1. |
- Herweijer, Eva, et al.
(author)
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Association of varying number of doses of quadrivalent human papillomavirus vaccine with incidence of condyloma.
- 2014
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In: JAMA: The Journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 311:6, s. 597-603
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Journal article (peer-reviewed)abstract
- Determining vaccine dose-level protection is essential to minimize program costs and increase mass vaccination program feasibility. Currently, a 3-dose vaccination schedule is recommended for both the quadrivalent and bivalent human papillomavirus (HPV) vaccines. Although the primary goal of HPV vaccination programs is to prevent cervical cancer, condyloma related to HPV types 6 and 11 is also prevented with the quadrivalent vaccine and represents the earliest measurable preventable disease outcome for the HPV vaccine.
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2. |
- Leval, Amy, et al.
(author)
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Quadrivalent Human Papillomavirus Vaccine Effectiveness: A Swedish National Cohort Study.
- 2013
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In: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 105:7, s. 469-474
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Journal article (peer-reviewed)abstract
- BackgroundIncidence of condyloma, or genital warts (GW), is the earliest possible disease outcome to measure when assessing the effectiveness of human papillomavirus (HPV) vaccination strategies. Efficacy trials that follow prespecified inclusion and exclusion criteria may not be fully generalizable to real-life HPV vaccination programs, which target a broader segment of the population. We assessed GW incidence after on-demand vaccination with quadrivalent HPV vaccine using individual-level data from the entire Swedish population.MethodsAn open cohort of girls and women aged 10 to 44 years living in Sweden between 2006 and 2010 (N > 2.2 million) was linked to multiple population registers to identify incident GW in relation to HPV vaccination. For vaccine effectiveness, incidence rate ratios of GW were estimated using time-to-event analyses with adjustment for attained age and parental education level, stratifying on age at first vaccination.ResultsA total of 124 000 girls and women were vaccinated between 2006 and 2010. Girls and women with at least one university-educated parent were 15 times more likely to be vaccinated before age 20 years than girls and women whose parents did not complete high school (relative risk ratio = 15.45, 95% confidence interval [CI] = 14.65 to 16.30). Among those aged older than 20 years, GW rates declined among the unvaccinated, suggesting that HPV vaccines were preferentially used by women at high risk of GW. Vaccination effectiveness was 76% (95% CI = 73% to 79%) among those who received three doses of the vaccine with their first dose before age 20 years. Vaccine effectiveness was highest in girls vaccinated before age 14 years (effectiveness = 93%, 95% CI = 73% to 98%).ConclusionsYoung age at first vaccination is imperative for maximizing quadrivalent HPV vaccine effectiveness.
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3. |
- Jahnmatz, Maja, et al.
(author)
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Pertussis-Specific Memory B-Cell and Humoral IgG Responses in Adolescents after a Fifth Consecutive Dose of Acellular Pertussis Vaccine
- 2014
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In: Clinical and Vaccine Immunology. - : American Society for Microbiology. - 1556-6811 .- 1556-679X. ; 21:9, s. 1301-1308
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Journal article (peer-reviewed)abstract
- In order to impede the increase in pertussis incidence in the adolescent group, a school-leaving booster dose administered at the age of 14 to 16 years will be introduced in Sweden in 2016. Preceding this introduction, an open-label, randomized, multicenter, clinical trial without a control group and with blinded analysis was performed, investigating both safety and immunogenicity. Reported here are the memory B-cell and serological responses detected in a smaller cohort (n = 34) of the 230 subjects recruited to the study. All subjects had received primary vaccination consisting of three doses of diphtheria-tetanus-5-component pertussis (DTaP5) vaccine, at 3, 5, and 12 months of age, and a tetanus-low-dose diphtheria-5-component pertussis (Tdap5) vaccine booster at 5.5 years. In this study, the subjects were randomly assigned and received either a Tdap1 or Tdap5 booster. Of the 230 participants, 34 subjects had samples available for evaluation of IgG-producing memory B-cell responses. Both vaccine groups had significant increases in pertussis toxin-specific serum IgG levels, but only the 1-component group showed significant increases in pertussis toxin-specific memory B cells. The 5-component group had significant increases in filamentous hemagglutinin- and pertactin-specific memory B-cell and serum IgG levels; these were not seen in the 1-component group, as expected. In conclusion, this study shows that a 5th consecutive dose of an acellular pertussis vaccine induces B-cell responses in vaccinated adolescents.
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4. |
- Netterlid, Eva
(author)
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Adverse Reactions after Vaccination and Allergen-Specific Immunotherapy: Contact Allergy to Aluminium and Itching Nodules
- 2010
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Doctoral thesis (other academic/artistic)abstract
- The aim of the work presented in this thesis was to investigate two different types of adverse reactions, persistent itching nodules and contact allergy to aluminium, after immunization with aluminium-containing vaccines and aluminium-containing allergen extracts used for allergen-specific immunotherapy (ASIT). The first paper describes active parental reporting of adverse events (AEFIs) after a booster dose of diphtheria-tetanus vaccine (DT). A parental questionnaire elicited reports of AEFIs within seven days of vaccination. A follow-up phone call was made in all cases of positive response. Active surveillance by parental reports was shown to be a useful complement to passive surveillance of childhood immunization. The proportion of late local reactions after immunization with a fourth dose of DT vaccines containing different aluminium compounds as adjuvant was investigated in the second study, in which a prospective cluster-randomized, active surveillance study was performed in 25,232 10-year-olds. Parental reports were collected 6 months after vaccination. 3-6 children per 10,000 had a persistent itching nodule. Contact allergy to aluminium was not detected. These findings support the continued use of the vaccine presently offered in the Swedish vaccination programme. However, continued surveillance is warranted. The study described in the third paper examined retrospectively whether ASIT could induce contact allergy to aluminium, and investigated a possible association between persistent subcutaneous nodules and aluminium allergy. The study consisted of a non-clinical part based on a questionnaire, and a clinical part involving a physical examination, self-assessment of itching, and patch testing. A statistically significant association was found between contact allergy to aluminium and persistent subcutaneous nodules in children given ASIT. Contact allergy was found in eight of the participants, all given ASIT. The fourth paper presents the results of a prospective study on whether ASIT with allergen preparations containing aluminium hydroxide induces contact allergy to aluminium. The association between contact allergy to aluminium and persistent itching nodules was also studied. Three groups undergoing ASIT were patch tested with aluminium chloride hexahydrate before and during ASIT. A control group was included (untreated). At the end of the study all groups were patch tested. A high rate of contact allergy to aluminium was found. The study did not confirm or refute ASIT as a risk factor. Allergy to aluminium and itching nodules after ASIT seemed to be more common among children, and among those suffering from atopic dermatitis.
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5. |
- Netterlid, Eva, et al.
(author)
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Does Allergen-specific Immunotherapy Induce Contact Allergy to Aluminium?
- 2013
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 93, s. 50-56
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Journal article (peer-reviewed)abstract
- Persistent, itching nodules have been reported to appear at the injection site after allergen-specific immuno-therapy with aluminium-precipitated antigen extract, occasionally in conjunction with contact allergy to aluminium. This study aimed to quantify the development of contact allergy to aluminium during allergen-specific immunotherapy. A randomized, controlled, single-blind multicentre study of children and adults entering allergen-specific immunotherapy was performed using questionnaires and patch-testing. A total of 205 individuals completed the study. In the 3 study groups all subjects tested negative to aluminium before allergen-specific immunotherapy and 4 tested positive after therapy. In the control group 4 participants tested positive to aluminium. Six out of 8 who tested positive also had atopic dermatitis. Positive test results were found in 5/78 children and 3/127 adults. Allergen-specific immunotherapy was not shown to be a risk factor for contact allergy to aluminium. Among those who did develop aluminium allergy, children and those with atopic dermatitis were more highly represented.
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7. |
- Stefanoff, Pawel, et al.
(author)
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Tracking parental attitudes on vaccination across European countries: The Vaccine Safety, Attitudes, Training and Communication Project (VACSATC)
- 2010
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In: Vaccine. - : Elsevier BV. - 1873-2518 .- 0264-410X. ; 28:35, s. 5731-5737
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Journal article (peer-reviewed)abstract
- The paper presents the first results from the European project VACSATC which aimed to track parental attitudes on vaccinations across several European countries. We compared five cross-sectional surveys of parents with children less than 3 years of age in England, Norway, Poland, Spain and Sweden carried out during 2008-2009. Data were collected from 6611 respondents. Two countries used face-to face interviews, one used telephone interviews, and two other countries used mail-in questionnaires. In all countries health professionals were indicated as the most important and trusted source of information on vaccination. The study results also show that parental attitudes on vaccinations in the childhood vaccination programs are generally positive However, there were differences in attitudes on vaccination between the five countries, possibly reflecting different methods of sampling the respondents, context-specific differences (e.g. level of activity of governmental agencies), but also individual-level parental variation in demographic and socioeconomic status variables (C) 2010 Elsevier Ltd. All rights reserved
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