Vaccines in the 21st century:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Sainders
2003
|
| Schriftenreihe: | Immunology and allergy clinics of North America
23,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 556 - 836 S. |
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Datensatz im Suchindex
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| adam_text | VAOONK.INTMfi2lSTCENTURY
CONTENTS
Preface xi
Gregory A. Poland
Vaccine Allergy: Diagnosis and Management 555
Arvind Madaan and Daniel E. Maddox
Because the beneficial effects of vaccines are a result of changes in
the immune system, so are some of the adverse effects. Adverse
reactions to vaccines can be local or systemic and immediate or
delayed in onset. Some reactions are mediated by hypersensitivity
whereas the mechanisms for other reactions are not well known.
Better understanding of these reactions can lead to proper vaccine
selection and can improve immunization acceptance rates in the
community. Prevention, avoidance, use of alternative agents, desen
sitization, and premedication remain the mainstays of therapy, even
as more refined diagnostic and management tools are developed.
Vaccine Safety 589
Robert M. Jacobson
Although tremendously successful in reducing the threat of many
deadly childhood diseases, vaccination remains at the forefront of
public debate due to safety concerns. This debate has interrupted
vaccine delivery and has resulted in preventable disease and out¬
breaks. This article addresses issues that concern most or all vac¬
cines as a class and specific vaccines routinely used in children and
adults. A discussion of the processes in place for evaluating vac¬
cine safety is included.
Immunization of Immunocompromised Persons 605
David J. Weber and William A. Rutala
Advances in medicine, science, and technology have led to increas¬
ing numbers of people in the general population with altered host
VOLUME 23 • NUMBER 4 • NOVEMBER 2003 v
defenses. The risk for clinical infection in an immunocompromised
host, such as a person who has received a solid organ transplant,
is determined largely by the interaction between two factors: the
epidemiologic exposures the person encounters and the person s
net state of immunosuppresson. Vaccination represents a crucial
approach for preventing infection in the general public and immuno¬
compromised persons. This article reviews the benefits of and risks
for immunization in immunocompromised persons and provides
recommendations for the use of specific vaccines.
Immunization of Egg Allergic Individuals with Egg or
Chicken Derived Vaccines 635
John M. Kelso and John W. Yunginger
Viruses used in several vaccines are propagated in embryonated
eggs. These vaccines contain variable quantities of residual egg or
chicken proteins and pose risks when administered to egg or
chicken sensitive persons. This article highlights differences in
how vaccines are prepared, with emphasis on the quantitation of
residual egg derived protein in each vaccine. Published reports
on the frequency and severity of these vaccine induced allergic
reactions are reviewed, and an algorithm is provided for the preim
munization evaluation of egg sensitive persons.
Does Antigenic Overload Exist? The Role of Multiple
Immunizations in Infants 649
Aric L. Gregson and Robert Edelman
Many parents are concerned that the administration of multiple
vaccines will overwhelm and weaken the immune system of
infants and children and lead to deleterious effects. This article
attempts to provide healthcare practitioners with information that
can be used to allay parental concerns regarding routine childhood
vaccinations. The following issues are discussed: (1) the develop¬
ment of the infant immune system and differences between adult
and infant immune systems that impact childhood vaccinations,
(2) the role of combination vaccines and potential complications of
their use, (3) the capacity of the immune system to deal effectively
with multiple vaccines, (4) the risk for infection after vaccination,
and (5) the response to vaccines during illness.
Allergic Reactions to Japanese Encephalitis Vaccine 665
Anne Marie Plesner
Japanese encephalitis (JE) is a mosquito borne viral infection
accounting for more than 16,000 sporadic cases of encephalitis and
5000 deaths reported annually in Asia. The most important pre¬
ventive measure against JE is vaccination, which is given as part
vi CONTENTS
of the childhood vaccination program in many countries in Asia.
In the Western part of the world, only inactivated mouse
brain derived vaccines are available, whereas live attenuated and
inactivated hamster kidney cell derived vaccines also are used in
Asia, primarily in China. Common side effects are mostly mild.
More severe allergic reactions to JE vaccinations, mainly muco
cutaneous reactions, mainly have presented in countries outside of
Asia since the early 1990s. Neurologic reactions with a possible
allergic pathogenesis have been reported.
Aluminum Inclusion Macrophagic Myofasciitis: A Recently
Identified Condition 699
Romain K. Gherardi and Frangois Jerome Authier
Macrophagic myofasciitis first was reported in 1998 and remained
of unknown cause until 2001. The condition is characterized by a
stereotyped and immunologically active lesion that is identified
with a deltoid muscle biopsy, which usually is performed in adult
patients with diffuse myalgias and chronic fatigue. Electron
microscopy, microanalytical studies, experimental procedures, and
an epidemiologic study have demonstrated that the lesion is
caused by the long term persistence at the site of injection of alu¬
minum hydroxide, an adjuvant used in vaccines against hepatitis B
virus, hepatitis A virus, and tetanus toxoid. Persistent systemic
immune activation that fails to switch off may represent the patho
physiologic basis of the chronic fatigue syndrome associated with
macrophagic myofasciitis, similar to what happens in patients with
postinfectious chronic fatigue and possibly idiopathic chronic
fatigue syndrome.
Anthrax Vaccine: A Review 713
John D. Grabenstein
Anthrax is a zoonotic disease, primarily of ruminants, that is
caused by Bacillus anthracis. The three most common forms of
anthrax are cutaneous, inhalational, and gastrointestinal. Anthrax
can be a deadly disease if treatment does not begin early in the
course of infection. An effective vaccine has been available in the
United States since 1970, although it was not used widely until
1998. Research is underway to change the current US licensed vac¬
cine s route of administration to intramuscular and to reduce the
number of doses in the basic series.
Smallpox Vaccine: Problems and Prospects 731
Gregory A. Poland and John M. Neff
Smallpox justifiably is feared because of its morbidity and mortality.
Widespread population level susceptibility to smallpox exists, and
CONTENTS vii
the only effective tool against the virus is a live, attenuated vaccine
that is highly reactogenic and controversial. A significant minority of
the population has contraindications that prevent preexposure use of
this vaccine. This article reviews the immunogenicity, efficacy, reacto
genicity, indications, and contraindications of the currently licensed
smallpox vaccine. New smallpox vaccines that are in development
are reviewed briefly. The need for widespread population level pro¬
tection against variola infection is apparent.
Safety and Efficacy of Live Attenuated, Cold Adapted, Influenza
Vaccine Trivalent 745
Robert B. Belshe and Paul M. Mendelman
This article describes the efficacy, immunogenicity, and safety of
cold adapted, live attenuated influenza vaccine trivalent (CAIV T).
With the use of live attenuated vaccines, evidence is accumulating
that broad immune responses are generated, and these antibody
responses may be focused primarily in the mucosal secretions. This
vaccine has the potential to significantly contribute to the control of
influenza infection and influenza associated illnesses, including
febrile otitis media and lower respiratory disease. When compared
with inactivated vaccine, CAIV T has significant advantages in
convenience of administration.
Meningococcal Immunology 769
Martha L. Lepow and Patricia A. Hughes
Neisseria meningitidis has several unique features among major
causes of bacterial meningitis. It can cause endemic and epidemic
disease. There is a major need for an effective vaccine against
serogroup B disease. The long term efficacy of the serogroups A, C,
Y and W135 conjugate vaccines and the need for booster vaccines
has to be determined, as does the effect of changing epidemiology
in the United States and worldwide. Control of serogroup A disease
in sub Saharan Africa is a major challenge.
Transcutaneous Immunization and Immunostimulant Strategies 787
Gregory M. Glenn, Richard T. Kenney, Scott A. Hammond,
and Larry R. Ellingsworth
The use of skin as a noninvasive route for vaccine delivery has
great potential for safe use of potent immune system stimulating
compounds that can target the dense population of immune cells
found in the skin. The use of such compounds to stimulate the skin
immune system leads to highly potent immune responses, and this
immune responsiveness, combined with an apparent high safety
margin, has fostered a great deal of interest in targeting the skin
with vaccines. The experience with the smallpox vaccine, the most
viii CONTENTS
successful vaccine in history and one that is delivered to the skin,
suggests that the advances in delivery of vaccines to the skin will
have an important impact on human health.
Cumulative Index 2003 815
CONTENTS ix
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