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Medical Countermeasures for Intoxication by Botulinum Neurotoxin
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Michael Adler, Ajay K. Singh, Nizamettin Gul, Frank J. Lebeda
Prophylaxis has traditionally involved immunization of at-risk personnel with a toxoid vaccine (Rusnak and Smith, 2009). From 1965 to 2011, this was accomplished by use of a pentavalent vaccine (PBT) containing toxoids for BoNT serotypes A–E. PBT was withdrawn by the CDC on November 30, 2011, based on the reduction in immunogenicity coupled with a progressive rise in reactogenicity (CDC, 2011). The Department of Defense decided not to replace PBT with a newly formulated toxoid vaccine, because of the risks involved in the required large-scale toxin production for the toxoiding process, but elected to develop a new-generation vaccine using the nontoxic recombinant C-terminal fragment of the BoNT heavy chain. A bivalent vaccine was preferred, because de novo pentavalent or heptavalent formulations would have been cost-prohibitive. The construct, designated as rBV A/B, targets BoNT serotypes A and B, since protection against these serotypes would provide prophylaxis against nearly 80% of human botulism (Woodruff et al., 1992).
Rotavirus
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Lijuan Yuan, Tammy Bui, Ashwin Ramesh
Regional rotavirus vaccines include the Lanzhou lamb rotavirus vaccine (LLR) licensed in China, a monovalent human-bovine vaccine (Rotavac) in India, and an attenuated G1P[8] strain vaccine (Rotavin) in Vietnam.2,201–203 More recently, a heat-stable oral bovine-human reassortant pentavalent vaccine (Rotasiil by Serum Institute of India) demonstrated a 66.7% efficacy against severe RV gastroenteritis with three doses in a randomized, placebo-controlled trial.204 The vaccine contains human RV serotypes G1, G2, G3, G4, and G9 on a bovine RV G6P[7] backbone (BRV-PV). The vaccine is stable for 2 years at a temperature of 37°C and for 6 months at 40°C; the heat stability makes it far easier to use in resource-limited countries.
Age and lifecourse transitions in health
Published in Kevin McCracken, David R. Phillips, Global Health, 2017
Kevin McCracken, David R. Phillips
Even when it does not kill, measles can leave many impairments, such as deafness, partial deafness, blindness and even brain damage. Sometimes healthy and well-nourished children without immunity are at risk, particularly when ‘herd immunity’ has declined, but the vast majority of measles deaths occur in developing countries, especially where immunity rates are low. The development of the measles vaccine and subsequent delivery campaigns (often delivered as MMR, measles-mumps-rubella in developed countries and previously via the Expanded Programme on Immunization in poorer countries) have had dramatic effects over the past four decades. The Expanded Programme on Immunization (EPI) was introduced by the WHO in 1974 and was pushed strongly through the 1980s and 1990s, including a Universal Child Immunization Programme (Phillips, 1990). The EPI focused especially on diphtheria, pertussis (whooping cough), tetanus, measles, poliomyelitis and tuberculosis. Millions of child deaths have undoubtedly been averted; for measles alone, an estimated 17.1 million deaths were prevented between 2000 and 2014. As noted above, GAVI has stressed the use of the pentavalent vaccine, illustrating the range of approaches and combinations possible.
A review of the DTaP-IPV-HB-PRP-T Hexavalent vaccine in pediatric patients
Published in Expert Review of Vaccines, 2023
Andrew Dakin, Ray Borrow, Peter D. Arkwright
The pentavalent vaccine, Pentaxim, was also compared with DT2aP-IPV-Hib-HBV, across numerous studies [34,35,38,39]. Pentaxim is a DTaP-IPV liquid suspension that is used to reconstitute freeze-dried Hib vaccine and must be administered with a standalone, monovalent Hep B vaccine such as Engerix B [34,35,39] or Euvax B [38]. DT2aP-IPV-Hib-HBV has also been compared with the pentavalent vaccine, Tritanrix-Hep B/Hib, and OPV, but only safety and Hep B immunogenicity was evaluated in this trial [44]. DT2aP-IPV-Hib-HBV was non-inferior to Pentaxim regardless of the choice of standalone HepB vaccination administered alongside it. DT2aP-IPV-Hib-HBV was more reactogenic and after the first dose, crying, and pyrexia were seen more frequently in children given DT2aP-IPV-Hib-HBV compared with Pentaxim and Engerix B [34]. Pyrexia was also more common in infants receiving DT2aP-IPV-Hib-HBV than in those who received Pentaxim with Euvax B [38]. Additionally, crying was also seen to be more common in infants who received DT2aP-IPV-Hib-HBV in comparison to DT3aP-IPV-Hib-HBV [36].
Combined vaccines for prophylaxis of infectious conditions
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Pravin Shende, Mansi Waghchaure
DTaP-IPV-Hib vaccine is a DTaP-based pentavalent vaccine which contains the combination of tetanus and diphtheria toxoids, acellular pertussis adsorbed, inactivated poliovirus and Haemophilus b conjugate (tetanus toxoid conjugate) vaccine (DTaP-IPV/Hib). The first marketed preparation approved in the US, based on DTaP includes both type b Haemophilus influenzae (Hib) and poliovirus antigen. The vaccine formulation consists of a liquid form of IPV and DTaP along with a lyophilized form of Hib, which is then reconstituted prior to administration [6]. No significant interaction was observed between DTaP and Hib components of vaccines when used in combination. The vaccine is administered via intramuscular route in four-dose series and the first dose is given at the age of 2 months and the remaining three doses are administered at 4, 6 and 15–18 months of age at a dose of 0.5 mL per administration. The combined vaccine increases immunogenicity against all diseases including Hib and the adverse event profile is the same as the vaccines administered separately and is well tolerated. Mild fever, drowsiness, redness and irritation at the site of action are the side effects associated with this vaccine [7].
The analysis of parental attitude towards active immunoprophylaxis and its influence on the implementation of an Immunization Schedule among children in Poland
Published in Children's Health Care, 2018
Marta Olszewska, Barbara Smykla, Marta Gdańska, Grzegorz Kiełbasa, Matthew Ficinski, Izabela Szymońska, Katarzyna Starzec, Przemko Kwinta
Four vaccination models were distinguished in the study group (Table 5). The immunization model with included vaccinations for extended protection was most popular in the analyzed group (44.1%). The vaccination model could not be determined in 89 children younger than 2 months or with significant immunization delays. Administration of combined vaccinations was found in 49.3% of children. Among them, a pentavalent vaccine was applied more frequently than a hexavalent (70.92% vs. 29.08%). The likelihood of use of combined vaccinations was increased in older parents (OR = 1.1, 95% CI: 1.04–1.16, p = 0.002, OR for 1 year increase in parental age) with higher education (OR = 2.97, 95% CI: 1.68–5.25, p < 0.001), good financial status (OR = 2.25, 95% CI: 1.28–3.55, p = 0.005), and living in the city of over 100,000 inhabitants (OR = 1.91, 95% CI: 1.07–3.41, p = 0.03).