meningitis + diphtheria vaccine (TetraMenD / Menak Trapani / Menactra)

A subunit vaccine protects A129 mice from death and joint swelling against lethal Chikungunya virus challenge.

Li Jiangfan J, Fang Ting T, Song Liyuan L, Qiang Li L et al.

Chikungunya virus (CHIKV) is primarily transmitted to humans through bites of infected Aedes mosquitoes, causing febrile illness as well as acute or chronic arthritis. With increasing reports in previously non-endemic regions, it poses an emerging threat to public health and a growing risk to travelers. Despite the recent approval of live-attenuated and virus-like particle-based vaccines, a safe, efficacious, and cost-effective vaccine remains urgently needed. The envelope glycoproteins E1 and E2, which play crucial roles in viral attachment and entry, are the major immunodominant structural proteins and can effectively elicit protective antibodies. We engineered mammalian cells to produce the ectodomains of the E1 and E2 glycoproteins and evaluated the protective efficacy of the resulting vaccine formulations in vivo. A two-dose vaccination regimen elicited high levels of antibodies and provided full protection against lethal challenge in A129 mice, preventing both death and joint swelling. These findings demonstrate the potential of this vaccine candidate against CHIKV and warrant its further development.

[Strategies to address vaccine hesitancy in Brazil: evidence synthesis].

Marques Ana Paula da Costa APDC, Gubert Vanessa Terezinha VT, Dias Adriano da Costa ADC, Gasparoto Antonio Luiz Dal Bello ALDB et al.

Etiological Spectrum of Hyponatremia in Tuberculous Meningitis: Insights from Referral Institute in Northern India.

Singla Neeraj N, Nc Meiherishankar M, Sharma Kusum K, Modi Manish M et al.

Tuberculous meningitis (TBM) causes death or severe disability in 50% of afflicted patients. Among the various complications, such as hydrocephalus, hyponatremia, cranial nerve palsies, seizures, and myeloradiculopathy, hyponatremia occurs more frequently, affecting 35-65% of patients with central nervous system (CNS) tuberculosis. To study the prevalence of hyponatremia in patients with TBM and its correlation with the clinical profile, severity of illness, and outcome. In suspected TBM patients with low sodium levels, serum and urine osmolality were measured by an osmometer [Advanced Instruments, Inc. (2020)] to evaluate the possible causes. Patients underwent brain imaging to look for hydrocephalus, vasculitic infarcts, and basal exudates. They were followed up with serum sodium levels until the completion of treatment and repeat brain imaging during follow-up to assess radiological recovery. A total of 100 suspected TBM patients with a mean age of 32.6 years and predominantly female (57%) were included. The most common symptoms were fever, headache, altered sensorium, and seizures. The VI cranial nerve was most frequently involved. A total of 31% of patients presented in stage III, with a significant association with mortality (p = 0.002). Hyponatremia was seen in 57% of patients. The GeneXpert Ultra-based polymerase chain reaction (PCR) test for tuberculosis was positive in 41% of patients. Basal exudates (p = 0.001) and tuberculomas (p = 0.004) on brain imaging had a significant association with mortality. On follow-up, 41% of patients had improvement, 35% expired, and 10% had a static condition. Repeat sodium levels along with brain imaging were assessed (p = 0.001). There was a high prevalence of hyponatremia in TBM patients, as seen in 57% of patients, which occurred most frequently due to syndrome of inappropriate antidiuretic hormone secretion (SIADH), followed by cerebral salt-wasting syndrome (CSWS), and was related to the severity of TBM.

Clinical effects of third doses of mRNA COVID-19 vaccines among hemodialysis patients: a nationwide retrospective cohort study.

Cho AJin A, Jeong Seon A SA, Seo Yu Bin YB, Park Hayne Cho HC et al.

Evidence on the effectiveness of third-dose messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccination during the Omicron-dominant period in Asian hemodialysis (HD) patients remains limited. We evaluated the clinical effectiveness of a third mRNA vaccine dose against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hospitalization, and mortality in Korean HD patients. Using the Korea Disease Control and Prevention Agency-National Health Insurance Service database, we conducted a nationwide cohort study of HD patients aged ≥18 years who received two or three doses of BNT162b2 or mRNA-1273 before January 16, 2022. Study outcomes were SARS-CoV-2 infection, hospitalization, and death. Cox proportional hazards models were used to assess the associations between third-dose vaccination and clinical outcomes. Among 66,389 HD patients (mean age, 65.7 ± 12.9 years; 60.5% male), 55,125 (83.0%) received three vaccine doses and 11,264 (17.0%) received two doses. Receipt of three doses was associated with a significantly lower risk of SARS-CoV-2 infection (adjusted hazard ratio [aHR], 0.58; 95% confidence interval [CI], 0.56-0.60). Among 17,886 patients with SARS-CoV-2 infection, third-dose vaccine recipients had a lower risk of hospitalization (aHR, 0.65; 95% CI, 0.62-0.70) and 30-day mortality (aHR, 0.35; 95% CI, 0.30-0.41) compared with those who received two doses. Receipt of mRNA-1273 as the third dose was associated with lower observed risks of infection and hospitalization than receipt of BNT162b2. A third dose of an mRNA COVID-19 vaccine was associated with lower risks of SARS-CoV-2 infection, hospitalization, and mortality among HD patients during the Omicron-dominant period. These findings support the clinical importance of booster vaccination in this high-risk population.