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Vizzotti C, Harris JB, Aquino A, Rancaño C, Biscayart C, Bonaventura R, Pontoriero A, Baumeister E, Freire MC, Magariños M, Duarte B, Grant G, Reef S, Laven J, Wannemuehler KA, Alvarez AMR, Staples JE. Immune response to co-administration of measles, mumps, and rubella (MMR), and yellow fever vaccines: a randomized non-inferiority trial among one-year-old children in Argentina. BMC Infect Dis 2023; 23:165. [PMID: 36932346 PMCID: PMC10021967 DOI: 10.1186/s12879-023-08114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 02/23/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND In yellow fever (YF) endemic areas, measles, mumps, and rubella (MMR), and YF vaccines are often co-administered in childhood vaccination schedules. Because these are live vaccines, we assessed potential immune interference that could result from co-administration. METHODS We conducted an open-label, randomized non-inferiority trial among healthy 1-year-olds in Misiones Province, Argentina. Children were randomized to one of three groups (1:1:1): Co-administration of MMR and YF vaccines (MMR1YF1), MMR followed by YF vaccine four weeks later (MMR1YF2), or YF followed by MMR vaccine four weeks later (YF1MMR2). Blood samples obtained pre-vaccination and 28 days post-vaccination were tested for immunoglobulin G antibodies against measles, mumps, and rubella, and for YF virus-specific neutralizing antibodies. Non-inferiority in seroconversion was assessed using a -5% non-inferiority margin. Antibody concentrations were compared with Kruskal-Wallis tests. RESULTS Of 851 randomized children, 738 were correctly vaccinated, had ≥ 1 follow-up sample, and were included in the intention-to-treat population. Non-inferior seroconversion was observed for all antigens (measles seroconversion: 97.9% in the MMR1YF1 group versus 96.3% in the MMR1YF2 group, a difference of 1.6% [90% CI -1.5, 4.7]; rubella: 97.9% MMR1YF1 versus 94.7% MMR1YF2, a difference of 3.3% [-0.1, 6.7]; mumps: 96.7% MMR1YF1 versus 97.9% MMR1YF2, a difference of -1.3% [-4.1, 1.5]; and YF: 96.3% MMR1YF1 versus 97.5% YF1MMR2, a difference of -1.2% [-4.2, 1.7]). Rubella antibody concentrations and YF titers were significantly lower following co-administration; measles and mumps concentrations were not impacted. CONCLUSION Effective seroconversion was achieved and was not impacted by the co-administration, although antibody levels for two antigens were lower. The impact of lower antibody levels needs to be weighed against missed opportunities for vaccination to determine optimal timing for MMR and YF vaccine administration. TRIAL REGISTRATION The study was retrospectively registered in ClinicalTrials.gov (NCT03368495) on 11/12/2017.
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Affiliation(s)
- Carla Vizzotti
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de Argentina, Buenos Aires, Argentina
| | - Jennifer B Harris
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
| | - Analía Aquino
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de Argentina, Buenos Aires, Argentina
| | - Carolina Rancaño
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de Argentina, Buenos Aires, Argentina
| | - Cristian Biscayart
- Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de Argentina, Buenos Aires, Argentina
| | - Romina Bonaventura
- Departamento de Virología, Instituto Nacional de Enfermedades Infecciosas, Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos Malbrán" (ANLIS), Buenos Aires, Argentina
| | - Andrea Pontoriero
- Departamento de Virología, Instituto Nacional de Enfermedades Infecciosas, Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos Malbrán" (ANLIS), Buenos Aires, Argentina
| | - Elsa Baumeister
- Departamento de Virología, Instituto Nacional de Enfermedades Infecciosas, Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos Malbrán" (ANLIS), Buenos Aires, Argentina
| | - Maria Cecilia Freire
- Departamento de Virología, Instituto Nacional de Enfermedades Infecciosas, Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos Malbrán" (ANLIS), Buenos Aires, Argentina
| | - Mirta Magariños
- Pan American Health Organization (PAHO), Buenos Aires, Argentina
| | - Blanca Duarte
- Programa Provincial Regular de Inmunizaciones, Ministerio de Salud de Misiones, Posadas, Argentina
| | - Gavin Grant
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Susan Reef
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Janeen Laven
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, CO, USA
| | - Kathleen A Wannemuehler
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
- Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
| | | | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins, CO, USA
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Kundro M, Losso M, Macchia A, Pastor I, Alonso Serena M, Gestoso C, Moreno Macías L, Crupi F, Acosta M, Ivalo S, Ghioldi M, Bouzas M, Mammana L, Zapiola I, Mazzitelli I, Varese A, Geffner J, Biscayart C, Angeleri P, Lopez E, Gentile A, Ferrante D, de Quiros FGB. Safety and immunogenicity of heterologous COVID-19 vaccine regimens to deal with product shortage: A randomised clinical trial in an elderly population. Public Health Pract (Oxf) 2022; 4:100313. [PMID: 36090797 PMCID: PMC9444309 DOI: 10.1016/j.puhip.2022.100313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/04/2022] [Accepted: 08/26/2022] [Indexed: 01/03/2023] Open
Abstract
Objectives In a context of COVID-19 vaccine shortages, this study sought to evaluate the safety and efficacy of receiving one dose of Gam-COVID-Vac rAd26 followed by a second COVID-19 vaccine dose of either Gam-COVID-Vac rAd5, ChAdOx1 nCoV-19 or BBIBP-CorV in a cohort of older adults. Study design Single-centre, randomised, open label, non-inferiority trial. Methods Adults aged ≥65 years who had received one dose of Gam-COVID-Vac rAd26 were randomised in a 1:1:1 ratio to receive a second-dose COVID-19 vaccination of either Gam-COVID-Vac rAd5, ChAdOx1 nCoV-19 or BBIBP-CorV. The primary outcome was the assessment of the humoral immune response to vaccination (i.e. antibody titres of SARS-CoV-2 spike protein at 28 days after second-dose vaccination). In addition, neutralising antibody titres at day 28 for the three schedules were measured. Results Of 85 participants who were enrolled in the study between 26 and July 30, 2021, 31 individuals were randomised to receive Gam-COVID-Vac rAd5, 27 to ChAdOx1 nCoV-19 and 27 to BBIBP-CorV. The mean age of participants was 68.2 years (SD 2.9) and 49 (57.6%) were female. Participants who received Gam-COVID-Vac rAd5 and ChAdOx1 nCoV1-19 showed significantly increased anti-S titres at 28 days after second-dose vaccination, but this magnitude of difference was not observed for those who received BBIBP-CorV. The ratio between the geometric mean at day 28 and baseline within each group was 11.8 (6.98-19.89) among patients assigned to Gam-COVID-Vac rAd26/rAd5, 4.81 (2.14-10.81) for the rAd26/ChAdOx1 nCoV-19 group and 1.53 (0.74-3.20) for the rAd26/BBIBP-CorV group. All of the schedules were shown to be safe. Conclusions The findings in this study contribute to the scarce information published on the safety and immunogenicity of Gam-COVID-Vac heterologous regimens and will help the development of guidelines and vaccine programme management.
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Affiliation(s)
- M.A. Kundro
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina,Corresponding author. Área de Investigación en Enfermedades Emergentes Departamento de Medicina Hospital J.M. Ramos Mejía Urquiza 609.Buenos Aires. Argentina.
| | - M.H. Losso
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - A. Macchia
- Ministerio de Salud del Gobierno de la Ciudad Autónoma de Buenos Aires, Argentina
| | - I. Pastor
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - M. Alonso Serena
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - C. Gestoso
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - L. Moreno Macías
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - F. Crupi
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - M.C. Acosta
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - S. Ivalo
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - M. Ghioldi
- Área de Investigación en Enfermedades Emergentes, Hospital General de Agudos “J.M. Ramos Mejía”, Ciudad Autónoma de Buenos Aires, Argentina
| | - M.B. Bouzas
- Unidad de Virología, División Análisis Clínicos, Hospital de Infecciosas “Francisco J. Muñiz", Ciudad Autónoma de Buenos Aires, Argentina
| | - L. Mammana
- Unidad de Virología, División Análisis Clínicos, Hospital de Infecciosas “Francisco J. Muñiz", Ciudad Autónoma de Buenos Aires, Argentina
| | - I. Zapiola
- Unidad de Virología, División Análisis Clínicos, Hospital de Infecciosas “Francisco J. Muñiz", Ciudad Autónoma de Buenos Aires, Argentina
| | - I. Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - A. Varese
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - J. Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - C. Biscayart
- Subsecretaría de Planificación Sanitaria, Ministerio de Salud de la Ciudad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - P. Angeleri
- Subsecretaría de Planificación Sanitaria, Ministerio de Salud de la Ciudad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - E. Lopez
- Departamento de Medicina, Hospital de Niños “Ricardo Gutiérrez”, Ciudad Autónoma de Buenos Aires, Argentina
| | - A. Gentile
- Departamento de Epidemiología, Hospital de Niños “Ricardo Gutiérrez”, Ciudad Autónoma de Buenos Aires, Argentina
| | - D. Ferrante
- Ministerio de Salud del Gobierno de la Ciudad Autónoma de Buenos Aires, Argentina
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Biscayart C, Angeleri P, Lloveras S, Chaves TDSS, Schlagenhauf P, Rodríguez-Morales AJ. The next big threat to global health? 2019 novel coronavirus (2019-nCoV): What advice can we give to travellers? - Interim recommendations January 2020, from the Latin-American society for Travel Medicine (SLAMVI). Travel Med Infect Dis 2020; 33:101567. [PMID: 32006657 PMCID: PMC7128745 DOI: 10.1016/j.tmaid.2020.101567] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Cristian Biscayart
- Fundación Centro de Estudios Infectológicos (FUNCEI), Buenos Aires, Argentina; Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | | | - Susana Lloveras
- Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Hospital de Enfermedades Infecciosas Francisco J. Muñiz, Buenos Aires, Argentina
| | - Tânia do Socorro Souza Chaves
- Evandro Chagas Institute, Health of Ministry of Brazil, Rodovia BR 316 Km 07, S/N, CEP 67030-000, Ananindeua, Pará, Brazil; Faculdade de Medicina da Universidade Federal Do Pará, Pará, Brazil; Centro Universitário Do Pará/Medicina, Pará, Brazil; Panel of Vaccines in Travelers, Latin American Society for Travel Medicine (SLAMVI), Pará, Brazil
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Alfonso J Rodríguez-Morales
- Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas, Pereira, Risaralda, 660004, Colombia.
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Juarez MDV, Rancaño C, Neyro S, Biscayart C, Katz N, Pasinovich M, Yunes ML, Aquino A, Vizzotti C. What's Happening With Haemophilus influenzae Type B Invasive Disease in Latin America Region? Argentina's Experience. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - Silvina Neyro
- Ministry of Health of Argentina, Buenos Aires, Argentina
| | | | - Nathalia Katz
- Ministry of Health of Argentina, Buenos Aires, Argentina
| | | | | | - Analia Aquino
- Ministry of Health of Argentina, Buenos Aires, Argentina
| | - Carla Vizzotti
- Ministry of Health of Argentina, Buenos Aires, Argentina
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Biscayart C. Yellow fever vaccine. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Biscayart C, Elmassian P, Macchi A, Verdaguer V, Latta MD, Torroija C, Stamboulian D. Immunizations in travelers attending a private center for infectious diseases and travel medicine in Buenos Aires, Argentina, 2005-2008. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Vidiella G, Rios P, Biscayart C, Castillo S, Botas A, Christin M, Stamboulian D, Iantorno PR, Vujacich C. Virological and biochemical evolution of HIV-HBV co-infected patients treated with tenofovir. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Elmassian P, Macchi A, Biscayart C, Verdaguer V, Latta MD, Stamboulian D. Characterization of pre-travel consults at a travel medicine clinic in Buenos Aires in 2008: Experience with 1,439 Travelers. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Botas M, Biscayart C, Elmassian P, Stamboulian D. Travelers’ diarrhea (TD) incidence in argentine travelers to high-risk destinations. A telephonic survey at a private ambulatory center for infectious diseases (ID) and travel medicine (TM) in Buenos Aires. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Vizzotti C, Biscayart C, Stecher D, Carrega EP, Morales M, Digiglio C, Enria D, Orduna T, Jimenez SG, Gentile A, Betancourt S, Diosque M. Yellow fever vaccine (YFV) and events supposedly attributable to vaccination or immunization (ESAVIs): Argentina's experience. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lepetic A, Biscayart C, Seigelchifer M, Arduino R, Stamboulian D. Persistence of immunity and seroprotection 4 years after a primary vaccination schedule with a Hansenula polymorpha recombinant hepatitis B vaccine. Vaccine 2003; 21:4481-5. [PMID: 14505931 DOI: 10.1016/s0264-410x(03)00306-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To evaluate the persistence of the immune response in a population of healthy volunteers that had been vaccinated with a new Hansenula polymorpha recombinant hepatitis B vaccine in a previous clinical study 4 years before, we measured the titre of anti-HBs. All, but one of the evaluated volunteers remained protected. None of them had experienced any adverse event related to the vaccine from the moment of immunization, to the present. The vaccine proved to be immunogenic and to confer long-term protection in this group.
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Affiliation(s)
- A Lepetic
- Fundación del Centro de Estudios Infectológicos (FUNCEI), French 3085 (C1425AWK), Buenos Aires, Argentina.
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