|
1
|
Cardenas-Brown C, Lucas RD, Buttery J, Britton PN, Wood N, Singh-Grewal D, Burgner D. Live vaccines following intravenous immunoglobulin for Kawasaki disease: Are we vaccinating appropriately? J Paediatr Child Health 2023; 59:1217-1222. [PMID: 37664891 DOI: 10.1111/jpc.16484] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/05/2023] [Accepted: 08/13/2023] [Indexed: 09/05/2023]
Abstract
AIM Australian and New Zealand guidelines recommend that live vaccines be postponed for 11 months after treatment of Kawasaki disease (KD) with intravenous immunoglobulin (IVIG). We aimed to describe patterns of live-vaccine administration after KD treatment, focusing on the measles-mumps-rubella/measles-mumps-rubella-varicella (MMR/MMRV) vaccines, and to compare real-world practice with current recommendations. METHODS We combined data from inpatient Electronic Health Records and the Australian Immunisation Register for all children who received IVIG for the treatment of KD under the age of 5 years at two Australian tertiary children's hospitals over a 12-year period. Children who received IVIG <11 months before a scheduled MMR/MMRV were deemed 'at risk' of breaching the guidelines, and those whose subsequent vaccination occurred <11 months after the IVIG were deemed to have 'breached' the guidelines. RESULTS Of those at risk, three-quarters (76%) breached the guidelines for their first MMR/MMRV. Findings were similar (50%-80%) for the second MMR/MMRV dose. CONCLUSIONS The majority of Australian children treated for KD with IVIG may not be optimally protected by MMRV vaccination. Immunisation systems should address this avoidable risk.
Collapse
Affiliation(s)
- Cassandra Cardenas-Brown
- Department of Rheumatology, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Ryan D Lucas
- Department of General Medicine, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Jim Buttery
- Infection and Immunity Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Medical School, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Analytics, Melbourne Children's Campus, Melbourne, Victoria, Australia
| | - Philip N Britton
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- National Centre for Immunisation Research & Surveillance, Sydney, New South Wales, Australia
- Department of Infectious Diseases, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
| | - Nicholas Wood
- Department of General Medicine, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- National Centre for Immunisation Research & Surveillance, Sydney, New South Wales, Australia
| | - Davinder Singh-Grewal
- Department of Rheumatology, The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- School of Women's and Children's Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - David Burgner
- Infection and Immunity Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne Medical School, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
|
2
|
Grant S, Patel NN, Philp AR, Grey CN, Lucas RD, Foster RG, Bowmaker JK, Jeffery G. Rod photopigment deficits in albinos are specific to mammals and arise during retinal development. Vis Neurosci 2001; 18:245-51. [PMID: 11417799 DOI: 10.1017/s095252380118209x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [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: 11/07/2022]
Abstract
Adult albino mammals have specific retinal defects, including reduced numbers of rod photoreceptors. To examine when this rod deficit arises and whether it exists in nonmammalian albinos, we have used absorbance spectrophotometry to measure photopigment levels in dark-adapted eyes taken from three groups of pigmented and albino animals: adult rodents (rats and mice), developing rats, and mature Xenopus frogs. Rhodopsin concentrations were consistently and significantly reduced in mammalian albinos compared to their wild-type counterparts from before the time of eye opening, but photopigment levels were similar in frogs of both pigmentation phenotypes. The results strongly suggest that deficits in the rod cell population arise early in development of the mammalian albino retina, but do not generalize to nonmammalian mutants lacking retinal melanin.
Collapse
Affiliation(s)
- S Grant
- Department of Sensorimotor Systems, Imperial College School of Medicine, London, UK.
| | | | | | | | | | | | | | | |
Collapse
|