Immunogenicity Of 23-valent Pneumococcal Polysaccharide Vaccination Among Indigenous Australian Adolescents And Adults
Funder
National Health and Medical Research Council
Funding Amount
$674,738.00
Summary
Multiple doses of pneumococcal vaccine are recommended for Indigenous Australians under a unique schedule aimed at reducing high rates of pneumococcal disease. However, disease rates have not reduced after several years of the program. This study examines a key, previously unstudied explanation for the lack of disease reduction in this population: that repeated vaccination could produce suboptimal protection against disease. It will provide evidence to underpin future vaccination policy.
Community-based Surveillance Of Bacterial Respiratory Pathogens In The NT And WA
Funder
National Health and Medical Research Council
Funding Amount
$782,905.00
Summary
This surveillance project is a continuation of previous work that describes the strains of respiratory bacterial pathogens in the various community groups - Indigenous and non-Indigenous - across the NT and in WA (urban and remote areas). New vaccines are complex and whilst overall benefits are considerable, there are potential influences on microbiology that may be unwanted. Detailed knowledge of these effects will assist in selection of the best vaccines for use in Australia.
Implications Of Bacterial Load For Vaccine Efficacy And Antibiotic Treatment Outcomes In High-risk Populations
Funder
National Health and Medical Research Council
Funding Amount
$345,000.00
Summary
Otitis media (middle ear disease) is a common childhood infection, and a major concern in remote Aboriginal communities of the Northern Territory. For these children, otitis media commences within the first few weeks of life and progresses to perforation of the ear drum in 60% of children by 12 months of age. Few children in remote Aboriginal communities have normal ear status or normal hearing and many have conductive hearing loss, affecting language development and education. Otitis media in t ....Otitis media (middle ear disease) is a common childhood infection, and a major concern in remote Aboriginal communities of the Northern Territory. For these children, otitis media commences within the first few weeks of life and progresses to perforation of the ear drum in 60% of children by 12 months of age. Few children in remote Aboriginal communities have normal ear status or normal hearing and many have conductive hearing loss, affecting language development and education. Otitis media in these children results from infection with the bacteria Streptococcus pneumoniae, Haemophilus influenzae and-or Moraxella catarrhalis. Therefore the types of interventions we are using to combat the high prevalence of ear disease are antibiotic therapy, Streptococcus pneumoniae vaccination, and hygiene interventions. However we fear that the high load of bacteria carried by these children compromises the treatment and prevention strategies. The current proposal will test this hypothesis, and if found to be true, there will be implications for the management of otitis media. For example, dose, frequency and choice of antibiotic treatment, and vaccine schedule changes including an early dose or a booster dose.Read moreRead less
The pneumococcus is a major cause of bacterial pneumonia, sepsis and meningitis especially in children and the elderly. Antibiotic-resistant pneumococci are becoming more prevalent, and available vaccines have major shortcomings. We propose to identify and characterise the factors produced by this organism during infection that enable it to cause invasive disease. Such factors could be incorporated into protein-based pneumococcal vaccines currently under development.
Streptococcus pneumoniae (the pneumococcus) is an important human pathogen, which is responsible for the deaths of millions of children each year in developing countries. The high morbidity and mortality associated with pneumococcal disease is also being exacerbated by the rate at which this organism is acquiring resistance to multiple antibiotics. Existing pneumococcal polysaccharide vaccines are poorly immunogenic in young children and only provide cover against a limited range of serotypes. S ....Streptococcus pneumoniae (the pneumococcus) is an important human pathogen, which is responsible for the deaths of millions of children each year in developing countries. The high morbidity and mortality associated with pneumococcal disease is also being exacerbated by the rate at which this organism is acquiring resistance to multiple antibiotics. Existing pneumococcal polysaccharide vaccines are poorly immunogenic in young children and only provide cover against a limited range of serotypes. Serotype coverage is even lower in the more immunogenic conjugate vaccines currently being developed; these will also be very expensive, thereby limiting their use in developing countries, where the need for effective paediatric vaccines is greatest. Pneumococci produce a variety of proteins which are important in causing disease, but the relative contribution of these factors at each stage of the infection process remain to be determined. Moreover, virtually nothing is known of the mechanism whereby these virulence factors are regulated in response to the external environment of the bacterium. In view of this, we are conducting a comprehensive examination of the mechanisms of pathogenesis of pneumococcal disease, with particular reference to the role of putative virulence proteins. This information is being used to develop cheap and effective vaccines based on pneumococcal protein antigens common to all serotypes.Read moreRead less
The Immunogenicity Of 7-valent Pneumococcal Conjugate Vaccine In Sick Elderly People For Whom Vaccine Is Not Registered
Funder
National Health and Medical Research Council
Funding Amount
$443,800.00
Summary
The bacteria pneumococcus (also known as streptococcus pneumoniae) is the most common cause of pneumonia in the community, and a major cause of illness and death in the elderly. Rates of antibiotic resistance are also increasing. The pneumococcus is a complex bacteria, with over 80 known serotypes. Most human disease in Australia is caused by 23 of these serotypes. Australia has an ageing population. The health and wellbeing of the elderly has been identified as a national priority. Vaccination ....The bacteria pneumococcus (also known as streptococcus pneumoniae) is the most common cause of pneumonia in the community, and a major cause of illness and death in the elderly. Rates of antibiotic resistance are also increasing. The pneumococcus is a complex bacteria, with over 80 known serotypes. Most human disease in Australia is caused by 23 of these serotypes. Australia has an ageing population. The health and wellbeing of the elderly has been identified as a national priority. Vaccination and prevention of serious infections, a common cause of illness in the elderly, is an achievable public health goal. The National Health and Medical Research Council (NHMRC) of Australia recommends that adults aged 65 years and over should be immunised with 23-valent polysaccharide pneumococcal vaccine (PPV). PPV has been available long term in Australia, but the dilemma associated with its use is that it is least effective in those at greatest risk of pneumococcal disease and its complications, the sick elderly population. A new 7-valent pneumococcal conjugate vaccine (PCV-7) has been available since the end of 2000, but is currently indicated only for children, because it has never been tested in adults. This vaccine uses different technology, and is conjugated to a protein to make it more effective. Clinicals trials of PCV7 have largely been limited to children aged 0-4 years, and have shown it protects 93.9% of children under 2 years of age against invasive pneumococcal disease (IPD). Our study aims to look at the efficacy of this new vaccine, currently only registered for children, in the sub-group of the population who are at highest risk for pneumococcal disease - hospitalised elderly. We will vaccinate hospitalised elderly people with PCV or PPV and compare their immune response to the two different vaccines. If PCV is more effective than PPV, this has implications for the development and use of conjuagated pneumococcal vaccines for adults.Read moreRead less
Impact Of DTP Schedules On The Immunogenicity Of 2 Doses Of 13v-PCV Followed By An Early Booster
Funder
National Health and Medical Research Council
Funding Amount
$2,651,687.00
Summary
This project aims to come up with a vaccination schedule to make pneumococcal vaccines more effective and affordable for Fiji and other developing countries. We will evaluate schedules involving a 2 dose primary series in early infancy with a booster at 9 months of age. We will compare the immune responses to 3 different primary series and 2 booster options. The results of this project will be used to provide advice, at global and country levels, regarding introduction of pneumococcal vaccines.
Immunising Aboriginal Mothers With Pneumococcal Polysaccharide Vaccine To Prevent Infant Ear Disease And Carriage
Funder
National Health and Medical Research Council
Funding Amount
$1,131,530.00
Summary
Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are nee ....Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are needed to eliminate, or at least delay, this early-onset pneumococcal colonisation. One such strategy is the administration to the mother of pneumococcal vaccine, which may protect the newborn infant by leading to higher titres of transplacental or breast milk pneumococcal antibodies and-or by reducing carriage (and transmission to the infant) of maternal pneumococci. Previous small studies using this strategy have been encouraging, but there have been no studies properly evaluating carriage or disease endpoints in infants. The polysaccharide pneumococcal vaccine is currently recommended for all Aboriginal and Torres Islander persons aged 15 years or more in the Northern Territory but uptake of the vaccine has been poor. We propose to conduct a pilot study to determine if maternal immunisation with this vaccine, either in the third trimester of pregancy of immediately following delivery, can reduce pneumococcal carriage and the prevalence of middle ear disease among Aboriginal infants at seven months of age. We aim to recruit 210 Aboriginal women who have uncomplicated pregnancies from Darwin and remote communities in the Top End of the Northern Territory. Each subject and their infant offspring will be followed-up after vaccination and at birth, one , two and seven months after birth.Read moreRead less