Giuseppe
Emeritus
Pandemic Influenza Vaccine Policy ? Considering the Early Evidence (NEJM, editorial, extract, edited)
[Source Full Free Document: LINK. EDITED.]
Pandemic Influenza Vaccine Policy ? Considering the Early Evidence
Kathleen M. Neuzil, M.D., M.P.H.
?Policy decisions regarding influenza rest on judgments about the behavior of the virus, the impact of the disease and our ability to interdict its course. But the virus is capricious, the disease elusive, and our remedies imperfect,? said a report on the 1976 swine-flu epidemic at Fort Dix.1 Two peer-reviewed articles now publicly available at NEJM.org, by Greenberg et al. (ClinicalTrials.gov number, NCT00938639)2 and Clark et al. (NCT00943358),3 describe preliminary data on the immunogenicity of the influenza A (H1N1) 2009 monovalent vaccine. These data have been eagerly anticipated, as governments, public health officials, and other stakeholders respond to the first influenza pandemic in over 40 years. The authors and their collaborators are to be commended for their prompt execution of the trials and rapid sharing of the results. The study by Greenberg et al. shows that a single dose of nonadjuvanted vaccine containing the usual 15 μg of hemagglutinin (HA) antigen is immunogenic in a high proportion of healthy young and middle-aged adults.2 These findings are welcome and reassuring, as there is little evidence of cross-reactive antibody against the novel 2009 pandemic influenza A (H1N1) virus in the general population, and the need for two doses had been predicted. Without a nonimmunized control group, it is impossible to determine whether subclinical infection may have boosted the immune response elicited by the vaccine. The study was conducted in Australia during a time when the pandemic virus was circulating, and one participant had laboratory-confirmed infection with the 2009 H1N1 virus during the course of the study. Therefore, responses could be somewhat lower if vaccine is administered under different epidemiologic circumstances.
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[Source Full Free Document: LINK. EDITED.]
Pandemic Influenza Vaccine Policy ? Considering the Early Evidence
Kathleen M. Neuzil, M.D., M.P.H.
?Policy decisions regarding influenza rest on judgments about the behavior of the virus, the impact of the disease and our ability to interdict its course. But the virus is capricious, the disease elusive, and our remedies imperfect,? said a report on the 1976 swine-flu epidemic at Fort Dix.1 Two peer-reviewed articles now publicly available at NEJM.org, by Greenberg et al. (ClinicalTrials.gov number, NCT00938639)2 and Clark et al. (NCT00943358),3 describe preliminary data on the immunogenicity of the influenza A (H1N1) 2009 monovalent vaccine. These data have been eagerly anticipated, as governments, public health officials, and other stakeholders respond to the first influenza pandemic in over 40 years. The authors and their collaborators are to be commended for their prompt execution of the trials and rapid sharing of the results. The study by Greenberg et al. shows that a single dose of nonadjuvanted vaccine containing the usual 15 μg of hemagglutinin (HA) antigen is immunogenic in a high proportion of healthy young and middle-aged adults.2 These findings are welcome and reassuring, as there is little evidence of cross-reactive antibody against the novel 2009 pandemic influenza A (H1N1) virus in the general population, and the need for two doses had been predicted. Without a nonimmunized control group, it is impossible to determine whether subclinical infection may have boosted the immune response elicited by the vaccine. The study was conducted in Australia during a time when the pandemic virus was circulating, and one participant had laboratory-confirmed infection with the 2009 H1N1 virus during the course of the study. Therefore, responses could be somewhat lower if vaccine is administered under different epidemiologic circumstances.
(...)
-
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