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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article summarizes several presentations which discussed recent publications that covered important advances in vaccinology.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EVaccinations\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EScreening \u0026amp; Prevention\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe following is a summary of several presentations which discussed recent publications that covered important advances in vaccinology.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EKathryn M. Edwards, MD, Vanderbilt University, Nashville, Tennessee, USA, opened the session with a discussion of a publication that analyzed bacterial meningitis trends in the United States between 1998 and 2007 [Thigpen MC et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2011]. Using data from eight surveillance areas, consisting of approximately 17.4 million persons, the authors identified 3188 cases of meningitis. During the study period, there was a 31% decrease in the incidence of meningitis and an increase in the median age of patients from 30.3 to 41.9 years. There was no change in case fatality rate (15.7% to 14.3%) or in the rate of disease in children aged \u0026lt;2 months. Dr. Edwards noted the marked reduction, by as much as 50% to 60%, in cases among children aged 2 to 10 years, which she attributed to the introduction of the conjugate pneumococcal vaccine in 2000. The study showed a much greater change in children than in adults, which raises a question as to whether herd immunity is going to be good enough to allow children to be immunized, without having adults immunized. In concluding, Dr. Edwards noted that while the rates of meningitis have decreased since 1998, largely due to effective immunization programs among children, the burden of disease is now being borne by adults, for whom new vaccine approaches are needed. In addition, there remains an enormous burden of Group B \u003Cem\u003EStreptococcus\u003C\/em\u003E (GBS) disease in children aged \u0026lt;2 months that still needs to be addressed (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/17\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Proportion of the 1670 Cases of Bacterial Meningitis Reported in 2003 to 2007 Caused by Each Pathogen, According to Age Group.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1881587647\u0022 data-figure-caption=\u0022Proportion of the 1670 Cases of Bacterial Meningitis Reported in 2003 to 2007 Caused by Each Pathogen, According to Age Group.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/17\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/17\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/17\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12447\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-4\u0022 class=\u0022first-child\u0022\u003EProportion of the 1670 Cases of Bacterial Meningitis Reported in 2003 to 2007 Caused by Each Pathogen, According to Age Group.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from KM Edwards, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-5\u0022\u003EDr. Edwards also discussed an animal study that provided a new method of identifying protective antigens of \u003Cem\u003EStaphylococcus aureus\u003C\/em\u003E [Kim HK et al. \u003Cem\u003EFASEB J\u003C\/em\u003E 2011]. Staphylococcal sepsis and skin and soft tissue infections are major problems. Antibiotic resistance is increasing, there are no vaccines to prevent staphylococcal infections, and staphylococcal infection does not confer immunity from repeat infection. This study hoped to address two questions: 1) whether a live, attenuated vaccine for \u003Cem\u003ES. aureus\u003C\/em\u003E could be developed; 2) whether this information could be used to contribute to our understanding of the pathogenesis of staphylococcal infections.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAn early step in this study was the development of a renal abscess model, in which mice were injected with various strains of \u003Cem\u003EStaph.\u003C\/em\u003E Those strains that did not produce an abscess were then injected into another cohort of mice that were treated with antibiotics on Day 19, rechallenged with virulent \u003Cem\u003EStaph\u003C\/em\u003E at Day 26, and sacrificed on Day 30, after which their kidneys were assessed for bacterial load and the presence of abscesses. \u201cThere were three interesting findings,\u201d said Dr. Edwards. \u201cMice that were not vaccinated had lots of bacteria and abscesses when they were rechallenged with wild-type \u003Cem\u003EStaph.\u003C\/em\u003E After vaccination and then rechallenge with wild-type \u003Cem\u003EStaph\u003C\/em\u003E, there was no change in the load of the \u003Cem\u003EStaph\u003C\/em\u003E nor in the number of abscesses; however, inoculation with srtA variants (and, to a lesser extent, saeR variants) led to a diminution in the number of organisms and in the number of abscesses, indicating that it confers some protection against rechallenge with virulent \u003Cem\u003EStaph.\u003C\/em\u003E\u201d\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EIn the next step, the animals were immunized using the isolated antigens that were identified in the prior step (Combo 1: ClFA, fibronectin-binding protein, SdrD; or Combo 2: ClfA, fibronectin-binding protein, SdrD, and SpA) or a mock injection and then rechallenged with virulent \u003Cem\u003EStaph.\u003C\/em\u003E When the bacteria in the renal tissues were counted at Day 4, animals that received the mock injection had about 4.5 logs; for Combo 1, it was 2.5 logs, and for Combo 2, there were about 1.5 logs. At Day 18, there was a further diminution in colony-forming units in Combo 1. Essentially no organisms were seen with Combo 2. In the final step, the animals were given active immunization with Combo 1 or 2 and then given lethal doses of \u003Cem\u003EStaph.\u003C\/em\u003E Four days postchallenge, all animals that received mock injections had died; 30% of the remaining animals survived to Day 18, with the survival rate of Combo 2 being significantly better than with Combo 1, suggesting that these antigens should be further studied. Dr. Edwards concluded by stating that the attenuated \u003Cem\u003EStaph\u003C\/em\u003E strains induced protection and that combinations of \u003Cem\u003EStaph\u003C\/em\u003E antigens resulted in nearly complete protection against lethal challenge in mice.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EJacek Mrucowicz, MD, Polish Institute for Evidence Based Medicine, Krakow, Poland, presented data from a Canadian study of the AS03-adjuvanted pandemic H1N1 vaccine [Skowronski DM et al. \u003Cem\u003EBr Med J\u003C\/em\u003E 2011]. The study group comprised 209 confirmed flu patients from over 500 community-based clinics. Participants were mostly (\u0026gt;80%) children and adults aged \u0026lt;50 years who received a single vaccination using the AS03 vaccine at least 14 days prior to their flu diagnosis. Data were collected during two periods: November 8 to December 5, 2009 (primary) and November 1 to December 31 2009 (secondary). The investigators concluded that the AS03-adjuvanted vaccine that was used was highly effective (adjusted vaccine effectiveness 93% [95% CI, 69% to 98%]) in preventing medically attended, laboratory-confirmed pandemic H1N1 illness. Similar positive results for the 2009\u20132010 pandemic and seasonal influenza vaccines were seen in the European I-MOVE trial [Valenciano M et al. \u003Cem\u003EPLOS Med\u003C\/em\u003E 2011]. Prof. Mrucowicz concluded by saying that although both studies found the adjuvanted H1N1 flu vaccines to be effective, as with all observational trials, there remains room for uncertainty.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003ECarol J. Baker, MD, Baylor College of Medicine, Houston, Texas, USA, discussed the results of a study from the United Kingdom that assessed the kinetics of immune responses to nasal challenge with meningococcal polysaccharide 1 year after serogroup glycoconjugate vaccination [Wing JB et al. \u003Cem\u003EClin Infect Dis\u003C\/em\u003E 2011]. The study objective was to measure the persistence of antibodies to serogroup C \u003Cem\u003EN. meningitidis\u003C\/em\u003E 1 year postimmunization with meningitis C conjugate vaccine (CV) and to investigate the kinetics of systemic and mucosal immune responses to intranasal challenge with meningococcal group C polysaccharide vaccine (PV). The study enrolled 116 vaccine-na\u00efve young adults (median age 23 years) who received meningococcal C CV. Eighty-nine participants (77%) consented to have meningococcal C PV inoculated into each nostril at 1 year. All subjects had protective (\u22658) serum bactericidal antibody titers (SBA) 28 days after the initial CV vaccination. One patient failed to respond to immunization when a 1:128 titer was used for response. After 12 months, 12.3% had SBA titers \u0026lt;8 (20.2% using a titer of 1:128). In the 12% to 20% of healthy adults who failed to retain protective serum bactericidal antibody (SBA) titers 1 year after meningitis C CV, immunological memory was unable to create a protective systemic or mucosal bactericidal antibodies until 7 days postchallenge. It is possible that the speed of this response is too slow to protect from natural meningococcal infection.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EIn the United States, we have had an adolescent vaccine program with a quadravalent conjugate vaccine (MenACWY\u003Csub\u003ED\u003C\/sub\u003E) for several years. Protective SBA titers in 50% of the adolescents who received the vaccine have fallen to nonprotective levels 5 years after vaccination. The data that were presented by Wing et al. support the recent ACIP recommendation for a booster dose of MenACWY\u003Csub\u003ED\u003C\/sub\u003E vaccine at age 16 years for individuals who were first vaccinated before the age of 15 years. The booster should provide protection through age 20 years, when the incidence of invasive meningococcal disease falls.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/12\/17.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmxdp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmxdp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}