WHO experts favor single-dose H1N1 vaccine regimen

first_imgOct 30, 2009 (CIDRAP News) – An expert committee that advises the World Health Organization (WHO) today updated its guidance on pandemic H1N1 vaccines, recommending a single dose for most age-groups and advising that any of the forms are safe for pregnant women.At a media briefing today, Dr Marie-Paule Kieny, director of the agency’s Initiative for Vaccine Research, said this week’s 3-day meeting of the Strategic Advisory Group of Experts (SAGE) on immunizations marked the group’s first discussion of the pandemic H1N1 vaccine since mid July, when it took up the vaccine priority question and addressed concerns about low yields with the first vaccine seed strains.”The level of evidence in October is much higher than July, and the recommendations are much more precise than July,” she said.After examining clinical trial data for all versions of the vaccine, the group recommended a single dose for everyone aged 10 and older, as long as such use in line with national regulatory authorities. Though the group said immunogenicity data are more limited for young children, it also recommended that countries that have children as a high-priority group administer one dose so that as many children can be vaccinated as possible.The United States has prioritized children to receive the pandemic vaccine has recommended that those under age 10 receive two doses. Also, Europe’s drug regulatory agency on Sep 23 announced it would stick to its initial recommendation that the three vaccines it approved be given in two doses, because data were insufficient to merit a one-dose recommendation. However, it added that one dose may be enough in adults.At a separate press briefing today, reporters asked Thomas Frieden, MD, director of the US Centers for Disease Control and Prevention (CDC), about the difference between the SAGE recommendation and the CDC’s guidance. He said preliminary vaccine data on children have not shown the desired immune response in children that would warrant a single-dose recommendation. Though the CDC is anticipating new data soon from the National Institutes of Health, “for the time being, we’re sticking with what the ACIP [Advisory Committee on Immunization Practices] has recommended,” Frieden said.Kieny said the WHO group advised that more studies are needed to guide a recommended vaccine dose for immunocompromised patients.Fourteen countries have now launched pandemic H1N1 vaccination programs, she said. In its review of early vaccine monitoring data for the pandemic, SAGE found no indication of unusual reactions, and it found that the events reported so far are well within the range of those seen with seasonal flu vaccines.Given concerns about vaccinating pregnant women, the WHO panel looked at animal studies of all forms of the vaccine and found no evidence of direct or indirect harm to fertility, pregnancy, embryonic or fetal development, birthing, or postnatal development. Given the high risk of flu complications in pregnant women, the group said any licensed vaccine can be used in pregnant women, unless specific contraindications have been outlined by national regulatory bodies.The United States is among countries where authorities have recommended that pregnant women not receive the intranasal, live attenuated H1N1 vaccine (LAIV). Public health officials were in a difficult position when the first pandemic vaccine doses were delivered, because nearly all of them were the LAIV version, though pregnant women are at the front of the line to be vaccinated. However, US officials have recently said the injectable version that pregnant women and other high-risk groups can receive makes up half of the increasing supply.The group also took up the issue of whether seasonal and pandemic H1N1 vaccines can be given at the same time. In a statement today, the WHO panel said clinical trials on coadministration of the vaccines are ongoing, but it endorsed the CDC recommendation that the intranasal versions of the seasonal and pandemic vaccines should not be given together. The group said the seasonal and pandemic vaccines can be given at the same time provided both are inactivated (injectable) or one is inactivated and the other is LAIV.Regarding options for the Southern Hemisphere’s 2009-2010 seasonal flu vaccine, SAGE weighed whether a trivalent vaccine (pandemic H1N1 plus seasonal H3N2 and B) or a bivalent vaccine (seasonal H3N2 and B) plus a separate pandemic H1N1 vaccine would be best. They concluded that both formulation options should be available, depending on national needs.See also:Oct 30 WHO statement on SAGE recommendationshttp://www.who.int/csr/disease/swineflu/notes/briefing_20091030/en/index.htmllast_img read more

PRESSURE POINT: Syracuse uses full-court defense to remedy early struggles against Eagles

first_img Related Stories Coleman, Grant combine for 25 points in win over Eastern Michigan Eastern Michigan press conference: Boeheim discusses team weaknessesGallery: Syracuse beats Eastern Michigan 84-48 The frustration built with each puzzling turnover. The fourth came on a lob by Syracuse point guard Michael Carter-Williams with no teammate in sight.It grew with each missed shot as the Orange fell into a seven-point hole against Eastern Michigan. The eighth miss in nine attempts came on a 3-pointer by Trevor Cooney after James Southerland’s fadeaway jumper was blocked.Less than six minutes into the game, Syracuse needed a spark.“We all was struggling,” SU guard Brandon Triche said. “No player was playing good on our team and we just needed easy buckets just to get everybody’s nerves calmed down.”Syracuse found the answer to its early struggles in the form of a full-court press. The rarely used defensive system sparked the No. 4 Orange (6-0) to an 84-48 victory over Eastern Michigan in front of 20,822 at the Carrier Dome on Monday night. SU turned the ball over 10 times and only shot 35.5 percent from the field in the first half, but overcame the sloppy performance behind its defensive pressure.AdvertisementThis is placeholder textThe Orange forced the Eagles to commit 24 turnovers and scored 31 points off the mistakes en route to the blowout victory.“We haven’t really tried to press that much,” SU head coach Jim Boeheim said. “I don’t think that’s the strength of our team. I think we can press a little bit.“But they have a couple of young guys and they made a couple mistakes early and they got a little bit shell-shocked against the pressure and we got some big turnovers.”Boeheim said his team didn’t move the ball well in addition to its inept shooting performance early in the game against the Eastern Michigan 2-3 zone.And he spent much of the first half befuddled by each mistake as he watched from the sideline. The head coach reacted to each with an animated display before calling his players over to point out their mistakes.After the game, Boeheim called them uncharacteristic mistakes by his backcourt of Carter-Williams and Triche. For the first time this season, Carter-Williams fell victim to poor decision-making while trying to find his teammates.Carter-Williams committed two of the team’s first four turnovers and finished with six in the game. Meanwhile, SU couldn’t find its stroke offensively, so it turned to the press — a weapon Triche said the team works on for 20 minutes each day at practice.“Once we all was kind of struggling, we were trying to rush a little bit and try to seek shots,” Triche said. “But us playing hard on our press, we were able to get steals, get them in foul trouble a little bit and get easy buckets.”The press was effective from the start as C.J. Fair stole a bounce pass by Da’Shonte Riley — thrown directly to him — and slammed it home to cut the lead to five. On the ensuing possession, Fair and Carter-Williams caused another turnover with a trap of EMU’s 5-foot-11-inch point guard just beyond half court.The Carrier Dome and the team suddenly had life. The press eventually wore down the Eagles and created easy scoring opportunities that Syracuse struggled to generate on its own.Southerland dropped in a floater on the baseline to give SU a 14-12 lead followed by a 10-second violation by Eastern Michigan as it continued to have trouble with the swarming SU press.Carter-Williams then found Triche for another bucket and Syracuse was starting to click. The turnovers continued to pile up as the Orange took an 18-point lead into halftime.The second half brought more of the same, and the team cleaned up its execution, committing eight turnovers and shooting 51.4 percent from the field.“I think in the second half we made better plays as a team and we played a lot better defense,” Cooney said.The defense remained at the forefront of Syracuse’s win. The Orange stayed in the press and remained aggressive to generate easy buckets down the stretch.The lead ballooned to 29 after Trevor Cooney knocked down a 3-pointer and raced down the court with his fist extended. On the ensuing possession, Triche elicited another excited reaction from the bench after forcing a turnover on Eastern Michigan’s Jamell Harris, chasing down the loose ball and finishing the layup to stretch the lead to 31.With less than eight minutes to play, Syracuse was well on its way to another blowout victory against a nonconference opponent. And it all started with the press.“I thought the press got us going from the slow start,” Carter-Williams said. “I think it got us some easy baskets and got our confidence up and we just was rolling from there.” Comments Published on December 4, 2012 at 3:03 am Contact Ryne: rjgery@syr.educenter_img Facebook Twitter Google+last_img read more