Older adults' vaccine hesitancy: Psychosocial factors associated with influenza,pneumococcal, and shingles vaccine uptake

Influenza, pneumococcal disease, and shingles (herpes zoster) are more prevalent in older people. These illnesses are preventable via vaccination, but uptake is low and decreasing. Little research has focused on understanding the psychosocial reasons behind older adults’ hesitancy towards different vaccines. A cross-sectional survey with 372 UK-based adults aged 65–92 years (M = 70.5) assessed awareness and uptake of the influenza, pneumococcal, and shingles vaccines. Participants provided health and socio-demographic data and completed two scales measuring the psychosocial factors associated with vaccination behaviour. Self-reported daily functioning, cognitive difficulties, and social support were also assessed. Participants were additionally given the opportunity to provide free text responses outlining up to three main reasons for their vaccination decisions. We found that considerably more participants had received the influenza vaccine in the last 12 months (83.6%), relative to having ever received the pneumococcal (60.2%) and shingles vaccines (58.9%). Participants were more aware of their eligibility for the influenza vaccine, and were more likely to have been offered it. Multivariate logistic regression analyses showed that a lower sense of collective responsibility independently predicted lack of uptake of all three vaccines. Greater calculation of disease and vaccination risk, and preference for natural immunity, also predicted not getting the influenza vaccine. For both the pneumococcal and shingles vaccines, concerns about profiteering further predicted lack of uptake. Analysis of the qualitative responses highlighted that participants vaccinated to protect their own health and that of others. Our findings suggest that interventions targeted towards older adults would benefit from being vaccine-specific and that they should emphasise disease risks and vaccine benefits for the individual, as well as the benefits of vaccination for the wider community. These findings can help inform intervention development aimed at increasing vaccination uptake in future.     

Recombinant zoster vaccine (RZV) second-dose series completion in adults aged 50–64 years in the United States

In 2018, CDC recommended a highly efficacious adjuvanted recombinant zoster vaccine (RZV) as a 2-dose series for prevention of herpes zoster (HZ) for immunocompetent persons age ≥ 50 years, with the 2nd dose recommended 2–6 months after the 1st dose. We estimated second-dose RZV series completion in the U.S. among 50–64-year-olds using two administrative databases. Second-dose RZV series completion was ～70% within 6-months and 80% within 12-months of first dose. Among those who received only 1 RZV dose with at least 12 months of follow-up time, 96% had a missed opportunity for a second-dose vaccination, defined as a provider or pharmacy visit, among whom 36% had a visit for influenza or pneumococcal vaccination within 2–12 months of their first-dose of RZV. We found that RZV series completion rates in 50–64-year-olds was high. Availability of RZV at pharmacies has potentially helped increase series completion, but missed opportunities remain.     

Photodynamic inhibition of infection caused by drug-resistant variants of herpes simplex virus type I

Membranotropic amphiphilic chromophore merocyanine 540 sensitized photodynamic inhibition of drug-resistant and sensitive variants of type I herpes simplex virus in cultured Vero cell. Optimal conditions of photodamage to virus particles and infected cells were determined (merocyanine 540 concentration 1 M, illumination dose 32.5-65.0 kJ/m², exposure at early stages of infection). Infected cells actively bind the photosensitizer, which explains their selective photodamage.     

长沙地区疱疹病毒性脑炎的病原研究

目的 :探讨长沙地区病毒性脑炎与疱疹病毒感染的关系。方法 :应用间接免疫荧光技术 (IFA)检测病毒性脑炎患者脑脊液或血清中疱疹病毒特异性IgG ,IgM。结果 :92 1例病毒性脑炎患者中有 1 33例 (1 4 4% )诊断为单纯疱疹病毒性脑炎 ,1 0岁以下年龄为发病高峰 ,9例 (0 98% )诊断为巨细胞病毒性脑炎 ,1 2例 (1 3 % )为水痘 带状疱疹病毒性脑炎。结论 :长沙地区疱疹病毒性脑炎病原以单纯疱疹病毒最常见 ;IFA法对疱疹病毒性脑炎具有诊断价值     

Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes

Herpes zoster and postherpetic neuralgia cause substantial pain in patients. Persons with type 2 diabetes (T2D) are prone to zoster infection and postherpetic neuralgia due to compromised immunity. We conducted this study to evaluate the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers. Propensity score matching was utilized to select 47 472 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. The Cox proportional hazards models were used for comparing the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers in patients with T2D. Compared with no-use of metformin, the adjusted hazard ratios (95% confidence interval) for metformin use in herpes zoster and postherpetic neuralgia were 0.70 (0.66, 0.75) and 0.510 (0.39, 0.68), respectively. A higher cumulative dose of metformin had further lower risks of herpes zoster and postherpetic neuralgia than metformin no-use. This nationwide cohort study demonstrated that metformin use was associated with a significantly lower risk of herpes zoster and postherpetic neuralgia than metformin no-use. Moreover, a higher cumulative dose of metformin was associated with further lower risks of these outcomes.     

Diaschisis in chronic viral encephalitis with Koshevnikov syndrome.

The authors report a 61-year-old man with chronic viral encephalitis and Koshevnikov syndrome occurring 42 months after initial symptom of right hemiparesis. Serial computed tomography of the brain showed changes in the attenuation of the left temporal lobe lesion over time. Magnetic resonance images of the brain showed enlargement of left temporoparietooccipital lobes with cortical gyral enhancement on T1-weighted images following intravenous administration of gadolinium-DTPA. 99mTc-HMPAO single-photon emission computerized tomography showed increased radioactivity and hyperperfusion in the left temporoparietal region with paradoxically decreased local tissue perfusion at the contralateral right hemisphere. Follow-up magnetic resonance images of the brain 4 years later showed atrophy of bilateral cerebral hemispheres. We postulate that a "transcallosal diaschisis" with subsequent degeneration is a possible mechanism. A brain biopsy from the left temporal lobe lesion showed pictures compatible with viral encephalitis probably herpes simplex encephalitis.     

Herpes simplex type 2 neutralization antibodies in patients with cancers of urinary bladder,prostate, and cervix

In the blood samples obtained from a total of 68 patients with cancers of the urinary bladder, prostate, and cervix, who applied to the Departments of Urology, Obstetrics, and Gynecology of Hacettepe Medical Faculty, neutralizing antibodies were sought for against herpes simplex type 2 by neutralization test. The same test was applied to 35 control patients with no known malignancies. In contrast to the presence of the antibody in 62.86% of the control subjects, this ratio was 90.70% in patients with cancer of the urinary bladder, 87.50% in those with prostatic carcinoma, and 88.89% in those with cancer of the cervix.     

Presence of human herpesvirus 6 and herpes simplex virus detected by polymerase chain reaction in surgical tissue from temporal lobe epileptic patients

We investigated the presence of human herpesvirus 6 (HHV-6) and herpes simplex virus (HSV) in surgical tissue from temporal lobe epileptic patients. A total of 17 cases were studied, including eight males and nine females. The mean age was 24.9 +/- 11.1 years and the mean age of onset was 11.1 +/- 5.4 years. Five patients were diagnosed as encephalitis/meningitis and another three had a history of suspected encephalitis/meningitis, but no patient showed any obvious neurological symptom or mental handicap. Mesial and lateral temporal tissues were examined by polymerase chain reaction. Among six patients positive for HHV-6 (35%), the mesial temporal lobe was positive in four and the lateral temporal lobe was positive in three. Herpes simplex virus was positive in only one patient. Three of the six patients positive for HHV-6 did not show any apparent causes. Mild encephalitis/meningitis induced by HHV-6, a condition sometimes not recognized as encephalitis/meningitis, may be one of the most frequent causes of temporal lobe epilepsy.     

脐血干细胞对单纯疱疹性角膜炎患者免疫指标水平的影响

目的　探讨脐血干细胞结膜下注射对单纯疱疹性角膜炎 (herpessimplexkeratitis ,HSK)患者血T淋巴细胞 (T -lymphocytes ,T -LC)亚群和白细胞介素 -2 (interleukin -2 ,IL -2 )及可溶性IL -2受体 (SIL -2R)水平含量的影响。方法　将患者随机分为两组 ,治疗组 5 0例5 1只眼 ,结膜下注射脐血干细胞 3次 ;对照组 5 0例 5 2只眼 ,静脉滴注病毒唑 2周。检测两组患者血T -LC亚群、IL -2及SIL -2R水平含量 ,并与 5 0例健康志愿者作正常对照。结果　两组患者治疗前血T -LC亚群CD4 、CD8、CD4 /CD8及IL -2、SIL -2R水平含量均明显不同于正常者(P <0 0 5～ 0 0 1) ;治疗后治疗组上述指标明显较治疗前改善 (P <0 0 5～ 0 0 1) ,基本接近正常者 (P >0 0 5 ) ,而对照组治疗前后上述指标差异均无显著性 (P >0 0 5 ) ,与正常者差异有显著性 (P <0 0 5～ 0 0 1) ;两组治疗后上述指标间比较均差异有显著性 (P <0 0 5～ 0 0 1) ;临床效果治疗组明显优于对照组 (P <0 0 5～ 0 0 1) ,平均痊愈时间缩短 (P <0 0 1)、复发率降低 (P <0 0 5 )。结论　脐血干细胞结膜下注射治疗HSK疗效好 ,有明显调节患者血T -LC亚群、IL -2及SIL -2R水平作用