Category: Vaccine

Jennifer P. Collins, MD1; Samuel J. Crowe, PhD1; Ismael R. Ortega-Sanchez, PhD2; Lynn Bahta, MPH3; Doug Campos-Outcalt, MD4; Jamie Loehr, MD5; Rebecca L. Morgan, PhD6; Katherine A. Poehling, MD7; Lucy A. McNamara, PhD1 (View author affiliations)

What is already known about this topic?

Meningococcal disease is a life-threatening invasive infection caused by Neisseria meningitidis. The pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya, Pfizer Inc.]) protects against N. meningitidis serogroups A, B, C, W, and Y and is licensed for use among persons aged 1025 years.

What is added by this report?

On October 25, 2023, the Advisory Committee on Immunization Practices recommended that MenACWY-TT/MenB-FHbp may be administered to persons aged 10 years when both a quadrivalent meningococcal conjugate vaccine (MenACWY) and meningococcal B vaccine (MenB) are indicated at the same visit.

What are the implications for public health practice?

MenACWY-TT/MenB-FHbp is the first pentavalent meningococcal vaccine approved for protection against serogroups A, B, C, W, and Y. Different manufacturers MenB vaccines are not interchangeable; when MenACWY-TT/MenB-FHbp is administered, subsequent doses of MenB should be from the same manufacturer (Pfizer Inc.).

Meningococcal disease is a life-threatening invasive infection caused by Neisseria meningitidis. Two quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccines (MenACWY) (MenACWY-CRM [Menveo, GSK] and MenACWY-TT [MenQuadfi, Sanofi Pasteur]) and two serogroup B meningococcal vaccines (MenB) (MenB-4C [Bexsero, GSK] and MenB-FHbp [Trumenba, Pfizer Inc.]), are licensed and available in the United States and have been recommended by CDCs Advisory Committee on Immunization Practices (ACIP). On October 20, 2023, the Food and Drug Administration approved the use of a pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya, Pfizer Inc.]) for prevention of invasive disease caused by N. meningitidis serogroups A, B, C, W, and Y among persons aged 1025 years. On October 25, 2023, ACIP recommended that MenACWY-TT/MenB-FHbp may be used when both MenACWY and MenB are indicated at the same visit for the following groups: 1) healthy persons aged 1623 years (routine schedule) when shared clinical decision-making favors administration of MenB vaccine, and 2) persons aged 10 years who are at increased risk for meningococcal disease (e.g., because of persistent complement deficiencies, complement inhibitor use, or functional or anatomic asplenia). Different manufacturers serogroup Bcontaining vaccines are not interchangeable; therefore, when MenACWY-TT/MenB-FHbp is used, subsequent doses of MenB should be from the same manufacturer (Pfizer Inc.). This report summarizes evidence considered for these recommendations and provides clinical guidance for the use of MenACWY-TT/MenB-FHbp.

Meningococcal disease is a life-threatening invasive infection caused by Neisseria meningitidis. CDCs Advisory Committee on Immunization Practices (ACIP) recommends routine administration of a single dose of quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccine (MenACWY) to persons at age 11 or 12 years, with a booster dose at age 16 years. ACIP recommends a 2-dose serogroup B meningococcal vaccine (MenB) series for persons aged 1623 years, based on shared clinical decision-making, to provide short-term protection against meningococcal disease caused by most serogroup B strains (1). ACIP also recommends routine vaccination with MenACWY (for persons aged 2 months) and MenB (for persons aged 10 years) who are at increased risk for meningococcal disease caused by the serogroups covered by each vaccine (Box) (1).

In October 2023, a pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya, Pfizer Inc.]) was licensed for use in persons aged 1025 years (2). MenACWY-TT/MenB-FHbp contains the same components as those in two existing meningococcal vaccines: 1) N. meningitidis polysaccharide groups A, C, W, and Y conjugated to tetanus toxoid carrier protein (MenACWY-TT* [Nimenrix, Pfizer Inc.], a nonU.S.-licensed vaccine), and 2) two recombinant lipidated factor Hbinding protein (FHbp) variants from N. meningitidis serogroup B (MenB-FHbp [Trumenba, Pfizer Inc.]). This report summarizes evidence considered for these recommendations and provides clinical guidance for the use of MenACWY-TT/MenB-FHbp.

During June 2022October 2023, the ACIP Meningococcal Vaccines Work Group held monthly conference calls to review meningococcal disease epidemiology and evidence regarding use of MenACWY-TT/MenB-FHbp in persons currently recommended to receive MenACWY and MenB (policy question 1), MenACWY only (policy question 2), or MenB only (policy question 3). To guide deliberations, ACIP used the Evidence to Recommendations framework and considered the importance of meningococcal disease as a public health problem, benefits, and harms of MenACWY-TT/MenB-FHbp, values of the target population, acceptability, resource use, equity, and feasibility. ACIP evaluated the available evidence on the following prespecified benefits and harms (each with ranked importance), using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach (3): disease caused by serogroups A, B, C, W, and Y (critical); short-term immunity (critical); persistent immunity (important); serious adverse events (critical); nonserious adverse events (important); and interference with other recommended vaccines administered concurrently (important).

The body of evidence comprised data from three randomized, quadruple-blinded multisite clinical trials that assessed immunogenicity and safety** among healthy participants aged 1025 years. Participants were randomized to 1) the pentavalent group (2 doses of MenACWY-TT/MenB-FHbp, administered 6 or 12 months apart) or 2) the control group (MenACWY-CRM [Menveo, GSK, 1 dose] + MenB-FHbp [2 doses administered 6 months apart]) (4). The trials included ACWY-naive and ACWY-primed participants; all study participants were MenB-naive. The GRADE assessment focused on the 6-month pentavalent dosing interval for immunity outcomes; data on both 6- and 12-month pentavalent dosing intervals were assessed for safety outcomes.

Among both MenACWY-naive and MenACWY-primed participants, seroresponse for serogroups A, C, W, and Y 1 month after the first trial dose of ACWY-containing vaccine was achieved as often or more often in the pentavalent group than in the control group. On the basis of a composite measure, seroresponse for serogroup B 1 month after the second dose of serogroup Bcontaining vaccine was achieved more often in the pentavalent group than in the control group. The overall level of certainty for the critical outcome short-term immunity for all serogroups was moderate for healthy persons and low for persons at increased risk because of underlying medical conditions.

Among ACWY-naive and ACWY-primed participants, seroprotection for meningococcal serogroups A, C, W, and Y occurred as often or more often in the pentavalent group (48 months after receipt of 2 doses MenACWY-TT/MenB-FHbp) compared with the control group (54 months after 1 dose MenACWY-CRM). Little or no difference was observed in the frequency of serogroup B strainspecific seroprotection*** 48 months after receipt of 2 doses of pentavalent vaccine when compared with those seen 48 months after receipt of 2 doses of MenB-FHbp + 1 dose MenACWY-CRM. The overall level of certainty for this important outcome was low for serogroups A, C, W, and Y for healthy persons, moderate for serogroup B for healthy persons, and low for all serogroups for those at increased risk because of underlying medical conditions.

The proportion of participants who experienced serious adverse events was similar in the pentavalent group (0.6%) and the control group (0.5%; p = 0.7). No serious adverse events were deemed related to the vaccine by the study investigators. The pentavalent group had significantly fewer nonserious adverse events (24.6%) than did the control group (32.5%; p<0.001). The most common solicited adverse events within 7 days after receipt of either trial dose of MenACWY-TT/MenB-FHbp were injection site pain (84.4%89.3%; mostly mild or moderate), fatigue (47.6%52.1%; mostly mild or moderate), and headache (39.8%46.8%; mostly mild or moderate) (5). For both serious and nonserious adverse events, the level of certainty was low for healthy persons and very low for those at increased risk because of underlying medical conditions.

No data exist on coadministration of MenACWY-TT/MenB-FHbp with other vaccines. Review of the interactions sections of the package inserts for the component vaccines Nimenrix (MenACWY-TT) and Trumenba (MenB-FHbp) did not identify any concerns for coadministration with other vaccines (6,7).

Findings from two economic models (CDC model and Pfizer Inc. model) that assessed the health benefits and cost-effectiveness of MenACWY-TT/MenB-FHbp for each policy question within the routine schedule were considered by ACIP (8). According to the CDC model, strategies likely to be societally cost-saving would use the pentavalent vaccine to 1) replace a single dose of MenACWY and MenB when both are indicated, or 2) replace MenACWY and MenB when both are indicated, followed by completion of the 2-dose MenB series with a second dose of pentavalent vaccine. The CDC model also illustrated that when immunization against serogroup B meningococcal disease is not indicated, replacing both doses of MenACWY with the pentavalent vaccine would be incrementally less cost-effective. Despite differences in input values and assumptions, similar conclusions were reported by the Pfizer Inc. model.

ACIP recommended that MenACWY-TT/MenB-FHbp may be used when both MenACWY and MenB are indicated at the same visit for 1) healthy persons aged 1623 years (routine schedule) when shared clinical decision-making favors administration of MenB vaccine and 2) persons aged 10 years who are at increased risk for meningococcal disease (e.g., because of persistent complement deficiencies, complement inhibitor use, or functional or anatomic asplenia) (Table) (Figure). Indications for MenACWY and MenB vaccination have not changed since they were previously published (1).

For healthy persons, use of MenACWY-TT/MenB-FHbp should not supersede discussion of whether to administer MenB using shared clinical decision-making (Table). Clinicians should refer to previously published considerations for shared clinical decision-making and timing of MenB administration (1).

MenACWY products are interchangeable; the same vaccine product is recommended, but not required, for all doses (1). Different manufacturers MenB products are not interchangeable; administration of a B-component vaccine (monovalent or pentavalent) requires that all subsequent B-component vaccine doses, including booster doses, be from the same manufacturer. If one MenB dose was received but the vaccine manufacturer is not known, the series must be restarted with any licensed product to ensure completion of the MenB series using products from a single manufacturer.

If MenACWY-TT/MenB-FHbp is inadvertently administered in lieu of MenACWY or MenB when only one (i.e., MenACWY or MenB) was indicated, the dose can be considered valid if it would otherwise have been a valid dose of MenACWY or MenB (i.e., on the basis of indication, patient age, and dosing interval).

The licensed dosing interval for MenACWY-TT/MenB-FHbp is 6 months. Data are not available regarding safety or immunogenicity of MenACWY-TT/MenB-FHbp with dosing intervals exceeding 12 months. Healthy adolescents and young adults aged 1623 years who receive 1 dose of MenACWY-TT/MenB-FHbp on the basis of shared clinical decision-making should complete the MenB series with a dose of MenB-FHbp 6 months after the pentavalent vaccine dose was administered (Table).

Persons at increased risk for meningococcal disease who receive a dose of MenACWY-TT/MenB-FHbp and are recommended to receive additional doses of MenACWY and MenB <6 months after a dose of pentavalent meningococcal vaccine should receive separate MenACWY and MenB-FHbp vaccines rather than MenACWY-TT/MenB-FHbp (Figure). MenACWY-TT/MenB-FHbp may be used for booster doses in persons who remain at increased risk if a booster dose of both MenACWY and MenB are indicated at the same visit. MenACWY-TT/MenB-FHbp doses deviating from the licensed 6-month interval can be considered valid for MenACWY or MenB if the timing would otherwise have been valid for that component.

Severe allergy. MenACWY-TT/MenB-FHbp is contraindicated for persons with a history of severe allergic reaction, such as anaphylaxis, to any component of the vaccine or to a tetanus toxoidcontaining vaccine.

Pregnancy and breastfeeding. No data exist on use of MenACWY-TT/MenB-FHbp during pregnancy or while breastfeeding. Because limited data are available for MenB vaccination during pregnancy, vaccination with MenB should be deferred unless the pregnant person is at increased risk for acquiring meningococcal disease, and, after consultation with their health care provider, the benefits of vaccination are considered to outweigh the potential risks. When MenACWY is indicated, persons who are pregnant or breastfeeding should receive MenACWY-CRM or MenACWY-TT (MenQuadfi, Sanofi Pasteur).

Adverse events that occur in a patient after meningococcal vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS), even if it is uncertain whether the vaccine caused the event. Instructions for reporting to VAERS are available online at https://vaers.hhs.gov/reportevent.html or by telephone (800-822-7967).

Alison Albert, Isha Berry, Gabrielle Cooper, LeAnne Fox, Susan Hariri, Angela Jiles, Shelby Miller, Noele Nelson, Amy Rubis, Jeremiah Williams, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC; Jonathan Duffy, Tanya Myers, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Andrew Leidner, Elisabeth Velazquez, JoEllen Wolicki, Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC; Jessica MacNeil, Melinda Wharton, Office of the Director, National Center for Immunization and Respiratory Diseases, CDC. Rosters of current and past members of the Advisory Committee on Immunization Practices are available at https://www.cdc.gov/vaccines/acip/members/index.html.

Katherine A. Poehling (Chair). Members: Lynn Bahta, Margaret Bash, Doug Campos-Outcalt, Jessica Cataldi, Paul Cieslak, Mark Connelly, Jeff Goad, Kathy Hsu, Francisco Leyva, Jamie Loehr, Karyn Lyons, Sharon McMullen, Rebecca L. Morgan, Amra Resic, David S. Stephens, Cacky Tate, Joseline Zafack.

1Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC; 2Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, CDC; 3Minnesota Department of Health; 4College of Medicine and Public Health, University of Arizona, Phoenix, Arizona; 5Cayuga Family Medicine, Ithaca, New York; 6Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; 7Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Abbreviations: ACIP=Advisory Committee on Immunization Practices; MenACWY=quadrivalent (serogroups A, C, W, and Y) meningococcal vaccine; MenB=serogroup B meningococcal vaccine.

* https://pubmed.ncbi.nlm.nih.gov/33417592/

Abbreviations: MenACWY=quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccine; MenACWY-TT/MenB-FHbp = Penbraya (Pfizer Inc.) pentavalent (serogroups A, B, C, W, and Y) meningococcal vaccine; MenB-FHbp=Trumenba (Pfizer Inc.) serogroup B meningococcal vaccine; MenB-4C = Bexsero (GSK) serogroup B meningococcal vaccine; NA=not applicable. * Assumes that a person has not previously been vaccinated with MenACWY or MenB. MenACWY vaccines are interchangeable; the same vaccine product is recommended, but not required, for all doses. Different manufacturers MenB vaccines are not interchangeable. https://pubmed.ncbi.nlm.nih.gov/33417592/ To determine catch-up vaccination recommendations for MenACWY and MenB, clinicians should see previously published recommendations. https://pubmed.ncbi.nlm.nih.gov/33417592/ Two-dose series with doses administered 1 month apart. ** Two-dose series with doses administered 6 months apart.

Abbreviations: MenACWY = quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccine; MenACWY-TT/MenB-FHbp = Penbraya (Pfizer Inc.) pentavalent (serogroups A, B, C, W, and Y) meningococcal vaccine; MenB-FHbp = Trumenba (Pfizer Inc.) serogroup B meningococcal vaccine; MenB-4C = Bexsero (GSK) serogroup B meningococcal vaccine.

* MenACWY products are interchangeable; the same vaccine product is recommended, but not required, for all doses.

Different manufacturers MenB vaccines are not interchangeable.

To determine whether MenACWY and MenB are indicated based on a persons risk factors and timing of any previous meningococcal vaccines, clinicians should see previously published recommendations. https://pubmed.ncbi.nlm.nih.gov/33417592/

If MenB was received previously but the vaccine manufacturer is not known, the series must be restarted with any licensed product to ensure completion of the series using products from a single manufacturer. For additional guidance, clinicians should see previously published recommendations. https://pubmed.ncbi.nlm.nih.gov/33417592/

** If MenB-FHbp was received previously, MenACWY-TT/MenB-FHbp may be used provided the person has not received MenACWY-TT/MenB-FHbp previously or 6 months have passed since the previous dose of MenACWY-TT/MenB-FHbp.

Suggested citation for this article: Collins JP, Crowe SJ, Ortega-Sanchez IR, et al. Use of the Pfizer Pentavalent Meningococcal Vaccine Among Persons Aged 10 Years: Recommendations of the Advisory Committee on Immunization Practices United States, 2023. MMWR Morb Mortal Wkly Rep 2024;73:345350. DOI: http://dx.doi.org/10.15585/mmwr.mm7315a4.

MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services. References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

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Use of the Pfizer Pentavalent Meningococcal Vaccine Among Persons Aged 10 Years: Recommendations of the ... - CDC

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The Chicago Department of Public Health is recommending medical providers consider administering a second dose of the measles vaccine to children earlier than usual, following community spread of measles in the last several weeks, the agency said Friday.

The city has seen 64 measles cases since early March, after not having a confirmed case of the virus in almost five years. Eleven new measles cases have been reported so far this month, with a peak in reported cases occurring in late March, according to CDPHs measles dashboard.

Measles cases in Chicago account for more than half of reported cases in the U.S. so far this year. More than half of the measles cases in the city were in children ages 4 or younger.

Most of the measles cases are connected to a migrant shelter in Pilsen; however, city health officials are also warning of measles cases in the broader community.

We need everyone whether a new arrival or a longtime Chicagoan to ensure they and their family members are up to date on their vaccinations, CDPH Commissioner Dr. Olusimbo Simbo Ige said in a statement. Too many Chicagoans are still not vaccinated against this highly contagious virus and other vaccine-preventable diseases.

The measles-mumps-rubella vaccine, or MMR vaccine, is considered highly effective at preventing measles. One dose of the vaccine typically given at 12 to 15 months of age is about 93% effective against the disease. A second dose typically given at 4 to 6 years of age bumps the efficacy up to 97%.

Now, CDPH is recommending medical providers consider administering the second MMR dose to Chicago children over 12 months of age on an earlier schedule as soon as 28 days after a first dose especially if those children are attending school or day care.

When we see community transmission, well oftentimes take a measure to boost that immunity with the second shot, said Dr. Larry Kociolek, pediatric infectious diseases physician at Lurie Childrens Hospital. Thats something providers can discuss with their patients and determine if thats the right measure for them.

Children who receive two appropriately timed MMR doses before 4 years of age should not need any additional doses in their lifetime, the city health department said.

So far, CDPH has reported administering more than 17,000 measles vaccine doses to Chicago residents, including newly arrived migrants at the Pilsen shelter, since the start of the measles outbreak on March 7.

(Its) hard to tell the end of an outbreak, but we certainly see the protection of this community in the setting and were certainly at the tail end of those cases presenting, Massimo Pacilli, deputy commissioner of the disease control bureau at the Chicago Department of Public Health, said during a media briefing last week.

Measles is a highly contagious, airborne respiratory infection that can lead to pneumonia and other serious complications. Symptoms of measles include rash, high fever, cough, runny nose and red and watery eyes.

While cases of measles are rare in Chicago due to high vaccination coverage from childhood, CDPH said, measles cases have been increasing recently in the U.S. and can be dangerous to those who are unvaccinated, especially babies and young children.

The increase in measles cases in Illinois, and in several other U.S. states, is a fairly predictable consequence of slowly declining vaccine rates all over the country, Kociolek said.

The MMR vaccine is available at most doctors offices and pharmacies. Additionally, CDPHs immunization clinics provide the MMR vaccine for no out-of-pocket cost to any child through 18 years of age and uninsured adults 19 and older.

Contact Eunice Alpasan:@eunicealpasan| 773-509-5362 |[emailprotected]

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Providers Should Consider Giving Kids 2nd Dose of Measles Vaccine Sooner as Chicago Sees New Cases, Health ... - WTTW News

A new oral vaccine for cholera has received prequalification by the World Health Organization (WHO) on 12 April. The inactivated oral vaccine Euvichol-S has a similar efficacy to existing vaccines but a simplified formulation, allowing opportunities to rapidly increase production capacity.

The new vaccine is the third product of the same family of vaccines we have for cholera in our WHO prequalification list, said Dr Rogerio Gaspar, Director of the WHO Department for Regulation and Prequalification. The new prequalification is hoped to enable a rapid increase in production and supply which many communities battling with cholera outbreaks urgently need.

WHO prequalification list already includes Euvichol and Euvichol-Plus inactivated oral cholera vaccines produced by EuBiologicals Co., Ltd, Republic of Korea, which also produces the new vaccine Euvichol-S.

Vaccines provide the fastest intervention to prevent, limit and control cholera outbreaks but supplies have been at the lowest point amidst countries facing dire shortcomings in other areas of cholera prevention and management such as safe water, hygiene and sanitation.

There were 473000 cholera cases reported to WHO in 2022 -- double the number from 2021. Further increase of cases by 700 000 was estimated for 2023. Currently, 23 countries are reporting cholera outbreaks with most severe impacts seen in the Comoros, Democratic Republic of the Congo, Ethiopia, Mozambique, Somalia, Zambia and Zimbabwe.

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WHO prequalifies new oral simplified vaccine for cholera - World Health Organization (WHO)

Tetanus is vaccine-preventable, yet it kills tens of thousands of infants worldwide every year

The dawn was slowly rising over the village of Abaradjou in the health district of Sankor in Mali's Tombouctou region. Once flourishing, the region was struggling with maternal and neonatal tetanus (MNT), an acute infectious disease that threatens the survival of mothers and their infants.

Caused by a bacterium found in the soil and in animal droppings, MNT results from the contamination of the umbilical stump during unhygienic cord care at childbirth. Symptoms usually occur from the third day in a newborn who was normal and suddenly becomes rigid, presenting with uncontrollable convulsions and muscle spasms. Without medical care, the mortality rate is nearly 100 percent.

In this neighborhood, as elsewhere in Mali, deliveries were often performed by traditional midwives, using contaminated equipment. This practice, coupled with adherence to ancient rituals, unfortunately made tetanus contamination all too common during deliveries.

Aissata, a 46-year-old resident of Abaradjou, was determined to change her fate. Having already lost a baby to this disease, she resolved not to let history repeat itself.

They did everything they could, but the baby passed away. The doctor explained to me that it was tetanus and that if I had been vaccinated during pregnancy, it could have saved my baby. Losing a child is terrible and I wouldn't wish it on any parent. Aissata, a 46-year-old mother in Mali

"I gave birth at home assisted by a grandmother," says Aissata. "A few days later, the baby couldnt breastfeed, and his condition was getting worse. So, I took him to the health center. They did everything they could, but the baby passed away. The doctor explained to me that it was tetanus and that if I had been vaccinated during pregnancy, it could have saved my baby. Losing a child is terrible and I wouldn't wish it on any parent."

Aware of the risks, Aissata sought out information and learned from a women's group in her village about a new initiative by the Malian government, with support from UNICEF and WHO, targeting the elimination of maternal and neonatal tetanus. Inspired by the possibility of a different ending for her story, Aissata decided to actively protect any future pregnancies by getting the tetanus vaccine.

The very next day, as if in answer to her determination, an advanced strategy team arrived by motorcycle in Aissatas village to administer the tetanus vaccine to all women of reproductive age (pregnant or not). Aissata was among the first to receive her dose and made the significant choice to travel to the Sankor community health center for the remaining doses of the vaccine. The road was long and arduous, but the hope of a better outcome for her future pregnancies sustained her.

"Today I am talking about my story to the women in my village and I am telling them to get vaccinated against tetanus and to have check-ups during pregnancy. When I talk about my story, some tell me that they have also lost babies following home births." recounts Aissata, after finishing an educational talk with other women from her village.

Today I am talking about my story to the women in my village and I am telling them to get vaccinated against tetanus and to have check-ups during pregnancy. Aissata

In 2023, the World Health Organization (WHO) announced that Mali had officially eliminated maternal and neonatal tetanus, a major advance for public health in a country where maternal and infant mortality rates are among the highest in the world.This status was confirmed following a detailed evaluation, which demonstrated that Mali meets WHO's standard of having less than one case of neonatal tetanus per 1,000 live births in each of its health districts.

Mali's significant milestone is a testament to the collective efforts of the country and its partners, including UNICEF. A comprehensive strategy to strengthen systematic vaccination played a pivotal role. Health centers across Mali were equipped with solar refrigerators to store vaccines efficiently, and provided with motorcycles and vehicles to facilitate the delivery of vaccination services.

Vaccinations were administered through a well-organized approach: at health facilities for fixed strategies, by motorcycle for areas located between 5 and 15 kilometers away, and through mobile clinics for communities more than 15 kilometers from a health facility.

From 2002, Mali embarked on several vaccination campaigns against tetanus, adopting fixed, advanced and mobile strategies. These efforts were significantly supported by financial contributions from the United States, underscoring the global commitment to combatting MNT. The vaccination program proved to be a lifeline for thousands of women, including Aissata.

Childbirth practices in Mali also saw remarkable improvements through the gradual introduction of qualified personnel including gynecologist-obstetricians, midwives and obstetric nurses into health centers and district hospitals. This initiative was supported by the state and partners like the World Bank to enhance the quality of maternal care.

Traditional midwives, integral to many communities, received training on essential hygiene practices to further reduce the risk of tetanus contamination. The training emphasized the importance of maintaining clean surfaces, hands and clothes during childbirth, using a new blade for umbilical cord cutting, applying chlorhexidine for cord care and avoiding the application of potentially harmful substances on the umbilical wound. Through these comprehensive measures, Mali has made significant strides in safeguarding the health of mothers and newborns against tetanus.

These practices have saved millions of women of childbearing age and newborns while protecting them against tetanus, explains Dr. Moumini Guindo, a physician at the Sankor community health center.

Aissata's determination and resilience are a symbol of the possibility of change and the power of taking proactive steps towards health and safety. In this region of Mali, her fight against MNT, marked by courage and transformation, serves as an inspiration for many women a new dawn for an era of health awareness and empowerment in the community.

UNICEF has immunized millions of women all over the globe, with support from partners like Kiwanis International and The Church of Jesus Christ of Latter-Day Saints, in an effort to eliminate tetanus in dozens of countries. As of December 2023, MNT remains endemic in just 11 countries.

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Vaccines Protect Mothers and Babies in Mali From Maternal and Neonatal Tetanus - UNICEF USA

There are many factors which affect how successfully a vaccine is rolled out. One of these is the public health communication strategy. Surprisingly, a key factor in determining the success of these strategies is religion. While some religious groups were keen to be vaccinated against COVID-19, others were much more hesitant.

During the height of the pandemic, getting vaccinated against COVID-19 quickly became the social norm. Having experienced pandemic life, most people were keen to get a full series of vaccinations as soon as they were made available.

Yet our new research, based on surveys of over 12,000 people found that there has been significant difference in vaccine uptake between religious communities.

Members of the Methodist and Church of England denominations are more likely to have been vaccinated, while Pentecostal, evangelical and Muslim respondents have received far fewer vaccinations. Methodists, on average, have had 3.48 vaccinations, while Pentecostals have only had 1.88.

Why is this the case? This is the difficult part of the story. We know that some minority groups have faced discrimination and this, in turn, can lead to lower levels of trust in authority figures. For instance, our recently published research shows that ethnic minorities have lower levels of trust in the NHS.

In terms of religion, we have noticed some unusual trends. Members of the Pentecostal denomination have high levels of trust in medical doctors but low levels of trust in scientists. This is an area we hope to explore further in future research.

Once we accept that there are differences in vaccine uptake across religions, we can then move on to the equally difficult question of what to do about it. We argue that health authorities, such as the NHS, need to actively engage with religious leaders and religious communities.

There are examples of community-based success stories. For instance, early in the pandemic, mosques in Birmingham were used as vaccination centres. This kind of religious community engagement in public health can be of vital importance.

Amid concerns during the pandemic that ethnic minority groups were more likely to be targeted with misinformation (sometimes from faith leaders outside the UK) and to be hesitant about getting vaccinated, religious leaders were deployed with great success. They were well placed to counter inaccurate information and encourage vaccine uptake.

We argue that there needs to be more formal recognition of such community-based public health messaging. When there are such stark differences in a vital area of public health such as vaccination, we really need health bodies to do all they can to reach out to the community. Sometimes, as in the case with religion, they cannot do this themselves with a traditional top-down communication model; they need to work with religious leaders.

Theres still much that we dont know. For instance, the interplay between religion and ethnicity is complex. This is an area we intend to explore in more depth in future research.

Apart from some notable exceptions, religion is often something of an elephant in the room in the political sphere. It is easy to see how it could also be ignored in a public health setting and perhaps why it became an issue during the COVID-19 vaccination rollout.

The NHS is clearly a secular organisation, and there would be no desire to change that. But we cannot ignore that, in terms of COVID-19 vaccine rollout, certain religious communities have been let down, or left behind. Future public health campaigns need to acknowledge this and find ways to overcome it.

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Religion and COVID-19: methodists and Church of England followers more likely to have been vaccinated than ... - The Conversation Indonesia

Study participants

Peripheral blood sampling was approved by the Institutional Ethics Review Board of Seoul National University Hospital (IRB approval number, 2102-032-1193). Informed consent was obtained from all participants of this study. The vaccinees had a median age of 30 years (range 2362) and showed a nearly equal distribution of males and females (46% and 54%, respectively). Demographic data for the 41 vaccinees are summarized in Supplementary Data5. Peripheral blood mononuclear cells (PBMCs) and plasma were separated using Lymphoprep (STEMCELL) Ficoll (Cytiva) following the manufacturers instructions. Total RNA was isolated using TRIzol Reagent (Invitrogen) according to the manufacturers instructions.

Plasma and phage ELISAs were performed in 96-well microtiter plates (Corning, 3690) coated with 100ng of recombinant SARS-CoV-2 proteins (Sino Biological, Ancestral RBD, 40592-V08H; Alpha RBD, 40592-V08H82; Beta RBD, 40592-V08H85; Gamma RBD, 40592-V08H86; Delta RBD, 40592-V08H90; Omicron BA.1 RBD, 40592-V08H121; Omicron BA.2 RBD, 40592-V08H123, Omicron BA.4/5 RBD, 40592-V08H130; Omicron BQ.1.1 RBD, 40592-V08H143; Omicron XBB.1.5, 40592-V08H146; Omicron XBB.1.16, 40592-V08H136; RBD Ancestral N, 40588-V08B) in coating buffer (0.1M sodium bicarbonate, pH 8.6) as described previously23. Briefly, the plates were coated with the antigen by incubation at 4C overnight and blocked with 3% bovine serum albumin (BSA) in PBS for 1h at 37C. Then, serially diluted plasma of 41 vaccinees and one COVID-19 patient23 (100-, 500-, 2,500-fold) or phage supernatant (twofold) in blocking buffer was added to the wells of microtiter plates, followed by incubation for 1h at 37C. Then, the plates were washed three times with 0.05% PBST. Horseradish peroxidase (HRP)-conjugated goat anti-human IgM and IgA (Invitrogen, A18835 and A18781, 1:5,000), rabbit anti-human IgG antibody (Invitrogen, 31423, 1:20,000) and HRP-conjugated anti-M13 antibody (Sino Biological, 11973-MM05T-H, 1:4,000) were used to determine the amount of bound antibody or M13 bacteriophage. A 3,3,5,5-tetramethylbenzidine liquid substrate solution (Thermo Fisher Scientific Inc.) was used as an HRP substrate.

In ELISA for the recombinant scFv-hFc-HA fusion proteins, the wells of microtiter plates (Corning) were first coated with 100ng of mouse anti-His antibody (Invitrogen, MA1-21315) and blocked. Then, the recombinant SARS-CoV-2 RBD protein with a polyhistidine tag (100nM) was added to the wells. After brief washing, the scFv-hFC-HA fusion proteins were serially diluted fourfold from 1 M to 0.24 pM in blocking buffer and added to wells of a microtiter plate. HRP-conjugated rat anti-HA antibody (Roche, 12013819001, 1:1,000) was used to determine the amount of bound antibody. All assays were performed in duplicate. The absorbance was measured at either 450 or 650nm using a microplate spectrophotometer (Thermo Fisher Scientific Inc., Multiskan GO), depending on the use of 2M sulfuric acid as the stop solution. All ELISA data were analyzed using GraphPad Prism software v6 (GraphPad Software).

Genes encoding the variable domain of the heavy chain (VH) and part of the first constant domain of the heavy chain (CH1) domain (VH-CH1) were amplified using specific primers, as described previously23. All primers used are listed in Supplementary Data6. These six IGHV-specific primers are expected to amplify a total of 269 out of 270 IGHV alleles (99.63%) available in the IMGT database. IGHV4-39*08 is expected to encounter difficulty in amplification, due to a mismatch with the germline sequence at the third nucleotide from the 3 end of the primer32 (Supplementary Data7). Briefly, total RNA was used as a template to synthesize complementary DNA (cDNA) using the SuperScript IV First-Strand Synthesis System (Invitrogen) with specific primers (primer No. 18) targeting the CH1 domain of each isotype (IgM, IgD, IgG, IgA, and IgE) according to the manufacturers protocol. After cDNA synthesis, 1.8 volumes of SPRI beads (Beckman Coulter, AMPure XP) were used to purify cDNA, which was eluted in 35l of water. The purified cDNA (15l) was subjected to second-strand synthesis in a 25l reaction volume using IGHV genespecific primers (primer No.914) and a KAPA Biosystems kit (Roche, KAPA HiFi HotStart). The PCR conditions were as follows: 95C for 3min, 98C for 30s, 60C for 45s, and 72C for 6min. After second-strand synthesis, dsDNA was purified using 1 volume of SPRI beads, as described above. VH-CH1 genes were amplified using purified dsDNA (15l) in a 25l reaction volume using primers containing indexing sequences (primers 15 and 16) and a KAPA Biosystems kit. The PCR conditions were as follows: 95C for 3min; 25 cycles of 98C for 30s, 60C for 30s, and 72C for 1min; and 72C for 5min. PCR products were subjected to electrophoresis on a 1.5% agarose gel and purified using a QIAquick gel extraction kit (QIAGEN Inc.) according to the manufacturers instructions. The gel-purified PCR products were purified again using 1 volume of SPRI beads and eluted in 20l water. The SPRI-purified sequencing libraries were quantified with a 4200 TapeStation System (Agilent Technologies) using a D1000 ScreenTape assay and subjected to next-generation sequencing on the Illumina NovaSeq 6000 250PE (SP Chip) platform using Novaseq 6000 reagent kits (Illumina Inc.). The total read counts of the chronological repertoires after NGS data processing is summarized in Supplementary Data8.

Raw sequencing reads obtained from sequencing the VH-CH1 region of B cells in peripheral blood were processed using a custom pipeline. The pipeline included adapter trimming and quality filtering; unique molecular identifier (UMI) processing; V(D)J gene annotation; clustering; quality control; and diversity analysis.

The forward reads (R1) and reverse reads (R2) of the raw NGS data were merged using paired-end read merger (PEAR) v0.9.10 with the default settings33. The merged reads were q-filtered under the q20p95 condition, resulting in 95% of base pairs in the reads having a Phred score greater than 20. Primer positions were identified in the quality-filtered reads, and primer regions were trimmed to remove the effects of primer synthesis errors while allowing one substitution or deletion. We identified 187 out of 270 IGHV alleles (69.3%) from the IMGT database across six time points in 41 vaccinees (246 BCR HC libraries) of Korean nationality. This ratio highly resembles the average allele distribution observed among Eastern Asian populations (62.7%)34 (Supplementary Data9).

Based on the primer recognition results, UMI sequences were extracted, and reads were clustered according to the UMI sequences. To eliminate index misassignment, we subclustered the clustered reads based on the similarity of the reads (allowing 5 mismatches in each subcluster) and matched the majority subcluster to the UMI. The subclustered reads were aligned using the multiple sequence alignment tool Clustal Omega v1.2.4 with the default settings35,36. Consensus calling was performed by selecting major frequency bases at every position of the aligned sequences. The number of reads in the consensus sequence was redefined as the number of UMI subclusters belonging to the consensus sequence.

Sequence annotation consisted of isotype annotation and V(D)J annotation. The consensus sequence was divided into a V(D)J region and a constant region. The isotype of the consensus sequence was annotated by aligning the extracted constant region with the constant gene of the International Immunogenetics Information System (IMGT)37. Then, the V(D)J region of the consensus sequence was annotated using an updated version of IgBLAST (v1.17.1)38. Among the annotation results, the IGHV genes, IGHJ genes, HCDR3 sequences, and number of SHMs were extracted for further analysis. The number of SHMs cannot be determined for sequences outside the primer binding sites; therefore, SHMs were calculated by comparing the amplified regions from primer-mediated amplification with the IGHV gene germline sequence. The nonfunctional consensus reads were defined and filtered using the following criteria: (i) sequence length shorter than 250 base pairs from each R1 and R2, (ii) presence of a stop codon or frameshift in the entire amino acid sequence, (iii) failure to annotate one or more HCDR1, HCDR2 and HCDR3 regions, and (iv) failure to annotate the isotype.

Six human scFv phage display libraries were constructed using the total RNA prepared from the sixth blood sample for vaccine Nos. 22, 27, 32, 35, 39 and 43 as described previously23. Briefly, for the VH and V/V genes, total RNA was employed to synthesize cDNA using the SuperScript IV First-Strand Synthesis System (Invitrogen) with gene-specific primers targeting the JH and C/ genes (primer No.1722), respectively. After cDNA synthesis, 1.8 volumes of SPRI beads (Beckman Coulter) were used to purify cDNA, which was eluted in 20l of water. The purified cDNA (11.25l) of the VH gene was subjected to second-strand synthesis in a 25l reaction volume using IGHV gene-specific primers (primer No. 2332, 7.5l) and a KAPA Biosystems kit (Roche). The reaction conditions were as follows: 95C for 3min, 98C for 1min, 60C for 1min, and 72C for 5min. In the case of the V/V gene, the eluted cDNA (17.25l) was used for the first round of PCR synthesis in a 25l reaction volume using V/V and J /J gene-specific primers (primer No. 3369, 0.75l). The PCR conditions were as follows: 95C for 3min; 4 cycles of 98C for 1min, 60C for 1min, and 72C for 1min; and 72C for 10min. After second-strand synthesis for the VH gene or PCR amplification of the V/V gene, double-stranded DNA (dsDNA) was purified with 1 volume of SPRI beads and eluted in 40l of water. VH and V/V genes were amplified using 10l of purified dsDNA, 2.5 pmol of the primers (primer No. 7073), and KAPA Biosystems kit components in a 50l total reaction volume with the following thermal cycling program: 95C for 3min; 30 cycles of 98C for 30s, 60C for 30s, and 72C for 1min; and 72C for 10min. Then, the amplified VH and V/V genes were subjected to electrophoresis on a 1.5% agarose gel and purified using a QIAquick gel extraction kit (QIAGEN Inc.) according to the manufacturers instructions. The purified VH and V/V gene fragments (100ng) were mixed and subjected to overlap extension PCR to generate scFv genes using 2.5 pmol of the overlap extension primers (primer No. 74 and 75) using the KAPA Biosystems kit. The PCR conditions were as follows: 95C for 3min; 25 cycles of 98C for 20s, 65C for 15s, and 72C for 1min; and 72C for 10min. The amplified scFv gene was purified and cloned into a phagemid vector39.

Human scFv phage display libraries with 7.1108, 6.1108, 8.1108, 8.3108, 7.9108, and 7.4108 colony-forming units were generated using cDNA prepared from vaccinee Nos. 22, 27, 32, 35, 39 and 43, respectively. The libraries were subjected to five rounds of biopanning against the recombinant SARS-CoV-2 BA.1 RBD protein (Sino Biological Inc.) as described previously40. Immune tubes (SPL, 43015) coated with 17g of the BA.1 RBD were used for the first round, and 5106 magnetic beads (Invitrogen, Dynabeads M-270 epoxy) conjugated with 1.4g of the BA.1 RBD protein were used for the other rounds. After each round of biopanning, the bound phages were eluted and amplified for the next round of biopanning. For the selection of BA.1 RBD-reactive scFv phage clones, individual phage clones were amplified from the titration plate of the last round and subjected to phage ELISA41. The genes encoding BA.1 RBD-reactive scFv clones were identified using phagemid DNA prepared from phage clones and Sanger nucleotide sequencing40. A recombinant scFv protein fused with human IgG1 FC and the HA peptide (scFv-hFc-HA) was expressed using a mammalian expression system with Expi293F cells (Gibco, A14527) and purified as described previously41.

The gene fragment encoding the VH region with a randomized HCDR3 sequence and another gene fragment encoding the rest of the scFv were amplified using phagemid DNA of clone 2760, primers for randomization (Primer No. 7679) and the KAPA Biosystems kit. The PCR conditions were as follows: 95C for 3min; 25 cycles of 98C for 20s, 65C for 15s, and 72C for 1min; and 72C for 10min. Then, the amplified genes were subjected to electrophoresis on a 1.5% agarose gel and purified using a QIAquick gel extraction kit (QIAGEN Inc.) according to the manufacturers instructions. The purified gene fragments (200ng) were mixed and subjected to overlap extension PCR to generate scFv genes using 2.5 pmol of the overlap extension primers (primer No.76 and 79) and the KAPA Biosystems kit. The PCR conditions were as follows: 95C for 3min; 25 cycles of 98C for 20s, 65C for 15s, and 72C for 1min; and 72C for 5min. The amplified scFv genes were purified and cloned into a phagemid vector38. For phage ELISA, individual phage clones were amplified from the titration plate and subjected to phage ELISA42.

The ancestral SARS-CoV-2 (CoV/Korea/KCDC03/2020 NCCP43326), Alpha B.1.1.7 (hCoV-19/Korea/KDCA51463/2021 (NCCP 43381), Beta B.1.351 (hCoV-19/Korea/KDCA55905/2021 (NCCP 43382), Gamma P.1 (hCoV-19/Korea/KDCA95637/2021 (NCCP 43388), Delta B.1.617.2 (hCoV-19/Korea/KDCA119861/2021 (NCCP 43390), and Omicron B.1.1.529 (hCoV-19/Korea/KDCA447321/2021 NCCP43408) viruses were obtained from the Korea Disease Control and Prevention Agency. The viruses were propagated in Vero cells (ATCC, CCL-81) in Dulbeccos Modified Eagles Medium (DMEM, Welgene) in the presence of 2% fetal bovine serum (Gibco, Thermo Fisher Scientific Inc.)23,43. Neutralization assays were performed as described previously23,44. Briefly, Vero cells were seeded in 96-well plates (1.5104 or 0.5104 cells/well) in Opti-PRO SFM (Thermo Fisher Scientific Inc.) supplemented with 4 mM L-glutamine and 1 Antibiotics-Antimycotic (Thermo Fisher Scientific Inc/) and grown for 24h at 37C in a 5% CO2 environment. Recombinant scFv-hFc proteins were diluted from 100 to 0.1953 g/ml (twofold) in phosphate-buffered saline (PBS, Welgene) and mixed with 100 or 500 TCID50 of SARS-CoV-2. Then, the mixture was incubated for 30min at 37C and added to the cells in tetrads, followed by incubation for 4 or 6 days at 37C in a 5% CO2 environment. The cytopathic effect (CPE) in each well was visualized following crystal violet staining 4 or 6 days post infection, and measured using the EVOS Digital Inverted Imaging System with 40X lens (AMG). The IC50 values were calculated using the doseresponse inhibition equation of GraphPad Prism v6 (GraphPad Software).

The most frequent BCR HC sequences of the 2760, 35-15, 3546, 43-09, and 43-34 clonotypes in the third BCR repertoires were mapped to the chronological BCR repertoires following the same definition of BCR HC clonotypes. All the mapped nucleotide sequences were aligned using the multiple sequence alignment tool Clustal Omega v1.2.4 with the default settings35,36 and processed using Ugene software v1.16.2. The aligned mapped nucleotide sequences were interpreted using a phylogenetic tree generated by IgPhyML v1.1.3 052020 using the HLP model option45. The phylogenetic trees were plotted using Interactive Tree of Life (iTOL) online tool v646.

Further information on research design is available in theNature Portfolio Reporting Summary linked to this article.

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An ancestral SARS-CoV-2 vaccine induces anti-Omicron variants antibodies by hypermutation - Nature.com

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Here's how the city decided on a controversial vaccine grant - Caller Times

Jessica Hopkins is a physician and Public Health Ontarios chief health protection and emergency preparedness officer.

In 1998, Canada achieved what is known as measles elimination status, which means we put an end to the spread of this virus within our borders. This significant public health milestone was the result of families coming together with public health agencies, doctors, nurses, scientists and governments across the country to prioritize ending what was then a common childhood disease.

How did they do it? Vaccines. And why did all of these groups support measles elimination? Because its a serious disease and almost entirely preventable.

Complications from measles include ear infections, types of pneumonia and brain inflammation. In the era before the measles vaccine routine vaccination programs were introduced in Canada in the early 1970s as many as three out of every 1,000 children with measles died. Most of these children were under five years of age.

The measles vaccine is highly effective even with a single dose. The safety of the vaccine has continued to be demonstrated through years of use. In Ontario, children routinely receive the measles vaccine at one and four years of age. Before 1970, measles was a common childhood disease and people werent routinely vaccinated, so most adults born before 1970 have natural immunity and dont need the measles vaccine.

I am both a public health physician and a family doctor. I have been involved in the public health follow-up of cases and the notification of contacts of many travel-related cases of measles. I feel fortunate that, until now, I had never seen a case of measles caught through community spread in Ontario. So far this year, we have had 13 cases of measles in Ontario. One of those cases did not involve travel outside of Canada, suggesting there has been some level of community spread.

Measles cases are increasing globally. Since October, England has reported more than 1,100 cases (in 2022-23, 84.5 per cent of Englands five-year-old children had received two doses of the measles vaccine.) Closer to home, Quebec has seen 46 cases of measles this year. Media reports put measles vaccine coverage in Montreal schools at around 80 per cent.

While not a perfect measure of vaccine coverage, Ontario monitors the vaccine records of school children, which are reported to local public health units. Prepandemic, records showed that 86 per cent of seven-year-old children had two doses of the measles vaccine. In the 2022-23 school year, these records dropped to 60 per cent. Even more worrisome, the proportion of seven year olds who have no record of even a single dose of measles vaccine increased from 3 per cent to almost 17 per cent.

While some of these children are vaccinated and their records are not up-to-date in the system, it is clear that there are currently more unprotected children than there were prepandemic, and that we are well below the 95-per-cent level of coverage needed for herd immunity (which is the level of coverage needed to protect those who cant be vaccinated for measles, such as babies under six months of age).

Higher numbers of global cases, increased travel and suboptimal vaccine coverage are creating the ideal conditions for a serious measles outbreak in Ontario. As we face the busy summer vacation and travel season, we need to be vigilant in monitoring for signs of measles. Due to the longer incubation period, which averages 14 days to the start of a measles rash, most people travelling in and out of Canada wont know theyve brought the infection home until at least two weeks after they return. People are contagious from four days before the rash starts until four days after leaving lots of time for the spread of the virus in our communities.

The good news is, we have the tools and experience to limit the impact this virus has on families across Ontario in our schools, daycares and health system. Measles is not the great unknown that COVID-19 was. The key is for all of us to find the space in our busy lives and jobs to make getting the measles vaccine a priority.

The first step is to get kids vaccinated now in particular, those children who have not had any doses of the measles vaccine. Then we can move on to prioritizing other vulnerable groups. Ill know were on the road to success when Im busier as a family doctor giving measles vaccines to my patients, than as a public health physician counting measles cases.

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Opinion: Why measles vaccination needs to be a top priority - The Globe and Mail

Washington D.C. 18 April 2024 (PAHO/WHO) With 15 out of every 100 children in the Americas only partially protected against vaccine-preventable diseases, the Pan American Health Organization (PAHO) Director, Dr. Jarbas Barbosa, has urged countries of the region to continue efforts to recover routine vaccination coverage.

Historically, our Region has always been a leader in disease elimination. However, for more than a decade, vaccination coverages have significantly decreased, Dr. Barbosa said during a press briefing today to mark the upcoming Vaccination Week in the Americas. This is due to several factors, including a false perception that eliminated and controlled disease no long pose a risk to peoples health; a reduction in the prioritization of vaccination programs; and the rise in disinformation since the COVID-19 pandemic, among other factors.

While improvements have been made to recover lost ground, the PAHO Director underscored that more must be done to recover regional vaccination coverage, particularly for highly contagious diseases such as measles. This is very concerning, given the rise in measles cases around the globe and the highly contagious nature of this virus, Dr. Barbosa said.

Countries also remain far from the 90% coverage rate needed to protect girls ages 9 to 14 against the Human Papilloma Virus (HPV), which affords them lifelong protection against cervical cancer, one of the main causes of death among women, Dr. Barbosa said.

The PAHO Director highlighted that as countries work towards recovery, they must overcome several challenges. To do this, they will need to increase financial and technical resources to improve the performance of essential vaccination services, establish effective communication strategies to tackle vaccine hesitancy, and increase political commitment to routine vaccination programs.

Dr. Barbosa assured that PAHO stands ready to support countries as they strengthen disease surveillance, increase vaccination coverage rates in all corners of their national territory and avoid outbreaks of vaccine-preventable diseases.

The Organizations regional vaccine procurement mechanism, the Revolving Fund for Access to Vaccines, which has provided countries with over 130 million doses of vaccines in 2022 and 2023, also enables countries of the region to access safe and quality vaccines at affordable prices.

Furthermore, PAHOs special program, innovation and regional production platform, continues to support the regional manufacturing of vaccines. This will not only benefit countries of the Americas during emergencies but will help to improve access to vaccines for regular programs, Dr. Barbosa said.

Thanks to vaccination, we have been able to live happier, healthier, longer, and more active lives, while minimizing the threat of vaccine-preventable diseases, the Director added.

This has only been possible thanks to immunization efforts. We cannot be complacent, he added. Vaccines keep us and our loved ones protected against more than 20 diseases and must continue performing their key role in our societies.

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Despite vaccination gains, 1.2 million children under one remain unprotected in the Americas - Pan American Health Organization

A team of Montana researchers is playing a key role in the development of a more effective vaccine against tuberculosis, an infectious disease that has killed more people than any other.

The BCG (Bacille Calmette-Gurin) vaccine, created in 1921, remains the sole TB vaccine. While it is 40% to 80% effective in young children, its efficacy is very low in adolescents and adults, leading to a worldwide push to create a more powerful vaccine.

One effort is underway at the University of Montana Center for Translational Medicine. The center specializes in improving and creating vaccines by adding wh...

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The Path to a Better Tuberculosis Vaccine Runs Through Montana - Three Forks Voice