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Hay JA, Routledge I, Takahashi S. Serodynamics: A primer and synthetic review of methods for epidemiological inference using serological data. Epidemics 2024; 49:100806. [PMID: 39647462 DOI: 10.1016/j.epidem.2024.100806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 11/21/2024] [Accepted: 11/25/2024] [Indexed: 12/10/2024] Open
Abstract
We present a review and primer of methods to understand epidemiological dynamics and identify past exposures from serological data, referred to as serodynamics. We discuss processing and interpreting serological data prior to fitting serodynamical models, and review approaches for estimating epidemiological trends and past exposures, ranging from serocatalytic models applied to binary serostatus data, to more complex models incorporating quantitative antibody measurements and immunological understanding. Although these methods are seemingly disparate, we demonstrate how they are derived within a common mathematical framework. Finally, we discuss key areas for methodological development to improve scientific discovery and public health insights in seroepidemiology.
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Affiliation(s)
- James A Hay
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Isobel Routledge
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Saki Takahashi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Park NY, Cho CM, Lee EH, Park JM, Lee YR, Hong JI, Kwon GY. Job analysis of vaccination health workers at public health centers and sub-centers. Public Health Nurs 2024; 41:723-735. [PMID: 38588062 DOI: 10.1111/phn.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To analyze duties, tasks, and task elements of health workers in charge of vaccination at public health centers in South Korea. DESIGN Descriptive study using a survey. SAMPLE Health workers in charge of vaccination for more than 1 year at 254 public health centers in South Korea. Of 631 health workers, 401 responded to the questionnaire, and 379 responses were included in the analysis after excluding 22 incomplete responses. MEASUREMENTS The Developing A Curriculum (DACUM) workshop was conducted to identify the frequency, importance, and difficulty of duties, tasks, and task elements. RESULTS Four duties (vaccination promotion, vaccination administration and symptom management, execution of vaccination, and vaccination education), 18 tasks, and 81 task elements were identified. "Execution of vaccination" exhibited the highest determinant coefficient. "Implementing the budget" exhibited the highest determinant coefficient among tasks, and "dealing with an emergency in the case of adverse events" exhibited the highest determinant coefficient among task elements. CONCLUSIONS Duty, task, and task elements with high determinant coefficients have high educational needs. Education demands was higher for administrative work than for direct vaccination. Developing an educational curriculum based on DACUM results could contribute to the professional education of vaccine workers.
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Affiliation(s)
- No-Yai Park
- Graduate School of Public Health, Inje University, Gimhae, Republic of Korea
| | - Chung-Min Cho
- College of Nursing, Sungshin Women's University, Seoul, Republic of Korea
| | - Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea
| | - Jeong-Mo Park
- Department of Nursing, Kyungin Women's University, Incheon, Republic of Korea
| | - Young-Ran Lee
- Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Jeong-Ik Hong
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Geun-Yong Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Toda M, Yoshifuji A, Nakayama T, Mise-Omata S, Oyama E, Uwamino Y, Namkoong H, Komatsu M, Yoshimura A, Hasegawa N, Kikuchi K, Ryuzaki M. Cellular and Humoral Immune Responses after Breakthrough Infection in Patients Undergoing Hemodialysis. Vaccines (Basel) 2023; 11:1214. [PMID: 37515030 PMCID: PMC10384632 DOI: 10.3390/vaccines11071214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/30/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) following primary immunization (breakthrough infection) has been reported in hemodialysis patients; however, their post-infection immune status remains unclear. We evaluated the humoral and cellular immunity of hemodialysis patients after breakthrough infection. Hemodialysis patients who had received primary immunization against COVID-19 at least six months prior to the study but developed mild/moderate COVID-19 before a booster dose (breakthrough infection group) and hemodialysis patients who were not infected with COVID-19 but received a booster dose (booster immunization group) were recruited. In both groups, SARS-CoV-2 antigen-specific cytokines and IgG levels were measured three weeks after infection or three weeks after receiving a booster dose. Memory T and B cells were also counted in the breakthrough infection group using flow cytometry three weeks after infection. Significantly higher SARS-CoV-2 antigen-specific IgG, IFN-γ, IL-5, TNF-α, and IL-6 levels occurred in the breakthrough infection group compared to the booster immunization group (p = 0.013, 0.039, 0.024, 0.017, and 0.039, respectively). The SARS-CoV-2 antigen-specific IgG and cytokine levels were not significantly different between the two groups. The breakthrough infection group had significantly higher percentages of central and effector memory T cells and regulatory T cells than the comparison group (p = 0.008, 0.031, and 0.026, respectively). Breakthrough infections may induce stronger cellular and humoral immune responses than booster immunizations in hemodialysis patients.
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Affiliation(s)
- Masataro Toda
- Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan
| | - Ayumi Yoshifuji
- Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tetsuo Nakayama
- Kitasato Institute for Life Sciences, Laboratory of Viral Infection, Kitasato University, Tokyo 108-8641, Japan
| | - Setsuko Mise-Omata
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Emi Oyama
- Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan
| | - Yoshifumi Uwamino
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Motoaki Komatsu
- Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan
| | - Akihiko Yoshimura
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kan Kikuchi
- Division of Nephrology, Shimoochiai Clinic, Tokyo 161-0033, Japan
| | - Munekazu Ryuzaki
- Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan
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Adabor ES. Computational investigations of the immune response to repeated influenza infections and vaccinations. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201433. [PMID: 33959318 PMCID: PMC8074957 DOI: 10.1098/rsos.201433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
Previous studies have shown that repeated influenza vaccination can enhance susceptibility to subsequent infection with a drifted influenza virus strain. This paper seeks to further understanding of the interactions between influenza viruses and specific immune cells that accompany this phenomenon. The paper argues that repeated vaccination increases susceptibility to infection only in the context of a residual immunity induced by prior vaccination or infection. The results of computational analysis indicate that this is a dynamic consequence of interactions between vaccines, influenza viruses and specific immune cells. In particular, mathematical modelling was used to show that in the presence of residual immunity conferred by a vaccine administered in Canada in the 2013-2014 influenza season, the 2014-2015 season vaccine enhanced susceptibility to infection. Such infection enhancement occurs when the 2014-2015 vaccine boosts suppressive T-regulatory cells induced by the 2013-2014 vaccine, decreasing the strength of antibody responses to the infecting strain. Overall, the study suggests probable characteristics of infecting viruses and vaccines that make repeated influenza infections and vaccinations detrimental.
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Affiliation(s)
- Emmanuel S. Adabor
- Reserch Centre, African Institute for Mathematical Sciences, Cape Town, South Africa
- Department of Mathematical Sciences, Stellenbosch University, Stellenbosch, South Africa
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Hitchings MDT, Cummings DAT, Grais RF, Isanaka S. A mixture model to assess the the immunogenicity of an oral rotavirus vaccine among healthy infants in Niger. Vaccine 2020; 38:8161-8166. [PMID: 33162202 DOI: 10.1016/j.vaccine.2020.10.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/18/2022]
Abstract
Analysis of immunogenicity data is a critical component of vaccine development, providing a biological basis to support any observed protection from vaccination. Conventional methods for analyzing immunogenicity data use either post-vaccination titer or change in titer, often defined as a binary variable using a threshold. These methods are simple to implement but can be limited especially in populations experiencing natural exposure to the pathogen. A mixture model can overcome the limitations of the conventional approaches by jointly modeling the probability of an immune response and the level of the immune marker among those who respond. We apply a mixture model to analyze the immunogenicity of an oral, pentavalent rotavirus vaccine in a cohort of children enrolled into a placebo-controlled vaccine efficacy trial in Niger. Among children with undetectable immunoglobulin A (IgA) at baseline, vaccinated children had 5.2-fold (95% credible interval (CrI) 3.7, 8.3) higher odds of having an IgA response than placebo children, but the mean log IgA among vaccinated responders was 0.9-log lower (95% CrI 0.6, 1.3) than among placebo responders. This result implies that the IgA response generated by vaccination is weaker than that generated by natural infection. Multivariate logistic regression of seroconversion defined by ≥ 3-fold rise in IgA similarly found increased seroconversion among vaccinated children, but could not demonstrate lower IgA among those who seroresponded. In addition, we found that the vaccine was less immunogenic among children with detectable IgA pre-vaccination, and that pre-vaccination infant serum IgG and mother's breast milk IgA modified the vaccine immunogenicity. Increased maternal antibodies were associated with weaker IgA response in placebo and vaccinated children, with the association being stronger among vaccinated children. The mixture model is a powerful and flexible method for analyzing immunogenicity data and identifying modifiers of vaccine response and independent predictors of immune response.
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Affiliation(s)
- Matt D T Hitchings
- Department of Biology, University of Florida, United States; Emerging Pathogens Institute, University of Florida, United States.
| | - Derek A T Cummings
- Department of Biology, University of Florida, United States; Emerging Pathogens Institute, University of Florida, United States
| | | | - Sheila Isanaka
- Department of Research, Epicentre, Paris, France; Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States
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Kang EK, Eun BW, Kim NH, Lim JS, Lee JA, Kim DH. The priming effect of previous natural pandemic H1N1 infection on the immunogenicity to subsequent 2010-2011 influenza vaccination in children: a prospective cohort study. BMC Infect Dis 2016; 16:438. [PMID: 27549626 PMCID: PMC4994212 DOI: 10.1186/s12879-016-1769-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 08/10/2016] [Indexed: 12/24/2022] Open
Abstract
Background The effect of previous natural pandemic H1N1 (H1N1 pdm09) influenza infection on the immunogenicity to subsequent inactivated influenza vaccination in children has not been well studied. We aimed to evaluate the effect of H1N1 pdm09 natural infection and vaccination on the immunogenicity to subsequent 2010-2011 seasonal inactivated influenza vaccination in children. Methods From October 2010 to May 2011, we conducted an open-label, multi-center study in children aged 6 months -18 years in Korea. We measured antibody titers with a hemagglutination-inhibition (HI) assay at baseline, 1 month, and 6 months after vaccination with trivalent split or subunit vaccines containing H1N1 pdm, A/H3N2, and B. The subjects were classified into 4 groups depending on the presence of laboratory-confirmed H1N1 pdm09 infection and/or vaccination in the 2009-2010 season; Group I: vaccination (-)/infection(-), Group II: vaccination (-)/infection(+), Group III: vaccination (+)/infection(-), Group IV: vaccination (+)/infection(+). Results Among the subjects in group I, 47 subjects who had a baseline titer >1:10 were considered to have an asymptomatic infection. They were included into the final group II (n = 80). We defined the new group II as the infection-primed (IP) group and group III as the vaccine-primed (VP) group. Seroconversion rate (57.5 % vs 35.9 %, p = 0.001), seroprotection rate at 6 months after vaccination (70.8 % vs 61.8 %, p = 0.032), and GMT at 1 month after vaccination (129.9 vs 66.5, p = 0.002) were significantly higher in the IP group than in the VP group. In the 9–18 year-old group, seroconversion rate and immunogenicity at 1 and 6 months were significantly higher in the IP group than in the VP group. However in the 1–7 year-old age group, there was no significant difference between the two groups. Conclusions Previous H1N1 pdm09 infection appears to have positive effects on immunogenicity of subsequent inactivated influenza vaccines against H1N1 pdm09 in older children.
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Affiliation(s)
- Eun Kyeong Kang
- Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Byung Wook Eun
- Department of Pediatrics, Eulji University Eulji General Hospital, Seoul, Korea
| | - Nam Hee Kim
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jung Sub Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Jun Ah Lee
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Dong Ho Kim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
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Fonville JM, Fraaij PLA, de Mutsert G, Wilks SH, van Beek R, Fouchier RAM, Rimmelzwaan GF. Antigenic Maps of Influenza A(H3N2) Produced With Human Antisera Obtained After Primary Infection. J Infect Dis 2015; 213:31-8. [PMID: 26142433 PMCID: PMC4676547 DOI: 10.1093/infdis/jiv367] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 06/25/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Antigenic characterization of influenza viruses is typically based on hemagglutination inhibition (HI) assay data for viral isolates tested against strain-specific postinfection ferret antisera. Here, similar virus characterizations were performed using serological data from humans with primary influenza A(H3N2) infection. METHODS We screened sera collected between 1995 and 2011 from children between 9 and 24 months of age for influenza virus antibodies, performed HI tests for the positive sera against 23 influenza viruses isolated between 1989 and 2011, and measured HI titers of antisera against influenza A(H3N2) from 24 ferrets against the same panel of viruses. RESULTS Of the 17 positive human sera, 6 had a high response, showing HI patterns that would be expected from primary infection antisera, while 11 sera had lower, more dispersed patterns of reactivity that are not easily explained. The antigenic map based on the high-response human HI data was similar to the map created using ferret data. CONCLUSIONS Although the overall structure of the ferret and human antigenic maps is similar, local differences in virus positions indicate that the human and ferret immune system might see antigenic properties of viruses differently. Further studies are needed to establish the degree of similarity between serological patterns in ferret and human data.
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Affiliation(s)
- Judith M Fonville
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge WHO Collaborating Centre for Modelling, Evolution, and Control of Emerging Infectious Diseases, Cambridge, United Kingdom Department of Viroscience, Erasmus MC
| | - Pieter L A Fraaij
- Department of Viroscience, Erasmus MC Department of Pediatrics, Erasmus MC-Sophia, Rotterdam, The Netherlands
| | | | - Samuel H Wilks
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge WHO Collaborating Centre for Modelling, Evolution, and Control of Emerging Infectious Diseases, Cambridge, United Kingdom
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Koutsonanos DG, Esser ES, McMaster SR, Kalluri P, Lee JW, Prausnitz MR, Skountzou I, Denning TL, Kohlmeier JE, Compans RW. Enhanced immune responses by skin vaccination with influenza subunit vaccine in young hosts. Vaccine 2015; 33:4675-82. [PMID: 25744228 PMCID: PMC5757502 DOI: 10.1016/j.vaccine.2015.01.086] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/03/2014] [Accepted: 01/14/2015] [Indexed: 11/26/2022]
Abstract
Skin has gained substantial attention as a vaccine target organ due to its immunological properties, which include a high density of professional antigen presenting cells (APCs). Previous studies have demonstrated the effectiveness of this vaccination route not only in animal models but also in adults. Young children represent a population group that is at high risk from influenza infection. As a result, this group could benefit significantly from influenza vaccine delivery approaches through the skin and the improved immune response it can induce. In this study, we compared the immune responses in young BALB/c mice upon skin delivery of influenza vaccine with vaccination by the conventional intramuscular route. Young mice that received 5 μg of H1N1 A/Ca/07/09 influenza subunit vaccine using MN demonstrated an improved serum antibody response (IgG1 and IgG2a) when compared to the young IM group, accompanied by higher numbers of influenza-specific antibody secreting cells (ASCs) in the bone marrow. In addition, we observed increased activation of follicular helper T cells and formation of germinal centers in the regional lymph nodes in the MN immunized group, rapid clearance of the virus from their lungs as well as complete survival, compared with partial protection observed in the IM-vaccinated group. Our results support the hypothesis that influenza vaccine delivery through the skin would be beneficial for protecting the high-risk young population from influenza infection.
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Affiliation(s)
- Dimitrios G Koutsonanos
- Department of Microbiology & Immunology, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322, United States; Influenza Pathogenesis and Immunology Research Center (IPIRC), Emory University School of Medicine, 1462 Clifton Road, Atlanta, GA 30322, United States; Emory Vaccine Center, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, United States
| | - E Stein Esser
- Department of Microbiology & Immunology, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322, United States; Emory Vaccine Center, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, United States
| | - Sean R McMaster
- Department of Microbiology & Immunology, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322, United States; Influenza Pathogenesis and Immunology Research Center (IPIRC), Emory University School of Medicine, 1462 Clifton Road, Atlanta, GA 30322, United States
| | - Priya Kalluri
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Fest Drive, Atlanta, GA 30332-0100, United States
| | - Jeong-Woo Lee
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Fest Drive, Atlanta, GA 30332-0100, United States
| | - Mark R Prausnitz
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Fest Drive, Atlanta, GA 30332-0100, United States
| | - Ioanna Skountzou
- Department of Microbiology & Immunology, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322, United States; Influenza Pathogenesis and Immunology Research Center (IPIRC), Emory University School of Medicine, 1462 Clifton Road, Atlanta, GA 30322, United States; Emory Vaccine Center, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, United States
| | - Timothy L Denning
- Center for Inflammation, Immunity, and Infection, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA 30303, United States
| | - Jacob E Kohlmeier
- Department of Microbiology & Immunology, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322, United States; Influenza Pathogenesis and Immunology Research Center (IPIRC), Emory University School of Medicine, 1462 Clifton Road, Atlanta, GA 30322, United States
| | - Richard W Compans
- Department of Microbiology & Immunology, Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA 30322, United States; Influenza Pathogenesis and Immunology Research Center (IPIRC), Emory University School of Medicine, 1462 Clifton Road, Atlanta, GA 30322, United States; Emory Vaccine Center, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, United States.
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