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Abstract This study evaluates the functional capacity of CD4+ and CD8+ terminally-differentiated effector (TEMRA), central memory (TCM), and effector memory (TEM) cells obtained from the volunteers vaccinated with an aluminum-adjuvanted inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac). The volunteers were followed for T cell immune responses following the termination of a randomized phase III clinical trial. Seven days and four months after the second dose of the vaccine, the memory T cell subsets were collected and stimulated by autologous monocyte-derived dendritic cells (mDCs) loaded with SARS-CoV-2 spike glycoprotein S1. Compared to the placebo group, memory T cells from the vaccinated individuals significantly proliferated in response to S1-loaded mDCs. CD4+ and CD8+ memory T cell proliferation was detected in 86% and 78% of the vaccinated individuals, respectively. More than 73% (after a short-term) and 62% (after an intermediate-term) of the vaccinated individuals harbored TCM and/or TEM cells that responded to S1-loaded mDCs by secreting IFN-γ. The expression of CD25, CD38, 4-1BB, PD-1, and CD107a indicated a modulation in the memory T cell subsets. Especially on day 120, PD-1 was upregulated on CD4+ TEMRA and TCM, and on CD8+ TEM and TCM cells; accordingly, proliferation and IFN-γ secretion capacities tended to decline after 4 months. In conclusion, the combination of inactivated whole-virion particles with aluminum adjuvants possesses capacities to induce functional T cell responses.

Influenza virus infects millions of people each year, possibly resulting in far more deaths and hospitalizations than reported. It is an acute respiratory tract infection caused by influenza A or B viruses, which recovers within one to two weeks in general, however can lead to fatal or long-term complications in adults. In particular, adults over the age of 65, children, pregnant women, healthcare professionals and those with comorbidities (or individuals having risk factors) are at serious risk for influenza infection and complications. Influenza infection creates a serious burden on individuals, society and health system. Influenza is a vaccine preventable disease; vaccination is recommended for every adult without contraindications, especially for those named under risk groups. It has been proven by studies that influenza vaccination is effective in protecting people from serious illness, intensive care hospitalization, complications, death and longterm sequela, as well as preventing the flu. Above mentioned public health effects have also been proved by studies and real world data.

Introduction: Splenectomy, whatever the reason, is an absolute indication for vaccination against encapsulated bacteria in order to prevent overwhelming post-splenectomy infections. This study aimed to determine compliance to immunization guidelines for splenectomy in General Surgery Clinics. Materials and Methods: In this observational cross-sectional study, we included patients who underwent splenectomy between April 2016 and April 2018, and recorded the patient data and vaccination status. Results: Splenectomy was performed in 65 patients, 40 (61.5%) were male and median age was 56 (19-90) years. Six of the operations were emergent, 21 were planned and 38 were urgent mostly due to solid organ malignancy. Only 14 (21.5%) patients were vaccinated with Haemophilus influenzae, meningococcal and pneumococcal vaccines according to the guidelines (≥2 weeks before the operation). 14 of the 21 patients (66.6%) who underwent planned splenectomy were vaccinated appropriately. Conclusion: Compliance with vaccination guidelines was low before splenectomy operations. There is a room for improvement particularly for patients undergoing elective splenectomy. A patient-centered team strategy is required to vaccinate patients at the stage of splenectomy planning.

Introduction: Pneumococcal and influenza infections are important sources of morbidity and mortality in older adults and high-risk persons. Although the efficacy and cost effectiveness of pneumococcal and influenza vaccines were shown by many studies, vaccination coverage of high-risk adults still remains low. In this study, we aimed to investigate the vaccination coverage rates of the patients, who were hospitalized at an acute care unit and their attitudes towards vaccination. Patients and Methods: A prospective observational study was done between November 2014-July 2015. A questionnaire, including their demographical characteristics, co morbidities, influenza and pneumococcal vaccination statuses and their attitudes towards vaccination was conducted on the patients admitted to the acute care unit. Their risk factors for vaccination indications were assessed. Results: 155 patients were enrolled to the study. The median age of the patients was 70 (18-91), and 41.3% of the patients were male. 93.5% of the patients had indication for both influenza and pneumococcal vaccination. Only 17.2% of the patients who had pneumococcal vaccination indication, and 29.7% of the patients who had influenza vaccination indication, were vaccinated. We found that recommendation to the vaccinated patients was mostly made by doctors from secondary or tertiary care rather than primary care doctors. The most common reason for not getting the vaccines was lack of knowledge of the patients. Conclusion: Influenza and pneumococcal vaccination indication rates were high in patients admitted to the acute care unit. In this study, we found that vaccination coverage rates are still low, there is a lack of knowledge of the patients and the doctors are not recommending vaccination to their patients. Raising awareness of healthcare providers and making them use every visit as an opportunity for vaccination would be effective to improve vaccination coverage rates for adults.

Introduction: Streptococcus pneumoniae is the cause of invasive pneumococcal diseases, and the elderly have the highest risk of death. However, pneumococcal vaccine coverage among high-risk adults has been much lower than the targets set by international authorities. The fi rst aim of this study was to fi nd out the pneumococcal vaccination coverage rate in the elderly population living in Denizli. The second aim was to evaluate vaccination coverage after a target was set to 60% to be attained in 6 months. Materials and Methods: A single day scientifi c education program was done by Infectious Diseases specialists and Internists for Family Physicians in Denizli in March 2011, where the goal of “60% pneumococcal vaccination coverage in the population over 65 years of age” was announced. Thereafter, a cross-sectional study was done within one month to evaluate the present vaccination rates of the elderly population living in Denizli. Afterwards, a second cross-sectional study was carried out between within 6th month. Since the target could not be met within 6 months, the study was extended to 8 months. Results: The vaccination data of 80.047 people among the 88.671 people living within Denizli was available. Pneumococcal vaccination coverage increased to 36.410 (45.5%) after the education program with 27.113 (33.9%) new vaccinations within the 6 months of the study. By the 8th month, vaccination coverage reached to 59.5% cumulatively with 47.9% of people vaccinated during the study period. Conclusion: In conclusion, we demonstrated that setting a target with a one-day education program resulted in a 4-fold increase in pneumococcal vaccination coverage in the elderly population. The education of family physicians in countries where there are strong and country-wide family physician systems can lead to increases in adult vaccination rates.