Booster immunisation

  • 文章类型: Journal Article
    目的:评估用脑膜炎球菌C(MenC)和ACWY(MenACWY)结合疫苗单次初次和加强免疫在预防MenC侵袭性脑膜炎球菌疾病(IMD)中的疫苗有效性(VE)和保护持续时间。
    方法:我们对年龄为12-23个月的初次和6-18岁的加强免疫参与者的VE和免疫原性(rSBA/hSBA滴度)的研究进行了系统评价(最后一次搜索:2023年8月18日)。评估偏倚风险和证据的确定性(PROSPERO:CRD42020178773)。
    结果:我们确定了10项研究。两项研究报告说,在2年和7年期间,用MenC疫苗进行初次免疫的VE介于90%(74.9-96.1)和84.1%(41.5-95.7)之间。分别。8项研究报道了用MenC和/或MenACWY疫苗初次免疫的免疫原性,其中两个报告了-另外-加强免疫。初次免疫后,具有保护性rSBA滴度的参与者百分比很高,但在接下来的6年里有所减弱。7岁或以上的单个助推器似乎可以延长保护数年。
    结论:12-23月龄的单剂量MenC或MenACWY疫苗可提供针对MenCIMD的强大保护。关于加强免疫的数据很少,但表明至少三年的长期保护。
    OBJECTIVE: To estimate vaccine effectiveness (VE) and duration of protection of single primary and booster immunisation with meningococcal C (MenC) and ACWY (MenACWY) conjugate vaccines in preventing MenC invasive meningococcal disease (IMD).
    METHODS: We performed a systematic review on studies of VE and immunogenicity (rSBA/hSBA titers) of participants aged 12-23 months for primary and 6-18 years for booster immunisation (last search: 18 August 2023). Risk of bias and certainty of evidence were evaluated (PROSPERO: CRD42020178773).
    RESULTS: We identified 10 studies. Two studies reported VE of primary immunisation with MenC vaccines ranging between 90% (74.9 - 96.1) and 84.1% (41.5 - 95.7) for periods of 2 and 7 years, respectively. Eight studies reported immunogenicity of primary immunisation with MenC and/or MenACWY vaccines, of which two reported -in addition- on booster immunisation. The percentage of participants with protective rSBA titers was high after primary immunisation, but waned over the following 6 years. A single booster at the age of 7 years or older seems to prolong protection for several years.
    CONCLUSIONS: A single dose of MenC or MenACWY vaccine at 12-23 months of age provides robust protection against MenC IMD. Data on booster immunisation are sparse, but indicate prolonged protection for three years at least.
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  • 文章类型: Journal Article
    背景:为了抗击2019年冠状病毒病(COVID-19),加强疫苗接种策略很重要。然而,加强疫苗平台的最佳给药方式尚不清楚.在这里,我们旨在评估3种或4种异源与同源加强方案的利弊.
    方法:从2022年11月3日至2023年12月21日,我们搜索了五个数据库中的随机临床试验(RCT)。审稿人筛选,提取的数据,并使用Cochrane偏差风险2工具独立评估偏差风险。我们对我们的主要结局(全因死亡率;实验室确认的有症状和严重COVID-19;严重不良事件[SAE])和次要结局(生活质量[QoL];不良事件[AE]视为非严重)进行了荟萃分析和试验序贯分析(TSA)。我们用分级方法评估了证据。对2023年前后的试验进行了亚组分析,三个或四个助推器,免疫受损状态,后续行动,偏见的风险,异源加强疫苗平台,和助推器的效价。
    结果:我们纳入了29项RCT和43项比较(12,538名参与者)。异源加强方案可能不会降低全因死亡率的相对风险(RR)(11项试验;RR0.86;95%CI0.33至2.26;I20%;非常低的确定性证据);实验室确认的有症状的COVID-19(14项试验;RR0.95;95%CI0.72至1.25;I20%;非常低的确定性);或严重的COVID-19(10项;IRR0.51;33%至2非常低的对于安全结果,异源加强方案可能对SAE没有影响(27项试验;RR1.15;95%CI0.68~1.95;I20%;非常低的确定性),但可能会增加被认为非严重的AE(20项试验;RR1.19;95%CI1.08~1.32;I264.4%;非常低的确定性)。没有可用的QoL数据。我们的TSA表明,累积Z曲线对于任何结果都没有达到徒劳。
    结论:根据我们目前的样本量,我们无法推断任何结果的影响差异,但是异源加强方案似乎会导致更多的非严重AE。此外,更可靠的数据有助于更新这篇评论。
    BACKGROUND: To combat coronavirus disease 2019 (COVID-19), booster vaccination strategies are important. However, the optimal administration of booster vaccine platforms remains unclear. Herein, we aimed to assess the benefits and harms of three or four heterologous versus homologous booster regimens.
    METHODS: From November 3 2022 to December 21, 2023, we searched five databases for randomised clinical trials (RCT). Reviewers screened, extracted data, and assessed bias risks independently with the Cochrane risk-of-bias 2 tool. We conducted meta-analyses and trial sequential analyses (TSA) on our primary (all-cause mortality; laboratory confirmed symptomatic and severe COVID-19; serious adverse events [SAE]) and secondary outcomes (quality of life [QoL]; adverse events [AE] considered non-serious). We assessed the evidence with the GRADE approach. Subgroup analyses were stratified for trials before and after 2023, three or four boosters, immunocompromised status, follow-up, risk of bias, heterologous booster vaccine platforms, and valency of booster.
    RESULTS: We included 29 RCTs with 43 comparisons (12,538 participants). Heterologous booster regimens may not reduce the relative risk (RR) of all-cause mortality (11 trials; RR 0.86; 95% CI 0.33 to 2.26; I2 0%; very low certainty evidence); laboratory-confirmed symptomatic COVID-19 (14 trials; RR 0.95; 95% CI 0.72 to 1.25; I2 0%; very low certainty); or severe COVID-19 (10 trials; RR 0.51; 95% CI 0.20 to 1.33; I2 0%; very low certainty). For safety outcomes, heterologous booster regimens may have no effect on SAE (27 trials; RR 1.15; 95% CI 0.68 to 1.95; I2 0%; very low certainty) but may raise AE considered non-serious (20 trials; RR 1.19; 95% CI 1.08 to 1.32; I2 64.4%; very low certainty). No data on QoL was available. Our TSAs showed that the cumulative Z curves did not reach futility for any outcome.
    CONCLUSIONS: With our current sample sizes, we were not able to infer differences of effects for any outcomes, but heterologous booster regimens seem to cause more non-serious AE. Furthermore, more robust data are instrumental to update this review.
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  • 文章类型: Journal Article
    It is accepted that booster vaccinations of chickens with live Salmonella vaccines are essential part of vaccinations schemes to induce an effective adaptive immune response. As manufacturer of registered live Salmonella vaccines recommend different times of booster the question raises whether the duration between the first and second immunisation might influence the protective effect against Salmonella exposure. Chickens were immunised with a live Salmonella Enteritidis vaccine on day 1 of age followed by a booster vaccination at different intervals (day 28, 35 or 42 of age) to study the effects on the colonisation and invasion of the Salmonella vaccine strain, the humoral immune response and the efficacy against infection with Salmonella Enteritidis on day 56 of age. Immunisation of all groups resulted in a very effective adaptive immune response and a high degree of protection against severe Salmonella exposure, however, the time of booster had only an unverifiable influence on either the colonisation of the vaccine strain, the development of the humoral immune response or the colonisation of the Salmonella challenge strain. Therefore, the first oral immunisation of the chicks on day 1 of age seems to be of special importance and prerequisite for the development of the effective immune response. A booster immunisation should be carried out, however, the time of booster may vary between week 3 and week 7 of age of the chickens without adversely impact on the efficacy of the adaptive immune response or the protective effects.
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