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Vaccines, Volume 5, Issue 1 (March 2017) – 8 articles

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195 KiB  
Article
The Cost of Cost-Sharing: The Impact of Medicaid Benefit Design on Influenza Vaccination Uptake
by Charles Stoecker, Alexandra M. Stewart and Megan C. Lindley
Vaccines 2017, 5(1), 8; https://doi.org/10.3390/vaccines5010008 - 06 Mar 2017
Cited by 12 | Viewed by 5440
Abstract
Prior research indicates that cost-sharing and lack of insurance coverage reduce preventive services use among low-income persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting [...] Read more.
Prior research indicates that cost-sharing and lack of insurance coverage reduce preventive services use among low-income persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts) on vaccine uptake in the fee-for-service Medicaid population 19–64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012. Data on influenza vaccination uptake were taken from the Behavioral Risk Factor Surveillance System. We used a differences-in-differences framework, controlling for national trends and state differences, to estimate the effect of each benefit design factor on vaccination uptake in different Medicaid-eligible populations. Each additional dollar of copayment for vaccination decreased influenza vaccination coverage 1–6 percentage points. The effects of covering vaccines or prohibiting cost-sharing were mixed. Imposing copayments for vaccination is associated with lower vaccination coverage. These findings have implications for the implementation of Medicaid expansion in states that currently impose copayments. Full article
1577 KiB  
Review
The Escape of Cancer from T Cell-Mediated Immune Surveillance: HLA Class I Loss and Tumor Tissue Architecture
by Federico Garrido, Francisco Perea, Mónica Bernal, Abel Sánchez-Palencia, Natalia Aptsiauri and Francisco Ruiz-Cabello
Vaccines 2017, 5(1), 7; https://doi.org/10.3390/vaccines5010007 - 27 Feb 2017
Cited by 62 | Viewed by 7947
Abstract
Tumor immune escape is associated with the loss of tumor HLA class I (HLA-I) expression commonly found in malignant cells. Accumulating evidence suggests that the efficacy of immunotherapy depends on the expression levels of HLA class I molecules on tumors cells. It also [...] Read more.
Tumor immune escape is associated with the loss of tumor HLA class I (HLA-I) expression commonly found in malignant cells. Accumulating evidence suggests that the efficacy of immunotherapy depends on the expression levels of HLA class I molecules on tumors cells. It also depends on the molecular mechanism underlying the loss of HLA expression, which could be reversible/“soft” or irreversible/“hard” due to genetic alterations in HLA, β2-microglobulin or IFN genes. Immune selection of HLA-I negative tumor cells harboring structural/irreversible alterations has been demonstrated after immunotherapy in cancer patients and in experimental cancer models. Here, we summarize recent findings indicating that tumor HLA-I loss also correlates with a reduced intra-tumor T cell infiltration and with a specific reorganization of tumor tissue. T cell immune selection of HLA-I negative tumors results in a clear separation between the stroma and the tumor parenchyma with leucocytes, macrophages and other mononuclear cells restrained outside the tumor mass. Better understanding of the structural and functional changes taking place in the tumor microenvironment may help to overcome cancer immune escape and improve the efficacy of different immunotherapeutic strategies. We also underline the urgent need for designing strategies to enhance tumor HLA class I expression that could improve tumor rejection by cytotoxic T-lymphocytes (CTL). Full article
(This article belongs to the Special Issue Mechanisms of Tumor Escape from Host Immunity)
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1231 KiB  
Review
Harnessing Nanoparticles for Immunomodulation and Vaccines
by Ariane C. Gomes, Mona Mohsen and Martin F. Bachmann
Vaccines 2017, 5(1), 6; https://doi.org/10.3390/vaccines5010006 - 14 Feb 2017
Cited by 115 | Viewed by 9476
Abstract
The first successful use of nanoparticles (NPs) for vaccination was reported almost 40 years ago with a virus-like particle-based vaccine against Hepatitis B. Since then, the term NP has been expanded to accommodate a large number of novel nano-sized particles engineered from a [...] Read more.
The first successful use of nanoparticles (NPs) for vaccination was reported almost 40 years ago with a virus-like particle-based vaccine against Hepatitis B. Since then, the term NP has been expanded to accommodate a large number of novel nano-sized particles engineered from a range of materials. The great interest in NPs is likely not only a result of the two successful vaccines against hepatitis B and Human Papilloma Virus (HPV) that use this technology, but also due to the versatility of those small-sized particles, as indicated by the wide range of applications reported so far, ranging from medicinal and cosmetics to purely technical applications. In this review, we will focus on the use of NPs, especially virus-like particles (VLPs), in the field of vaccines and will discuss their employment as vaccines, antigen display platforms, adjuvants and drug delivery systems. Full article
(This article belongs to the Special Issue Nanoparticles to Co-Deliver Immunopotentiators and Antigens)
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1676 KiB  
Review
Human T Cell Memory: A Dynamic View
by Derek C. Macallan, José A. M. Borghans and Becca Asquith
Vaccines 2017, 5(1), 5; https://doi.org/10.3390/vaccines5010005 - 04 Feb 2017
Cited by 46 | Viewed by 10145
Abstract
Long-term T cell-mediated protection depends upon the formation of a pool of memory cells to protect against future pathogen challenge. In this review we argue that looking at T cell memory from a dynamic viewpoint can help in understanding how memory populations are [...] Read more.
Long-term T cell-mediated protection depends upon the formation of a pool of memory cells to protect against future pathogen challenge. In this review we argue that looking at T cell memory from a dynamic viewpoint can help in understanding how memory populations are maintained following pathogen exposure or vaccination. For example, a dynamic view resolves the apparent paradox between the relatively short lifespans of individual memory cells and very long-lived immunological memory by focussing on the persistence of clonal populations, rather than individual cells. Clonal survival is achieved by balancing proliferation, death and differentiation rates within and between identifiable phenotypic pools; such pools correspond broadly to sequential stages in the linear differentiation pathway. Each pool has its own characteristic kinetics, but only when considered as a population; single cells exhibit considerable heterogeneity. In humans, we tend to concentrate on circulating cells, but memory T cells in non-lymphoid tissues and bone marrow are increasingly recognised as critical for immune defence; their kinetics, however, remain largely unexplored. Considering vaccination from this viewpoint shifts the focus from the size of the primary response to the survival of the clone and enables identification of critical system pinch-points and opportunities to improve vaccine efficacy. Full article
(This article belongs to the Special Issue T Cell Memory to Vaccination)
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Review
From Immunologically Archaic to Neoteric Glycovaccines
by Marco Cavallari and Gennaro De Libero
Vaccines 2017, 5(1), 4; https://doi.org/10.3390/vaccines5010004 - 27 Jan 2017
Cited by 10 | Viewed by 7306
Abstract
Polysaccharides (PS) are present in the outermost surface of bacteria and readily come in contact with immune cells. They interact with specific antibodies, which in turn confer protection from infections. Vaccines with PS from pneumococci, meningococci, Haemophilus influenzae type b, and Salmonella typhi [...] Read more.
Polysaccharides (PS) are present in the outermost surface of bacteria and readily come in contact with immune cells. They interact with specific antibodies, which in turn confer protection from infections. Vaccines with PS from pneumococci, meningococci, Haemophilus influenzae type b, and Salmonella typhi may be protective, although with the important constraint of failing to generate permanent immunological memory. This limitation has in part been circumvented by conjugating glycovaccines to proteins that stimulate T helper cells and facilitate the establishment of immunological memory. Currently, protection evoked by conjugated PS vaccines lasts for a few years. The same approach failed with PS from staphylococci, Streptococcus agalactiae, and Klebsiella. All those germs cause severe infections in humans and often develop resistance to antibiotic therapy. Thereby, prevention is of increasing importance to better control outbreaks. As only 23 of more than 90 pneumococcal serotypes and 4 of 13 clinically relevant Neisseria meningitidis serogroups are covered by available vaccines there is still tremendous clinical need for PS vaccines. This review focuses on glycovaccines and the immunological mechanisms for their success or failure. We discuss recent advances that may facilitate generation of high affinity anti-PS antibodies and confer specific immunity and long-lasting protection. Full article
(This article belongs to the Special Issue Glycopeptide-based and Related Vaccines)
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3355 KiB  
Article
A Protective Vaccine against Chlamydia Genital Infection Using Vault Nanoparticles without an Added Adjuvant
by Janina Jiang, Guangchao Liu, Valerie A. Kickhoefer, Leonard H. Rome, Lin-Xi Li, Stephen J. McSorley and Kathleen A. Kelly
Vaccines 2017, 5(1), 3; https://doi.org/10.3390/vaccines5010003 - 19 Jan 2017
Cited by 25 | Viewed by 6529
Abstract
Chlamydia trachomatis genital infection is the most common sexually transmitted bacterial disease, causing a significant burden to females due to reproductive dysfunction. Intensive screening and antibiotic treatment are unable to completely prevent female reproductive dysfunction, thus, efforts have become focused on developing a [...] Read more.
Chlamydia trachomatis genital infection is the most common sexually transmitted bacterial disease, causing a significant burden to females due to reproductive dysfunction. Intensive screening and antibiotic treatment are unable to completely prevent female reproductive dysfunction, thus, efforts have become focused on developing a vaccine. A major impediment is identifying a safe and effective adjuvant which induces cluster of differentiation 4 (CD4) cells with attributes capable of halting genital infection and inflammation. Previously, we described a natural nanocapsule called the vault which was engineered to contain major outer membrane protein (MOMP) and was an effective vaccine which significantly reduced early infection and favored development of a cellular immune response in a mouse model. In the current study, we used another chlamydial antigen, a polymorphic membrane protein G-1 (PmpG) peptide, to track antigen-specific cells and evaluate, in depth, the vault vaccine for its protective capacity in the absence of an added adjuvant. We found PmpG-vault immunized mice significantly reduced the genital bacterial burden and histopathologic parameters of inflammation following a C. muridarum challenge. Immunization boosted antigen-specific CD4 cells with a multiple cytokine secretion pattern and reduced the number of inflammatory cells in the genital tract making the vault vaccine platform safe and effective for chlamydial genital infection. We conclude that vaccination with a Chlamydia-vault vaccine boosts antigen-specific immunities that are effective at eradicating infection and preventing reproductive tract inflammation. Full article
(This article belongs to the Special Issue Nanoparticles to Co-Deliver Immunopotentiators and Antigens)
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267 KiB  
Editorial
Acknowledgement to Reviewers of Vaccines in 2016
by Vaccines Editorial Office
Vaccines 2017, 5(1), 2; https://doi.org/10.3390/vaccines5010002 - 10 Jan 2017
Cited by 1 | Viewed by 3309
Abstract
The editors of Vaccines would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2016.[...] Full article
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Article
Young Hungarian Students’ Knowledge about HPV and Their Attitude Toward HPV Vaccination
by Bettina Claudia Balla, András Terebessy, Emese Tóth and Péter Balázs
Vaccines 2017, 5(1), 1; https://doi.org/10.3390/vaccines5010001 - 29 Dec 2016
Cited by 17 | Viewed by 6216
Abstract
(1) Background: Hungarys’s estimated cervical cancer mortality was 6.9/100,000 in 2012, above the average of the EU27 countries (3.7/100,000) in the same year. Since 2014, the bivalent HPV vaccine has been offered to schoolgirls aged 12–13. (2) Methods: We conducted a [...] Read more.
(1) Background: Hungarys’s estimated cervical cancer mortality was 6.9/100,000 in 2012, above the average of the EU27 countries (3.7/100,000) in the same year. Since 2014, the bivalent HPV vaccine has been offered to schoolgirls aged 12–13. (2) Methods: We conducted a cross-sectional study among 1022 high school seniors (492 girls, 530 boys) in 19 randomly selected schools in Budapest. Our anonymous questionnaire contained 54 items: basic socio-demographic data, knowledge about HPV infection/cervical cancer and HPV vaccination. (3) Results: 54.9% knew that HPV caused cervical cancer, and 52.1% identified HPV as an STD. Knowledge of risk factors such as promiscuity (46.9%) and early sexual activity (15.6%) was low, but higher than that of further HPV-induced diseases: genital warts (in females 9.9%, in males 9%), anal cancer (in females 2.2%, in males 1.9%), penile cancer (9.4%), and vulvar cancer (7.8%). A percentage of 14.6% feared getting infected, and 35.7% supported compulsory HPV vaccination. A percentage of 51.2% would have their future children vaccinated—significantly more girls than boys. (4) Conclusion: Our results support the findings of previous studies about young adults’ HPV-related knowledge, which was poor, especially regarding pathologies in men. Despite the low level of awareness, the students’ attitude was mostly positive when asked about vaccinating their future children. Full article
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