vaccine delivery

疫苗递送
  • 文章类型: Journal Article
    生物材料是可以注射的物质,植入,或应用于生物医学应用中的组织表面,并具有与生物系统相互作用以引发治疗反应的能力。基于生物材料的疫苗递送系统具有强大的包装能力,使药物在目标部位持续和局部释放。在整个疫苗接种过程中,它们可以有助于保护,稳定,并指导免疫原,同时还用作佐剂以增强疫苗功效。在这篇文章中,我们全面回顾了生物材料对疫苗发展的贡献。我们首先对生物材料的类型和性质进行分类,详细说明他们的后处理策略,探索几种常见的交付系统,如聚合物纳米颗粒,脂质纳米粒,水凝胶,还有微针.此外,我们研究了生物材料的理化性质和传递途径如何影响免疫反应。值得注意的是,我们深入研究了生物材料作为疫苗佐剂的设计考虑,展示了它们在癌症疫苗开发中的应用,获得性免疫缺陷综合症,流感,2019年冠状病毒病(COVID-19),结核病,疟疾,在这篇综述中,我们重点介绍了生物材料增强疫苗效力的成功实例,并讨论了生物材料在疫苗递送和免疫疗法中的局限性和未来方向。本文旨在让研究人员全面了解生物材料在疫苗开发中的应用,并促进相关领域的进一步发展。
    Biomaterials are substances that can be injected, implanted, or applied to the surface of tissues in biomedical applications and have the ability to interact with biological systems to initiate therapeutic responses. Biomaterial-based vaccine delivery systems possess robust packaging capabilities, enabling sustained and localized drug release at the target site. Throughout the vaccine delivery process, they can contribute to protecting, stabilizing, and guiding the immunogen while also serving as adjuvants to enhance vaccine efficacy. In this article, we provide a comprehensive review of the contributions of biomaterials to the advancement of vaccine development. We begin by categorizing biomaterial types and properties, detailing their reprocessing strategies, and exploring several common delivery systems, such as polymeric nanoparticles, lipid nanoparticles, hydrogels, and microneedles. Additionally, we investigated how the physicochemical properties and delivery routes of biomaterials influence immune responses. Notably, we delve into the design considerations of biomaterials as vaccine adjuvants, showcasing their application in vaccine development for cancer, acquired immunodeficiency syndrome, influenza, corona virus disease 2019 (COVID-19), tuberculosis, malaria, and hepatitis B. Throughout this review, we highlight successful instances where biomaterials have enhanced vaccine efficacy and discuss the limitations and future directions of biomaterials in vaccine delivery and immunotherapy. This review aims to offer researchers a comprehensive understanding of the application of biomaterials in vaccine development and stimulate further progress in related fields.
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  • 文章类型: Journal Article
    养猪已成为全球具有战略意义和经济重要性的行业。由于跨界疾病所带来的挑战,它也是一个潜在的脆弱部门,病毒感染是最重要的。在猪病毒性疾病中,非洲猪瘟,经典猪瘟,口蹄疫,猪繁殖与呼吸综合征,伪狂犬病,猪流感,传染性胃肠炎是一些在养猪业造成重大经济损失的疾病。众所周知,疫苗接种无疑是控制动物病毒感染的最有效策略。从詹纳和巴斯德时期到最近的新一代技术时代,疫苗的开发大大有助于减轻病毒感染对动物和人类的负担。灭活和修饰的活病毒疫苗提供针对关键病原体的部分保护。然而,有必要改进这些疫苗,以更全面地应对新出现的感染,并确保其安全性。最近关于针对DNA等猪病毒的新一代疫苗的报道,基于病毒载体的复制子,嵌合,肽,植物制造,病毒样粒子,基于纳米粒子的疫苗非常令人鼓舞。当前的评论收集了有关可用疫苗的全面信息以及对猪病毒疫苗的未来展望。
    Pig farming has become a strategically significant and economically important industry across the globe. It is also a potentially vulnerable sector due to challenges posed by transboundary diseases in which viral infections are at the forefront. Among the porcine viral diseases, African swine fever, classical swine fever, foot and mouth disease, porcine reproductive and respiratory syndrome, pseudorabies, swine influenza, and transmissible gastroenteritis are some of the diseases that cause substantial economic losses in the pig industry. It is a well-established fact that vaccination is undoubtedly the most effective strategy to control viral infections in animals. From the period of Jenner and Pasteur to the recent new-generation technology era, the development of vaccines has contributed significantly to reducing the burden of viral infections on animals and humans. Inactivated and modified live viral vaccines provide partial protection against key pathogens. However, there is a need to improve these vaccines to address emerging infections more comprehensively and ensure their safety. The recent reports on new-generation vaccines against swine viruses like DNA, viral-vector-based replicon, chimeric, peptide, plant-made, virus-like particle, and nanoparticle-based vaccines are very encouraging. The current review gathers comprehensive information on the available vaccines and the future perspectives on porcine viral vaccines.
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  • 文章类型: Journal Article
    近年来,肿瘤疫苗被认为是治疗癌症的有希望的治疗方法。随着测序技术的发展,基于肿瘤细胞中特异性表达的新抗原或基因组的肿瘤疫苗,主要是肽的形式,核酸,和树突状细胞,开始受到广泛关注。因此,在这次审查中,我们介绍了不同形式的新抗原疫苗,并讨论了这些疫苗在治疗癌症方面的发展。此外,新抗原疫苗受抗原稳定性等因素的影响,弱免疫原性,和生物安全除了测序技术。因此,生物纳米材料,聚合物纳米材料,无机纳米材料,等。,用作疫苗载体的主要概述,这可能有助于新抗原疫苗的设计,以提高稳定性和更好的功效。
    Tumor vaccines have been considered a promising therapeutic approach for treating cancer in recent years. With the development of sequencing technologies, tumor vaccines based on neoantigens or genomes specifically expressed in tumor cells, mainly in the form of peptides, nucleic acids, and dendritic cells, are beginning to receive widespread attention. Therefore, in this review, we have introduced different forms of neoantigen vaccines and discussed the development of these vaccines in treating cancer. Furthermore, neoantigen vaccines are influenced by factors such as antigen stability, weak immunogenicity, and biosafety in addition to sequencing technology. Hence, the biological nanomaterials, polymeric nanomaterials, inorganic nanomaterials, etc., used as vaccine carriers are principally summarized here, which may contribute to the design of neoantigen vaccines for improved stability and better efficacy.
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  • 文章类型: Journal Article
    我们使用定性和定量方法进行了现场评估,以评估在最近开发的,世界卫生组织-与目前使用的标准冷箱(SCB)相比,预先认证的防冻冷箱(FPCB)。该研究评估了FPCB的实际应用,卫生工作者验收,卫生系统适合度(包括成本考虑),以及卫生工作者在不同条件和地理环境中面临的挑战。评估分两个阶段在尼泊尔丘陵和平原地区的五个医疗机构进行:第一阶段涉及FPCB与SCB一起模拟使用。在第二阶段,实际疫苗被用于FPCB。该研究从放置在冷箱内部和外部的日志和电子温度监测器中收集了定量数据。从卫生工作者那里收集了定性数据,冷链人员,和免疫计划管理人员在多个层面参与疫苗冷链。没有损坏,耐久性问题,或在使用FPCB时观察到冻结事件,但是使用SCB时发生了两起冻结事件。与SCB相比,FPCB的冷却时间也更长。参与者大多发现FPCB对于疫苗运输和短期储存是安全和用户友好的。与SCB相比,FPCB的优势包括其减少疫苗浪费的能力。为保证冷冻敏感疫苗的安全(每批运输的冷冻敏感疫苗的平均价值为1,704美元),并通过消除调节冰袋的需要来简化准备工作。FPCB的采购价格范围与SCB的采购价格范围重叠。FPCB的缺点包括其较大的尺寸和重量,在运输过程中需要更多的人员和车辆。这表明,更轻和更小的FPCB对于尼泊尔免疫计划和其他免疫计划将更有效和可接受,全球开展类似的免疫计划。
    We conducted a field evaluation using qualitative and quantitative methods to assess freeze prevention of vaccines transported and stored in a recently developed, World Health Organization-prequalified freeze-preventive cold box (FPCB) as compared to currently used standard cold boxes (SCBs). The study assessed the FPCB\'s practical use, health worker acceptance, health system fit (including cost considerations), and challenges faced by health workers in variable conditions and geographical settings. The evaluation took place in five health facilities across hilly and plains districts of Nepal in two phases: Phase 1 involved FPCBs in simulated use alongside SCBs. In Phase 2, actual vaccines were used in the FPCBs. The study gathered quantitative data from logbooks and electronic temperature monitors placed inside and outside the cold boxes. Qualitative data were collected from health workers, cold chain personnel, and immunization program managers involved in the vaccine cold chain at multiple levels. No damage, durability issues, or freezing incidents were observed when using FPCBs, but two incidents of freezing occurred when using SCBs. FPCBs also took longer to cool down than SCBs. Participants mostly found the FPCB to be safe and user friendly for vaccine transportation and short-term storage. Advantages of the FPCB as compared to the SCB include its ability to minimize vaccine wastage, to keep freeze-sensitive vaccines safe (the average value of freeze-sensitive vaccines transported per shipment was $1,704), and to ease preparation through elimination of the need to condition ice packs. Procurement price ranges for FPCBs overlap those for SCBs. Disadvantages of the FPCB include its greater size and weight, which require more personnel and vehicles during transportation. This suggests that lighter and smaller FPCBs would be more effective and acceptable for the Nepal immunization program and other, similar immunization programs conducted globally.
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  • 文章类型: Journal Article
    世界卫生组织建议将人乳头瘤病毒(HPV)疫苗纳入国家免疫计划,以解决宫颈癌的全球问题。在菲律宾,HPV疫苗接种于2015年分阶段引入。本研究旨在评估HPV疫苗接种计划的交付成本及其在菲律宾的运营背景。
    这是一个回顾,横断面微观成本计算研究的重点是正在进行的HPV疫苗接种及其在各级卫生系统中的操作背景.使用结构化问卷和二级来源的数据收集,加权平均财务和经济成本以及国家/剂量的成本,国家以下,估计了医疗机构的水平。
    在各级卫生系统中,每剂量HPV疫苗接种计划的加权平均财务和经济成本分别为3.72美元和29.74美元。对成本贡献最大的活动是在卫生设施和行政一级提供服务以及疫苗的收集或分发和储存,分别。卫生工作者和非卫生工作者时间的机会成本占每剂经济成本的77%。
    HPV交付的总加权平均财务和经济成本在其他国家报告的范围内。成本计算研究可以帮助确定与当地运营背景的成本驱动因素,以帮助决策者和计划管理人员在预算和计划干预措施方面提供信息,以改善计划实施。
    UNASSIGNED: The World Health Organization has recommended the inclusion of human papillomavirus (HPV) vaccines in national immunization programs to address the global problem of cervical cancer. In the Philippines, HPV vaccination was introduced in a phased approach in 2015. This study seeks to estimate the cost of delivery of the HPV vaccination program and its operational context in the Philippines.
    UNASSIGNED: This was a retrospective, cross-sectional micro-costing study focused on ongoing HPV vaccination delivery and its operational context across all levels of the health system. Using structured questionnaires and data collection from secondary sources, the weighted mean financial and economic costs and costs per dose at the national, subnational, and health facility levels were estimated.
    UNASSIGNED: The weighted mean financial and economic costs per dose of the HPV vaccination program aggregated across all levels of the health system were $US3.72and $29.74, respectively. Activities contributing most significantly to costs were service delivery and vaccine collection or distribution and storage at the health facility and administrative levels, respectively. The opportunity costs for health worker and non-health worker time accounted for 77% of the economic cost per dose.
    UNASSIGNED: The total weighted mean financial and economic costs of HPV delivery are within range of those reported in other countries. Costing studies can help identify cost drivers with local operational context to help inform policymakers and program managers in budgeting and planning interventions to improve program implementation.
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  • 文章类型: Journal Article
    位于密歇根州东北部的自由放养的白尾鹿(Odocoileusvirginianus),(美国)是牛结核病(bTB)的自我维持库。农场缓解措施,诱饵禁令,无鹿角鹿的收成对消除白尾鹿的bTB和对牛的风险无效。鹿的表观患病率保持相对稳定,引起野生动物研究人员的兴趣,经理,和兽医为鹿接种bTB疫苗的有效手段。常用的bTB人类疫苗,卡介苗(BCG),是主要的候选人,口服分娩是给鹿接种疫苗的合理手段。
    我们开发了疫苗递送单元,并在将其递送到鹿之前掺入了生物标志物罗丹明B,以评估可实现的覆盖水平。在Alpena县的17个农业研究地点部署了载有罗丹明B的疫苗交付单位之后,2016年3月/4月,我们对鹿进行了采样,以检测罗丹明B消费的证据。
    我们总共收集了116只鹿,并对它们进行了病毒标记/瘤胃标记,发现收集的鹿中有66.3%(n=77)表现出疫苗递送单位消耗量的证据。了解我们通过将疫苗递送单位中的生物标志物口服递送到鹿所达到的覆盖水平,使自然资源专业人员能够预测下一步进一步减少鹿中bTB的预期。
    UNASSIGNED: Free-ranging white-tailed deer (Odocoileus virginianus) in northeastern lower Michigan, (United States) are a self-sustaining reservoir for bovine tuberculosis (bTB). Farm mitigation practices, baiting bans, and antlerless deer harvests have been ineffective in eliminating bTB in white-tailed deer and risks to cattle. The apparent prevalence has remained relatively constant in deer, prompting interest among wildlife researchers, managers, and veterinarians for an effective means of vaccinating deer against bTB. The commonly used human vaccine for bTB, Bacillus Calmette Guerin (BCG), is the primary candidate with oral delivery being the logical means for vaccinating deer.
    UNASSIGNED: We developed vaccine delivery units and incorporated the biomarker Rhodamine B before delivering them to deer to assess the level of coverage achievable. Following deployment of Rhodamine B-laden vaccine delivery units on 17 agricultural study sites in Alpena County, MI in Mar/Apr 2016, we sampled deer to detect evidence of Rhodamine B consumption.
    UNASSIGNED: We collected a total of 116 deer and sampled them for vibrissae/rumen marking and found 66.3% (n = 77) of the deer collected exhibited evidence of vaccine delivery unit consumption. Understanding the level of coverage we achieved with oral delivery of a biomarker in vaccine delivery units to deer enables natural resource professionals to forecast expectations of a next step toward further minimizing bTB in deer.
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  • 文章类型: Journal Article
    疫苗是预防感染和控制威胁公共卫生的传染病传播的重要工具。大多数感染因子通过粘膜表面进入宿主,它们构成了宿主防御病原体的关键第一道防线。粘膜免疫应答在宿主免疫防御中起关键作用,以提供持久和更好的回忆应答。大量注意力集中在开发有效的粘膜疫苗以通过粘膜途径给药引起强烈的局部和全身免疫应答。引发有效免疫应答的粘膜疫苗产生优于肠胃外递送疫苗的保护作用。除了它们有价值的免疫原性,粘膜疫苗可以更便宜,更容易给药,而不需要注射材料和训练有素的人员。然而,开发有效的粘膜疫苗面临许多挑战,他们的发展已经付出了很多努力。在这篇文章中,我们回顾了黏膜疫苗的发展历史,并概述了黏膜隔室生物学以及黏膜免疫在防御感染中的作用。有助于粘膜疫苗开发的知识。我们探索了粘膜疫苗设计和优化的新进展,并为提高粘膜疫苗的有效性和安全性创造了新的方法。
    Vaccines are essential tools to prevent infection and control transmission of infectious diseases that threaten public health. Most infectious agents enter their hosts across mucosal surfaces, which make up key first lines of host defense against pathogens. Mucosal immune responses play critical roles in host immune defense to provide durable and better recall responses. Substantial attention has been focused on developing effective mucosal vaccines to elicit robust localized and systemic immune responses by administration via mucosal routes. Mucosal vaccines that elicit effective immune responses yield protection superior to parenterally delivered vaccines. Beyond their valuable immunogenicity, mucosal vaccines can be less expensive and easier to administer without a need for injection materials and more highly trained personnel. However, developing effective mucosal vaccines faces many challenges, and much effort has been directed at their development. In this article, we review the history of mucosal vaccine development and present an overview of mucosal compartment biology and the roles that mucosal immunity plays in defending against infection, knowledge that has helped inform mucosal vaccine development. We explore new progress in mucosal vaccine design and optimization and novel approaches created to improve the efficacy and safety of mucosal vaccines.
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  • 文章类型: Journal Article
    这项研究基于2016年乌干达人口与健康调查(UDHS)数据集,分析了乌干达五岁以下儿童的疫苗覆盖率和公平性。了解疫苗获取和决定因素的公平性对于纠正新兴和持续存在的不平等现象至关重要。
    应用于2000年,2006年,2011年和2016年的UDHS,可持续发展和公平性疫苗经济学研究(VERSE)公平性工具包通过(1)对样本人群进行综合直接不公平指数排名,提供了免疫接种覆盖率和公平性的多变量评估。(2)生成效率(覆盖率)和公平性的定量度量,(3)将不公平分解为其影响因素。直接不公平排序变量是基于疫苗接种覆盖率的公平和不公平差异来源的逻辑模型预测的疫苗接种覆盖率。我们合理的变异来源定义为儿童的年龄-年龄太小而无法接受常规免疫接种的儿童预计不会接种疫苗。不公平的变异来源是孩子的居住地,无论他们生活在城市还是农村,母亲的教育水平,家庭的社会经济地位,孩子的性别,以及他们的保险状况。对于每个不公平的变异来源,我们确定了一个“更特权”的情况。
    白喉-百日咳-破伤风疫苗的覆盖率和公平性,第三剂(DPT3)和含麻疹疫苗,第一剂(MCV1)-表明卫生系统性能的两种疫苗-自2000年以来显着提高,从49.7%提高到76.8%,从67.8%提高到82.7%,分别,零剂量儿童人数较少:从8.4%到2.2%。在将儿童保留在计划中以便他们完成免疫计划方面的改进更为适度(从38.1%到40.8%)。覆盖面方面的进展是有利于穷人的,集中度指数(仅限财富)从2000年的0.127(DPT3)和0.123(MCV1)移动到2016年的-0.042和-0.029。总股本(综合)收益较为温和,尽管对于除MCV1外的大多数疫苗都很重要:2000年的浓度指数为0.150(DPT3)和0.087(MCV1),2016年为0.054和0.055。自2000年以来,居住区域和环境(城市/农村)的影响显着下降。
    在过去的二十年中,疫苗覆盖率和公平性得到了显着改善。由于努力加强常规免疫和正在进行的补充免疫活动,如家庭健康日。在保持向所有地区定期提供疫苗的同时,应努力减轻孕产妇教育和识字率低对疫苗接种的影响。
    This study analyses vaccine coverage and equity among children under five years of age in Uganda based on the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Understanding equity in vaccine access and the determinants is crucial for the redress of emerging as well as persistent inequities.
    Applied to the UDHS for 2000, 2006, 2011, and 2016, the Vaccine Economics Research for Sustainability and Equity (VERSE) Equity Toolkit provides a multivariate assessment of immunization coverage and equity by (1) ranking the sample population with a composite direct unfairness index, (2) generating quantitative measure of efficiency (coverage) and equity, and (3) decomposing inequity into its contributing factors. The direct unfairness ranking variable is the predicted vaccination coverage from a logistic model based upon fair and unfair sources of variation in vaccination coverage. Our fair source of variation is defined as the child\'s age - children too young to receive routine immunization are not expected to be vaccinated. Unfair sources of variation are the child\'s region of residence, and whether they live in an urban or rural area, the mother\'s education level, the household\'s socioeconomic status, the child\'s sex, and their insurance coverage status. For each unfair source of variation, we identify a \"more privileged\" situation.
    The coverage and equity of the Diphtheria-Pertussis-Tetanus vaccine, 3rd dose (DPT3) and the Measles-Containing Vaccine, 1st dose (MCV1) - two vaccines indicative of the health system\'s performance - improved significantly since 2000, from 49.7% to 76.8% and 67.8% to 82.7%, respectively, and there are fewer zero-dose children: from 8.4% to 2.2%. Improvements in retaining children in the program so that they complete the immunization schedule are more modest (from 38.1% to 40.8%). Progress in coverage was pro-poor, with concentration indices (wealth only) moving from 0.127 (DPT3) and 0.123 (MCV1) in 2000 to -0.042 and -0.029 in 2016. Gains in overall equity (composite) were more modest, albeit significant for most vaccines except for MCV1: concentration indices of 0.150 (DPT3) and 0.087 (MCV1) in 2000 and 0.054 and 0.055 in 2016. The influence of the region and settings (urban/rural) of residence significantly decreased since 2000.
    The past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing supplemental immunization activities such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake.
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  • 文章类型: Journal Article
    流产衣原体(Cab)导致感染的反刍动物和孕妇的自然流产和新生儿死亡。大多数Cab感染是无症状的,尽管它们可以用抗生素治疗,这表明控制这些感染可能需要替代策略,包括使用有效的疫苗。然而,减毒活疫苗和灭活疫苗的局限性进一步表明,可能需要考虑使用亚单位疫苗.在妊娠小鼠中评估了带有CabPmp18D蛋白(rVCG-Pmp18.3)的N末端部分的新生成的基于霍乱弧菌(rVCG)的亚单位疫苗预防Cab引起的流产或新生儿死亡的功效。小鼠鼻内(IN)免疫并加强两次,疫苗间隔两周,免疫和未免疫的小鼠在免疫后4周用雄性笼。然后在怀孕后10天对小鼠进行IN或经宫颈(TC)感染,产后7天确定生育率。交货后八天,小鼠被处死,通过在组织培养物中培养组织匀浆来评估肺和脾中的Cab感染性。我们的结果表明,在IN免疫后,疫苗诱导的免疫效应子介导了肺部感染的完全清除,并显着降低了脾脏中的Cab感染性。疫苗免疫还提供针对Cab诱导的上生殖道病理(子宫扩张)的保护。此外,虽然在免疫和未免疫的小鼠中都没有流产的发生率,与未免疫的感染对照相比,免疫的小鼠完全防止新生儿死亡,产后7天损失了很大一部分产仔。我们的结果建立了rVCG-Pmp18.3疫苗预防肺部(粘膜)和脾脏(全身)感染的能力,并保护小鼠免受Cab引起的输卵管病变和新生儿死亡。反刍动物Cab感染的标志.为了提高这种疫苗的商业潜力,未来的研究将优化保护反刍动物所需的抗原剂量和疫苗剂量。
    Chlamydia abortus (Cab) causes spontaneous abortion and neonatal mortality in infected ruminants and pregnant women. Most Cab infections are asymptomatic, although they can be treated with antibiotics, signifying that control of these infections may require alternative strategies, including the use of effective vaccines. However, the limitations imposed by live attenuated and inactivated vaccines further suggest that employment of subunit vaccines may need to be considered. The efficacy of a newly generated Vibrio cholerae ghost (rVCG)-based subunit vaccine harboring the N-terminal portion of the Cab Pmp18D protein (rVCG-Pmp18.3) in preventing Cab-induced abortion or neonatal mortality was evaluated in pregnant mice. Mice were intranasally (IN) immunized and boosted twice, 2 weeks apart with the vaccine, and immunized and unimmunized mice were caged with males 4 weeks postimmunization. The mice were then infected either IN or transcervically (TC) 10 days after pregnancy, and the fertility rate was determined 7 days postpartum. Eight days after delivery, the mice were sacrificed, and Cab infectivity in the lungs and spleens was evaluated by culturing tissue homogenates in tissue culture. Our results demonstrated that the vaccine induced immune effectors that mediated complete clearance of infection in the lungs and significantly reduced Cab infectivity in the spleen following IN immunization. Vaccine immunization also afforded protection against Cab-induced upper genital tract pathology (uterine dilation). Furthermore, while there was no incidence of abortion in both immunized and unimmunized mice, immunized mice were completely protected against neonatal mortality compared to unimmunized infected controls, which lost a significant percentage of their litter 7 days postpartum. Our results establish the capability of the rVCG-Pmp18.3 vaccine to prevent infection in the lungs (mucosal) and spleen (systemic) and protect mice from Cab-induced tubal pathologies and neonatal mortality, a hallmark of Cab infection in ruminants. To advance the commercial potential of this vaccine, future studies will optimize the antigen dose and the number of vaccine doses required for protection of ruminants.
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  • 文章类型: Journal Article
    儿童接种疫苗是降低传染病负担的有效干预措施。全球疫苗覆盖率增加,但是疫苗的犹豫和拒绝威胁着这些收益。5C疫苗接种的心理先例(“5C”)提供了“疫苗犹豫或信心”的有效度量,以评估疫苗接种背后的个人思想和行为。我们调查了导致赞比亚疫苗接种覆盖率高和持续的人群水平因素,尼泊尔,塞内加尔,并与5C对齐。
    数据是在较大的疫苗交付示例研究中收集的,从全国焦点小组讨论(FDG)和关键线人访谈(KIIs)中,区域,区,卫生机构,以及赞比亚卫生系统的社区水平,尼泊尔,塞内加尔。我们评估了需求环境,正如参与者传达的那样,并确定了据报道对需求产生成功的干预措施,然后将干预措施与5C结构追溯对齐。
    需求与高信心和集体责任呈正相关。心理约束有时会影响需求。身体上的限制在一些社区造成了障碍,特别难以访问(即,山区)。偶尔,身体限制并不影响疫苗接种行为-父母认为疫苗接种的益处值得追求.与需求和意图负相关的因素,自满和计算,影响有限。关键干预措施是:有针对性和量身定制的健康教育活动(媒体伙伴关系、学校外展);社区参与;社区所有权;和社区参与(社区卫生工作者,领导人,宗教人物)。
    我们发现了用于产生需求的类似干预措施,与5C结构保持一致的策略。按需求驱动因素对干预措施进行分类可能有助于战略规划和资源分配;决策者可以选择实施我们建议的干预措施。评估5C允许决策者将需求产生转化为具体的干预措施和政策,并确定这些结构对人口的个人影响,并将重点放在针对特定需求的干预措施上。
    UNASSIGNED: Childhood vaccination is an effective intervention for lowering the burden of infectious disease. Vaccine coverage has increased globally, but vaccine hesitancy and refusal threatens these gains. The 5C psychological antecedents of vaccination (\"5C\") provides a validated measure of \"vaccine hesitancy or confidence\" to assess individual thoughts and behaviors behind vaccination. We investigated population-level factors that contributed to high and sustained vaccination coverage in Zambia, Nepal, and Senegal, and alignment with the 5Cs.
    UNASSIGNED: Data was collected in the larger Exemplars in Vaccine Delivery study, from focus group discussions (FDGs) and key informant interviews (KIIs) at the national, regional, district, health facility, and community levels of health systems in Zambia, Nepal, and Senegal. We assessed the demand environment, as relayed by participants, and identified interventions reported as successful for demand generation, then retroactively aligned the interventions with the 5C constructs.
    UNASSIGNED: Demand was positively correlated with high confidence and collective responsibility. Psychological constraints sometimes impacted demand. Physical constraints created barriers in some communities, particularly difficult to access (i.e., mountainous). Occasionally, physical constraints did not affect vaccination behavior - parents believed the benefits of vaccination worth pursuing. Factors negatively correlated with demand and intent, complacency and calculation, had limited impact. Critical interventions were: targeted and tailored health education activities (media partnerships, school outreach); community engagement; community ownership; and community involvement (community health workers, leaders, religious figures).
    UNASSIGNED: We found similar interventions used to generate demand, with strategies aligned with the 5C constructs. Categorizing interventions by drivers of demand may help strategic planning and the division of resources; decision makers may choose to implement our suggested interventions. Assessing the 5Cs allows decision-makers to operationalize demand generation into concrete interventions and policies, and determine the individual impact of these constructs on the population and focus efforts on interventions tailored to a specific need.
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