The Attitudes of Healthcare Professionals in an Autonomous Community in Spain towards Paediatric Influenza Vaccination.

In the 2022-2023 influenza season, three autonomous communities anticipated the document approved by the Public Health Commission recommending influenza vaccination for all children aged 6 to 59 months. The primary objective of this study was to evaluate the attitude of healthcare professionals towards the first universal vaccination campaign in our region, as well as the acceptability of the vaccines used and their attitude towards pilot school vaccination. This was a cross-sectional, survey-based, descriptive study. All healthcare professionals involved in the campaign were invited to participate. Overall, 91.9% of surveyed professionals thought that influenza vaccination from 6 to 59 months was important or very important, and 89.8% had previous experience regarding the intramuscular vaccine. Healthcare professionals rated the intranasal vaccine significantly more positively, but there were no differences when asking about each vaccine without comparison. The inhaled vaccine was preferred by 97.5% for the following campaign. Pilot school vaccination had a 75% acceptance rate. The inhaled vaccine was preferred by most professionals, and pilot school vaccination was highly accepted and independently associated with the importance of vaccination as considered by physicians, being a medical doctor, and participation in the pilot programme.

Vacunación antigripal en niños / Anti-flu Vaccination in Children

El Comité Asesor de Vacunas de la Asociación Española de Pediatría considera que la vacunación antigripal de los niños/as mayores de 6 meses no incluidos en grupos de riesgo es una medida recomendable, pues proporciona protección individual y favorece la protección familiar y comunitaria. Es decir, se recomienda la vacunación antigripal infantil universal en niños/as entre 6 y 59 meses, tal y como propone, asimismo, la Organización Mundial de la Salud (OMS).Los niños/as sanos son la principal fuente de difusión de la gripe en la familia, pues excretan una mayor carga viral y durante más tiempo que los adultos. Los niños/as que parecen tener el mayor riesgo de complicaciones por la gripe son aquellos con una afección médica crónica subyacente y, por tanto, es necesario que se vacunen.Para la temporada 2022-2023, en España, se disponen de dos tipos de vacunas antigripales autorizadas para menores de 18 años, parenterales inactivadas e inhalada atenuada. Las vacunas parenterales están autorizadas a partir de los 6 meses (una de ellas a partir de los 24 meses) y la inhalada a partir de los 24 meses. El Consejo Interterritorial del Sistema Nacional de Salud ha incluido recientemente esta vacunación para todos los niños/as para la temporada 2023-2024.(AU)

The Vaccine Advisory Committee of the Spanish Paediatrics Association considers that anti-flu vaccination for children >6 months of age not included in risk groups is a recommended measure, because it provides individual protection and improves family and community protection. That is to say, universal anti-flu paediatric vaccination is recommended for children between 6 and 59 months of age; this is also suggested by the World Health Organization (WHO).Healthy children are the main source for spreading flu in the family, because they excrete a higher viral load, and for a longer time than adults. Children who seem to have the highest risk of flu-related complications are those with an underlying medical condition and, therefore, it is necessary to get them vaccinated.For the 2022-2023 season, there are two types of anti-flu vaccines authorized in Spain for <18-year-olds, which are the parenteral inactivated and the inhaled attenuated vaccines. Parenteral vaccines are authorized for >6-month-old children (one of them, for >24-month-old children), and the inhaled vaccine from the age of 24 months. The Interterritorial Council of the National Health System has recently included this vaccination for all children in the 2023-2024 season.(AU)

Polymeric Nanoparticles for Inhaled Vaccines.

Many recent studies focus on the pulmonary delivery of vaccines as it is needle-free, safe, and effective. Inhaled vaccines enhance systemic and mucosal immunization but still faces many limitations that can be resolved using polymeric nanoparticles (PNPs). This review focuses on the use of properties of PNPs, specifically chitosan and PLGA to be used in the delivery of vaccines by inhalation. It also aims to highlight that PNPs have adjuvant properties by themselves that induce cellular and humeral immunogenicity. Further, different factors influence the behavior of PNP in vivo such as size, morphology, and charge are discussed. Finally, some of the primary challenges facing PNPs are reviewed including formulation instability, reproducibility, device-related factors, patient-related factors, and industrial-level scale-up. Herein, the most important variables of PNPs that shall be defined in any PNPs to be used for pulmonary delivery are defined. Further, this study focuses on the most popular polymers used for this purpose.

Intranasal administration of immunogenic poly-epitope from influenza H1N1 and H3N2 viruses adjuvanted with chitin and chitosan microparticles in BALB/c mice.

OBJECTIVES: Prevalence of influenza virus, creates the need to achieve an efficient vaccine against it. We examined whether the predicted antigenic epitopes of HA, NP, and M2 proteins of the influenza H1N1 and H3N2 viruses accompanied by chitin and chitosan biopolymers might be relevant to the induction of effective proper mucosal responses. MATERIALS AND METHODS: The construct was prepared using B and T cell predicted epitopes of HA, NP, and M2 proteins from the influenza H1N1 and H3N2 viruses by considering haplotype "d" as a dominant allele in the BALB/c mice. Intranasal immunization with purified LPS free recombinant protein together with chitin and chitosan microparticles as adjuvants was administered at an interval of 2 weeks in thirty-five BALB/c female mice which were divided into seven groups. Ten days after the last immunization, humoral and cellular immune responses were examined. RESULTS: Elevated systemic IgG2a, IgA, and mucosal IgA revealed a humoral response to the construct. An increase in the number of IFN-γ-producing cells in re-stimulation of splenocytes in the culture medium by poly-tope as well as rise in the concentrations of IL-6, IL-17, and TNF-α along with the regulatory response of IL-10, presented the capacity of the designed protein to provoke significant immune responses. The neutralization test ultimately confirmed the high efficacy of the protein in inhibiting the virus. CONCLUSION: The results support the fact that immunogenic poly-tope protein in the presence of chitin and chitosan microparticles as mucosal adjuvants is able to induce humoral and cell-mediated responses in BALB/c mice.

Novel and Evolving Therapies for COVID-19 Related Pulmonary Complications.

Coronaviruses disease 2019 (COVID-19) is the most crucial threat, the world has ever witnessed. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of this disease pandemic. The World Health Organization has confirmed the continuing epidemic as a worldwide public health crisis. Presently, the research on COVID-19 is even in the primitive stage. Studies on unveiling the natural route of COVID-19 infection and related pathophysiology, the biology of pulmonary airways pose a more rational restorative approach in the management of COVID-19. Thus, based on the existing facts, we methodically reviewed the efforts put forth by various research institutes, pharmaceutical companies and biotechnology firms in pulmonary delivery to prevent and control the COVID-19. This article would be valuable for the healthcare community, which is efficiently dealing with the SARS-CoV-2 crisis.

Nasally inhaled therapeutics and vaccination for COVID-19: Developments and challenges.

The nose is the initial site of viral infection, replication, and transmission in the human body. Nasally inhaled vaccines may act as a promising alternative for COVID-19 management in addition to intramuscular vaccination. In this review, the latest developments of nasal sprays either as repurposed or antiviral formulations were presented. Nasal vaccines based on traditional medicines, such as grapefruit seed extract, algae-isolated carrageenan, and Yogurt-fermenting Lactobacillus, are promising and under active investigations. Inherent challenges that hinder effective intranasal delivery were discussed in detail, which included nasal device issues and human nose physiological complexities. We examined factors related to nasal spray administration, including the nasal angiotensin I converting enzyme 2 (ACE2) locations as the delivery target, nasal devices, medication translocation after application, delivery methods, safety issues, and other nasal delivery options. The effects of human factors on nasal spray efficacy, such as nasal physiology, disease-induced physiological modifications, intersubject variability, and mucociliary clearance, were also examined. Finally, the potential impact of nasal vaccines on COVID-19 management in the developing world was discussed. It is concluded that effective delivery of nasal sprays to ACE2-rich regions is urgently needed, especially in the context that new variants may become unresponsive to current vaccines and more refractory to existing therapies.