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Diabetes mellitus imposes a significant and increasing burden on society, with major consequences for human health, welfare and the economy worldwide. Persons with diabetes mellitus are at increased risk of developing severe complications after influenza virus infection and guidelines advise vaccination. The present evidence for influenza vaccine effectiveness in persons with diabetes mellitus is...
Numerous studies have explored whether the antibody response to influenza vaccination in elderly adults is as strong as it is in young adults. Results vary, but tend to indicate lower post-vaccination titers (antibody levels) in the elderly, supporting the concept of immunosenescence—the weakening of the immunological response related to age. Because the elderly in such studies typically have been...
The 2010 Cochrane review on efficacy, effectiveness and safety of influenza vaccination in the elderly by Jefferson et al. covering dozens of clinical studies over a period of four decades, confirmed vaccine safety, but found no convincing evidence for vaccine effectiveness (VE) against disease thus challenging the ongoing efforts to vaccinate the elderly.However, the Cochrane review analyzed and...
In a phase I/IIa clinical trial, 17 HIV-1 infected patients, stable on cART, received 4 vaccinations with autologous dendritic cells electroporated with mRNA encoding Tat, Rev and Nef, after which cART was interrupted. Vaccination was safe and feasible. During the analytical treatment interruption (ATI), no serious adverse events were observed. Ninety-six weeks following ATI, 6/17 patients remained...
For many vaccines the amount of antibodies induced has a positive correlation with the likelihood of clinical protection from disease. Mean antibody level is therefore frequently used as a serological surrogate endpoint for vaccine efficacy. In addition, a dichotomous surrogate endpoint is often defined: seroprotection. We explore the relationship between mean antibody level, seroprotection and clinical...
In the literature, different definitions of clinical illness cases and observation period are used to assess influenza vaccine effectiveness, usually without addressing their actual specificity and sensitivity. These properties, however, have large implications on influenza vaccine effectiveness estimates in single trials and meta-analyses of trials. Re-arranging 30 trials (in 17 publications) with...
In 2003 an outbreak of highly pathogenic avian influenza virus (H7N7) struck poultry in The Netherlands. A European Commission directive made vaccination of valuable species in zoo collections possible under strict conditions. We determined pre- and post-vaccination antibody titres in 211 birds by haemagglutination inhibition test as a measure of vaccine efficacy. After booster vaccination, 81.5%...
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