Hepatitis A HM175 strain (adsorbed) / Typhoid polysaccharide vaccine suspension for injection 1ml pre-filled syringes

BackgroundSalmonella infections represent a major global public health concern due to their widespread zoonotic transmission, antimicrobial resistance, and associated morbidity and mortality. This review aimed to summarize the zoonotic nature of Salmonella, the challenges posed by antimicrobial resistance, the global burden of infections, and the need for effective vaccination strategies to mitigate the rising threat of Salmonella.MethodsA systematic review of literature was conducted using databases such as PubMed, Scopus, Web of Science, and Google Scholar. Relevant studies published in English were identified using keywords including Salmonella, vaccination, antimicrobial resistance, and public health. Articles focusing on epidemiology, vaccine development, and strategies to control Salmonella infections were included, while conference abstracts and non-peer-reviewed studies were excluded.ResultsSalmonella infections result in approximately 95 million global cases annually, with an estimated 150,000 deaths. Regional variations were evident, with higher infection rates in low- and middle-income countries due to poor sanitation and food safety standards. Salmonella Enteritidis and S. Typhimurium were the most prevalent serovars associated with human infections. The review highlighted an alarming rise in multidrug-resistant (MDR) Salmonella strains, particularly due to the overuse of antibiotics in humans and livestock. Despite progress in vaccine development, challenges remain in achieving a universal vaccine that targets diverse Salmonella serovars. Live-attenuated, killed, recombinant, subunit, and conjugate vaccines are currently under development, but limitations such as efficacy, cost, and accessibility persist.ConclusionsSalmonella infections continue to impose a significant burden on global health, exacerbated by rising antimicrobial resistance. There is an urgent need for a multifaceted approach, including improved sanitation, prudent antibiotic use, and the development of affordable, broad-spectrum vaccines. Strengthening surveillance systems and promoting collaborative global efforts are essential to effectively control and reduce the burden of Salmonella.

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Background/Objectives: Over the past 50 years, developing new vaccines has been pivotal in responding to emerging and re-emerging diseases globally. However, despite substantial partner support, introducing new vaccines in sub-Saharan Africa remains challenging. This systematic review documents the barriers to new vaccine introduction in sub-Saharan Africa by distinguishing between vaccines integrated into routine immunization programs and those introduced primarily for outbreak response. Methods: A comprehensive electronic search was conducted across five databases for articles published in English or French on the challenges of new vaccine introduction in sub-Saharan Africa. Three reviewers screened articles independently based on the titles and abstracts, with full-text assessments conducted for inclusion. Data were analyzed thematically and synthesized narratively. Results: A total of 796 articles were retrieved from the five databases. Following the screening, 33 articles were finally retained and included in the review. These articles concerned the introduction of eight new vaccines (malaria vaccine, COVID-19 vaccine, HPV vaccine, Ebola vaccine, cholera vaccine, hepatitis B vaccine, rotavirus vaccine, and typhoid vaccine). The analyses revealed coordination and financing challenges for six vaccines in seventeen countries, acceptability challenges for five vaccines in ten countries, logistical challenges for two vaccines in six countries, and quality service delivery challenges for three vaccines in thirteen countries. Conclusions: Addressing the challenges of introducing new vaccines in sub-Saharan Africa requires targeted, evidence-based strategies. Prioritizing political commitment, innovative funding, public education, workforce development, and infrastructure improvements will strengthen immunization systems and enable timely vaccine delivery. Collaborative efforts and a focus on local context can advance equitable health outcomes, safeguard public health, and support global immunization goals.

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Background: Co-administration of vaccines can impact the immune response and safety. We aim to systematically review the current scientific literature and find evidence regarding the immunogenicity and safety of pneumococcal vaccines co-administered with common vaccines that are recommended for travelers, including hepatitis A, hepatitis B, yellow fever, tetanus, diphtheria, and acellular pertussis (Tdap), Japanese encephalitis, rabies, typhoid, or meningococcal (MCV) vaccine in adults (18 years or older). Methods: We followed the PRISMA 2020 guidelines and used the PICOS process to select the keywords. We searched PubMed, Web of Science, Scopus, EMBASE, and Google from 1 January 2000 to 30 June 2024. We included randomized controlled trials, non-randomized controlled trials, observational studies, case series, and case reports in adults, all published in English. Results: Out of 598 articles screened, 6 studies were included in our study. Three studies involved immunocompetent individuals, and three involved immunocompromised individuals. Co-administration of pneumococcal vaccine with Tdap or Hepatitis A in immunocompetent individuals was safe and immunogenic. Similar findings were reported for immunocompromised individuals when pneumococcal vaccines were co-administered with Tdap, hepatitis A, and hepatitis B. However, no reports investigated the co-administration of yellow fever, rabies, Japanese encephalitis, and typhoid. Two non-randomized studies in immunocompromised individuals had a high risk of bias. Conclusions: The studies collectively indicate that the co-administration of pneumococcal vaccines with Hepatitis A and Tdap vaccines in adult immunocompetent and immunocompromised individuals is safe and immunogenic. However, a knowledge gap remains, and further high-quality studies are needed, particularly due to the limited number of studies and the potential risk of bias.

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BackgroundImmunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. Additionally, there has been a remarkable 99.9% reduction in wild poliovirus cases since 1988, decreasing from more than 350,000 cases that year to just 30 cases in 2022.ObjectivesThe objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults.Search methodsA thorough search was conducted in the CENTRAL, Embase Ovid, Medline Ovid, PubMed, Web of Science, and Global Index Medicus databases for primary studies. This search was conducted in August 2021 and updated in November 2024.Selection criteriaRandomized trials were eligible for inclusion in this review, regardless of publication status or language.Data analysisTwo authors independently screened the search outputs to select potentially eligible studies. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for each randomized controlled trial (RCT). A meta-analysis was conducted using a random-effects model, and the quality of the evidence was assessed using the GRADE approach.Main resultsA total of 35 randomized controlled trials met the inclusion criteria and were included in this review, with the majority conducted in the United States. The interventions targeted adults aged 18 and older who were eligible for vaccination, involving a total of 403,709 participants. The overall pooled results for interventions aimed at increasing influenza vaccination showed a risk ratio of 1.41 (95% CI: 1.15, 1.73). Most studies focused on influenza vaccination (18 studies), while the remaining studies examined various other vaccines, including those for hepatitis A, COVID-19, hepatitis B, pneumococcal disease, tetanus, diphtheria, pertussis (Tdap), herpes zoster, and human papillomavirus (HPV). The results indicate that letter reminders were slightly effective in increasing influenza vaccination uptake compared to the control group (RR: 1.75, 95% CI: 0.97, 1.16; 6 studies; 161,495 participants; low-certainty evidence). Additionally, participants who received education interventions showed increased levels of influenza vaccination uptake compared to those in the control group (RR: 1.88, 95% CI: 0.61, 5.76; 3 studies; 1318 participants; low-certainty evidence). Furthermore, tracking and outreach interventions also led to an increase in influenza vaccination uptake (RR: 1.87, 95% CI: 0.78, 4.46; 2 studies; 33,752 participants; low-certainty evidence).ConclusionsLetter reminders and educational interventions targeted at recipients are effective in increasing vaccination uptake compared to control groups.

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ABSTRACT Background Randomized clinical trials provide the highest standard of evidence about vaccine efficacy. Modelling exercises such as in evidence synthesis and health economic models where efficacy estimates are combined with other data to obtain effectiveness and cost-effectiveness estimates help inform policy decisions. The main challenge with such sensitivity analyses is in deciding on which assumptions to model. Purpose To identify plausible ranges for differential vaccine efficacy across high- and low-income settings. Data Sources and Study Selection MEDLINE, EMBASE, clinicaltrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP) were searched for multi-site randomized clinical trials of bacterial and viral vaccines for the period of 01/01/1990 to 31/12/2020. Articles were restricted to those where at least one trial had included a low- or lower-middle-income setting, published in English, and conducted in humans. Methods A Bayesian random-effects meta-analysis was used to estimate the difference in vaccine efficacy in high-(high or upper middle) and low-(low or lower middle) income settings. A single hierarchical model that included all trials was used so that the degree to which estimates of vaccine efficacy against different diseases influenced one another was estimated from the observed data. Results Across 65 eligible trials (37 high-income, 21 low-income, and 7 both) covering 7 pathogens, only one trial reported efficacy estimates stratified by setting. Trials were similar in terms of design across settings. There was evidence of heterogeneity by vaccine target, typhoid vaccine demonstrated higher vaccine efficacy in low-income settings than in high-income settings but for all other vaccines, the point estimates indicated efficacy was lower in low-income settings; however, all credible intervals crossed the null. Conclusions The percentage of trials in low-income settings poorly reflects the burden of disease experienced in low-income settings. While there is evidence of lower vaccine efficacy in low-income settings relative to high-income settings, the credible intervals were very wide. Vaccine efficacy trials should report treatment effects stratified by settings.

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Background & objectives The expanded programme on immunization launched in India in 1978, with its focus on preventing six diseases in children (tetanus, diphtheria, pertussis, poliomyelitis, typhoid, and childhood tuberculosis), was widened in its scope in 1985-86. This new avtaar, the Universal Immunization Programme (UIP), incorporated measles vaccine for children and rubella and adult diphtheria vaccines for pregnant women. We conducted this rapid review on adult immunization relevant for India, as recent COVID-19 experience revealed how newly emergent or re-emergent pathogens could have their onslaughts on the elderly and adults with comorbidities. Methods Three different bibliographic databases, namely PubMed, Scopus and Ovid were searched electronically to access the articles published in peer-reviewed journals. Relevant consensus guidelines by in-country professional groups were also collated. We conducted deduplication and screening of the outputs of these searches (1242 bibliographical records). Finally, 250 articles were found eligible for inclusion. As trials on the reduction of morbidities, mortalities and hospitalizations in adults due to proposed vaccines under Indian consensus guidelines were not available, no meta-analysis was conducted. Results Evidence from articles finally included in this synthesis were grouped under (i) preventing viral and bacterial infections in adults; (ii) adult vaccination and awareness tools; (iii) vaccine hesitancy/acceptance; and (iv) adult vaccination guidelines. In-country research revealed the need for introducing the Human Papilloma Virus (HPV) vaccine in adolescence or early-adulthood to prevent ano-genital cancers in elderly and later life. Importantly HPV prevalence among cervical cancer patients varied between 88 to 98 per cent in Andhra Pradesh, Odisha and Delhi. The importance of conducting regular surveillance of pneumococcal diseases and influenza, as well as tweaking the vaccines accordingly, was revealed in other articles. A poor uptake of influenza vaccine (≤2%) in adults (≥45 yr) was documented. The uptake of hepatitis B vaccine in Health Care Workers (HCWs) in Delhi and Mumbai was of concern and ranged from 55 to 64 per cent. The vulnerability of HCWs to rubella was investigated in a paediatric ophthalmic hospital in Madurai: a tenth of the selected HCWs were rubella seronegative and mounted good protective immunity following RA 27/3 vaccine administration. An outbreak of measles in college students in Pune emphasized the phenomenon of waning immunity. Similarly, a study in the infectious disease hospital in Kolkata and in-patients in Delhi revealed a lack of protective immunity against diphtheria and tetanus in adults. The researchers estimated the economic benefits of providing a typhoid vaccine to a household to be US$ 23 in a middle-income neighbourhood and US$ 14 in slum settings. The authors highlighted the importance of preventive strategies, finding that the cost of severe typhoid fever was US$ 119.1 in 18 centres across India. Both qualitative and quantitative investigations explored vaccine hesitancy, which was studied more during the COVID-19 pandemic than earlier. Interpretation & conclusions Vaccination programmes in India would require (i) increasing awareness around vaccine-preventable diseases among adults and HCWs; (ii) actively engaging health care systems and community-based organizations; and (iii) developing and producing affordable, safe, and country-appropriate vaccines. Effective communication strategies and tools will be the key to the success of such interventions.

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