Health officials want you to keep an eye out for symptoms of measles if you were at one of three locations in Arlington and D.C. in early July.
A person with a now-confirmed case of measles, visiting from outside the D.C. area, stopped at all three of those locations on July 1 and July 2. That means other people at those locations may have been exposed to measles while that person was contagious.
Here are the locations, dates and times where people may have been exposed to measles, according to Arlington County Public Health and D.C. Department of Health officials:
If you or someone you know was at any of those locations at those times, here's what to know.
As the school year gets closer, it's important to make sure kids are up to date on all their vaccinations. News4's Jummy Olabanji takes a look at what exactly is required to make sure your children are safe when they return to the classroom. Heres more info on childhood vaccines and school requirements in your area. D.C.: http://nbc4dc.com/6OaU4pQ Maryland: http://nbc4dc.com/lNvbfrB Virginia: http://nbc4dc.com/821GIM3
Those who are vaccinated against measles are protected.
Two doses of the MMR vaccine, which vaccinates against measles, mumps and rubella, provides full protection against the disease. (There are also measles-only vaccines given in other countries that provide the same level of protection as the U.S.'s MMR vaccine.)
The two-dose MMR vaccine gives lifelong protection.
If you only received one dose of the MMR vaccine, you are very likely to be protected even if you were exposed to measles. However, even though your risk of infection is low, health officials recommend contacting your doctor or another healthcare provider about getting that second vaccine dose.
People born before 1957 have what's called presumptive immunity to measles, because they likely caught the highly contagious disease while attending school before the first vaccine was available, Bloomberg reports.
But those born after 1957 who never got vaccinated against measles, those under 12 months old who are too young to be vaccinated, and those who are immunocompromised should keep an eye out for any possible symptoms.
Measles is very, very contagious. It spreads when someone infected with the virus breathes, coughs or sneezes, and symptoms appear in two stages, according to D.C. health officials.
The first stage gives most infected people a fever of 101 degrees or higher, along with a runny nose, watery red eyes, and a cough -- the same way a cold, COVID, or the flu might look and feel.
That first stage can begin anywhere between seven and 14 days after a person is exposed to measles. For people exposed in Arlington or D.C., that means symptoms may appear anytime before July 15 or 16.
The second stage of measles brings a rash that starts on the face and spreads to the rest of the body. The rash may appear anywhere between three and five days after the first stage of symptoms.
The contagious window of measles begins four days before the rash appears, and continues until four days after the rash starts.
Because of that window when measles is contagious, health officials are asking anyone who might have been exposed to the virus in Arlington or D.C. to keep an eye out for symptoms until July 22.
You do not need to automatically isolate yourself if you were exposed to measles.
However, if you notice any symptoms of measles, health officials ask that you immediately isolate yourself at that point. Stay at home, and stay away from others who live in the same home as you.
It is especially important that anyone who might have measles stay away from infants under 12 months old, or other people who are not vaccinated against the virus. Those unvaccinated individuals are very susceptible to the disease if they're exposed.
Contact your healthcare provider right away if you start to show symptoms that could be measles. Call your doctor's office or clinic before you visit in person to notify them, so they can protect staff and the other patients from the virus.
Colossal, the de-extinction company, announces that themRNA vaccineit helped to provide research support and acceleration funding for has been administered to the first elephant in captivity.
Elephant endotheliotropic herpesvirus (EEHV) is the number one killer of Asian elephant calves living under managed care in North America and Europe and significantly impacts free-ranging populations of Asian elephants as well. Recent EEHV related deaths in several African elephants in the US have now raised concerns about EEHV in this elephant species, as well. The ground-breaking work will help with efforts to generate EEHV vaccines for both species of elephants.
The pioneering work of Dr. Paul Ling at the Baylor College of Medicine began in 2009 with a partnership with Houston Zoo where they developed better tools to detect and manage the elephant endotheliotropic herpesvirus (EEHV) associated disease. In the past few years, progress on the development of the vaccine accelerated, in part due to the involvement of Colossal.
Colossal supported our efforts to work on an mRNA solution approach.It quickly became evident that the mRNA solution was going to be feasible, so we prioritized implementation of that approach. We are much further along today than we would have been without Colossals scientific support, research teams and funding.
Dr. Paul Ling, Professor at the Department of Microbiology and Virology at Baylor College of Medicine
EEHV can cause lethal hemorrhagic disease and is often associated with massive levels of virus in multiple organs. The EEHV mRNA vaccine is designed to expose elephants to viral proteins critical for attachment and entry of the virus into host cells, thereby enabling induction of an immune response to block these processes, and help elephants control viral growth and prevent lethal disease. The initial EEHV vaccine is specific for the EEHV1A strain of the virus, which causes the majority of lethal infections in Asian elephants. It is envisioned that the mRNA vaccine platform can be easily modified to express similar viral proteins for other EEHV strains, including those that circulate in African elephants, in the future.
Extensive preclinical trials of the mRNA vaccine have been conducted and the results show that it can induce antibodies against the virus without adverse impacts. The vaccine was recently approved by multiple entities involved in overseeing use of experimental products to be applied to elephants. The Houston Zoo approved the vaccine for their managed community, and they have inoculated 40 year old Asian elephant, Tess.Over the next few weeks, animal care experts and veterinary staff will closely monitor Tess to learn how effective this vaccine is for elephants.Upon the successful outcome from this first vaccination, the zoo plans to vaccinate additional animals under its care.
Following encouraging results from the initial vaccine trials, the vaccine will begin to be offered to more facilitiesespecially those with vulnerable young elephants. In the next three to five years, Dr. Ling hopes that this vaccine will be applied to the broad population of elephants under human care, worldwide. Following that, the team would look to applications with animals in the wild. This represents a massive step forward for the protection of elephants globally, and a huge step forward for science.
Im glad we could help accelerate and shorten this multi-decade journey with EEHV. We felt that there was not enough advanced technology or funding going into this work. And, yet the science necessary to stop animals on the brink of extinction from dying must be our priority,said CEO and co-founder of Colossal Ben Lamm.Elephants are incredibly intelligent keystone species that are critical to their ecosystems and worth saving. What Dr. Ling and our team have done in the past few years is incredible and we are thrilled that our partnership was essential to making this happen.
Colossals advanced technology tools, research support, and funding help to accelerate the vaccine development and deployment, in part because of Colossals early role using its proprietary AI computational technologiesto sequence the Asian elephant genome, which provided additional important information to evaluate responses to the vaccine.
In my 15 years caring for elephants, I have witnessed elephants battle EEHV time and time again. I even lost a juvenile elephant under my care. It was among the most excruciating moments of my careersaid Colossals Chief Animal Officer Matt James.To be able to get a vaccine into the world that can stop that sort of senseless loss means everything to me. This is why I joined Colossal. I know we can work faster, and smarter, to save species on the brink of extinction: this is proof.
Colossal believes that everyone must work together, quickly and efficiently, to stop the coming extinction crisis. Conservation of the past has helped, but without the integration of advanced scientific developments and faster timelines to completion, we will fail to save important species. Today, we are one step closer with elephants; there are so many more species to go.
Cador, C. et al. Maternally-derived antibodies do not prevent transmission of swine influenza A virus between pigs. Vet. Res. 47, 86 (2016).
Article PubMed PubMed Central Google Scholar
Anderson, T. K. et al. A phylogeny-based global nomenclature system and automated annotation tool for H1 hemagglutinin genes from swine influenza A viruses. Msphere 1, e0027516 (2016).
Article CAS PubMed PubMed Central Google Scholar
Chauhan, R. P. & Gordon, M. L. A systematic review analyzing the prevalence and circulation of influenza viruses in swine population worldwide. Pathogens 9, 355 (2020).
Article CAS PubMed PubMed Central Google Scholar
Hennig, C. et al. Are pigs overestimated as a source of zoonotic influenza viruses? Porcine Health Manag. 8, 30 (2022).
Article PubMed PubMed Central Google Scholar
Abdelwhab, E. M. & Mettenleiter, T. C. Zoonotic animal influenza virus and potential mixing vessel hosts. Viruses 15, 980 (2023).
Article CAS PubMed PubMed Central Google Scholar
Pitzer, V. E. et al. High turnover drives prolonged persistence of influenza in managed pig herds. J. R. Soc. Interface 13, 20160138 (2016).
Article PubMed PubMed Central Google Scholar
Kessler, S., Harder, T. C., Schwemmle, M. & Ciminski, K. Influenza A viruses and zoonotic events-are we creating our own reservoirs? Viruses 13, 2250 (2021).
Article PubMed PubMed Central Google Scholar
Henritzi, D. et al. Surveillance of European domestic pig populations identifies an emerging reservoir of potentially zoonotic swine influenza A viruses. Cell Host Microbe 28, 614627.e6 (2020).
Article CAS PubMed Google Scholar
Sun, H. L. et al. Prevalent Eurasian avian-like H1N1 swine influenza virus with 2009 pandemic viral genes facilitating human infection. Proc. Natl Acad. Sci. USA 117, 1720417210 (2020).
Article CAS PubMed PubMed Central Google Scholar
Vincent, A. L., Ma, W. J., Lager, K. M., Janke, B. H. & Richt, J. A. Swine influenza viruses: a North American perspective. Adv. Virus Res. 72, 127154 (2008).
Article CAS PubMed Google Scholar
Kristensen, C. et al. Experimental infection of pigs and ferrets with pre-pandemic, human-adapted, and swineadapted variants of the H1N1pdm09 Influenza A virus reveals significant differences in viral dynamics and pathological manifestations. PLos Pathog. 19, e1011838 (2023).
Article CAS PubMed PubMed Central Google Scholar
Souza, C. K. et al. Antigenic distance between North American swine and human seasonal H3N2 influenza A viruses as an indication of zoonotic risk to humans. J. Virol. 96, e0137421 (2022).
Lopez-Moreno, G., Schmitt, C., Spronk, T., Culhane, M. & Torremorell, M. Evaluation of internal farm biosecurity measures combined with sow vaccination to prevent influenza A virus infection in groups of due-to-wean pigs. BMC Vet. Res. 18, 393 (2022).
Article PubMed PubMed Central Google Scholar
Diaz, A. et al. Association between influenza A virus infection and pigs subpopulations in endemically infected breeding herds. PLos ONE 10, e0129213 (2015).
Article PubMed PubMed Central Google Scholar
Keay, S. et al. Does vaccine-induced maternally-derived immunity protect swine offspring against influenza A viruses? A systematic review and meta-analysis of challenge trials from 1990 to May 2021. Animals 13, 3085 (2023).
Article PubMed PubMed Central Google Scholar
Van Reeth, K. & Ma, W. Swine influenza virus vaccines: to change or not to change-thats the question. Curr. Top. Microbiol. Immunol. 370, 173200 (2013).
PubMed Google Scholar
Deblanc, C. et al. Maternally-derived antibodies do not inhibit swine influenza virus replication in piglets but decrease excreted virus infectivity and impair post-infectious immune responses. Vet. Microbiol. 216, 142152 (2018).
Article CAS PubMed Google Scholar
Everett, H. E. et al. Vaccines that reduce viral shedding do not prevent transmission of H1N1 pandemic 2009 swine influenza A virus infection to unvaccinated pigs. J. Virol. 95, e01787-20 (2021).
Shin, S., Park, S. H., Park, J. H., Kim, S. M. & Lee, M. J. Age-dependent dynamics of maternally derived antibodies (MDAs) and understanding MDA-mediated immune tolerance in foot-and-mouth disease-vaccinated pigs. Vaccines 10, 677 (2022).
Article CAS PubMed PubMed Central Google Scholar
Vono, M. et al. Maternal antibodies inhibit neonatal and infant responses to vaccination by shaping the early-life B cell repertoire within germinal centers. Cell Rep. 28, 17731784.e1775 (2019).
Article CAS PubMed Google Scholar
Deblanc, C. et al. Evaluation of the pathogenicity and the escape from vaccine protection of a new antigenic variant derived from the European human-like reassortant swine H1N2 influenza virus. Viruses 12, 1155 (2020).
Article CAS PubMed PubMed Central Google Scholar
Ryt-Hansen, P. et al. Substantial antigenic drift in the hemagglutinin protein of swine influenza A viruses. Viruses 12, 248 (2020).
Article CAS PubMed PubMed Central Google Scholar
Ryt-Hansen, P. et al. Acute Influenza A virus outbreak in an enzootic infected sow herd: impact on viral dynamics, genetic and antigenic variability and effect of maternally derived antibodies and vaccination. PLos ONE 14, e0224854 (2019).
Article CAS PubMed PubMed Central Google Scholar
Trovo, N. S., Khan, S. M., Lemey, P., Nelson, M. I. & Cherry, J. L. Comparative evolution of influenza A virus H1 and H3 head and stalk domains across host species. mBio 15, e0264923 (2023).
Article PubMed Google Scholar
Platt, R. et al. Comparison of humoral and cellular immune responses to inactivated swine influenza virus vaccine in weaned pigs. Vet. Immunol. Immunopathol. 142, 252257 (2011).
Article CAS PubMed Google Scholar
Rahn, J., Hoffmann, D., Harder, T. C. & Beer, M. Vaccines against influenza A viruses in poultry and swine: Status and future developments. Vaccine 33, 24142424 (2015).
Article CAS PubMed Google Scholar
Vincent, A. L. et al. Influenza A virus vaccines for swine. Vet. Microbiol. 206, 3544 (2017).
Article CAS PubMed Google Scholar
Chan, L. et al. Review of influenza virus vaccines: the qualitative nature of immune responses to infection and vaccination is a critical consideration. Vaccines 9, 979 (2021).
Article CAS PubMed PubMed Central Google Scholar
Graaf, A. et al. Cold-passaged isolates and bat-swine influenza a chimeric viruses as modified live-attenuated vaccines against influenza a viruses in pigs. Vaccine 40, 62556270 (2022).
Article PubMed Google Scholar
Lee, J. et al. Bat influenza vectored NS1-truncated live vaccine protects pigs against heterologous virus challenge. Vaccine 39, 19431950 (2021).
Article CAS PubMed PubMed Central Google Scholar
Gracia, J. C. M., Pearce, D. S., Masic, A. & Balasch, M. Influenza A virus in swine: epidemiology, challenges and vaccination strategies. Front. Vet. Sci. 7, 647 (2020).
Article Google Scholar
Ciminski, K., Thamamongood, T., Zimmer, G. & Schwemmle, M. Novel insights into bat influenza A viruses. J. Gen. Virol. 98, 23932400 (2017).
Article CAS PubMed PubMed Central Google Scholar
Juozapaitis, M. et al. An infectious bat-derived chimeric influenza virus harbouring the entry machinery of an influenza A virus. Nat. Commun. 5, 4448 (2014).
Article CAS PubMed Google Scholar
Ma, W. J., Garcia-Sastre, A. & Schwemmle, M. Expected and unexpected features of the newly discovered bat influenza A-like viruses. PLos Pathog. 11, e1004819 (2015).
Article PubMed PubMed Central Google Scholar
Yang, J. et al. Pathogenicity of modified bat influenza virus with different M genes and its reassortment potential with swine influenza A virus. J. Gen. Virol. 98, 577584 (2017).
Article CAS PubMed Google Scholar
Ricklin, M. E. et al. Partial protection against porcine influenza A virus by a hemagglutinin-expressing virus replicon particle vaccine in the absence of neutralizing antibodies. Front. Immunol. 7, 253 (2016).
Article PubMed PubMed Central Google Scholar
Finkelshtein, D., Werman, A., Novick, D., Barak, S. & Rubinstein, M. LDL receptor and its family members serve as the cellular receptors for vesicular stomatitis virus. Proc. Natl Acad. Sci. USA 110, 73067311 (2013).
Article CAS PubMed PubMed Central Google Scholar
Walz, L., Kays, S. K., Zimmer, G. & von Messling, V. Neuraminidase-inhibiting antibody titers correlate with protection from heterologous influenza virus strains of the same neuraminidase subtype. J. Virol. 92, e01006e01018 (2018).
Article PubMed PubMed Central Google Scholar
Halbherr, S. J. et al. Vaccination with recombinant RNA replicon particles protects chickens from H5N1 highly pathogenic avian influenza virus. PLos ONE 8, e66059 (2013).
Article CAS PubMed PubMed Central Google Scholar
Kalhoro, N. H., Veits, J., Rautenschlein, S. & Zimmer, G. A recombinant vesicular stomatitis virus replicon vaccine protects chickens from highly pathogenic avian influenza virus (H7N1). Vaccine 27, 11741183 (2009).
Article CAS PubMed Google Scholar
Simon-Grif, M. et al. Swine influenza virus infection dynamics in two pig farms; results of a longitudinal assessment. Vet. Res. 43, 24 (2012).
Article PubMed PubMed Central Google Scholar
Loeffen, W. L., Heinen, P. P., Bianchi, A. T., Hunneman, W. A. & Verheijden, J. H. Effect of maternally derived antibodies on the clinical signs and immune response in pigs after primary and secondary infection with an influenza H1N1 virus. Vet. Immunol. Immunopathol. 92, 2335 (2003).
Article CAS PubMed Google Scholar
Kitikoon, P. et al. The immune response and maternal antibody interference to a heterologous H1N1 swine influenza virus infection following vaccination. Vet. Immunol. Immunopathol. 112, 117128 (2006).
Article CAS PubMed Google Scholar
Vincent, A. L. et al. Live attenuated influenza vaccine provides superior protection from heterologous infection in pigs with maternal antibodies without inducing vaccine-associated enhanced respiratory disease. J. Virol. 86, 1059710605 (2012).
Article CAS PubMed PubMed Central Google Scholar
Allerson, M. et al. The impact of maternally derived immunity on influenza A virus transmission in neonatal pig populations. Vaccine 31, 500505 (2013).
Article CAS PubMed Google Scholar
Andraud, M. et al. Evaluation of early single dose vaccination on swine influenza A virus transmission in piglets: from experimental data to mechanistic modelling. Vaccine 41, 31193127 (2023).
Article CAS PubMed Google Scholar
Rajao, D. S. et al. Heterologous challenge in the presence of maternally-derived antibodies results in vaccine-associated enhanced respiratory disease in weaned piglets. Virology 491, 7988 (2016).
Article CAS PubMed Google Scholar
Fu, Y. G. et al. Infection studies in pigs and porcine airway epithelial cells reveal an evolution of A(H1N1)pdm09 influenza A viruses toward lower virulence. J. Infect. Dis. 219, 15961604 (2019).
Article CAS PubMed Google Scholar
Sunwoo, S. Y. et al. A universal influenza virus vaccine candidate tested in a pig vaccination-infection model in the presence of maternal antibodies. Vaccines 6, 64 (2018).
Article CAS PubMed PubMed Central Google Scholar
McNee, A. et al. A direct contact pig influenza challenge model for assessing protective efficacy of monoclonal antibodies. Front. Immunol. 14, 1229051 (2023).
Article CAS PubMed PubMed Central Google Scholar
Corzo, C. A. et al. Relationship between airborne detection of influenza A virus and the number of infected pigs. Vet. J. 196, 171175 (2013).
Article PubMed Google Scholar
What is the current recommended treatment for COVID? Dr. Sobieszczyk: Antivirals like Paxlovid, as well as others like molnupiravir and remdesivir, continue to be effective against the latest strains of COVID. We recommend these medications to people who are more likely to get sick from COVID, such as older individuals especially those who are over 65 years old, since risk for severe illness increases with advancing age unvaccinated people, and those with certain medical conditions like chronic lung disease or weakened immune systems.
How can people stay safe and prevent infection amid the spike in cases this summer? Dr. Furuya: How best to protect yourself against COVID has not changed and involves everything we have already learned over the past few years, including wearing a mask and avoiding crowded, poorly ventilated settings. It is important for everyone to stay up to date with their vaccinations as well.
If you are feeling sick, stay home. Even though the CDC has relaxed its guidance around returning to work as early as 24 hours after you are feeling better and you have had no fevers (without fever-reducing medication like Tylenol, Motrin, or Advil), they still recommend taking extra precautions around other people for five days thereafter, including wearing a mask indoors around others. Guidelines are more stringent for healthcare settings.
Is COVID considered a summer virus or a year-round virus? Dr. Furuya: At this point, we see that COVID numbers can go up and down at any time of the year, usually increasing when new variants seem to arise. The bigger COVID spikes seem to mainly happen in the wintertime, but we are seeing upticks at other times of the year as well. Summer spikes could also happen when people gather indoors in air conditioning when it is especially hot outside.
Will there be an updated COVID vaccine and will they protect against new variants? Dr. Sobieszczyk: Vaccine manufacturers are currently working on an updated formulation of the COVID vaccine for fall 2024 based on more recently circulating strains.
As of June 13, the FDA issued new guidance to vaccine manufacturers advising them to base the new formulation on the KP.2 strain if feasible, since it is one of the currently circulating FLiRT variants. And because the FLiRT variants, as well as the newest variant, LB.1, are all descendants of a strain known as JN.1, a vaccine based on KP.2 should protect against any of the currently circulating strains, and most likely it should provide protection against new strains that may arise this fall and winter. We expect these vaccines will be available in the fall.
Does Long COVID remain a concern? Dr. Sobieszczyk: Long COVID continues to be a concern. As of May 2024, the CDC estimates that 6% of all U.S. adults are currently experiencing Long COVID. While Long COVID is defined as symptoms that last for at least three months, some people can suffer from these symptoms for years. We are continuing to learn how best to help and care for people with Long COVID. At Columbia, we have specialists in this area and are also doing research to understand what causes Long COVID and what are the best treatments for it.
What should the public keep in mind as COVID continues to evolve? Dr. Furuya: While we all understandably want to move on from worrying about COVID, unfortunately we know that it is here to stay. Cases will continue to go up and down, and probably not just in the wintertime like flu. When COVID numbers rise, it is important for us to take the appropriate measures to protect ourselves, especially if we or our household members have anything that puts us at higher risk for severe illness. Thankfully, we now have a healthy arsenal of effective antiviral treatments and vaccines that can protect us from getting sick enough to be hospitalized, but it is important for people to stay updated on the current recommendations and vaccines.
To offer cross-protection against diverse influenza virus variants, nanoparticle vaccines can produce pivotalcellular and mucosal immune responses that enhance vaccine efficacy and broaden protection, according to a study by researchersin theInstitute for Biomedical SciencesatGeorgia State University.
The study, published in the journal Nature Communications,offersvaluable insights into tailoring immunization strategies to optimize influenza vaccine effectiveness. To alleviate the significant public health burden of influenza epidemics and occasional pandemics, it's essential to enhance influenza vaccine cross-protection, according to the authors.
While the Centers for Disease Control and Prevention (CDC) recommends annual influenza vaccination, current seasonal influenza vaccines typically provide strain-specific and short-lived immunity. Seasonal influenza vaccines offer limited cross-protection against antigenically diverse virus variants and provide no defense against sporadic influenza pandemics, the authors explained.
Developing effective influenza vaccines or vaccination strategies that can confer cross-protection against variant influenza viruses is a high priority to mitigate the public health consequences of influenza."
Dr.Chunhong Dong, first author of the study and postdoctoral fellowin theInstitute for Biomedical Sciences at Georgia State
In the study, the researchers investigated the effects of immunization strategies on the generation of cross-protective immune responses in female mice using mRNA lipid nanoparticle (LNP) and protein-based polyethyleneimine-HA/CpG (PHC) nanoparticle vaccines targeting influenza hemagglutinin. The mice were immunized with either intramuscular mRNA LNP or intranasal PHC vaccines in a typical prime-plus-boost regimen.A variety ofsequential immunization strategies were includedin this study for parallel comparison.
"We demonstrated that cellular and mucosal immune responses are pivotal correlates of cross-protection against influenza,"said Dr. BaozhongWang,senior author of the study and a Distinguished University Professor in the Institute for Biomedical Sciences at Georgia State."Notably, intranasal PHC immunization outperforms its intramuscular counterpart in inducing mucosal immunity and conferring cross-protection. Sequential mRNA LNP prime and intranasal PHC boost demonstrated optimal cross-protection against antigenically drifted and shifted influenza strains."
The study highlights the importance of immunization orders andindicates thatin a sequential immunization, an mRNA vaccineprimingplays an importantrole in steeringtheTh1/Th2immune responses. Also, the intranasal PHC boost iscrucialto the induction of mucosal immunity, Wang said.
Additional authors of the study includeWandi Zhu, Lai Wei, Joo Kyung Kim, Yao Ma and Sang-Moo Kangof theInstitute for Biomedical Sciences atGeorgia State.
The study is funded by the National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases (NIAID).
Source:
Journal reference:
Dong, C., et al. (2024). Enhancing cross-protection against influenza by heterologous sequential immunization with mRNA LNP and protein nanoparticle vaccines.Nature Communications. doi.org/10.1038/s41467-024-50087-5.
Y. Tony Yang, ScD, LLM, MPH
Credit: George Washington University Nursing
Despite notable disruptions to routine childhood vaccinations during the COVID-19 pandemic, findings from a recent study suggest hepatitis B birth dose vaccination efforts improved from 2017-2022.1
The analysis of newborn hepatitis B vaccination records from the Washington, DC Department of Health Vital Statistics Division revealed a decline in refusal of hospital-administered birth doses of the vaccine, likely attributable to revised Advisory Committee on Immunization Practices (ACIP) hepatitis B vaccination guidelines. Released in 2018, the revision recommends universal hepatitis B vaccination within 24 hours of birth for medically stable infants weighing 2000 grams and removes permissive language for delaying the birth dose until after hospital discharge.1,2
The 2018 guideline changes were followed by the COVID-19 pandemic in 2020, causing reduced uptake of routine childhood vaccines, Y. Tony Yang, ScD, LLM, MPH, associate dean for health policy and population science and endowed professor in health policy at the George Washington University School of Nursing, and colleagues wrote.1 It is uncertain whether the pandemic affected the rate of hospital-administered birth doses of the hepatitis B vaccination.
According to the World Health Organization, an estimated 254 million people were living with chronic hepatitis B infection in 2022, with 1.2 million new infections each year. Perinatal transmission from mother to child at birth is common, and the development of chronic infection is frequent in infants infected from their mothers or before the age of 5 years. Although it is preventable with a vaccine, newborn hepatitis B vaccination rates have historically been lower than desired, necessitating updated ACIP guidance.2,3
To assess the rate of hospital-administered birth doses of the hepatitis B vaccination after the revised ACIP guidelines and during the COVID-19 pandemic, investigators conducted a retrospective, repeated, cross-sectional study leveraging electronic records for newborn hepatitis B vaccinations from the DC Department of Health Vital Statistics Division from January 1, 2017, to December 31, 2022. The analysis was restricted to births at 6 local hospitals with documented hepatitis B vaccine refusal status and a valid birth date. Investigators assessed the percentage of hepatitis B vaccine refusals across the entire cohort and stratified by the mothers self-reported race.1
Of the 76,194 recorded births, investigators excluded 757 nonhospital births, 639 with missing refusal information, and 135 lacking a valid date, leaving 74,660 for analysis. Among the cohort, 40.8% of mothers were Black; 41.4% were White; and 17.9% were categorized as other races.1
Investigators noted the overall hepatitis B refusal rate decreased from 12.1% of 10,982 births in 2017 to 3.5% of 11,304 births in 2022, with the most substantial declines occurring in 2019 and 2020. Further analysis of weekly refusal rates revealed a gradual decline beginning in early 2018, with a more significant decrease in late 2019 and early 2020 before stabilizing in mid-2020.1
By race, White mothers had the greatest initial refusal rates, with 14.7% refusing the vaccine in 2017 compared to 11.2% of Black mothers and 8.8% of mothers of other races. However, mothers who identified as White had the earliest decline, with refusal decreasing to 12.1% in 2018 versus Black mothers, who increased to 11.6%, and mothers of other races, who stayed the same at 8.8%.1
From 2018 through 2022, investigators pointed out overall refusal rates of mothers of all races decreased. Although Black mothers and those of other races had similar trends in refusals over time, mothers in the other race cohort consistently had lower refusal rates than Black and White mothers.1
Investigators recognized multiple limitations to these findings, including missing data on maternal HBsAg status, infant birth weight, and medical stability; limited generalizability due to the focus on the Washington, DC, area; and the inability to determine a specific cause of the decline in refusals observed over the study period.1
Despite the pandemic disrupting routine childhood vaccinations,5 hepatitis B vaccination efforts remained strong, with sustained low refusal rates in 2021 and 2022, especially for hospital-based birth doses, investigators concluded.1 Further research is needed to investigate the role of the hospital setting in sustaining hepatitis B vaccination rates during the pandemic.
References
Register for free to listen to this article
Thank you. Listen to this article using the player above.
A new study has found that a vaccine against respiratory syncytial virus (RSV) administered during pregnancy was not associated with increased risks of preterm birth or other poor outcomes. This finding supports the safety of vaccination against RSV, which can cause serious respiratory illness in newborns and infants.
The study was published in JAMA Network Open.
RSV can cause severe illness in newborns and young infants. It is one of the leading causes of hospitalizations for infants and young children, causing an estimated 3.2 million hospital admissions among children under 5 year of age worldwide.
Continue reading below...
In 2023, Pfizers RSV vaccine, Abrysvo, was approved for use in weeks 3236 of pregnancy to protect infants for 6 months after birth. Although clinical trial data prior to its approval supported the vaccines safety, a Phase 3 trial found a 1% higher rate of preterm birth in the vaccination group compared to the control group, limiting the vaccines use to after 32 weeks.
Dr. Moeun Son, an associate professor of obstetrics and gynecology at Weill Cornell Medical College, led a new study to investigate these concerns surrounding the vaccines safety.
Using real-world clinical data, we wanted to see if these concerns persisted in a general obstetric population in New York City, Son explained, speaking to Technology Networks. We hypothesized that there would be no significant difference in preterm birth in patients who had documented evidence of RSV vaccination during pregnancy and those who did not.
The analyzed data from 1,026 vaccinated and 1,947 unvaccinated pregnant patients who gave birth between September 2023 and January 2024.
Preterm birth occurred in 5.9% of vaccinated pregnancies and 6.7% of unvaccinated pregnancies. Our study showed no increase in the rate of preterm birth among vaccinated pregnant individuals, said Son.
We also found that other birth risks were similar between patients who had documented evidence of vaccination and those who did not, Son explained. These other risks included stillbirths, small-for-gestational-age birthweight, neonatal intensive care unit (NICU) admissions, jaundice, etc.
Additional statistical analysis found a slightly increased risk of high blood pressure during pregnancy in the vaccinated group. However, further investigation is needed to determine whether this is the result of chance or real differences among the two groups. For example, the study also found that those in the vaccinated group were more likely to have health insurance or to have undergone in vitro fertilization.
Overall, the findings are encouraging, as the new studys use of real-world data i.e., not data from clinical trial participants, who usually fit strict inclusion criteria suggests that the vaccine remains safe in a broader range of patients.
The data are particularly reassuring because we include a broader group of women, including some with health conditions that could increase the risks of poor pregnancy outcomes whowere excludedfrom the clinical trial, said Son.
Nonetheless, Son also highlights that there are important limitations to consider, such as the location of the study population in New York City, which may not be generalizable to other settings.
Now, Son and colleagues plan to explore this research area further: Although the frequency of RSV vaccination was higher at our hospitals than what was reported nationally, prenatal RSV vaccination remains underutilized, and we plan to explore the factors and disparities associated with prenatal RSV vaccination. In addition, potential associations between vaccination and hypertensive disorders of pregnancy need to be further explored in other studies.
We hope our findings will reassure pregnant individuals that the RSVpreF (Abrysvo) vaccine is safe and help guide clinicians who are or will provide care to pregnant patients who are set to deliver during the upcoming RSV season, summarized Son.
Reference: Son M, Riley LE, Staniczenko AP, et al. Nonadjuvanted bivalent respiratory syncytial virus vaccination and perinatal outcomes. JAMA Network Open. 2024;7(7):e2419268. doi: 10.1001/jamanetworkopen.2024.19268
Dr. Moeun Son was speaking to Dr. Sarah Whelan, Science Writer for Technology Networks.
About the interviewee:
Dr. Moeun Son is an associate professor of obstetrics and gynecology at Weill Cornell Medical College. She earned her medical degree from Columbia University College of Physicians and Surgeons and a masters degree in scientific clinical investigation from Northwestern University Feinberg School of Medicine.
The Advisory Committee on Immunization Practices (ACIP) approved new recommendations during their recent meeting held on June 26-28, 2024, regarding the administration of respiratory syncytial virus (RSV) vaccines for adults.
According to the new recommendations, ACIP recommends that adults ages 75 years and older receive a single dose of RSV vaccine. It is a single-dose-per lifetime recommendation, so those who have already received a dose of RSV vaccine in the past are not recommended to receive an additional dose.
This new guidance for adults 75 and older supersedes the previous recommendation for adults 60 years and older to consider RSV vaccination based on shared clinical decision-makingi.e., the decision whether to vaccinate is made between a patient and their healthcare provider on a case-by-case basis after a discussing the potential benefits and risks for that individual.
The new guidance also specifies that adults ages of 60 to 74 who are not at an increased risk of severe RSV disease are not recommended to receive the vaccine.
Accordingly, for adults ages 60 to 74 and older who are considered to be at an increased risk for developing severe RSV disease, ACIP now recommends a single dose of RSV vaccine. The CDC offers clinical considerations, including chronic medical conditions and other risk factors associated with severe RSV disease, to support this risk-based recommendation.
These risk factors include lung disease, heart disease, immune compromise, diabetes, obesity with a BMI of 40 or more, neurological conditions, neuromuscular conditions, chronic kidney disease, liver disorders and hematologic disorders, Sandra Fryhofer, M.D., the American Medical Associations liaison to ACIP, said in a recent AMA Update interview.
Also, frailty, as well as living in a nursing home or other long-term care facility are considered risk factors for severe RSV disease, she said.
Fryhofer said that the best time to get the RSV vaccine is late summer to early fall, so think August through October. She also confirmed that the RSV vaccine can be administered at the same time as other vaccines, including flu, COVID, pneumococcal, Tdap and shingles vaccines.
Currently, three RSV vaccines are available for adults: Arexvy (GSK), mRESVIA (Moderna), and Abrysvo (Pfizer).
These updated recommendations have been adopted by the CDC Director and align with the latest scientific evidence and expert consensus for RSV prevention strategies. The new guidelines ultimately aim to contribute to better health outcomes for older adults.
London (Precision Vaccinations News)
The United Kingdom's NHS recently updated its urinary tract infection (UTI) webpage to explain that some people may experience persistent UTI symptoms, and current urine tests may not detect chronic infections caused by bacteria embedded in the bladder lining.
Chronic UTIs, also known as recurrent UTIs (rUTIs), are typically treated with antibiotics. The NHS advises patients to ask their GP to refer them to a specialist if they experience rUTIs.
A recent study in England revealed that a novel oral spray vaccine could potentially prevent rUTIs for years. Researchers at the Royal Berkshire Hospital conducted a significant clinical trial using the Uromune (MV140) vaccine.
Nine years after treatment, 54% of participants in the study reported the vaccine's continued efficacy without significant side effects.
In previous clinical research, Uromuneinducedimmune responses systemicallyand in thegenitourinarytract, especially the bladder's innate immune system.
This multi-dose vaccinecontainsfourwhole-cell inactivated bacteria:Escherichia coli,Klebsiellapneumoniae,Proteus vulgaris,andEnterococcus faecalis.UropathogenicEscherichia coli accounts for themajorityof community-acquired UTIs.
Recently, access to Uromune in Englandhas expanded topatients who have been treated in secondary care before referral and have failed standard treatment protocols for uncomplicated urinary tract infections, overactive bladder, and chronic bladder pain.
These vaccine providers include:
London Urologica operates from The London Clinic, a charitable hospital in central London.At The London Clinic,internationalconsultants with teams of health professionalsspecializein the care and treatment of complex medical conditions.
The Lower Urinary Tract Symptoms Service is a specialist for adult patients with complex chronic or rUTIs. Specialists in this tertiary clinic adhere to protocols requiringstrict clinical governance.
The Urology Partnership (The Reading Urology Partnership) comprisesconsultants, each with a particular field of excellence. Allconsultants hold substantive appointments at theRoyal Berkshire NHS Foundation Trust Hospitalin Reading, Berkshire.
For rUTI patients willing to travel, the Uromune vaccine may be offered via Expanded Access Programs. Theseprograms arefor individuals for whom antibiotic therapy has failed, antibiotic-induced adverse reactions, and increasing antibiotic resistance.
Uromune is offered inthe DominicanRepublic, Singapore, and other countries. Vaccine appointments can be requested at Vax-Before-Travel.
However, Uromune is unavailable in the United States, but UTI vaccineclinical trialsare active in 2024.
The vaccine, developed by Cubas Molecular Immunology Center, was the first therapeutic vaccine against lung cancer patented and officially registered in the world.
Cuban Ambassador to Belarus Santiago Prez commented that the decision by the Belarusian regulatory agency to register Cimavax is an indisputable achievement of Cubas biotechnology in a country with such high standards and demands as Belarus.
Prez recalled that Belarus was precisely the first country in the continent where Cubas Soberana vaccine against Covid-19 was registered.
According to the Cuban diplomat, this registration is a sign of the progress of bilateral relations, specifically in the economic and commercial fields, and would contribute to increasing Cubas exports.
It also shows the progress in cooperation between the scientific communities of the two countries, and perhaps it is the beginning of a more dynamic process of mutual registration of medicines both in Belarus and Cuba, Prez stressed.
jg/jav/rgh/gfa
