Wendy Spragins

The Safety of Yellow Fever Vaccine 17D or 17DD in Children, Pregnant Women, HIV+ Individuals, and Older Persons: Systematic Review

Yellow fever vaccine provides long-lasting immunity. Rare serious adverse events after vaccination include neurologic or viscerotropic syndromes or anaphylaxis. We conducted a systematic review of adverse events associated with yellow fever vaccination in vulnerable populations. Nine electronic bibliographic databases and reference lists of included articles were searched. Electronic databases identified 2,415 abstracts for review, and 32 abstracts were included in this review. We identified nine studies of adverse events in infants and children, eight studies of adverse events in pregnant women, nine studies of adverse events in human immunodeficiency virus-positive patients, five studies of adverse events in persons 60 years and older, and one study of adverse events in individuals taking immunosuppressive medications. Two case studies of maternal-neonate transmission resulted in serious adverse events, and the five passive surveillance databases identified very small numbers of cases of yellow fever vaccine-associated viscerotropic disease, yellow fever vaccine-associated neurotropic disease, and anaphylaxis in persons ≥ 60 years. No other serious adverse events were identified in the other studies of vulnerable groups.

Systematic Review of Mentoring to Prevent or Reduce Tobacco Use by Adolescents

BACKGROUND Surveys conducted 1998 to 2008 (530,849 13- to 15-year-olds, 100 countries) by the World Health Organization and the Centers for Disease Control and Prevention found increased tobacco use. OBJECTIVES To conduct a systematic review of mentoring to prevent/reduce youth smoking. DATA SOURCES Eight electronic peer-reviewed databases and gray literature searched through January 2013. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Studies were included if they were randomized controlled trials, included children or adolescents, employed mentoring (consistent companionship, support, guidance to develop youth competence and character), and reported tobacco use. STUDY APPRAISAL/SYNTHESIS METHODS Two reviewers independently assessed abstracts and full-text studies. Disagreements were resolved through consensus. RESULTS Four randomized controlled trials were identified. Two studies focused exclusively on tobacco outcomes; the other 2 reported on both drug and tobacco use reductions. Only 1 study reported that mentoring (by peers) reduced adolescent smoking. Heterogeneity of both participants and outcome measures did not permit meta-analysis. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS There is limited literature on this topic. Further research achieving sample sizes required by power computations, minimizing attrition, and ascertaining mentoring content and achievements from mentor and mentee perspectives is needed.

Mortality and morbidity among military personnel and civilians during the 1930s and World War II from transmission of hepatitis during yellow fever vaccination: systematic review.

During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced.

Mentoring of children and adolescents for preventing drug and alcohol use.

The objectives of the intervention are: To identify and systematically review all mentoring interventions in all languages to prevent drug and alcohol use by children and adolescents. Control and comparison groups may have received no intervention, or the standard health education curriculum, or the alcohol and drug education curriculum normally used in the school or institution the adolescent attends, or individual counselling or support groups. The primary clinical outcomes are never starting to use drugs and alcohol or reduction in consumption.