settings. Practical and scalable solutions to these problems were developed by a volunteer group of continuous improvement professionals, working to assist 2 non-governmental organizations engaged in coordinating refugee health services: the Somali Health Board of Seattle, WA and Community Health Services Inc. of Rochester, MN. Our shared goal was to get more shots in arms by bringing vaccines to small communities through pop-up clinics that are quick to set-up and require minimal resources. The clinics were developed using continuous improvement methods, thereby yielding a 2-minute vaccine administration time and an 8-fold improvement in productivity as a result of Federal Emergency Management Agency (FEMA) guidance. This report details our field-tested methods and achieved results. The relevance and benefits of this approach deserve attention as pandemic response needs continue to evolve and vaccines become more globally available.
Coronavirus disease (COVID-19) vaccine studies are continuing in many centers. However, the public’s preference for vaccination against COVID-19 is not clear. This study aims to determine the knowledge level of people about vaccines developed against the COVID-19 and their preferences for vaccination.
Methods:
Participants’ knowledge of COVID-19 vaccines was evaluated with a questionnaire. Participants were selected by a stratified method using age, gender, education, and occupation group.
Results:
The study includes 1508 participants with a mean age of 38.97 ± 14.50 (min = 18, max = 82); 24.7% (n = 373) of the participants stated that they wanted to be vaccinated, 34.5% (n = 521) did not want to be vaccinated, and 40.7% (n = 614) stated that they were undecided about vaccination; 39.11% (n = 444) of the participants stated that they were afraid of the vaccine’s side effects, and 19.55% (n = 222) thought that the vaccines produced were used for malicious purposes and hesitated to vaccinate; 7.57% (n = 86) of the participants stated that they thought the vaccines were rushed too much and not yet reassuring.
Conclusions:
The study results show that individuals are hesitant and unwilling to get the COVID-19 vaccine. Persuasion interventions and information are necessary, as the rate of those who accept vaccination is very low.
In a bid to end the ongoing coronavirus disease 2019 pandemic, many countries, including the UK, have rolled out mass immunisation programmes. While considered generally safe and effective, vaccines against coronavirus disease 2019 have been reported to be associated with rare and potentially adverse reactions and side effects.
Case report
This paper reports an unusual case of a patient who developed a unilateral vocal fold paralysis shortly after receiving the first dose of the Oxford-AstraZeneca ChAdOx1 nCov-19 vaccine.
Conclusion
To our knowledge, this is the first reported case of vocal fold paralysis following administration of the Oxford-AstraZeneca vaccine. The authors support the position that currently approved coronavirus disease 2019 vaccines remain safe and effective; however, further surveillance and vigilance using real-world data are highly encouraged.
The coronavirus disease (COVID-19) pandemic has somehow affected the lives of 80% of the world’s population. Iran has also experienced numerous outbreaks of this disease. The fifth wave having occurred in August 2021 was one of the most agonizing incidences of the pandemic in the country.
Method:
We reviewed all of publications and govermental statistics about COVID-19 pandemic In Iran between 2019 to 2021.
Results:
The current study discusses the possible dimensions and causes of successive waves of COVID-19 in Iran, namely, the consequences of a significant delay in vaccination administration in due time, the collective overwhelming fallacy toward immunization, the polypharmacy controversy, inadequate community-based participation in risk reduction, and noticeable decrease in the public’s resilience.
Conclusion:
A variety of strategies have been recommended in the article to modify the principal challenges in order to help control the pandemic in the country.
This study examines the factors associated with the willingness to get the coronavirus vaccine among individuals aged 18 and above.
Methods:
This cross-sectional study was conducted in Turkey. The participants aged 18 and older were recruited between December, 2020 and January, 2021 through conventional social media sites. Snowball sampling was used. An anonymous questionnaire consisted of demographics, vaccination experiences, and perceived risk of coronavirus disease.
Results:
1202 women and 651 men were included in the data analysis. Findings showed that demographics, vaccination experience, and perceived risk of getting COVID-19 were explained. 37% of the variance in people’s willingness to get the COVID-19 vaccination was according to hierarchical logistic regression. Furthermore, increasing age, being male, acquiring positive information about COVID-19 vaccines, having a lower level of vaccine hesitancy, the high level of worry about COVID-19, and low level of perceptions of the possibility of becoming infected by the COVID-19 were the main predictors of COVID-19 vaccine willingness.
Conclusions:
Factors affecting adults’ willingness to be inoculated with COVID-19 vaccines were related to demographics, vaccination experiences, and perceived risk of getting COVID-19. We recommend that public health authorities and practitioners should consider these multiple factors regarding vaccine confidence to achieve herd immunity.
Vaccines against HPV are highly efficacious in preventing infection and disease in the cervix, vulva, anus, oropharynx as well as the anogenital warts caused by HPV types included in the vaccine cocktail. The efficacy is optimal if vaccines are given in prepubertal girls and boys before coitarche, while it remains an individual choice for older women. Vaccination is efficacious in women who have been infected but cleared the infection, although the upper age of vaccination depends on cost-effectiveness and is country-specific. School-based gender-neutral vaccination optimizes coverage and herd immunity. Two doses suffice under the age of 15 with an interval of 6–12 months, while the standard three-dose regimen is recommended thereafter. Vaccine will modify screening strategies, possibly with longer screening intervals in vaccinated cohorts, but will not obviate them. Vaccination in low-resource setting is especially important as lack of infrastructure prevents screening, but affordability remains a major issue.
This study aimed to investigate whether children with cochlear implants received the recommended vaccinations according to New Zealand national immunisation guidelines and to report the incidence of meningitis in this population after intervention.
Method
A retrospective review of the vaccination coverage of paediatric patients receiving cochlear implants between 2005 and 2019 was performed.
Results
Data were collected on 203 children. Evidence of immunisation against Haemophilus influenza B was documented in 94.1 per cent of this cohort and 21.2 per cent received the seasonal influenza vaccine. The pneumococcal conjugate vaccine was fully administered in 81.8 per cent of children; however, only 16.9 per cent of eligible children had received the pneumococcal polysaccharide vaccine. There was marked improvement in compliance to the pneumococcal conjugate vaccine once it became fully funded for cochlear implant patients.
Conclusion
Despite established guidelines, the paediatric vaccination rates were less than expected. Work is in progress to address this.
Mass vaccination campaigns have been used effectively to limit the impact of communicable disease on public health. However, the scale of the coronavirus disease (COVID-19) vaccination campaign is unprecedented. Mass vaccination sites consolidate resources and experience into a single entity and are essential to achieving community (“herd”) immunity rapidly, efficiently, and equitably. Health care systems, local and regional public health entities, emergency medical services, and private organizations can rapidly come together to solve problems and achieve success. As medical directors at several mass vaccination sites across the United States, we describe key mass vaccination site concepts, including site selection, operational models, patient flow, inventory management, staffing, technology, reporting, medical oversight, communication, and equity. Lessons learned from experience operating a diverse group of mass vaccination sites will help inform not only sites operating during the current pandemic, but also may serve as a blueprint for future outbreaks of highly infectious communicable disease.