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Vaccination system feasibility test
No full textHet ministerie van VWS wil het aanbod aan vaccinaties voor volwassenen makkelijker en duidelijker aanbieden. Dan kunnen volwassenen beter van het hele aanbod gebruikmaken. Het is dan bijvoorbeeld mogelijk om de griep- en de coronaprik tegelijk te halen. Ook wil VWS nieuwe vaccinaties in de toekomst makkelijker, toegankelijker en sneller kunnen toevoegen. Het RIVM heeft daarom verkend of het mogelijk is in Nederland alle vaccinaties voor volwassenen bij de GGD'en te organiseren. Dit houdt in dat er één organisatie is die alle vaccinaties voor volwassenen aanbiedt. Dat blijkt te kunnen. Het RIVM zou dan de landelijke regie over deze 'vaccinatievoorziening' hebben en de 25 GGD'en voeren de vaccinaties in hun regio uit. De voorziening zal in fases worden opgezet, omdat niet alle vaccinaties voor volwassenen tegelijk kunnen worden opgenomen. Een aantal voorwaarden zijn belangrijk om deze vaccinatievoorziening mogelijk te maken. Zo moet deze goed worden voorbereid, moeten de gegevens goed worden geregistreerd en gedeeld met het RIVM, en moet er structureel geld voor zijn. Dit blijkt uit een verkenning van het RIVM, in samenwerking met GGD GHOR Nederland en de 25 GGD'en. Nu bieden verschillende instanties deze vaccinaties aan, zoals de GGD en de (huis)artsen. Al deze partijen selecteren de doelgroep op een andere manier. Dat geldt ook voor de manier waarop de doelgroep wordt uitgenodigd en de vaccinaties worden geregistreerd. In deze zogeheten uitvoeringstoets beschrijft het RIVM op hoofdlijnen hoe zo'n vaccinatievoorziening eruit kan komen te zien. Deze beschrijving bevat de stappen om daartoe te komen, van besluitvorming en advies tot nazorg en toezicht. Het is een eerste onderzoek en geen plan om het uit te voeren. Zo'n plan wordt pas opgesteld nadat VWS een definitief besluit heeft genomen over het toekomstige vaccinatiestelsel. De vaccinaties voor kinderen vallen buiten deze verkenning. Deze zijn goed georganiseerd in het Rijksvaccinatieprogramma (RVP).The Ministry of Health, Welfare and Sport wants to make it clearer to adults what vaccinations are available to them, while also making these vaccinations more accessible. This will make it easier for adults to make use of the full range of vaccination options, for example by getting the flu vaccine and the coronavirus vaccine at the same time. The Ministry also wants to make the process of adding new vaccinations easier, faster and more accessible. RIVM has therefore explored the feasibility of having the Municipal Public Health Services take care of all vaccinations for adults in the Netherlands. This means a single organisation will be offering all vaccinations for adults. This appears to be feasible. In this scenario, RIVM would be responsible for the national coordination of this 'vaccination service', and the 25 Municipal Public Health Services would be administering the vaccines in their regions. The service will be expanded in stages, since it would not be possible to incorporate all vaccinations for adults at the same time. Several preconditions are important to make the vaccination service possible. Among other things, it will require solid preparations, effective registration of data, sharing of these data with RIVM and structural funding. These are the results of an exploration by RIVM, in collaboration with the Netherlands Municipal Public Health Services and Medical Assistance in Accidents and Disasters (GGD GHOR Nederland) and the 25 Municipal Public Health Services. Currently, vaccinations are offered by various bodies, including the Municipal Public Health Services, physicians and GPs. All of these parties have different criteria for including people in their target group. This also applies to the way in which members of the target group are invited to be vaccinated and how the vaccinations are registered. In this so-called feasibility test, RIVM describes roughly what such a vaccination service would look like. This description includes the necessary steps to achieve this, from decision-making and advice to aftercare and supervision. This constitutes an initial study and is not yet a plan for making this reality. Such a plan will only be drawn up after the Ministry of Health, Welfare and Sport has taken a final decision on the future vaccination system. This exploration did not consider vaccinations for children. These are currently organised effectively in the Dutch National Immunisation Programme
Assessment of Mycotoxin Exposure and Associated Risk in Pregnant Dutch Women: The Human Biomonitoring Approach
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Determinants of Systemic SARS-CoV-2-Specific Antibody Responses to Infection and to Vaccination: A Secondary Analysis of Randomised Controlled Trial Data
No full textSARS-CoV-2 infections elicit antibodies against the viral spike (S) and nucleocapsid (N) proteins; COVID-19 vaccines against the S-protein only. The BCG-Corona trial, initiated in March 2020 in SARS-CoV-2-naïve Dutch healthcare workers, captured several epidemic peaks and the introduction of COVID-19 vaccines during the one-year follow-up. We assessed determinants of systemic anti-S1 and anti-N immunoglobulin type G (IgG) responses using trial data. Participants were randomised to BCG or placebo vaccination, reported daily symptoms, SARS-CoV-2 test results, and COVID-19 vaccinations, and donated blood for SARS-CoV-2 serology at two time points. In the 970 participants, anti-S1 geometric mean antibody concentrations (GMCs) were much higher than anti-N GMCs. Anti-S1 GMCs significantly increased with increasing number of immune events (SARS-CoV-2 infection or COVID-19 vaccination): 104.7 international units (IU)/mL, 955.0 IU/mL, and 2290.9 IU/mL for one, two, and three immune events, respectively (p < 0.001). In adjusted multivariable linear regression models, anti-S1 and anti-N log10 concentrations were significantly associated with infection severity, and anti-S1 log10 concentration with COVID-19 vaccine type/dose. In univariable models, anti-N log10 concentration was also significantly associated with acute infection duration, and severity and duration of individual symptoms. Antibody concentrations were not associated with long COVID or long-term loss of smell/taste
A reference standard for urinary tract infection research: a multidisciplinary Delphi consensus study
No full textThe absence of a consensus-based reference standard for urinary tract infection (UTI) research adversely affects the internal and external validity of diagnostic and therapeutic studies. This omission hinders the accumulation of evidence for a disease that imposes a substantial burden on patients and society, particularly in an era of increasing antimicrobial resistance. We did a three-round Delphi study involving an international, multidisciplinary panel of UTI experts (n=46) and achieved a high degree of consensus (94%) on the final reference standard. New-onset dysuria, urinary frequency, and urinary urgency were considered major symptoms, and non-specific symptoms in older patients were not deemed indicative of UTI. The reference standard distinguishes between UTI with and without systemic involvement, abandoning the term complicated UTI. Moreover, different levels of pyuria were incorporated in the reference standard, encouraging quantification of pyuria in studies done in all health-care settings. The traditional bacteriuria threshold (105 colony-forming units per mL) was lowered to 104 colony-forming units per mL. This new reference standard can be used for UTI research across many patient populations and has the potential to increase homogeneity between studies
Regional variation in the role of humidity on city-level heat-related mortality
No full textThe rising humid heat is regarded as a severe threat to human survivability, but the proper integration of humid heat into heat-health alerts is still being explored. Using state-of-the-art epidemiological and climatological datasets, we examined the association between multiple heat stress indicators (HSIs) and daily human mortality in 739 cities worldwide. Notable differences were observed in the long-term trends and timing of heat events detected by HSIs. Air temperature (Tair) predicts heat-related mortality well in cities with a robust negative Tair-relative humidity correlation (CT-RH). However, in cities with near-zero or weak positive CT-RH, HSIs considering humidity provide enhanced predictive power compared to Tair. Furthermore, the magnitude and timing of heat-related mortality measured by HSIs could differ largely from those associated with Tair in many cities. Our findings provide important insights into specific regions where humans are vulnerable to humid heat and can facilitate the further enhancement of heat-health alert systems
Importance of investing time and money in integrating large language model-based agents into outbreak analytics pipelines
No full textTrends and geographic variation in adverse impacts of nitrogen use in Europe on human health, climate, and ecosystems: A review
No full textNo detectable fitness cost of infection by cell-fusing agent virus in Aedes aegypti mosquitoes
No full textAedes mosquitoes are well-known vectors of arthropod-borne viruses (arboviruses). Mosquitoes are more frequently infected with insect-specific viruses (ISVs) that cannot infect vertebrates. Some ISVs interfere with arbovirus replication in mosquito vectors, which has gained attention for potential use against arbovirus transmission. Cell-fusing agent virus (CFAV), a widespread ISV, can reduce arbovirus dissemination in Ae. aegypti. However, vectorial capacity is largely governed by other parameters than pathogen load, including mosquito survival and biting behaviour. Understanding how ISVs impact these mosquito fitness-related traits is critical to assess the potential risk of using ISVs as biological agents. Here, we examined the effects of CFAV infection on Ae. aegypti mosquito fitness. We found no significant reduction in mosquito survival, blood-feeding behaviour and reproduction, suggesting that Ae. aegypti is tolerant to CFAV. The only detectable effect was a slight increase in human attraction of CFAV-infected females in one out of eight trials. Viral tolerance is beneficial for introducing CFAV into natural mosquito populations, whereas the potential increase in biting activity must be further investigated. Our results provide the first insight into the link between ISVs and Aedes mosquito fitness and highlight the importance of considering all aspects of vectorial capacity for arbovirus control using ISVs