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Background: Older patients with cancer are at a higher risk of invasive infections. Vaccination is an effective approach to decrease the mortality and morbidity associated with infections. Objective(s): Our primary objective was to evaluate the proportion of older patients with cancer who had received routine vaccinations against pneumococcal, influenza, and coronavirus disease 2019 (COVID-19). Our secondary objective was to identify the factors associated with vaccine uptake such as age, sex, education, marital status, comorbidities, and place of residence. Material(s) and Method(s): This cross-sectional observational study was conducted in the geriatric oncology outpatient clinic of the Department of Medical Oncology at the Tata Memorial Hospital, a tertiary care cancer hospital in Mumbai, India, from February 2020 to January 2023. We included all patients aged >=60 years who were evaluated in the geriatric oncology clinic during the study period and for whom the immunization details were available. The uptake of COVID-19 vaccine was calculated from March 2021 onwards, which was when the COVID-19 vaccine became available to patients aged >=60 years in India. Result(s): We enrolled 1762 patients;1342 (76.2%) were male. The mean age was 68.4 (SD, 5.8) years;795 (45%) patients were from the west zone of India. Only 12 (0.68%) patients had received the pneumococcal vaccine, and 13 (0.7%) had received the influenza vaccine. At least one dose of the COVID-19 vaccine had been taken by 1302 of 1562 patients (83.3%). On univariate logistic regression, education, marital status, geographic zone of residence, and primary tumor site were correlated with the uptake of COVID-19 vaccine. Factors associated with a greater COVID-19 vaccine uptake included education (up to Std 10 and higher vs. less than Std 10: Odds Ratio [OR], 1.46;95% confidence interval [CI], 1.07-1.99;P = 0.018, and illiterate vs. less than Std 10: OR, 0.70;95% CI, 0.50-0.99;P = 0.041), marital status (unmarried vs. married: OR, 0.27;95% CI, 0.08-1.08;P = 0.046, and widow/widower vs. married: OR, 0.67;95% CI, 0.48-0.94;P = 0.017), lung and gastrointestinal vs. head-and-neck primary tumors (lung cancer vs. head-and-neck cancer: OR, 1.60;95% CI, 1.02-2.47;P = 0.038, and gastrointestinal vs.head-and-neck cancer: OR, 2.18;95% CI, 1.37-3.42;P < 0.001), and place of residence (west zone vs. central India: OR, 0.34;95% CI, 0.13-0.75;P = 0.015). Conclusion(s): Fewer than 1 in 100 older Indian patients with cancer receive routine immunization with influenza and pneumococcal vaccines. Hearteningly, the uptake of COVID-19 vaccination in older Indian patients with cancer is over 80%, possibly due to the global recognition of its importance during the pandemic. Similar measures as those used to increase the uptake of COVID-19 vaccines during the pandemic may be beneficial to increase the uptake of routine vaccinations.Copyright © 2023 Cancer Research, Statistics, and Treatment.
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Respiratory syncytial virus (RSV) infection remains a major public health problem, especially in younger children and the elderly. But several monoclonal antibodies, antivirals and vaccines, either recently launched or in development, offer new hope for RSV prevention and treatment.Copyright © 2023 Wiley Interface Ltd.
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Introduction: Patients with chronic lymphocytic leukaemia (CLL) are at increased risk of infection. CLL is associated with a secondary immunodeficiency and impaired response to vaccination. Recent British Society of Haematology guidelines recommend that patients with CLL should receive vaccination against pneumococcal infection at diagnosis, an annual influenza vaccine and COVID-19 vaccination. Patients aged 70-79 years should also receive the Shingrix vaccine. Patients with CLL should not receive live vaccines. In response to this guideline, a letter detailing vaccination requirements was created for patients to give to their general practitioner (GP). The local process for vaccination referral has since changed. Previously, vaccination requirements were communicated to the GP via letter. There is now a dedicated Vaccination Hub to which clinicians can directly refer patients for appropriate vaccinations. Aim(s): The aim of this project was to assess vaccination referral and vaccination status in patients with newly diagnosed CLL. Method(s): All new diagnoses of CLL from 2021 to 2022 were identified by review of the Haematology Multi-Disciplinary Team meeting electronic registration forms. Electronic patient records were reviewed to determine vaccination referral completion and vaccination status. Result(s): A total of 29 patients were identified as new diagnoses of CLL. Seventeen patients were diagnosed in 2021 and 12 in 2022. Sixty-nine percent of the patients were male and the average age was 70.9 years. Vaccination was discussed with 11 patients (38%) and 10 patients (34%) were referred for vaccination. Eleven patients (38%) had never received a pneumococcal vaccine. Nine patients (31%) had previously received the vaccine but not within the past 5 years. Five patients (17%) patients had received one dose of Pneumovax 23 following referral. No patients had received the initial Prevenar 13 vaccine. Twelve patients (41%) had not received an influenza vaccine. Of those who had received the vaccine, the majority (70%) had received this routinely. Similarly, 71% of patients had received the COVID-19 vaccine routinely as opposed to three patients who received this postreferral. Of those who were eligible, 50% had received the Shingrix vaccine. Conclusion/Discussion: Local rates of vaccination in patients with CLL are low. Numbers were too small to allow for comparison between the methods of referral. Of those referred, not all received the appropriate vaccinations. Further work is therefore required to improve both the number and completion of the referrals. Future steps will include local teaching on vaccinations in CLL and the referral pathway.
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In the context of a pandemic of a new coronavirus infection, vaccine prophylaxis within the framework of the National Calendar of Preventive Vaccinations (NCPV) is an absolute priority in the fight against infectious diseases. The lecture presents the structure and features of the NCPV, the main directions of its improvement, information on the priority infections for vaccination. The strategy of immunization throughout life, which guarantees the creation of maximum protection against infections and preservation of the optimal level of health of people without age restrictions, is considered. Information is provided on approaches to vaccination of various patient populations against new coronavirus, pertussis, pneumococcal, and rotavirus infections. The presented lecture materials can be useful both to medical students and doctors of various specialties (infectious disease specialists, pediatricians, epidemiologists, bacteriologists).Copyright © 2022 by the authors.
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In the Chelyabinsk region in 2020, 33 473 cases of a new coronavirus infection (COVID-19) were detected, of which 493 were fatal. The peak incidence of COVID-19 was recorded in November-December 2020. Purpose of research: description of the course of the infectious process of COVID-19 in patients with a fatal outcome. Material and methods. A retrospective analysis of case histories of patients with COVID-19 who had a lethal outcome was carried out using the method of continuous sampling from November 2020 to April 2021 on the basis of the Regional Infectious Diseases Center of the Regional Clinical Hospital No. 3 of the Chelyabinsk Region. Diagnosis was based on a comprehensive assessment of the anamnesis, clinical, laboratory and instrumental data in accordance with the Interim Guidelines "Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19)" version 9 dated 10/26/2020. Verification of the etiological diagnosis was carried out by PCR with reverse transcription to detect SARS-CoV-2 RNA in the nasopharyngeal secretion. The autopsy material was studied in the Pathoanatomical Department No. 9 of the Chelyabinsk Regional Pathological Bureau. Results and discussion. The average age of patients with a fatal outcome was 70 years, more often they were people with blood groups I and II, not vaccinated against COVID-19, pneumococcal infection and influenza;no gender differences were found. For patients with a fatal outcome from COVID-19, the presence of concomitant pathology is most characteristic: arterial hypertension (58%), atherosclerosis (45%), type 2 diabetes mellitus (41.5%), malignant neoplasms (17%). Among the "lethal patients", 50% had lung lesions at admission CT 2 and 25% had changes in the lungs consistent with CT 1;there was also a violation of cognitive functions in 21% of individuals. When comparing the analysis of studies of autopsy material and the clinical picture of patients, it was found that the morphological substrate of COVID-19 is both diffuse alveolar damage and simultaneous damage to the vascular bed, which is accompanied by damage to various organs and systems of the patient's body.Copyright © Eco-Vector, 2022.
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Implementation of national vaccination programme as well as providing catch-up immunization schedule for war refugees from Ukraine is a challenge for Polish primary care physi-cians. Measles, mumps, rubella, polio and COVID-19 catch-up vaccinations are considered a priority. The Ukrainian Immunization Programme is similar to the Polish one, but it does not include vaccination against pneumococcal disease and rotavirus. Moreover there are differences between Ukrainian and Polish vaccination schedules against pertussis, polio and Haemophilus influenzae. In this article we present principles and practical guidelines for preparing catch-up immunization schedules for refugees from Ukraine, as well as a list of vaccine preparations available in Ukraine and their Polish equivalents. For preparations available only in Ukraine, a vaccine with the most similar composition was proposed.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
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Background: Patients with Immune Mediated Inflammatory Diseases (IMIDs) treated with immunosuppressive drugs are at an increased risk of infections and a more complicated course of the infection, including vaccine-preventable infections. National and international guidelines have specified vaccination strategies in patients with IMIDs. However, the adherence to these guidelines in clinical practice is uncertain. Therefore, we evaluated the current vaccination status of patients with IMIDs at the outpatient clinic of the Erasmus MC Rotterdam. Method(s): Between August 2022 and October 2022, a survey was sent out to patients with various IMIDs at the rheumatology, dermatology and gastroenterology outpatient clinics. Only patients on immunosuppressive treatment were included. The survey contained questions on patient demographics, disease characteristics and current vaccination status. Result(s): The survey was sent out to 3,345 patients with IMIDs, of whom 1,094 patients filled in the questionnaire (response rate 32.7%). Mean age was 51 +/- 16 years and 40.8% were male (Table 1). Patients were treated by a dermatologist (n=306), gastroenterologist (n=414) and/or rheumatologist (n=527). Overall, 55.1% of patients received a yearly influenza vaccination and 9.2% occasionally (Table 2). Furthermore, 8.7% of patients received the pneumococcal vaccination five-yearly and 1.4% occasionally. Both the influenza and pneumococcal vaccination rates were highest in patients with rheumatoid arthritis (64.1%, and 14.7%, respectively). On the contrary, patients with hidradenitis suppurativa had the lowest rates for both the influenza vaccination (32.3%) and pneumococcal vaccination (n=0). Overall, 91.7% of patients (n=1,003) received one or more COVID-19 vaccinations. Conclusion(s): Patients with Immune Mediated Inflammatory Diseases are insufficiently protected against vaccine-preventable infections due to low vaccination rates. Better implementation strategies of current guidelines on seasonal influenza vaccination and pneumococcal vaccination are required. A high rate of COVID-19 vaccination was observed, possibly indicating the willingness of patients to receive vaccinations. Further research into facilitators and barriers to vaccination in these specific patient populations is required.
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Upper respiratory tract infections are responsible for millions of physician visits in the United States annually. Although viruses cause most acute upper respiratory tract infections, studies show that many infections are unnecessarily treated with antibiotics. Because inappropriate antibiotic use results in adverse events, contributes to antibiotic resistance, and adds unnecessary costs, family physicians must take an evidence-based, judicious approach to the use of antibiotics in patients with upper respiratory tract infections. Antibiotics should not be used for the common cold, influenza, COVID-19, or laryngitis. Evidence supports antibiotic use in most cases of acute otitis media, group A beta-hemolytic streptococcal pharyngitis, and epiglottitis and in a limited percentage of acute rhinosinusitis cases. Several evidence-based strategies have been identified to improve the appropriateness of antibiotic prescribing for acute upper respiratory tract infections.Copyright © 2022 American Academy of Family Physicians.
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Objective: An increased risk of invasive pneumococcal disease (IPD) has been reported in children with asthma before the introduction of pneumococcal vaccines (PVs). However, the evidence is limited after PV entered the routine immunization schedule. We aimed to investigate whether pediatric allergists recommend additional PV (aPV) to asthmatic children and if so whether there are any asthma-specific risk factors they consider. We also wanted to determine any changes in their recommendations during the COVID-19 pandemic. Material(s) and Method(s): A questionnaire was e-mailed to all members of the Academy of Pediatric Allergy and Asthma in Turkey. The questionnaire was filled online and consisted of 14 questions. Result(s): The questionnaire was e-mailed to 220 members. The response rate was 56.3% and 60.5% of PA recommended aPV. The most frequent asthma specific factors for aPV were severe asthma (70.2%), long term oral corticosteroid use (65.3%) and frequent exacerbations / hospitalizations (62.9%). COVID-19 pandemic increased the rate of questions asked to PA about aPV for asthmatic children compared to previous periods (75.8 vs 33.9%) (p<0.001) and %27 of PA changed their recommendations in favor of aPV during pandemic. Conclusion(s): Asthmatic children is not infrequent. Severe asthma and related factors seem to be the leading reasons to recommend aPV for asthmatic children. The aPV recommendation by PA is increased during COVID-19 pandemic.Copyright © 2022 Bilimsel Tip Yayinevi. All rights reserved.
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Introduction: During the COVID-19 pandemic, the incidence of many droplet-transmitted infections decreased due to increased mask-wearing and social distancing. Contrastingly, there has been concern that COVID-19 countermeasures, such as lockdowns, may increase legionellosis incidence via water stagnation. During the pandemic in Japan, four state of emergency declarations were imposed between 2020 and 2021, which makes it particularly suitable to test this hypothesis. Methods: We use country-level surveillance data from the National Institute of Infectious Diseases to track the relative incidence of legionellosis compared to invasive pneumococcal disease (IPD) during the COVID-19 pandemic in Japan, with a focus on the periods just after state of emergency declarations were lifted. Results: The absolute number of legionellosis and IPD cases decreased in 2020 and 2021 compared to previous years. The average relative incidence of legionellosis as well as the variance of the relative incidence significantly increased during the pandemic compared to previous years. There were no increases in the relative incidence of legionellosis during the periods immediately following emergency declaration liftings, but the relative incidence did increase considerably during the first two states of emergency. Conclusions: COVID-19 countermeasures appear more effective at decreasing the incidence of human-to-human transmitted infections, such as IPD, compared to environmentally-transmitted infections, such as legionellosis. Though no evidence was found to suggest that legionellosis cases increased after state of emergency declarations, public health efforts should continue to emphasize the importance of routine sanitation and water system maintenance to prevent water stagnation and Legionella spp. contamination. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
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Pneumococcal infection strongly contributes to morbidity and mortality in Spain. A total of 253,899 hospitalizations related to pneumococcal infection occurred from 2016 to 2020. Fifty-eight percent were men, the mean age was 67 years old, and the average length of hospitalization was 12.72 days. The annual hospitalization rate was 10.84 hospitalizations per 10,000 population, increasing significantly with age, reaching 65.75 per 10,000 population in those aged >85 years. The hospitalization rates for pneumococcal pneumonia, sepsis, and meningitis were 2.91, 0.12, and 0.08 hospitalizations per 10,000, respectively, and reached the highest value in those aged >85 for pneumococcal pneumonia and sepsis, with 22.29 and 0.71 hospitalizations per 10,000, respectively, and in children up to 1 year old for pneumococcal meningitis, with 0.33 hospitalizations per 10,000. The total number of deaths during the study period was 35,716, with a case-fatality rate of 14.07%. For pneumococcal pneumonia, sepsis, and meningitis, the case-fatality rates were 8.47%, 23.71%, and 9.99%, respectively. The case-fatality rate increased with age and did not vary by sex. The annual cost of these hospitalizations was more than EUR 359 million. There is therefore a high burden of disease and mortality caused by pneumococcal infection in our country, especially in elderly individuals.
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Relevance. To date, there is ample evidence that diabetes mellitus (DM) and obesity are predictors of a severe course and adverse outcome of COVID-19. The SARS-CoV-2 virus is known to have deleterious effects on the pancreas, exacerbating insulin resistance The SARS-CoV-2 virus is known to have deleterious effects on the pancreas, exacerbating insulin resistance. Long-term data have been accumulated regarding pneumococcal infection and influenza, both of which are severe in patients with diabetes and obesity. The aim is to analyze scientific publications on the problems of vaccinating patients with diabetes and obesity against SARS-CoV-2, pneumococcal infection, and influenza. Conclusions. Vaccination against COVID-19 in patients with DM and obesity is an effective preventive measure. Experience with vaccination against COVID-19 using the following vaccines: Moderna mRNA-1273, PfizerBioNTech, BNT162b2, AstraZeneca COVID-19 vaccine AZD1222, SII Covishield, SK Bioscience, Sputnik V showed similar safety and efficacy profiles among obese and DM patients and those at risk. Researchers in numerous publications have emphasized the importance of routine vaccination for people living with diabetes amid a pandemic of a new coronavirus infection. Researchers in numerous publications have emphasized the importance of routine vaccination for people living with diabetes in the face of a new coronavirus pandemic. Analysis of the literature reviewed in this review suggests that vaccination against SARS-CoV-2, especially for those at risk, will be an intensive area of research in the coming years and that vaccination against coronavirus infection is likely to be routine for people with diabetes and obesity. © 2022, Numikom. All rights reserved.
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Vaccines are important for everyone, but they’re critical for adults older than 65 years.
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Background: Vaccines are the safest and most effective method to prevent invasive and life-threatening infections. Vaccines against infuenza, pneumococcal disease, herpes zoster, and human papillomavirus are the main recommended vaccines for adults. In addition, rheumatology patients are advised to receive adult vaccinations according to the vaccines available in their country and local guidelines. In Turkey, both infuenza and pneumococcal disease vaccines are commercially available. In addition, these vaccines are strongly recommended for rheumatology patients in local guidelines. Although familial Mediterranean fever (FMF) is one of the most common rheu-matological diseases in Turkey, it is often neglected in vaccination recommendations. Objectives: In this study, we surveyed the vaccination practice against infuenza or pneumococcal diseases of adult FMF patients in our cohort. In addition, we evaluated the factors related to favorable vaccination practice. Methods: We included 360 FMF patients over 18 years of age. All patients ful-flled the Tel-Hashomer criteria for FMF. We asked them if they had ever been vaccinated against pneumococcal or infuenza, and how often they received them. In addition, we dichotomised patients in terms of vaccinated against at least one of infuenza or pneumococcal diseases. We then compared the groups for demographic (age gender and comorbidities) and disease related characteristics (disease duration, disease activity calculated by ISSF and colchicine dose). We used qi-square test to compare categorial variables and Mann-Whitney U test to compare continuous variables. P<0.05 was accepted as signifcant. Results: Of 360 FMF patients, 238 (66.1%) were female. The mean age of the patients was 34.5±10.7 years. Disease duration of the patients was 9.38±0.7 years. In addition, the mean ISSF score of the patients was 1.83±1.5. The mean dose of colchicine received by the patient was 1.23 ± 0.47 mg. Only 54 (15.0%) of the patients had at least one comorbidity. In our cohort, 22 (6.1%) patients were vaccinated against infuenza or pneumococcal disease. Only 18 (5.0%) of the patients have been vaccinated against infuenza at least once so far. Half of these patients (9/18) were vaccinated against infuenza each year. In addition, 8/360 (2.2%) patients were fully vaccinated against pneumococcal diseases. Here, six of them received the pneumococcal vaccine after the start of the COVID-19 outbreak. There was no statistically signifcant difference between the groups in terms of demographic and disease related characteristics. Conclusion: We found that vaccination practice of FMF patients in our cohort was unsatisfactory. Few patients follow adult vaccination recommendations. In addition, clinicians should be concerned about the importance of vaccination and guide their patients to get the adult vaccines available in their country.
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RATIONALE: The COVID-19 pandemic highlighted the need for population adherence to recommended prevention and control measures for acute respiratory infections. This study aims to summarize and evaluate the evidence on barriers for populational adherence to vaccine to prevent acute respiratory infections. METHODS: A qualitative evidence synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols statement and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. An electronic search was performed in three databases (MEDLINE [Ovid], Embase [Ovid], and PsycINFO) from their inception to the present. We included studies published in Portuguese, English and Spanish that used both qualitative data collection and analysis methods. We also included studies that used mixed methods, when used qualitative methods of analysis. Risk of bias of the included studies was assessed using the Critical Skills Appraisal Programme (CASP). The certainty of the evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluations-Confidence in the Evidence from Reviews of Qualitative research (GRADECERQual) approach. The best-fit framework approach was followed as the strategy for data analysis and synthesis. Data were synthesized using adapted dimensions from the 'The Health Belief Model' (HBM) and the 'Behaviour Change Wheel' (BCW). RESULTS: Thirteen studies were included. The studies were related to influenza, H1N1, invasive pneumococcal disease, pertussis, and other acute respiratory infections. Most studies were assessed as having appropriate methological rigour. Regarding the confidence in the evidence of the thirteen findings, identified from the thirteen included studies, four were we graded four as high confidence certainty of evidence, four as moderate, three as low and two as very low certainty of evidence. The findings were presented within the six identified themes of the being two of the HBM model (perceived susceptibility and perceived barriers) and four of the COM-B model (social opportunity, automatic motivation, psychological capability and reflective motivation). CONCLUSIONS: Several factors can be considered barriers to implementing adequate populational adherence to immunization against respiratory infectious diseases: misperceptions on vaccination costs, lack of knowledge about the disease and its severity, lack of personal and environmental susceptibility, general misperceptions about vaccines (including their production, testing, and distribution protocols) and vaccine availability. In addition, other cultural and personal backgrounds can also be considered a leading cause: fear, lack of public awareness, inconvenience to take vaccination, unfortunate experiences in the past, and other misperceptions about efficacy, risks, side effects, among others.
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Vaccination plays an important role in the prevention of infectious diseases in patients with immunoinflammatory diseases. When vaccinating patients with systemic lupus erythematosus (SLE), as with other immunoinflammatory rheumatic diseases, its safety is of great importance, including mitigating the risks of the primary disease or the development of new autoimmune phenomena. Many practitioners continue to consider autoimmune diseases as a contraindication for vaccination due to the perceived possibility of their exacerbation and reduced vaccine effectiveness during active immunosuppressive therapy. The lecture presents current data on the immunogenicity, efficacy and safety of vaccines against a number of infections caused by influenza viruses, hepatitis B, Herpes zoster, human papilloma viruses, COVID-19 and pneumococcus in patients with SLE. It has been shown that the benefits of vaccination in patients with SLE significantly outweigh the risk of adverse events or exacerbations of the disease. At the same time, it was noted that the problem of vaccination of such patients requires further study. © 2022, Ima-Press Publishing House. All rights reserved.
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Cancer patients have an increased risk of infectious complications, the main cause of which is an immunodeficiency condition caused by the cancer itself and its therapy. Therefore, it is appropriate to protect patients by vaccination, in particular vaccination against influenza, pneumococcal infections and covid-19. Appropriately chosen vaccines and the right timing of their administration can as a part of supportive care contribute to the success of cancer therapy.