Probiotic bacteria stimulate virus–specific neutralizing antibodies following a booster polio vaccination

Summary Background Orally ingested probiotic bacteria may modulate the immune response and increase antibody titers against enteric infections by bacteria or viruses. Even though positive effects of probiotics on respiratory tract infections have been reported, overall only few studies have examined effects on virus infections concerning organs other than the gastrointestinal tract. Aim of the study It was the aim of the study to investigate whether and how probiotics affect the immune response to a standardized enterovirus challenge (polio) and infections not limited to the gastrointestinal tract in healthy adults. Methods In a randomized, controlled and double–blind study 64 volunteers consumed for 5 weeks chemically acidified clotted milk without bacteria or with 10¹⁰/serving ^{Lactobacillus rhamnosus} GG or Lactobacillus acidophilus CRL431 added. In the second week subjects were vaccinated orally against polio 1, 2 and 3. Polio virus neutralizing serum activity, the primary parameter, was determined by the standard neutralization test (WHO) before and three times after vaccination. Polio–specific IgA, IgG and IgM were detected by ELISAs. Results Probiotics increased poliovirus neutralizing antibody titers (NT) and affected the formation of poliovirus–specific IgA and IgG in serum. The maximum increase after immunization was about 2, 2.2, or 4–fold higher, respectively, for NT, IgG or, IgA, in volunteers consuming probiotics instead of placebo. No consistent difference was noted between bacterial strains. Conclusions Probiotics induce an immunologic response that may provide enhanced systemic protection of cells from virus infections by increasing production of virus neutralizing antibodies. The work was supported by the German Academy of Nutritional Medicine, Freiburg, Germany; by MONA, division of Campina Melkunie, Woerden, The Netherlands and by Chr. Hansen, H?rsholm, Denmark.     

Antibody persistence of two pentavalent DTwP–HB–Hib vaccines to the age of 15–18 months,and response to the booster dose of quadrivalent DTwP–Hib vaccine

Objectives

Antibody persistence in children following three doses of primary vaccination with diphtheria, tetanus, whole-cell-pertussis (DTwP), hepatitis B, and Haemophilus influenzae type b (Hib) vaccines (SIIL Pentavac vaccine vs. Easyfive^® of Panacea Biotec), and response to the booster dose of DTwP–Hib (Quadrovax^®) vaccine.

Methods

Children who completed their primary immunization were assessed for antibodies at 15–18 months of age, and then given a booster dose of DTwP–Hib vaccine. Reactogenicity and safety of the booster dose was evaluated.

Results

Both pentavalent vaccines demonstrated a good immune response at 15–18 months. Following the booster dose, all vaccinated subjects achieved protective titers against diphtheria, tetanus and Hib, whereas the response to pertussis antigen was ∼78%. Fever and irritability was noted in 24%, local pain in 51%, and swelling in 36% of the children following booster dose.

Conclusions

Primary immunization with either pentavalent vaccine induced an excellent immunity lasting till the second year of life. A booster dose with DTwP–Hib (Quadrovax^®) vaccine effectuated a good anamnestic response to all vaccine components, being specially strong for Hib in children previously vaccinated with SIIL liquid pentavalent vaccine (Pentavac^®). Also, the safety profile of SIIL quadrivalent vaccine (Quadrovax^®) administered as booster dose was acceptable.     

Pertussis epidemiology including direct and indirect effects of the childhood pertussis booster vaccinations,Norway, 1998–2019

BackgroundThe acellular pertussis vaccine has been used in the Norwegian national immunisation program since 1998. Following an increase in pertussis incidence in all age groups, booster doses were introduced for 7–8-year-olds in 2006, and for 15–16-year-olds in 2013. We assessed the effects of the booster doses on pertussis incidence in different age groups to inform potential changes in vaccination policy.MethodsWe included all pertussis cases notified to the Norwegian Surveillance System for Communicable Diseases in 1998–2019. We calculated annual incidence rates (IR, per 100,000 inhabitants) by age group. We estimated average annual changes in IRs (incidence rate ratios, IRR) for each age group for 2006–2012 and 2013–2019 using Poisson regression.ResultsIn 1998–2019, 74,675 cases of pertussis were notified. Coinciding with booster introduction, between 2006 and 2012 the IR decreased among 8–15-year-olds (from 433 to 199/100,000, IRR 0.89 [95% confidence interval 0.88–0.90]). A similar decrease was seen between 2013 and 2019 among 16–19-year-olds (from 171 to 77/100,000, IRR 0.84 [0.82–0.86]). There was no significant change in IRs among children < 1 year of age between 2006 and 2012 (IRR 0.99 [0.95–1.04]) or 2013–2019 (IRR 0.96 [0.91–1.02]). The IR decreased in both periods among adults aged 20–39 and 40+ (IRR 0.94 [0.93–0.95] and 0.92 [0.91–0.92] in 2006–2012; IRR 0.97 [0.96–0.99] and 0.97 [0.96–0.99] in 2013–2019, respectively). Despite steady, high vaccination coverage, in 2013–2019, there was an increase in the IR among children aged 1–7 (63 to 86/100,000, IRR 1.05 [1.03–1.07]) and 8–15 years (88 to 122/100,000, IRR 1.08 [1.06–1.10]).ConclusionsPertussis booster doses have offered direct protection in the targeted age groups. Our findings suggest indirect protection in adults, while the incidence in infants hasn’t changed. The recent increase in IRs among 1–15-year-olds warrants close monitoring and further evaluation of the vaccination schedule.     

Psychosocial working conditions and self-reported health in a representative sample of wage-earners: a test of the different hypotheses of the Demand–Control–Support–Model

Purpose  This paper presents an in-depth examination of the demand–control–support–model (DCS-model). Each hypothesis of the DCS-model is tested: the main effects of job demands, job autonomy, task variation and social support; the additive effects of job strain, active learning and iso-strain; and the interactive buffer-effects of job autonomy, task variation and support on job demands. Methods  Data from a representative cross-sectional sample of 11,099 male and female wage-earners are investigated using log linear methods. The outcome measures are self-reported persistent fatigue, musculoskeletal complaints and emotional well-being. Results  There is some support for each of the hypotheses. Quantitative job demands and superior support have the strongest effects. The job autonomy and buffer hypotheses are only partially supported. Conclusions  The strong effects of job demands, support, job strain and active learning are suggesting that a policy aimed at improving psychosocial working conditions should focus on a bearable level of job demands and the quality of social relationships at work.     

Antibody kinetics among 8–10 years old respondents to hepatitis B vaccination in a low endemic country and the effect of a booster dose given 5 or 10 years later

Few data are available concerning the persistence of anti-HBs and the effect of booster doses given several years post-vaccination against hepatitis B during preadolescence. The objective of this open-labelled clinical trial was to evaluate the persistence of antibodies after vaccination with three paediatric doses of Engerix-B at the age of 8–10 years and the effect of a booster dose given 5 (Group Y5) or 10 (Group Y10) years later. Anti-HBs were measured before and one month post-primary vaccination, then 5 and 10 years later, before the booster dose, as well as one month and 1 year post-booster. The anamnestic response was defined as a ≥fourfold increase of anti-HBs post-booster (≥10 IU/L) when compared to pre-booster. Ten years post-primary vaccination, 559 of the 652 initially randomized subjects (86%) were eligible for analysis. Group Y5, 5 years post-booster results: 99% of subjects had detectable levels of antibodies and 96% a titer ≥10 IU/L. The anti-HBs GMTs decreased from 114,489 IU/L one month post-booster to 3354 IU/L 5 years later. Group Y10 results: 10 years post-primary vaccination 96% of subjects had a detectable level of anti-HBs and 85% were above the threshold of 10 IU/L. The GMTs one month post-booster were 31,030 IU/L. The challenge with a booster demonstrated an anamnestic response in 99% of subjects in group Y5 and 100% of subjects in group Y10. All subjects were anti-HBc negative. The booster doses were well tolerated. The excellent anamnestic response observed after the booster dose demonstrates the persistence of immunity in virtually all young adults vaccinated at the age of 8–10 with three paediatric doses of Engerix-B.     

Decreased antibody titers and booster responses in tick-borne encephalitis vaccinees aged 50–90 years

Because of decreased immune functions of older people booster intervals of 3 years – instead of 5 – are recommended for tick-borne encephalitis (TBE) vaccinations for persons ≥60 years in Austria. So far, no comparative data on the immune-responsiveness of the age group 50–59 years are available. We therefore investigated the antibody titers and booster responses (in ELISA and neutralization assays) for the age groups 50–59, 60–69, and >69 years in comparison to a control group below 30 years. The age group 50–59 years displayed the same decreased antibody response, also characteristic for persons 60 years and older. Although antibody concentrations were lower after 5–7 years compared to 3–4 year intervals, antibodies were still detectable and could be sufficiently increased by booster shots in the vast majority of persons. Our results clearly indicate that the responsiveness of the immune system to vaccination is already impaired at the age of 50.     

Safety and immunogenicity of a measles–mumps–rubella–varicella vaccine given as a second dose in children up to six years of age

Two doses of measles–mumps–rubella vaccine (MMR) are widely recommended and consideration is being given to a similar schedule for varicella vaccine. A combined measles–mumps–rubella–varicella vaccine (MMRV) could be considered for this second dose in children previously vaccinated separately with MMR and varicella vaccines. Healthy children (N = 390) aged 15–75 months (median 54 months) previously immunized with MMR and varicella vaccines were randomly allocated to receive MMRV or separate injections of MMR and varicella vaccines. Before administration of study vaccines, seropositivity rates were 96.4% for measles, 94.3% for mumps, 99.5% for rubella, and 97.9% for varicella. Post-immunization, seropositivity rates were 99.5% for measles and mumps and 100% for rubella and varicella in the MMR + varicella group and 100% for all four antigens in the MMRV group; a 26.2- and 27.2-fold increase in varicella titer was observed in the MMR + varicella vaccine and MMRV groups, respectively. Except for more frequent pain in the MMRV group (33.3% vs. 23.7%, p = 0.043), there were no differences in the incidence of local and solicited symptoms between groups. In children primed with MMR and varicella vaccine, MMRV had non-inferior immunogenicity and similar safety profiles as a second dose of licensed MMR and varicella vaccine administered concomitantly.     

Boosters, anyone? Exploring the added value of booster sessions in a self-management intervention

The current study explored the benefits of adding booster sessions to a validated and successful self-management intervention for type 2 diabetes patients (i.e. Beyond Good Intentions). Although the addition of booster sessions to self-management interventions is often recommended, it has not been empirically established to what extent booster sessions are in fact appreciated by participants. Participants in the current study (N?=?129) followed the Beyond Good Intentions program and were offered a series of three booster sessions at 1, 3 and 5 months afterwards. Primary outcome variables included participants' attendance and evaluations of the booster phase. In addition, self-management behavior was assessed at baseline (T1), after the initial phase (T2) and after the booster phase (T3). Results showed that more than one-fourth of participants who completed the initial phase dropped out during the booster phase, and those who did complete both phases evaluated the booster phase significantly less positive as compared to the initial phase. With regard to the behavioral outcomes, we replicated previous findings showing positive effects on all measures during the initial phase. The booster phase, however, did not result in further improvements. It was concluded that the added value of booster sessions was, at best, questionable.     

Burnout and effort–reward-imbalance in a sample of 949 German teachers

Objectives High rates of teachers’ premature retirement initiated a research investigating their occupational burden. The aim of this study was to elaborate on and extend previous investigations exploring (1) teacher burnout and (2) the relationship between teachers’ efforts and their rewards. Methods A sample of 949 German teachers in 10 Gymnasien (grammar schools) and 79 Hauptschulen (secondary modern schools) was investigated applying the Maslach Burnout Inventory (MBI-D) and the Effort Reward Imbalance Inventory (ERI). Results Compared with other studies investigating burnout in employees, we found high rates of burnout symptoms such as emotional exhaustion, depersonalisation, and low personal accomplishment. Male teachers showed significantly lower personal accomplishment and more depersonalization than female teachers. With respect to school types, teachers in Hauptschulen were more often affected by emotional exhaustion and showed more depersonalization. Part-time teachers felt less personal accomplishment than full-time teachers. The ERI cut off was exceeded by 21.6% of all teachers indicating that this subgroup is affected by an imbalance between too much effort and too little reward. With respect to the ERI, significant differences were found for school types, with a higher proportion of Hauptschulen teachers being above this cut off. Conclusions At present, the working situation of teachers appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.     

Mortality rates and causes of death in a cohort of HIV-infected and uninfected women, 1993–1999

HIV/AIDS-associated and non-HIV/AIDS-associated death rates and causes of death between 1993 and 1999 were examined in 885 HIV-infected women and 425 uninfected women of the HIV Epidemiology Research Study cohort. Causes of death were determined by review of death certificates and the National Death Index. Adjusted bazard ratios were calculated for mortality risk factors. In the 885 HIV-infected women and 425 uninfected women, 234 deaths and 8 deaths, respectively, occurred by December 31, 1999. All-cause death rates in the HIV-infected women were unchanged between the pre-HAART (1993–1996) and HAART eras (1997–1999) —5.1 versus 5.4 deaths per 100 person-years (py). AIDS as a cause of death decreased from 58% of all deaths in 1996 to 19% in 1999, while HAART use increased to 42% by the end of 1999. In spite of the modest proportion ever using HAART, HIV-related mortality rates did decline, particularly in women with CD4+cell counts less than 200/mm³. Drug-related factors were prominent: for the 129 non-AIDS-defining deaths, hepatitis C positivity (relative bazard [RH] 2.6, P<0.001) and injection drug use (RH 1.7, P=0.02) were strong predictors of mortality, but were not significant in the Cox model for 105 AIDS-defining deaths (RH 0.9, P>30 and RH 0.7, P>.30, respectively. The regression analysis findings, along with the high percentage of non-AIDS deaths attributable to illicit drug use, suggest that high levels of drug use in this population offset improvements in mortality from declining numbers of deaths due to AIDS. Supported by cooperative agreements No. U64/CCU106795, U64/CCU206798, U64/CCU306802, and U64/CCU506831 with the Centers for Disease Control and Prevention including supplementary support from the National Institute on Drug Abuse. Centers for Disease Control and Prevention, Division of HIV     

Antibody persistence and booster response 68 months after vaccination at 2–10 years of age with one dose of MenACWY-TT conjugate vaccine

BackgroundWe evaluated antibody persistence up to 68 months (M) post-vaccination with a quadrivalent meningococcal serogroups A, C, W and Y tetanus toxoid conjugate vaccine (MenACWY-TT) or a licensed monovalent MenC conjugate vaccine (MenC-CRM₁₉₇) and subsequent booster responses to MenACWY-TT in healthy European children.MethodsIn the initial study (NCT00674583), healthy children, 2–10 years of age, were randomized to receive a single dose of either MenACWY-TT or MenC-CRM₁₉₇. In the follow-up study, we present the persistence at 32, 44, 56, and 68 M post-vaccination, overall and stratified by age (2–5 and 6–10 years), and the immunogenicity and safety of MenACWY-TT administered to all study participants at M68 post-primary vaccination.ResultsAt M68, 33.3% (age group 2–5 years) and 47.1% (age group 6–10 years) of the children vaccinated with MenACWY-TT, and 50.0% (age group 2–5 years) and 75.9% (age group 6–10 years) vaccinated with MenC-CRM₁₉₇ retained titers ≥1:8 for MenC, as assessed by a serum bactericidal assay using rabbit complement (rSBA). In the MenACWY-TT recipients, the percentages of children retaining rSBA titers ≥1:8 for MenA, MenW, and MenY were 81.7%, 47.3% and 66.7% in age group 2–5 years and 91.8%, 58,8% and 76.5% in age group 6–10 years, respectively. The booster dose induced robust responses (100% for all serogroups) and was well-tolerated.ConclusionsAntibody persistence (rSBA titers ≥ 1:8) for serogroups A, W and Y was observed in more than 50.0% of the children 68 M after receiving one dose of MenACWY-TT; for MenC, antibody persistence was observed in more than one third of MenACWY-TT and more than half of MenC-CRM₁₉₇ recipients. Vaccination with a booster dose of MenACWY-TT induced robust immune responses for all serogroups.     

Vaccine safety implications of Ontario,Canada's switch from DTaP–IPV to Tdap–IPV for the pre-school booster

Ontario, Canada, replaced the 4–6 year old diphtheria (D, d), tetanus (T), acellular pertussis (aP, ap) and polio (IPV) booster from DTaP–IPV to Tdap–IPV in May 2012. We assessed the impact of this replacement on the rate and types of reported adverse events following immunization (AEFIs). We used AEFIs reported among 4–6 years olds, through the provincial surveillance system, following administration of DTaP–IPV or Tdap–IPV from 2009 to 2013. Reporting rates per 100,000 doses distributed were calculated using publicly funded doses distributed as the denominator. A total of 204 AEFIs were reported (DTaP–IPV, n = 182; Tdap–IPV, n = 22). AEFI reporting rates were 33.1 and 6.3 per 100,000 doses distributed for DTaP–IPV and Tdap–IPV, respectively. Injection site reaction rate was lower for Tdap–IPV compared with DTaP–IPV (1.7 vs 20.6 per 100,000 doses). The replacement resulted in a decline in the number of reports and AEFI reporting rates, most notably a substantial decrease in injection site reactions.     

Anti-pertussis antibody kinetics following DTaP-IPV booster vaccination in Norwegian children 7–8 years of age

At the age of 7–8 years a booster of diphtheria, tetanus, acellular pertussis and polio vaccine is recommended for children in Norway. In this cross-sectional study we have analysed the antibody levels against pertussis vaccine antigens in sera from 498 children aged 6–12 years. The purposes of this study were to investigate the duration of the booster response against the pertussis vaccine antigens pertussis toxin (PT) and filamentous haemagglutinin (FHA); to determine the presence of high levels of pertussis antibodies in absence of recent vaccination; and to analyse how booster immunisation may interfere with the serological pertussis diagnostics. Prior to the booster the IgG antibody levels against PT revealed a geometric mean of 7.3 IU/ml. After the booster the geometric mean peak anti-PT IgG response reached to 45.6 IU/ml, followed by a steady decline in antibody levels over the next few years. The IgG anti-FHA levels followed the anti-PT IgG profiles. Three years after the booster the geometric mean IgG levels were only slightly above pre-booster levels. Prior to the booster 44% of the sera contained ≤5 IU/ml of anti-PT IgG compared to18% 3 years after and 30% 4 years after the booster. When recently vaccinated children were excluded, 6.2% of the children had anti-PT IgG levels above 50 IU/ml which may indicate pertussis infection within the last 2 years. This study indicates that the currently used acellular pertussis vaccines induce moderate immune responses to the pertussis antigens and that the antibodies wane within few years after the booster. This lack of sustained immune response may partly be responsible for the increased number of pertussis cases observed in this age group during the last years.     

Feasibility and Integrity of a Parent–Teacher Consultation Intervention for ADHD Students

This study examined the feasibility and integrity of a daily report card (DRC) intervention in a small sample of randomly assigned elementary students with previously diagnosed ADHD and classroom impairment. In order to enhance implementation, a conjoint behavioral consultation approach was used in which parents were engaged as active participants in the treatment. Intervention parents and teachers maintained moderately high levels of adherence over 4 months based on multiple methods of implementation assessment, and acceptability ratings were all very favorable. Intervention participants demonstrated significant improvement in academic skills and productivity at post-test as compared to control participants, with moderately large effect sizes. Results suggest that a DRC intervention implemented within conjoint parent–teacher consultation may help to reduce the research to practice gap in evidence-based school interventions.

Dietary Energy–Density and Adiposity Markers Among a Cohort of Multi-ethnic Children

Maternal and Child Health Journal - Evidence suggests that the association between dietary energy density (DED) and body composition in children is different than in adults. The purpose of this...     

Coffee consumption and risk of pancreatic cancer: a systematic review and dose–response meta-analysis

The association between coffee consumption and pancreatic cancer risk has been extensively studied; however, there is no consistent conclusion. Therefore, this meta-analysis study sought to evaluate dose–response relationship between them. A search was conducted using the PubMed and Web of Science databases. Thirteen high-quality cohort studies were identified, involving in 959,992 study participants and 3831 pancreatic cancer cases. Comparing the highest with lowest categories of coffee intake, the pooled relative risk (RR) was 1.08 (95% CI 0.94–1.25). For dose–response analysis, no evidence of a nonlinear dose–response association between coffee consumption and pancreatic cancer (p for nonlinearity =0.171) was found. The risk of pancreatic cancer was increased by 5.87% (RR =1.06, 95% CI 1.05–1.07) with the increment of one cup/day. Coffee consumption was identified to be related with the increasing risk of pancreatic cancer in a dose–response manner. Nevertheless, further mechanistic studies are needed to clarify the concerned issues.     

Low back pain and lumbago–sciatica in nurses and a reference group of clerks: results of a comparative prevalence study in Germany

OBJECTIVES: To gain more conclusive evidence on the question of work-related low-back disorders in German nurses, a comprehensive study with several methodological approaches was performed. METHODS: As part of this project, a cross-sectional study on working conditions and prevalence of low back pain, a sample of 3,332 nurses and 1,720 clerks as reference group was investigated by a questionnaire. In this article, final results referring to a sub-sample of 2,207 nurses and 1,177 clerks who had always worked in their profession, so that we could exclude confounding effects of former occupations, will be presented. Excluding the confounding effects of several covariates by logistic regression, we computed relative risks for different pain symptoms. RESULTS: The data suggest a considerably higher risk of low back pain for nurses than for the reference population of clerks. Results, however, differ markedly when specific pain symptoms are considered. With respect to lumbago-sciatica and sciatica - which have to be regarded as indicators for possible disc herniation - the study group's relative risk is the most elevated (2.88 for point prevalence of lumbago-sciatica/sciatica). Adjusting the results for several confounders and covariates leads to still higher estimations of nurses' relative risk.     

Immunisation of chickens with live Salmonella vaccines – Role of booster vaccination

It is accepted that booster vaccinations of chickens with live Salmonella vaccines are essential part of vaccinations schemes to induce an effective adaptive immune response. As manufacturer of registered live Salmonella vaccines recommend different times of booster the question raises whether the duration between the first and second immunisation might influence the protective effect against Salmonella exposure. Chickens were immunised with a live Salmonella Enteritidis vaccine on day 1 of age followed by a booster vaccination at different intervals (day 28, 35 or 42 of age) to study the effects on the colonisation and invasion of the Salmonella vaccine strain, the humoral immune response and the efficacy against infection with Salmonella Enteritidis on day 56 of age. Immunisation of all groups resulted in a very effective adaptive immune response and a high degree of protection against severe Salmonella exposure, however, the time of booster had only an unverifiable influence on either the colonisation of the vaccine strain, the development of the humoral immune response or the colonisation of the Salmonella challenge strain. Therefore, the first oral immunisation of the chicks on day 1 of age seems to be of special importance and prerequisite for the development of the effective immune response. A booster immunisation should be carried out, however, the time of booster may vary between week 3 and week 7 of age of the chickens without adversely impact on the efficacy of the adaptive immune response or the protective effects.     

Physical activity and the risk of heart failure: a systematic review and dose–response meta-analysis of prospective studies

European Journal of Epidemiology - Although physical activity is an established protective factor for cardiovascular diseases such as ischemic heart disease and stroke, less is known with regard to...