NEWS SCAN: H1N1 vaccine effectiveness and uptake, public input on non-O157 E coli testing, varicella vaccination benefits, TB roadmap

Nov 30, 2011

Spanish data show 48% to 72% H1N1 vaccine effectiveness
Spanish surveillance data published today revealed pandemic 2009 H1N1 (pH1N1) vaccine effectiveness to be 48% to 72%, although low numbers limited the statistical power of the results. The research involved two case-control studies, the first of which included 331 vaccinated patients and 995 controls from the Spanish Influenza Sentinel Surveillance System for the 2009-10 flu season. The second involved 85 vaccinated patients and 351 controls from seven Spanish regions in the surveillance system who participated in an observational study to estimate vaccine effectiveness (the cycEVA study). Controls in both groups were patients with flu-like illness who tested negative for influenza. The researchers noted nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. After adjusting for variables in the surveillance database and restricting their analysis to patients swabbed within 4 days of symptom onset, they found pH1N1 vaccine effectiveness in the larger group to be 48% (95% confidence interval [CI], -110% to 82%). Vaccine effectiveness for the cycEVA cohort was 68% (95% CI, -215% to 97%) after adjusting for common variables in the surveillance system and 72% (95% CI, -290% to 99%) after adjusting for all variables collected. The low numbers of participants explain the study's failure to show statistically significant effectiveness, the report indicated.. Spain used three brands of pH1N1 vaccine during the study period; the majority of these data are for adjuvanted vaccines.
Nov 30 BMC Public Health abstract

UK H1N1 vaccine uptake much lower than seasonal vaccine uptake in risk groups
Among risk groups in Britain during the 2009-10 flu season, 40.3% received the pH1N1 vaccine and 61.3% received the trivalent seasonal flu vaccine, according to a study in Vaccine. UK researchers studied data from 708,609 patients in the UK General Practice Research Database and found that, for both seasonal and pH1N1, uptake was positively associated with older age and greater number of underlying medical conditions. They also found that children in clinical risk groups were more likely to receive pH1N1 than seasonal flu vaccine, and that having a history of Guillain-Barre syndrome was associated with a reduced likelihood of receipt of both vaccines.
Nov 29 Vaccine abstract

Public teleconference tomorrow on non-O157 E coli testing
The US Department of Agriculture's (USDA's) Food Safety and Inspection Service (FSIS) is holding a public teleconference tomorrow, Dec 1, from 1:00 to 3:00 pm EST to discuss testing for non-O157 Shiga toxin–producing Escherichia coli (STEC) in ground beef or beef trim. Participants may register formal comments on the agency's implementation strategy for testing for the six non-O157 STECs deemed the most problematic: O26, O103, O45, O111, O121, and O145. Pre-registration is strongly suggested. On Nov 18 the FSIS announced that it had extended the comment period on the new policy by 1 month, to Dec 21.
Nov 23 FSIS announcement
Meeting registration page
Nov 18 CIDRAP News Scan on comment period extension

Study: Infants have benefited indirectly from varicella vaccination program
Although infants less than 1 year old are not eligible for varicella (chicken pox) vaccination, they have benefited substantially from the varicella vaccination program that began in the United States in 1995, according to a study in Pediatrics. The authors examined 14 years' worth of data (1995 to 2008) from community-based varicella surveillance projects in an area of Los Angeles County and in West Philadelphia, with a combined population base of more than 600,000. The researchers found that the incidence of varicella in infants declined 89.7% over that period, showing "the tremendous indirect benefits of the varicella vaccination program in protecting infants through lowered risk of exposure as a result of high population immunity." They also found that among babies who did contract varicella, those 1 to 5 months old had milder cases than those 6 to 11 months old. Previous research showed that children of women with a history of varicella have maternal varicella-zoster antibodies at birth, but these decline rapidly in the first months of life, the researchers say. Therefore they suggest that maternal antibodies may explain the milder illness in the youngest infants.
Nov 28 Pediatrics abstract

Report addresses global TB funding, research needs
Efforts to control tuberculosis (TB) globally require billions of dollars in funding and a focused research agenda, according to a report yesterday in PLoS Medicine that tracked progress over the past 2 years of the TB Research Movement, which was formed by the Stop TB Partnership of the World Health Organization. The report estimates that at least $9.8 billion is needed for TB research and development (R&D) worldwide over the next 5 years to reduce TB prevalence and mortality 50% by 2015, which is more than double the estimate from 5 years ago. Based on that figure, the report authors estimate the funding gap to be $6.4 billion, with the biggest gap in R&D of new drugs and diagnostics. The report also endorses a roadmap for research priorities devised at a meeting earlier this year in Bellagio, Italy, to elaborate key areas of research and to match funding with research efforts.
Nov 29 PLoS Med report

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