Search

We report a 12‐month‐old boy with a skin eruption that developed 15 days after receiving the measles, mumps, rubella (MMR), pneumococcal, and meningococcal vaccines, consistent with the diagnosis of Wells syndrome. Patch testing showed a positive reaction to gelatin, which is used as a stabilizer for both live and inactivated vaccines. Gelatin was only present in the MMR vaccine. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, public health institutions, particularly the Centers for Disease Control and Prevention (CDC), were frequently attacked by politicians. Popular trust in these institutions declined, particularly among self-identified Republicans. Therefore, the effectiveness of public health institutions as vaccination messengers might have been weakened in the post-COVID-19 period. We conducted a survey experiment examining the effectiveness of messaging from the CDC in shaping people's attitudes toward mandatory MMR (measles-mumps-rubella) vaccination for schoolchildren. Methods: The experiment was embedded in a survey fielded in South Dakota, a "red state" with a population predisposed to distrust the CDC. Using registration-sampling, we received 747 responses. We used difference-in-means tests and multivariate regression to analyze the data. Results: We found that participants who received a message from the CDC were more likely to support MMR vaccine mandate for schoolchildren than participants who received the same prompt from a state agency. Further analyses showed that messaging from the CDC was particularly effective among Republicans. Discussion: Overall, our study showed that although the CDC was caught up in the political skirmishes during the COVID-19 pandemic, it remains an authoritative source of public health information. Conclusions: Public health officials at the local and state levels should not shy away from referring to the CDC in their vaccination messaging. [ABSTRACT FROM AUTHOR]

Mumps is a vaccine‐preventable acute viral infectious disease. To understand the incidence of mumps and population immunity in Quzhou City after measles mumps rubella vaccine (MMR) was included in the immunization program, we analyzed the epidemiological characteristics of mumps cases from 2009 to 2023 and a cross‐sectional serosurvey of IgG antibodies to mumps conducted in 2024. We found that 15 years after the MMR vaccine was included in the immunization program, the incidence of mumps was significantly reduced in all populations, but the incidence remained highest in vaccinated children aged 0–12 years. Vaccine escape may explain the high incidence of mumps in highly vaccinated populations. Updating vaccines or developing a new vaccine that targets multiple viral genotypes may be necessary to improve the effectiveness of the vaccine against infection and fully control infections and outbreaks. The positive rate and concentration of mumps IgG antibody were inconsistent with the incidence data. mumps IgG antibody is not an ideal substitute for immunity and cannot be used to accurately predict whether a target population is susceptible or protected. Natural infections may provide longer‐lasting immunity than vaccination. [ABSTRACT FROM AUTHOR]

This study employs comprehensive clustering analysis to examine COVID-19 vaccine hesitancy and related socio-demographic factors across U.S. counties, using the collected and curated data from Johns Hopkins University. Utilizing K-Means and hierarchical clustering, we identify five distinct clusters characterized by varying levels of vaccine hesitancy, MMR vaccination coverage, population demographics, and political affiliations. Principal Component Analysis (PCA) was conducted to reduce dimensionality, and key variables were selected based on their contribution to cumulative explained variance. Our analysis reveals significant geographic and demographic patterns in vaccine hesitancy, providing valuable insights for public health strategies and future pandemic responses. Geospatial analysis highlights the distribution of clusters across the United States, indicating areas with high and low vaccine hesitancy. In addition, multiple regression analyses within each cluster identify key predictors of vaccine hesitancy in corresponding U.S. county clusters, emphasizing the importance of socio-economic and demographic factors. The findings underscore the need for targeted public health interventions and tailored communication strategies to address vaccine hesitancy across the United States and, potentially, across the globe. [ABSTRACT FROM AUTHOR]

Objective Measles immunity testing, unlike that for rubella, is not currently part of prenatal screening even though immunity to both is conferred by the measles–mumps–rubella (MMR) vaccine. Although endemic transmission of measles was declared eliminated in the United States in 2001, outbreaks have continued to occur. Given the risks associated with measles infection during pregnancy, we sought to identify risk factors for measles nonimmunity (MNI) in rubella-immune (RI) pregnant individuals. Methods We performed a retrospective observational cross-sectional study of patients receiving prenatal care and delivering at two university hospitals and a county hospital in Southern California from April 1, 2019 to February 1, 2021. Inclusion criteria were pregnant individuals ≥18 years old who had serological testing for rubella and measles during pregnancy. Demographic data were extracted from electronic medical records, including results of serological testing and chronic medical conditions. All subjects were rubella immune, and we compared measles-immune (MI) with MNI groups. Results In total, 1,813 RI individuals were identified, with 1,467 (81%) MI and 346 (19%) MNI individuals. Variables associated with an increased risk of MNI included having public health insurance (adjusted relative risk [aRR]: 1.56; 95% confidence interval [CI]: 1.24, 1.97) and Hispanic ethnicity (aRR: 1.37; 95% CI: 1.06, 1.78). Black race was associated with a decreased risk of MNI (aRR: 0.52; 95% CI: 0.29, 0.91). Birth year before 1989 demonstrated a trend toward increased risk of MNI, but this did not reach statistical significance (aRR 1.23; 95% CI: 1.00, 1.52). No differences were seen between the two groups for medical comorbidities. Conclusion Our study is the first to demonstrate risk factors for measles MNI in patients with documented rubella immunity. In the absence of universal measles serological screening recommendations, the risk factors identified could help guide clinicians in selective screening for those at risk of needing postpartum MMR vaccination. Key Points The rate of measles nonimmunity is higher than previously reported. Hispanic ethnicity and use of public insurance are risk factors for measles nonimmunity. The current recommendation for history-based screening for measles immunity is likely insufficient. [ABSTRACT FROM AUTHOR]

Introduction:Mumps is a highly contagious viral infection affecting the salivary glands, primarily caused by the mumps virus, a member of the Paramyxoviridae family. Despite being a self-limiting disease, mumps can lead to severe complications such as meningitis, encephalitis, orchitis, oophoritis, and permanent hearing loss. The introduction of the MMR vaccine has significantly reduced the incidence of mumps globally, but outbreaks continue to occur, particularly in areas with low vaccination coverage. In India, mumps is not a notifiable disease, and the vaccine is not included in the Universal Immunization Program (UIP), leading to underreporting and insufficient control measures. This study aims to analyze the recent trends in mumps cases in a paediatric population in Vijiyapura town of Bangalore Rural district and emphasize the need for including the mumps vaccine in the national immunization schedule. Methodology:This study was conducted at the Community Health Center (CHC) of Vijiyapura town in Bangalore Rural district. Cases were collected on an Paediatric Outpatient department (OPD) basis from children presenting with symptoms of mumps between March and May 2024. The World Health Organization (WHO) clinical case definition was used to diagnose mumps. Data were collected from all children who visited the OPD and met the clinical case definition. Results:A total of 18 cases of mumps were identified between March and May 2024. The age distribution ranged from 3 to 14 years, with a mean age of 7.1 years and a median age of 7 years. The majority of cases (77.8%) were male. Clinical presentations included fever (100%), constitutional symptoms such as headache and myalgia (80%), swelling of salivary glands (100%), with (27%) having unilateral parotid swelling and (73%) having bilateral parotid swelling. Cough and cold were observed in (80%) of the cases. Conclusion: The study highlights the increasing incidence of mumps in the paediatric population of Vijiyapura town of Bangalore Rural district, emphasizing the need for the inclusion of the mumps vaccine in the UIP. Strengthening the surveillance system and healthcare infrastructure is crucial for better management and control of mumps outbreaks. Collaboration among government agencies, healthcare workers, parents, and the community is essential to implement sustainable solutions and prevent future outbreaks. [ABSTRACT FROM AUTHOR]

The effectiveness of vaccination programmes depends on high levels of public trust in political, scientific and health-related institutions, but public trust in vaccines can waver. This article explores aspects of public trust and mistrust on a web media platform about the MMR (measles-mumps-rubella) vaccine through the statements of a doctor and an anonymised 'anti-vaxxer'. Thematic analysis identifies commonalities and divergences in both perspectives. Both trust and mistrust of MMR vaccination are presented as moral, reasoned stances by their proponents; they are connected to the individual's experiences and situations, but are associated with very different trust attitudes to scientific and political institutions. Moreover, both the trustworthiness of the speakers themselves and the (un)trustworthiness of authorities are emphasised. Trust and mistrust are also thematised in relation to contextual matters such as the role of social media and the historical MMR controversy. Further research towards identifying common ground between trust positions is recommended. [ABSTRACT FROM AUTHOR]

In 2014, the Expanded Program on Immunization of Thailand changed the timing of the second dose of the measles–mumps–rubella (MMR) vaccine from 4–6 years to 2.5 years, while maintaining the first dose at 9 months of age. This study aimed to examine the dynamics and durability of immune responses induced by the two-dose MMR vaccine in a group of 169 Thai children from 4 to 7 years of age (4.5 years after the second MMR dose). We followed a cohort of healthy children from a clinical trial (ClinicalTrials.gov NCT02408926) where they were administered either the Priorix vaccine (GlaxoSmithKline Biologicals, Rixensart, Belgium) or M-M-RII (Merck & Co., Kenilworth, NJ, USA) at 9 months and 2.5 years of age. Blood samples were collected annually from ages 4 to 7 years. Anti-measles, -mumps, and -rubella IgG levels were evaluated using the enzyme-linked immunosorbent assay (EUROIMMUN, Lubeck, Germany). A total of 169 children completed this study. Over the 4.5 years following the two-dose MMR vaccination, we observed a decline in the seroprotection rates against measles and mumps, but not rubella. Longitudinal monitoring of antibody persistence, among other strategies, will help predict population-level immunity and inform public health interventions to address potential future outbreaks. [ABSTRACT FROM AUTHOR]

Background: After the military coup in Myanmar in February 2021, the health system began to disintegrate when staff who called for the restoration of the democratic government resigned and fled to states controlled by ethnic minorities. The military retaliated by blocking the shipment of humanitarian aid, including vaccines, and attacked the ethnic states. After two years without vaccines for their children, parents urged a nurse-led civil society organization in an ethnic state to find a way to resume vaccination. The nurses developed a vaccination program, which we evaluated. Methods: A retrospective cohort study and participatory evaluation were conducted. We interviewed the healthcare workers about vaccine acquisition, transportation, and administration and assessed compliance with WHO-recommended practices. We analyzed the participating children's characteristics. We calculated the proportion of children vaccinated before and after the program. We calculated the probability children would become up-to-date after the program using inverse survival. Results: Since United Nations agencies could not assist, private donations were raised to purchase, smuggle into Myanmar, and administer five vaccines. Cold chain standards were maintained. Compliance with other WHO-recommended vaccination practices was 74%. Of the 184 participating children, 145 (79%, median age five months [IQR 6.5]) were previously unvaccinated, and 71 (41%) were internally displaced. During five monthly sessions, the probability that age-eligible zero-dose children would receive the recommended number of doses of MMR was 92% (95% confidence interval [CI] 83–100%), Penta 87% (95% CI 80%–94%); BCG 76% (95% CI 69%–83%); and OPV 68% (95% CI 59%–78%). Migration of internally displaced children and stockouts of vaccines were the primary factors responsible for decreased coverage. Conclusions: This is the first study to describe the situation, barriers, and outcomes of a childhood vaccination program in one of the many conflict-affected states since the coup in Myanmar. Even though the proportion of previously unvaccinated children was large, the program was successful. While the target population was necessarily small, the program's success led to a donor-funded expansion to 2,000 children. Without renewed efforts, the proportion of unvaccinated children in other parts of Myanmar will approach 100%. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Ensuring equitable vaccination access for immigrant communities is critical for guiding efforts to redress health disparities, but vaccine coverage data are limited. We evaluated childhood vaccination coverage by parental birth country (PBC) through the linkage of Washington State Immunization Information System data and birth records. METHODS: We conducted a retrospective cohort evaluation of children born inWashington from January 1, 2006 to November 12, 2019. We assessed up-to-date vaccination coverage status for measles, mumps, and rubella (MMR), diphtheria, tetanus, and pertussis (DTaP), and poliovirus vaccines at ages 36 months and 7 years. Children with ≥1 parent(s) born in selected non-US countries were compared with children with 2 US-born parents, using Poisson regression models to provide prevalence ratios. RESULTS: We identified 902 909 eligible children, of which 24% had ≥1 non-US-born parent(s). Vaccination coverage at 36 months by PBC ranged from 41.0% to 93.2% for ≥1 MMR doses and ≥3 poliovirus doses and 32.6% to 86.4% for ≥4 DTaP doses. Compared with children of US-born parents, the proportion of children up to date for all 3 vaccines was 3% to 16% higher among children of Filipino-, Indian-, and Mexican-born parents and 33% to 56% lower among children of Moldovan-, Russian-, and Ukrainian-born parents. Within-PBC coverage patterns were similar for all vaccines with some exceptions. Similar PBC-level differences were observed at 7 years of age. CONCLUSIONS: The linkage of public health data improved the characterization of community-level childhood immunization outcomes. The findings provide actionable information to understand communitylevel vaccination determinants and support interventions to enhance vaccine coverage. [ABSTRACT FROM AUTHOR]

In October 2023, the Tel Aviv District was notified of ten cases of measles. The outbreak initiated in a preschool with high vaccination coverage with one dose of MMR vaccine. Serological testing was available for eight patients (six children and two adults). Among the six children vaccinated with one dose of MMR vaccine, primary vaccine failure was demonstrated. Among the adults, secondary vaccine failure was confirmed. The outbreak was successfully contained due to a combination of factors, notably its occurrence within a population characterized by high vaccination coverage in Tel Aviv, during a period of restricted public interactions due to the prevailing state of war in the country. Despite challenging wartime conditions, effective prophylactic measures were promptly executed, encompassing a 2-dose MMR vaccination schedule for close contacts and the broader community of children in the TA district, successfully curbing the outbreak and preventing widespread infections. [ABSTRACT FROM AUTHOR]

Background: Warts pose a considerable challenge in dermatology, necessitating effective therapeutic interventions. This prospective study aims to compare the efficacy and safety of intralesional administration of the measles, mumps, and rubella (MMR) vaccine with intralesional vitamin D3 in patients with multiple warts. Methods: Conducted at the Department of Dermatology, Government Medical College, Anantnag, this prospective study involved patients attending the Dermatology OPD with clinically diagnosed cutaneous warts, either multiple or single, based on predefined inclusion and exclusion criteria. A total of 200 patients were randomly selected, with 100 patients allocated to each group. Patients clinically diagnosed with cutaneous warts were divided into two groups: Group A received intralesional MMR, and Group B received intralesional vitamin D3. Results: In Group A, 43 cases (86%) exhibited a complete treatment response, 4 cases (8%) showed a partial response, and 3 cases (6%) had no response to treatment. Similarly, in Group B, 39 cases (78%) demonstrated a complete treatment response, 6 cases (12%) showed a partial response, and 5 cases (10%) had no response. The comparison between the two groups yielded a non-significant p-value of 0.578. Regarding distant wart clearance, Group A displayed a complete response in 39 cases (78%), while Group B showed a comparable response in 35 cases (70%). Partial response was observed in 14% of cases in Group A and 16% in Group B. Additionally, no response was recorded in 8% of cases in Group A and 14% in Group B. Both groups were comparable with respect to the clearance of distant warts with a non-significant p-value of 0.576. Furthermore, our findings affirm the favorable tolerability and safety profiles of both intralesional MMR vaccine and vitamin D3 immunotherapy, with no occurrences of serious adverse events documented. Conclusion: The study demonstrates that both treatments exhibit similar effectiveness and safety profiles, with MMR showing slightly better response rates. No serious adverse events were reported with either treatment. [ABSTRACT FROM AUTHOR]

Copyright of Health Bulletin / Zdravstveni Glasnik is the property of Faculty of Health Studies, University of Mostar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• MMR vaccinated children had lower rates of antibiotic treatments than children with no MMR. • Bias may explain at least some of the observed association. • Limited non-specific effects of MMR vaccine on infections treated out-of-hospital. Previous studies have shown that vaccination against measles, mumps, and rubella (MMR) may have beneficial non-specific effects, reducing the risk of infections not targeted by the vaccine. We investigated if MMR vaccine given after the third dose of diphtheria-tetanus-acellular pertussis vaccine (DTaP3), was associated with reduced rates of antibiotic treatments. Register-based cohort study following children from the age of recommended MMR vaccination until age 2 years. We included 831,287 children born in Denmark, Finland, Norway, and Sweden who had received DTaP3 but not yet MMR vaccine. Cox proportional hazards regression with age as the underlying timescale and vaccination status as a time-varying exposure was used to estimate covariate-adjusted Hazard Ratios (aHRs) and inverse probability of treatment weighted (IPTW) HRs of antibiotic treatments. Summary estimates were calculated using random-effects meta-analysis. Compared with only having received DTaP3, receipt of MMR vaccine after DTaP3 was associated with reduced rates of antibiotic treatments in all countries: the aHR was 0.92 (0.91–0.93) in Denmark, 0.92 (0.90–0.94) in Finland, 0.84 (0.82–0.85) in Norway, and 0.87 (0.85–0.90) in Sweden, yielding a summary estimate of 0.89 (0.85–0.93). A stronger beneficial association was seen in a negative control exposure analysis comparing children vaccinated with DTaP3 vs two doses of DTaP. Across the Nordic countries, receipt of MMR vaccine after DTaP3 was associated with an 11% lower rate of antibiotic treatments. The negative control analysis suggests that the findings are affected by residual confounding. Findings suggest that potential non-specific effects of MMR vaccine are of limited clinical and public health importance for the milder infections treated out-of-hospital in the Nordic setting. [ABSTRACT FROM AUTHOR]

B cell transcriptomic signatures hold promise for the early prediction of vaccineinduced humoral immunity and vaccine protective efficacy. We performed a longitudinal study in 232 healthy adult participants before/after a 3rd dose of MMR (MMR3) vaccine. We assessed baseline and early transcriptional patterns in purified B cells and their association with measles-specific humoral immunity after MMR vaccination using two analytical methods ("per gene" linear models and joint analysis). Our study identified distinct early transcriptional signatures/genes following MMR3 that were associated with measles-specific neutralizing antibody titer and/or binding antibody titer. The most significant genes included: the interleukin 20 receptor subunit beta/IL20RB gene (a subunit receptor for IL-24, a cytokine involved in the germinal center B cell maturation/response); the phorbol-12-myristate-13-acetate-induced protein 1/PMAIP1, the brain expressed X-linked 2/BEX2 gene and the B cell Fas apoptotic inhibitory molecule/FAIM, involved in the selection of high-affinity B cell clones and apoptosis/regulation of apoptosis; as well as IL16 (encoding the B lymphocytederived IL-16 ligand of CD4), involved in the crosstalk between B cells, dendritic cells and helper T cells. Significantly enriched pathways included B cell signaling, apoptosis/regulation of apoptosis, metabolic pathways, cell cycle-related pathways, and pathways associated with viral infections, among others. In conclusion, our study identified genes/pathways linked to antigen-induced B cell proliferation, differentiation, apoptosis, and clonal selection, that are associated with, and impact measles virus-specific humoral immunity after MMR vaccination. [ABSTRACT FROM AUTHOR]

The measles, mumps, and rubella (MMR) vaccine protects against all-cause mortality in children, but the immunological mechanisms mediating these effects are poorly known. We systematically investigated whether MMR can induce long-term functional changes in innate immune cells, a process termed trained immunity, that could at least partially mediate this heterologous protection. In a randomized, placebo-controlled trial, 39 healthy adults received either the MMR vaccine or a placebo. Using single-cell RNA-Seq, we found that MMR caused transcriptomic changes in CD14+ monocytes and NK cells, but most profoundly in γδ T cells. Monocyte function was not altered by MMR vaccination. In contrast, the function of γδ T cells was markedly enhanced by MMR vaccination, with higher production of TNF and IFN-γ, as well as upregulation of cellular metabolic pathways. In conclusion, we describe a trained immunity program characterized by modulation of γδ T cell function induced by MMR vaccination. [ABSTRACT FROM AUTHOR]

Background: Child vaccinations are among the most effective public health interventions. However, wide gaps in child vaccination remain among different groups with uptake in most minorities or ethnic communities in Europe substantially lower compared to the general population. A systematic review was conducted to understand health system barriers and enablers to measles, mumps and rubella (MMR) and human papilloma virus (HPV) child vaccination among disadvantaged, minority populations in middle- and high-income countries. Methods: We searched Medline, Cochrane, CINAHL, ProQuest and EMBASE for articles published from 2010 to 2021. Following title and abstract screening, full texts were assessed for relevance. Study quality was appraised using Critical Appraisal Skills Program checklists. Data extraction and analysis were performed. Health system barriers and enablers to vaccination were mapped to the World Health Organization health system building blocks. Results: A total of 1658 search results were identified from five databases and 24 from reference lists. After removing duplicates, 1556 titles were screened and 496 were eligible. Eighty-six full texts were assessed for eligibility, 28 articles met all inclusion criteria. Factors that affected MMR and HPV vaccination among disadvantaged populations included service delivery (limited time, geographic distance, lack of culturally appropriate translated materials, difficulties navigating healthcare system), healthcare workforce (language and poor communication skills), financial costs and feelings of discrimination. Conclusion: Policymakers must consider health system barriers to vaccination faced by disadvantaged, minority populations while recognizing specific cultural contexts of each population. To ensure maximum policy impact, approaches to encourage vaccinations should be tailored to the unique population's needs. A one-size-fits-all approach is not effective. [ABSTRACT FROM AUTHOR]

Mumps is a global public health problem caused by mumps virus, a member of paramyxoviridae family. MMR (Mumps, Measles, Rubella), an effective vaccine, has been incorporated into routine immunization schedules in over 100 countries. On the contrary, in India, vaccine against mumps has not been included in the routine immunization schedule as mumps is still not viewed as a significant public health problem by the government to warrant such an intervention. An increasing number of mumps outbreaks being reported from many parts of the country in the recent past, is matter of concern. The current paper reviews the situation of mumps in India including the recent surge, and discusses the remedial measures to contain these outbreaks. We conclude that inclusion of Mumps component as MMR vaccine in the Universal Immunization Programme of India along with strengthening surveillance is required to tackle the situation. [ABSTRACT FROM AUTHOR]

Measles, mumps, rubella (MMR), and varicella incidence rates have increased due to the delayed vaccination schedules of children secondary to the COVID-19 pandemic. Decreased herd immunity creates a risk for immunocompetent children and immunocompromised individuals in the community. Historically, live-attenuated vaccines (MMR and varicella) were recommended before solid organ transplants. The amount of time before transplant when this is appropriate is often debated, as is the utility of vaccine titers. MMR and varicella vaccines previously were not recommended in immunocompromised patients post-solid organ transplant due to the undue risk of transmission and posed infection risk. The new literature on live-attenuated vaccines in post-transplant pediatric patients provides more insight into the vaccines' safety and efficacy. The present article aims to provide guidance on live-attenuated vaccines (MMR and varicella) in the pre-transplant and post-operative solid organ transplant phases of care in pediatric patients. [ABSTRACT FROM AUTHOR]

• Real-world evidence of MMRV clinical protection against varicella is essential. • Data showed effectiveness of two doses MMRV against varicella of any severity of 93%. • Two-dose schedule should be recommended to optimise immunisation programmes worldwide. Priorix-Tetra ™ (MMRV GlaxoSmithKline Biologicals' vaccine) was developed based on the existing measles-mumps-rubella and varicella vaccines. In this study, we aimed to estimate the effectiveness of the combined measles-mumps-rubella-varicella Priorix-Tetra™ vaccine against varicella in real-world conditions. We conducted a post-marketing retrospective case-control study in the Apulia region of Italy in children aged 1–9 years born between January 1, 2008 and December 31, 2016. We assessed the effectiveness against varicella of all grades of severity (including hospitalisation) and against hospitalisation for varicella of a single and two doses of Priorix-Tetra™. Moreover, we also assessed effectiveness of monovalent varicella (monovalent-V) vaccine and any varicella vaccines. Vaccine effectiveness was calculated as (1–OR) x 100. We introduced demographic variables in the model to adjust Vaccine effectiveness (aVE) by potential confounders (sex and year of birth). We recorded 625 varicella cases and matched them with 1,875 controls. Among 625 cases, 198 had received a single MMRV dose, 10 two MMRV doses, 46 a single monovalent-V dose, none two monovalent-V doses; four a monovalent-V as first dose and MMRV as second dose, and one a MMRV as first dose and monovalent-V as second dose; 366 cases were not vaccinated. The aVE against varicella of all grades of severity was 77.0% and 93.0% after a single dose and after two doses of MMRV, respectively. The aVE against varicella of all grades was 72.0% after a single dose of monovalent-V vaccine. The aVE against varicella of all grades of severity was 76.0% after a single dose and 94.0% after two doses of any varicella vaccine. The aVE against varicella hospitalisation was 96% after a single dose of any varicella vaccine. Priorix-Tetra™ showed to be an effective vaccine and the two-dose schedule should be recommended to optimise immunisation programmes. A single dose was able to provide protection against varicella hospitalisation. [ABSTRACT FROM AUTHOR]

Background and Objective: Current regulatory labeling recommends avoiding live vaccine use in dupilumab‐treated patients. Clinical data are not available to support more specific guidance for live or live attenuated vaccines administration in dupilumab‐treated patients. Methods: Children (6 months–5 years old) with moderate‐to‐severe atopic dermatitis (AD) enrolled in a phase 2/3 clinical trial of dupilumab (LIBERTY AD PRESCHOOL Part A/B; NCT03346434) and subsequently participated in the LIBERTY AD PED‐OLE (NCT02612454). During these studies, protocol deviations occurred in nine children who received measles, mumps, rubella (MMR) vaccine with or without varicella vaccine; five with a ≤12‐week gap between dupilumab administration and vaccination and four with a >12‐week gap after discontinuing dupilumab. Results: Nine children (1 female; 8 male) had severe AD at baseline (8–56 months old). Of the nine children, five had a ≤12‐week gap ranged 1–7 weeks between dupilumab administration and vaccination who received MMR vaccine (n = 2) or MMR and varicella vaccines (n = 3); among these, one resumed dupilumab treatment as early as 2 days and four resumed treatment 18–43 days after vaccination. No treatment‐emergent adverse events, including serious adverse events and infections, were reported within the 4‐week post‐vaccination period in any children. Conclusions: In this case series of dupilumab‐treated children with severe AD who received MMR vaccine with or without varicella vaccine, no adverse effects (including vaccine‐related infection) were reported within 4 weeks after vaccination. Further studies are warranted to evaluate the safety, tolerability, and immune response to live attenuated vaccines in dupilumab‐treated patients. [ABSTRACT FROM AUTHOR]

The United Kingdom (UK) has a comprehensive national immunisation programme which comprises both routine and selective immunisation schedules (UK Health Security Agency [UKHSA], 2023). The routine programme includes those vaccines offered to the population, with eligibility predicated on age. For the last few years, vaccine coverage has been falling in the majority of children’s and young people’s immunisation programmes (UKHSA, 2022; UKHSA 2023a; UKHSA 2023b; UKHSA 2023c). The decline in coverage has been made worse by the Covid-19 pandemic and consequent lockdowns, illness among recipients, and confusion and hesitancy about vaccines in general. This article discusses the drop in coverage of the adolescent immunisation programmes in England, and the role that general practice nurses (GPNs) and primary care immunisers can play in ensuring that young people are offered missing vaccines. The benefit of this catch-up activity is seen in reduced risk of morbidity and mortality from vaccine preventable illness in both individuals and those around them. [ABSTRACT FROM AUTHOR]

The article describes the case of a healthy 13-month-old Indian boy with erythema nodosum (EN) after receiving his 12-month routine vaccine. Topics discussed include tender erythematous nodules on the boy's legs that appeared 24 hours after vaccination, most common etiological factors for EN in children, and differential diagnoses for EN.

Background A measles epidemic affected the Nouvelle-Aquitaine region from November 2017 to May 2018 with clusters among Travellers. This indicates that measles vaccination rates among Travellers remain lower than in the general population. The objective of this study was to estimate the 'declarative vaccination' against measles, mumps and rubella (MMR) and to propose a conceptual framework to help identify determinants of MMR vaccination uptake among adult Travellers in Nouvelle-Aquitaine in 2019–20. Methods A cross-sectional study using random sampling was performed and included 612 adult Travellers from 1 November 2019 to 31 March 2020. A conceptual framework to model vaccination adherence was tested among this underserved population by using structural equation modelling. This model included five latent variables: health literacy, attitudes toward preventive measures, stigma, accessibility to care and perceived needs and five measured variables: information received on vaccination, perception of barriers, support for administrative documents, social support and housing conditions. Results Individuals who did not answer all the questions linked to the variables included in the model were excluded, thus 347 adults were included in the final sample. The declared vaccination rate against MMR was 74.0%, and 72.4% of the participants were favorable to vaccination. Vaccination adherence was significantly correlated with favorable attitudes toward preventive measures such as having a history of MMR vaccination and not having already refused a recommended vaccine and finally satisfactory information received on vaccination. Discussion To improve vaccination adherence, health authorities should lean on personal history with vaccination and on transmitting information on vaccination. [ABSTRACT FROM AUTHOR]

• Children living in deprived vs affluent areas are >10 % less likely to be vaccinated. • Mothers vaccinated in pregnancy vs unvaccinated 40% more likely to vaccinate child. • Pregnancy is an opportunity to promote both maternal & childhood vaccines to parents. We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant women's pertussis vaccine uptake and their children's MMR vaccine uptake. We used nationally-representative linked mother-baby electronic records from the United Kingdom's Clinical-Practice-Research-Datalink. We created a birth cohort of children born between 01.01.2000 and 12.12.2020. We estimated the proportion vaccinated with first MMR vaccine by age 2 years and first and second MMR vaccines by age 5 years. We used survival-analysis and Cox proportional hazard models to examine the association between deprivation, ethnicity and maternal age and pertussis vaccination in pregnancy and children's MMR uptake. Overall, 89.4 % (710,797/795,497) of children had first MMR by age 2 years and 92.6 % (736,495/795,497) by age 5 years. Among children still in the cohort when second MMR was due, 85.9 % (478,480/557,050) had two MMRs by age 5 years. Children from the most-deprived areas, children of Black ethnicity and children of mothers aged < 20 years had increased risk of being unvaccinated compared with children from the least-deprived areas, White children and children of mothers aged 31–40 years: first MMR by 5 years, adjusted Hazard Ratios (HR):0.86 (CI:0.85–0.87), HR:0.87 (CI:0.85–0.88) & HR:0.89 (CI:0.88–0.90) respectively. Deprivation was the determinant associated with the greatest risk of missed second MMR: adjusted HR:0.82 (CI:0.81–0.83). Children of mothers vaccinated in pregnancy were more likely than children of unvaccinated mothers to have MMR vaccines after adjusting for ethnicity, deprivation, and maternal age (First and Second MMRs adjusted HRs:1.43 (CI:1.41–1.45), 1.49 (CI:1.45–1.53). Children from most-deprived areas are less likely to have MMR vaccines compared with children from least-deprived areas. Mothers who take up pregnancy vaccines are more likely to have their children vaccinated with MMR. Healthcare services should promote and facilitate access to both maternal and childhood vaccines during pregnancy. [ABSTRACT FROM AUTHOR]

Background A third dose of measles-mumps-rubella vaccine (MMR) may be administered for various reasons, but data on long-term immunity are limited. We assessed neutralizing antibody levels against measles and rubella among adults up to 11 years after receipt of a third MMR dose. Methods In this longitudinal study, healthy adults who received a third MMR dose as young adults (ages 18–28 years) were recalled around 5 years and 9–11 years after the third dose. Measles and rubella antibody levels were assessed by plaque-reduction and immunocolorimetric neutralization assays, respectively. Antibody concentrations <120 mIU/mL and <10 U/mL were considered potentially susceptible to measles and rubella, respectively. Geometric mean concentrations (GMCs) and 95% confidence intervals (CIs) over time were estimated from generalized estimating equation models. Results Approximately 5 and 9–11 years after receipt of the third dose, 405 and 304 adults were assessed, respectively. Measles GMC was 428 mIU/mL (95% CI, 392–468 mIU/mL) 5 years postvaccination, declining to 381 mIU/mL (95% CI, 339–428 mIU/mL) 11 years postvaccination. At the last follow-up visit (9–11 years postvaccination), 10% of participants were potentially susceptible to measles infection. Rubella GMCs were stable throughout the follow-up period (63 U/mL to 65 U/mL); none of the participants was susceptible to rubella at the last follow-up visit. Conclusions Eleven years after receiving a third MMR dose, measles and rubella neutralizing antibody levels remained high in adults. However, on the basis of waning antibody levels, some adults may become susceptible to measles infection over time despite receipt of 3 vaccine doses. [ABSTRACT FROM AUTHOR]

Aim: This analysis was conducted to review the number, and describe the characteristics of first-in-human (FIH) Phase 1 clinical trials registered in India from 2008 to 2022. Materials and Methods: The data were extracted from the Clinical Trials Registry - India database for all FIH Phase 1 clinical trials registered between 2008 and 2022. Early-phase trials that were not FIH trials (e.g., pharmacokinetic studies and drug-drug interaction studies) were excluded from the study. Results: A total of 1891 trials were retrieved and 220 were included in the analysis. Most of the investigational products were drugs (55%) followed by vaccines (38.2%). The most common therapeutic class of drugs was cancer chemotherapy (19.8%), followed by antimicrobial chemotherapy and endocrinology (18.2% each). The most common vaccine was the influenza vaccine (21.4%), followed by the measles-mumps-rubella vaccine (15.5%). The pharmaceutical industry was the predominant sponsor for most (91%) of the Phase 1 trials. Of the top five sites where most of the Phase 1 trials were conducted, three were private nonacademic centers (cumulatively 31%) and two were tertiary care medical colleges (cumulatively 9%). Conclusion: Phase 1 clinical trials seem to be conducted in India predominantly with industry sponsorship. There is a need to have an alternate ecosystem to take forward molecules that do not receive adequate attention from the industry and molecules that are of national health priority other than areas such as chemotherapy, antimicrobials, and endocrinology. The Indian Council of Medical Research is setting up Phase 1 clinical trial capacity for molecules that predominantly may arise from nonindustry channels. [ABSTRACT FROM AUTHOR]

Introduction: Measles, mumps, and rubella (MMR) vaccine is a part of the childhood routine immunization program. It is known that allergic reactions, from urticaria to anaphylaxis, may develop against MMR vaccines containing trace amounts of egg protein and other ingredients. Aim: To determine whether children with any degree of egg allergy show allergic reactions to the MMR vaccine application and to draw attention to the fact that children without a history of anaphylaxis can be vaccinated safely by practitioners and/or family physicians in health centers. Material and methods: The files of 90 patients who were vaccinated between 2017 and 2022 in the pediatric allergy clinic were retrospectively analyzed. These patients were those who were followed up due to egg allergy in our outpatient clinic or were referred from the family health centers because the family said that the baby had an egg allergy. Results: A total of 94 doses of vaccination were given to 90 patients. Four doses were for those who were vaccinated for a second time. All skin prick tests with 94 doses of MMR vaccine were negative, and only 1 patient (1/94, 1.06%) developed nonspecific macular rash 0.5 h after vaccination. No other allergic reactions or anaphylaxis were observed. Conclusions: No serious allergic reaction developed after MMR vaccination in IgE-mediated egg allergy patients. We think that there is no harm in administering MMR vaccine to these patients in family health centers where other vaccines are applied, without testing with the vaccine and without the need for divided doses. [ABSTRACT FROM AUTHOR]

Background: Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized. Objectives: To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS. Methods: Retrospective observational study in pwMS vaccinated against VAR and/or MMR. We compared seroprotection rates and antibody geometric mean titers (GMTs) between the two strategies. Results: Ninety-six patients were included. Thirty-one patients received VAR and 67 MMR. In the SDA group, the seroprotection rate was 66.7% (95% confidence interval (CI): 53.3–78.3) versus 97.2% (95% CI: 85.5–99.9) in the SIS (p < 0.001). For the seroprotected patients, GMTs were similar for both schemes. Conclusion: An SDA of VAR and/or MMR vaccines could be sufficient to protect almost two-thirds of patients. Testing immunogenicity after a single dose of VZ and/or MMR could be included in routine clinical practice to achieve rapid immunization. [ABSTRACT FROM AUTHOR]

Investigating the completion rate of 12-month vaccinations and parental perspectives on vaccine services during COVID-19. Service evaluation including parental questionnaire. Uptake of 12-month vaccinations in three London general practices during three periods: pre-COVID (1/3/2018–28/2/2019, n = 826), during COVID (1/3/2019–28/2/2020, n = 775) and post-COVID first wave (1/8/2020–31/1/2021, n = 419). Questionnaire of parents whose children were registered at the practices (1/4/2019–1/22/2021, n = 1350). Comparing pre-COVID and both COVID cohorts, the completion rates of 12-month vaccines were lower. Haemophilus influenzae type B/meningococcal group C (Hib/MenC) vaccination uptake was 5.6% lower (89.0% vs 83.4%, P =<0.001), meningococcal group B (MenB) booster uptake was 4.4% lower (87.3% vs 82.9%, P = 0.006), pneumococcal conjugate vaccine (PCV) booster uptake was 6% lower (88.0% vs 82.0%, P < 0.001) and measles, mumps and rubella (MMR) vaccine uptake was 5.2% lower (89.1% vs 83.9%, P = 0.003). Black/Black-British ethnicity children had increased odds of missing their 12-month vaccinations compared to White ethnicity children (adjusted odds ratio 0.43 [95% confidence interval 0.24–0.79, P = 0.005; 0.36 [0.20–0.65], P < 0.001; 0.48 [0.27–0.87], P = 0.01; 0.40 [0.22–0.73], P = 0.002; for Hib/MenC, MenB booster, PCV booster and MMR. Comparing pre-COVID and COVID periods, vaccinations coded as not booked increased for MMR (10%), MenB (7%) and PCV booster (8%). Parents reported changes to vaccination services during COVID-19, including difficulties booking and attending appointments and lack of vaccination reminders. A sustained decrease in 12-month childhood vaccination uptake disproportionally affected Black/Black British ethnicity infants during the first wave of the pandemic. Vaccination reminders and availability of healthcare professionals to discuss parental vaccine queries are vital to maintaining uptake. [ABSTRACT FROM AUTHOR]

• The immunogenicity and safety of concomitant administration of three vaccines are unclear in Chinese infants. • Concomitant administration can alleviate the burden on healthcare systems. • Concomitant administration can minimize discomfort in children. • Simultaneous vaccination is suitable for developing countries. During the COVID-19 pandemic, there was a decline in vaccine coverage, and the implementation of combined vaccines and co-administration strategies emerged as potential solutions to alleviate this predicament. Our objective is to delve into the concurrent administration of the sabin-strain-based inactivated poliovirus vaccine (sIPV), the diphtheria-tetanus-acellular pertussis vaccine (DTaP), and measles-mumps-rubella vaccine (MMR), with the intention of bridging the evidentiary gap pertaining to vaccine co-administration in Chinese infants, and to ensure a safe and effective vaccination strategy, ultimately leading to an augmentation in immunization coverage. This study was a follow-up trial of the "Immunogenicity and safety of concomitant administration of the sIPV with the DTaP vaccine in children: a multicenter, randomized, non-inferiority, controlled trial." Blood samples were collected on day 0 and day 30, and serum antibody levels were detected to measure antibody responses to each of the antigens. Local and systemic adverse events were monitored and compared among groups. This study is the first to fill the knowledge gap in China regarding the safe and effective combined vaccination of sIPV, DTaP, and MMR vaccines. The geometric mean titer of the poliovirus types I, II, and III neutralizing antibodies were 1060.22 (95% CI: 865.73-1298.39), 1537.06 (95% CI: 1324.27-1784.05), and 1539.10 (95% CI: 1296.37-1827.29) in group I on day 30; geometric mean titer of antibodies against DTaP and MMR in the simultaneous vaccination group was non-inferior to those in the DTaP alone and MMR alone group. Reporting rates of local and systemic adverse reactions were similar between groups and no serious adverse events were reported throughout the clinical study period. Co-administration of the sIPV, DTaP, and MMR was safe and did not impact immunogenicity, which would help to mitigate administrative costs and enhance vaccine coverage rates. [ABSTRACT FROM AUTHOR]

Background The poor health status of underserved populations is compounded by low vaccination uptake, leading to a greater risk of epidemics. On October 2017, a measles outbreak started in the southwest of France among under-vaccinated social groups, including Travellers. We aimed to describe the health status, healthcare use and child measles–mumps–rubella (MMR) vaccination coverage in Travellers according to their environmental and living conditions. Methods A cross-sectional study with a three-stage random sample design was conducted between October 2019 and March 2022 in the Nouvelle-Aquitaine region in France. Trained social workers administered face-to-face questionnaires to collect data on adults and children. Anthropometric measurements, vaccination records and data using an environmental exposure questionnaire were also collected. Results The participation rate was high (73.6%), with 1030 adults and 337 children included. Concerning the adults, 36.6% had obesity, 14.4% reported diabetes, 24.7% hypertension and 14.4% major depression. The prevalence of major depression was significantly higher in adults living in precarious and unauthorized housing than in those with adequate housing (19.8 vs. 14.7%, P  = 0.03). With regard to children, 45.3% had full (i.e. 2-dose) MMR vaccination coverage at 24 months and 17.9% had obesity. Finally, 74.5% of the households experienced housing insecurity, and 22.2% did not have a supply of drinking water. Conclusion Traveller children and adults faced deleterious environmental and living conditions potentially affecting their health, healthcare use and vaccination coverage. These results demonstrate the need for urgent interventions for underserved populations which take into account their specific needs. [ABSTRACT FROM AUTHOR]

In May 2019, a measles outbreak occurred in the French subregion of Loire‐Atlantique, particularly affecting Roma settlements. Various obstacles hindered the implementation of postexposure measures among Roma population, resulting in the spread of the cases to other settlements. Suspected cases of measles were immediately investigated and concerned settlements were visited for measles–mumps–rubella (MMR) vaccination. From July 1 to September 3, 2019, a first and then a second Health Reserve team helped for vaccination on the affected and then also the measles‐free settlements. Vaccination uptake was monitored with the use of the department's vaccination center immunization registry. Genotyping of selected samples was performed for comparison with viruses circulating at the same time in France and Romania. As of September 16 2019, 109 cases of measles were confirmed among Roma population, including 99 (91%) children under 15 years. Of the 85 people eligible for vaccination, 60 (71%) had not been vaccinated and 23 (27%) had an unknown vaccination status. Sequence comparison revealed that 28/29 sequenced D8 strains were 100% identical to the strain responsible for a large number of cases throughout France in 2019, and to two sequences reported in Romania among sporadic cases. The vaccination campaign resulted in 1136 people on 35 settlements receiving at least one dose of MMR vaccine and in the increase of one‐dose MMR vaccine coverage at 24 months from 43% (23/53) to 91% (48/53). With measles transmission continuing in Europe, efforts must be made to meet immunization coverage targets, particularly in hard‐to‐reach communities where outbreaks may be difficult to control. [ABSTRACT FROM AUTHOR]

Background: There is considerable variation in vaccination practices between pediatric transplant centers. This study aims to evaluate active immunization attitudes and practices among ERN‐TransplantChild centers and identify potential areas of improvement that could be addressed by shared evidence‐based protocols. Methods: A cross‐sectional questionnaire of attitudes and practices toward immunization of pediatric SOT and HSCT candidates and recipients was sent to a representative member of multidisciplinary teams from 27 European centers belonging to the ERN‐TransplantChild. Results: A total of 28/62 SOT programs and 6/12 HSCT programs across 21 European centers participated. A quarter of centers did not have an on‐site protocol for the immunizations. At the time of transplantation, pediatric candidates were fully immunized (80%–100%) in 57% and 33% of the SOT and HSCT programs. Variations in the time between vaccine administration and admission to the waiting list were reported between the centers, with 2 weeks for inactivated vaccines and variable time (2–4 weeks) for live‐attenuated vaccines (LAVs). Almost all sites recommended immunization in the post‐transplant period, with a time window of 4–8 months for the inactivated vaccines and 16–24 months for MMR and Varicella vaccines. Only five sites administer LAVs after transplantation, with seroconversion evaluated in 80% of cases. Conclusions: The immunization coverage of European pediatric transplant recipients is still inconsistent and far from adequate. This survey is a starting point for developing shared evidence‐based immunization protocols for safe vaccination among pediatric transplant centers and generating new research studies. [ABSTRACT FROM AUTHOR]

Building upon recent theoretical perspectives on emotional flow and the dynamic nature of fear appeals specifically, this study examined the sequencing effects of the emotions (i.e., fear and hope) induced from a fear appeal on persuasion in the context of MMR vaccination. Specifically, an experiment (N = 386) with 2 video messages was conducted that manipulated the sequence in which participants experienced fear and hope, resulting in a fear → hope appeal and a hope → fear appeal. The findings show that the fear → hope appeal was more effective in increasing activism intentions than the hope → fear appeal. Fear and hope at different time points served as mediators for this effect. In addition, issue relevance was a moderator for this effect such that the fear → hope appeal was more effective only among those perceiving the issue as highly relevant. Discussions and implications are provided. [ABSTRACT FROM AUTHOR]

As SARS-CoV-2 variants of concern (VoCs) that evade immunity continue to emerge, next-generation adaptable COVID-19 vaccines which protect the respiratory tract and provide broader, more effective, and durable protection are urgently needed. Here, we have developed one such approach, a highly efficacious, intranasally delivered, trivalent measles-mumps-SARS-CoV-2 spike (S) protein (MMS) vaccine candidate that induces robust systemic and mucosal immunity with broad protection. This vaccine candidate is based on three components of the MMR vaccine, a measles virus Edmonston and the two mumps virus strains [Jeryl Lynn 1 (JL1) and JL2] that are known to provide safe, effective, and long-lasting protective immunity. The six proline-stabilized prefusion S protein (preS-6P) genes for ancestral SARS-CoV-2 WA1 and two important SARS-CoV-2 VoCs (Delta and Omicron BA.1) were each inserted into one of these three viruses which were then combined into a trivalent “MMS” candidate vaccine. Intranasal immunization of MMS in IFNAR1−/− mice induced a strong SARS-CoV-2-specific serum IgG response, cross-variant neutralizing antibodies, mucosal IgA, and systemic and tissue-resident T cells. Immunization of golden Syrian hamsters with MMS vaccine induced similarly high levels of antibodies that efficiently neutralized SARS-CoV-2 VoCs and provided broad and complete protection against challenge with any of these VoCs. This MMS vaccine is an efficacious, broadly protective next-generation COVID-19 vaccine candidate, which is readily adaptable to new variants, built on a platform with a 50-y safety record that also protects against measles and mumps. [ABSTRACT FROM AUTHOR]

This study tested whether a simple fact-checking label on Twitter effectively reduces vaccine conspiracy beliefs, misinformation engagement intentions, and vaccination intentions. A web-based experiment (N = 206) of adults living in the United States through Amazon Mechanical Turk (MTurk) was conducted for the measles–mumps–rubella (MMR) vaccine in March 2020. The results showed that the fact-checking label attached to the conspiratorial misinformation post significantly reduced MMR vaccine conspiracy beliefs compared to the no fact-checking (misinformation-only) condition but did not directly affect MMR misinformation engagement intentions and MMR vaccination intentions. In addition, we found that the fact-checking label effectively decreased vaccine conspiracy beliefs and misinformation engagement intentions for those whose prior favorable attitudes toward MMR vaccination were relatively low. Based on our findings, we suggest that public health professionals and health communicators use the fact-checking label as a promising tool for countering conspiracy theories about vaccination. However, they should further seek alternative ways to limit the public's engagement in misinformation-related activities on social media and promote health protective behavioral intentions, given the limited effects of fact-checking labels. [ABSTRACT FROM AUTHOR]

Purpose: This qualitative study utilizing phenomenological methodology aimed to depict parental measles mumps rubella (MMR) vaccine acceptance through the work experiences of health personnel. Materials and Methods: Twenty-two public health workers working as vaccination providers in the three southern border provinces of Thailand were recruited. In-depth, face-to-face, semi-structured interviews were conducted. Data were analyzed using thematic analysis. Results: Four main themes emerged: (1) religious beliefs, (2) personal disagreements, (3) fear and mistrust regarding potential vaccine side effects, and (4) misperceptions about the potential severity of measles. Four subthemes were identified: (1) haram (prohibited), (2) the will of Allah, (3) spousal disagreement, and (4) disagreement from a religious leader. The results of this study indicated that perceived religious prohibition was the most important reason for refusing to vaccinate among Muslim parents. Vaccine-hesitant parents were concerned that the vaccine might contain gelatin derived from pig products. Also, halal certification of the vaccine was required from Muslim parents to ensure that vaccine has been approved for Muslims. Meanwhile, a lack of knowledge and positive attitudes concerning immunizations of vaccine-hesitant parents were also found as predominant reasons for incomplete childhood immunizations in the deep south of Thailand. Conclusion: Health education and engagement by religious leaders to endorse the vaccination and bridge the gap between religious beliefs and vaccine acceptance is needed to overcome this issue. This study findings could be effectively applied to improve vaccination uptake in a Muslim majority context. [ABSTRACT FROM AUTHOR]

(1) Background: This implementation study reports on the results of the mobile vaccination teams' (MVTs) activities during the first two years of the COVID-19 pandemic in Kyrgyzstan, when other vaccination services were disrupted. (2) Methods: Through a national health system-strengthening project under an order of the Ministry of Health, in 2020, the number of MVTs was increased, focusing on internal immigrant settlements around the cities of Bishkek and Osh and geographically remote areas. MVTs provided free vaccination services. (3) Results: MVTs vaccinated a total of 125,289 and 158,047 children in 2020 and 2021, respectively. The higher contribution of MVTs to vaccination coverage was in children under 5 years of age, with the three top vaccines being IPV (8.9%), MMR (7%), and PCV (6.6%). In 2021, 13,000 children who had not received an IPV vaccination and 8692 children who had not received the Pentavalent vaccine (DPT-HBV-Hib) were reached. The number of cases of vaccine-preventable disease reported in official statistics has reduced over time. (4) Conclusions: MVTs increased vaccination coverage in Kyrgyzstan, in particular in remote regions and migrant settlements, where it accounted for a considerable proportion of the vaccinated. This study adds to previous evidence in the literature of the role of MVTs as a strategy to improve immunization in hard-to-reach populations, particularly children. [ABSTRACT FROM AUTHOR]

A surge in measles cases has prompted the UK Health Security Agency (UKHSA) to declare a national incident. Agency chief executive Jenny Harries says the UK is on a ‘trajectory for everything getting much worse’ because of low vaccination uptake. Nurses have described the situation as frustrating because the virus is preventable with two doses of the measles, mumps and rubella (MMR) vaccine. [ABSTRACT FROM AUTHOR]

Congenital rubella syndrome is a constellation of birth defects that can have devastating consequences, impacting approximately 100,000 births worldwide each year. The incidence is much lower in countries that routinely vaccinate their population. In the US, postnatal immunization of susceptible women is an important epidemiological strategy for the prevention of rubella as the Center for Disease Control (CDC) does not recommend administering this vaccine during pregnancy due to its nature as a live attenuated virus vaccine. However, concerns that the co-administration of rubella vaccine with other immunoglobins (i.e., Rhogam) could compromise vaccine efficacy has produced warnings that can delay the administration of rubella vaccination postpartum, leaving women susceptible to the disease in subsequent pregnancies. We aimed to address whether the co-administration of the measles, mumps, and rubella (MMR) vaccine and Rhogam decreased antibody responses compared to those receiving only MMR vaccination. This retrospective cohort study utilized clinical data from 78 subjects who received the MMR vaccine and Rhogam after delivery and 45 subjects who received the MMR vaccine alone. Maternal demographics, pregnancy complications and rubella status at the start of a subsequent pregnancy were recorded for analysis. Overall, the two cohorts had similar baseline characteristics; however, lower parity was noted in the participants that received both MMR vaccination and Rhogam. Making assessments based on maternal antibody IgG index for rubella during the next pregnancy, we observed that 88% of the Rhogam + MMR vaccine group had positive serology scores, which was not significantly different from the 80% rate in the MMR-vaccine-only cohort (p = 0.2). In conclusion, no differences were observed in rubella immunity status in subsequent pregnancies in those mothers given both the MMR vaccine and Rhogam concurrently. Given these findings, warnings against co-administration of vaccines in combination with Rhogam appear unwarranted. [ABSTRACT FROM AUTHOR]

Simple Summary: This research has been suggested after a gap was found in the previous literature, and our hypothesis of the MMR vaccine being an oncolytic virus. The present study has been designed to study and cover the followings objectives: to evaluate the therapeutic effect of the measles virus vaccine strains on cancer, through wet-lab experimental analysis; and to study the previous literature on the application of oncolytic viruses. Our findings highlight the therapeutic potential of the MMR vaccine strain for the treatment of glioblastoma (GBM). Background: Oncolytic viruses (OVs) have been utilized since 1990s for targeted cancer treatment. Our study examined the Measles–Mumps–Rubella (MMR) vaccine's cancer-killing potency against Glioblastoma (GBM), a therapy-resistant, aggressive cancer type. Methodology: We used GBM cell lines, primary GBM cells, and normal mice microglial cells, to assess the MMR vaccine's efficacy through cell viability, cell cycle analysis, intracellular viral load via RT-PCR, and Transmission Electron Microscopy (TEM). Results: After 72 h of MMR treatment, GBM cell lines and primary GBM cells exhibited significant viability reduction compared to untreated cells. Conversely, normal microglial cells showed only minor changes in viability and morphology. Intracellular viral load tests indicated GBM cells' increased sensitivity to MMR viruses compared to normal cells. The cell cycle study also revealed measles and mumps viruses' crucial role in cytopathic effects, with the rubella virus causing cell cycle arrest. Conclusion: Herein the reported results demonstrate the anti-cancer activity of the MMR vaccine against GBM cells. Accordingly, the MMR vaccine warrants further study as a potential new tool for GBM therapy and relapse prevention. Therapeutic potential of the MMR vaccine has been found to be promising in earlier studies as well. [ABSTRACT FROM AUTHOR]

Objective: Cases of cow's milk allergy (CMA) who reacted to measles or measles, mumps, and rubella (MMR) vaccines containing alpha-lactalbumin have been reported. The purpose of this study was to assess patients with CMA who received measles or MMR vaccines containing alpha-lactalbumin, as well as the characteristics of those who developed reactions to these vaccines. Study Design: Patients followed up in the allergy clinic for CMA and who received measles or MMR vaccines containing alpha-lactalbumin at 9 or 12 months of age were included in the study, and their characteristics were analyzed retrospectively from the hospital registry system. Results: Forty-nine patients were included in the study. Six patients received the measles vaccine, whereas 43 patients received the MMR vaccine containing alpha-lactalbumin. Vaccine skin tests were performed on these 6 patients. One patient had a positive intradermal test, so an alternative vaccine not containing alpha-lactalbumin was administered. The other 5 patients were vaccinated, and no reaction was observed. Anaphylaxis was observed in 3 of 43 patients who received the MMR vaccine containing alpha-lactalbumin. In all of these patients, the first reaction to dairy products was anaphylaxis. In 2 of those patients, cow's milk-specific IgE (spIgE) levels were >100 kU/L, and alpha-lactalbumin-spIgE levels were also high at 97 and 90 kU/L. The third patient's cow's milk-spIgE level was 15.9 kU/L, whereas the alpha-lactalbumin-spIgE level was 0.04 kU/L. Conclusion: Especially in patients with an initial reaction of anaphylaxis to dairy products and high cow's milk-spIgE levels, the risk of reaction is high with the MMR vaccine. [ABSTRACT FROM AUTHOR]

Objective: Patients with egg allergy have had hesitations about measles-mumps-rubella (MMR) vaccination for a long time due to the egg protein contained in the vaccine. In this study, we aimed to share our clinical experience on this subject. Methods: This descriptive study included all 179 patients with egg allergies who received MMR in our clinic between 2015 and 2022. The patients’ age, sex, clinical findings, allergy tests, total IgE, eosinophil values, and postvaccine reaction status were evaluated retrospectively. Results: The median age of those vaccinated in our clinic was 13.0 months (9.0-84.0). The median value for the calendar delay in the vaccine dose was 1.0 months (minimum: 0, maximum: 72.0). The median absolute eosinophil value of the patients was 360.0 10³/uL (10.0-2220.0), the median eosinophil value (%) was 3.4% (0.1-20.0%), and the median total IgE value was 53.5 IU/mL (1.0-2500.0). The most common clinical findings were atopic dermatitis and urticaria (54.7% and 44.1%, respectively). No patient had developed a previous anaphylaxis. A postvaccine reaction developed in one out of 179 children who received the MMR vaccine. This patient presented with urticaria. No serious reaction was observed in any of the other patients. Conclusion: Children with egg allergy should be evaluated by pediatric allergy clinics; however, this should not cause a delay in the MMR vaccination schedule. [ABSTRACT FROM AUTHOR]

• The MMR booster vaccine demonstrated long-term immunogenicity in the majority of children with JIA. • Percentages of protective antibody levels against measles were lower in bDMARD users compared to non-bDMARD users. • Clinicians should consider to measure antibody levels at least five years after MMR booster in bDMARD users and advice an extra booster accordingly. Vaccines, especially live attenuated vaccines, in children with JIA pose a great challenge due to both potential lower immunogenicity and safety as a result of immunosuppressive treatment. For many years, in the Netherlands, JIA patients receive a measles-mumps-rubella (MMR) booster vaccine at the age of nine years as part of the national immunization program. To study long-term humoral immunoprotection in a large cohort of JIA patients who received the MMR booster vaccine while being treated with immunomodulatory therapies at the Wilhelmina Children's Hospital in Utrecht, the Netherlands. MMR-specific IgG antibody concentrations in stored serum samples of vaccinated JIA patients were determined with chemiluminescent microparticle immunoassays (CMIA). Samples were analyzed five years after MMR booster vaccination and at last available follow-up visit using both crude and adjusted analyses. Additional clinical data were collected from electronic medical records. In total, 236 samples from 182 patients were analyzed, including 67 samples that were available five years post-vaccination, and an additional 169 samples available from last visits with a median duration after vaccination of 6.9 years (IQR: 2.8–8.8). Twenty-eight patients were using biologic disease-modifying antirheumatic drugs (bDMARDS) of whom 96% anti-TNF agents and 4% tocilizumab. Percentages of protective antibody levels against measles after five years were significantly lower for patients who used bDMARD therapy at vaccination compared to patients who did not: 60% versus 86% (P = 0.03). For mumps (80% versus 94%) and rubella (60% versus 83%) this difference did not reach statistical significance (P = 0.11 and P = 0.07, respectively). Antibody levels post-vaccination decreased over time, albeit not significantly different between bDMARD users and non-bDMARD users. The MMR booster vaccine demonstrated long-term immunogenicity in the majority of children with JIA from a large cohort, although lower percentages of protective measles antibody levels were observed in bDMARD users. Hence, it might be indicated to measure antibody levels at least five years after MMR booster vaccination in the latter group and advice an extra booster accordingly. [ABSTRACT FROM AUTHOR]

Research has extensively studied parental vaccination decision-making drivers and barriers. The most powerful predictors of vaccination actions include the understanding of the risks posed by the disease; and the side effects of vaccination; vaccine beliefs and attitudes; and their effectiveness and safety concerns. Thus, this study aimed to explore the parents decision-making experience in choosing MMR vaccine in Banten, Indonesia. In qualitative study, a purposeful sampling process was used to identify parents with a variety of expected MMR decisions: (1) accept MMR on time, (2) accept MMR late, (3) receive one or more individuals, (4) obtain no MMR or individuals. A qualitative quality analysis was used to interpret the transcribed text. A total of 25 participants from 5 different FGDs were included in this study. This qualitative interview resulted in 4 themes, namely: healthy life, own health perceptions, disease history, perceived severity, and susceptibility of vaccine-preventable illnesses. Research on the MMR vaccination should move a step forward and include studies looking at similarities and differences in the factors predicting parents' intention to follow MMR vaccination recommendations by comparing parents of very young children, being the primary target group of MMR vaccination campaigns and interventions, with parents of adolescent children. [ABSTRACT FROM AUTHOR]

We aimed to quantify rates of waning immunity after measles vaccination from seroprevalence data collected in a study of a population with high vaccination coverage and a fixed vaccination schedule. Data were collected during a national survey (the Immunological Survey) carried out in the Slovak Republic in 2018. The average rate of waning immunity against measles after the first dose of measles, mumps, and rubella (MMR) vaccine (ages 1.5–10 years) was 9.7% per year from the geometric mean titer value of 2,634 mUI/mL. The average waning rate after the second dose of MMR vaccine (ages 10–33 years) was significantly lower: 4.8% per year from the lower geometric mean titer of 1,331 mUI/mL. This decline in antibody levels suggests that vaccine-induced protection may be compromised and results in an increase in the proportion of seronegative/borderline individuals. These outcomes may provide a valuable source for critical assessment of direct and indirect effects of MMR vaccination. [ABSTRACT FROM AUTHOR]

A large proportion of children do not receive vaccines within the recommended timeframe. This study examined ethnic and socioeconomic differences in age-appropriate immunization of children in Israel, where immunization is freely available. Percent of children receiving MMR/V at 12–13 months, and four doses of DTP/IPV/Hib by 18 months were obtained from the National Programme for Quality Measures between 2015 and 2018. Ethnic group (Jewish vs Arab) (defined by proxy by the neighbourhood in which the clinic was located), neighbourhood socioeconomic status and peripherality were obtained. Rates of MMR vaccination were 61% in the Jewish and 82% in the Arab population; for DPT/IPV/Hib 75% in the Jewish, compared to 92% in the Arab population. These patterns were stable over time. Lowest rates occurred in the most peripheral areas for Arab children, and in urban areas for Jewish children. Differences between ethnic groups were significant at higher SES levels. Greater adherence to the vaccination schedule occurred in the Arab minority in contrast to studies showing lower vaccination in ethnic minorities elsewhere. Lower immunization rates among rural Arab children suggest a need for improved access to clinics. Efforts should be directed towards lower SES groups, while emphasizing the importance of timely vaccination in wealthier groups in order to achieve herd immunity. [ABSTRACT FROM AUTHOR]

Introduction: In some cases, MMR vaccine injection causes fever, seizures, parotitis, and aseptic meningitis in children. Since in patients suspected of having meningitis, antibiotics are initially started with a meningeal dose and considering that a group of patients receive antibiotics despite the diagnosis of aseptic meningitis, evaluation of the effectiveness of antibiotics in the treatment of aseptic meningitis caused by the MMR vaccine is necessary in order to prevent drug resistance, indiscriminate use of antibiotics, and additional costs. Materials and methods: In this descriptive-analytical study, which was conducted from 2016 to 2019 at Hazrat Ali Asghar Hospital in Iran, the number of samples studied was 50 patients. The patients were included in the study after checking the children's vaccination cards and considering the inclusion and exclusion criteria. Cerebrospinal fluid samples were taken and sent to the laboratory for culture and analysis and latex agglutination test. Also, in order to ensure the viral origin of the studied meningitis patients, antibiotic effectiveness was evaluated using the disk diffusion method. The demographic and medical information of the patients was recorded in a researcher-made questionnaire, and finally, the data were analyzed using SPSS version 22 software. Results: The mean and standard deviation of the children's age was 13.35±1.26 months. Also, 36.6% of the children were girls and 63.1% of them were boys. The youngest age was 1.2 and the oldest age was 2 years. Among the studied patients, 12 children did not receive antibiotics during hospitalization and 38 people received antibiotics during hospitalization. At first, ceftriaxone was started for 38 people and vancomycin for 36 people. Then, ceftriaxone was continued for 14 people, ceftriaxone and vancomycin for 6 people, cefotaxime for 14 people, and cefotaxime and vancomycin were continued for 4 people. Among the 12 children who did not receive secondary treatment with antibiotics, 10 children had initially received ceftriaxone and 8 children had received vancomycin. Examining the relationship between hospital symptoms and antibiotic prescription showed that the degree of fever was significantly different in both groups. There was no significant relationship between the duration of fever and the use of antibiotics, and also between the duration of hospitalization and the use of antibiotics. Discussion and conclusion: Antibiotic use in children with aseptic meningitis caused by MMR vaccine injection, in addition to having no effect on the treatment, may cause the exacerbation of meningitis complications. Also, there was no significant difference between the duration of hospitalization in people who received antibiotics and patients who did not receive antibiotics. [ABSTRACT FROM AUTHOR]