Mumps

Vaccinations were up four fold in those aged five to 25 years old. Image credit: Shutterstock/didesign021. England’s NHS is calling its recent campaign to boost vaccination rates a success amidst a surge in measles, mumps , and rubella (MMR) cases. Latest data released by the health service shows that there were 23% more vaccinations in the first quarter of 2024 compared to the same time last year. A total of 360,964 jabs were delivered between January and March this year, compared to 293,847 in 2023. The biggest jump was seen in those aged five to 25 years old, with vaccinations up four-fold in that group between 2024 and 2023. In January, the UK Health Security Agency (UKHSA) declared a national incident following a surge in measles outbreaks across Britain. The highly contagious measles virus can cause serious illness and, in some cases, even death, in children and adults. It is also dangerous if caught during pregnancy, potentially resulting in stillbirth, miscarriage, and low birth weight. In the same month, the NHS started contacting millions of patients and carers in England to book their children in for a catch-up vaccine with a GP. The campaign also targeted those in the 11 to 25 year-age group in areas with low vaccine uptake rates such as London and the West Midlands. See Also: Touchlight joins forces with University of Liverpool for NSCLC vaccine Zoetis gets grant for recombinant viral vectors for multivalent pathogen protection in vaccines At the time, the NHS said its figures indicated that more than 3.4 million children under 16 years of age were unprotected against the three infectious diseases. There have been 934 confirmed cases of measles in England since the beginning of October last year, according to data from the UKSHA. The West Midlands accounted for around half of the cases seen since January. UKSHA head of immunisation Dr Mary Ramsay said: “The big increase in people, especially children, getting their MMR vaccine following our recent marketing campaign on missed immunisations is fantastic to see.” The NHS uses MSD’s M-M-RVaxPro and GSK ’s Priorix for MMR vaccines. The shots were approved for use in the UK in 1997 and 2006, respectively. They are recommended for all babies and young children, with adults able to receive one if unvaccinated. Two doses of the vaccines are required, resulting in lifelong protection with high efficacy against the three viruses which are easily spread between unvaccinated people. The World Health Organization (WHO) has said 95% vaccine coverage would eliminate measles in a population completely. The US has also seen a surge in measles cases , with the Centers for Disease Control and Prevention (CDC) reporting 97 cases in 2024 so far. Over half of the patients diagnosed with the virus were hospitalised. The CDC issued a health alert urging travellers, especially children, to get vaccinated. A statement from the American Medical Association echoed the call for vaccinations.  The US also uses MSD’s M-M-R II and GSK’s Priorix.

随着全球出生率的低迷、人口老龄化的加剧，以及疫苗新技术的应用，成人疫苗市场越来越被业内看好。近日Nature子刊npj vaccines发表了一篇关于对未来成人疫苗格局及挑战的研究，研究以美国市场为主要研究对象，采用定性和定量法对美国的关键行业利益相关者、免疫工作者和成人消费者进行调查，以衡量成人疫苗市场未来容量和挑战。01  |mRNA技术或将颠覆疫苗研发格局新冠大流行这场全球卫生危机暴露了全球成人疫苗产品布局的短板，但也刺激了疫苗创新，制药行业的领导者将成人疫苗行业内的挑战视为变革的催化剂——一预计未来10年成人疫苗市场可能会推出100多种针对新适应症的疫苗产品。成人疫苗的持续和加速转型预计将由RNA技术的崛起推动，将我们带入到数字疫苗的新时代。与传统的生物制品相比，基于RNA的解决方案不受不同抗原序列生产过程的限制，生产过程基本保持不变，只是RNA疫苗中编码的抗原序列有所变化——这是对“过程即产品”的传统疫苗研发原则的背离，也是未来疫苗设计和开发的一大飞跃。02    |儿童 VS.成人疫苗市场的此消彼长既往儿童疫苗的研发次序和上市应用数量都优于成人疫苗，这种偏见的形成主要是由于二战后医疗保健的改善和婴儿潮的出现导致青少年人口激增，迫切需要更多儿童疫苗来改善人口增长。中国也曾经面临着出生人口快速上升的情况，推动国家免疫规划和儿童疫苗的快速发展。同时，儿童、青少年群体对常见传染病（如麻疹、腮腺炎和风疹）的易感性也需要一个强有力的儿童免疫计划，儿童群体的同质性和他们与医疗保健系统的频繁互动，推动确定性的免疫程序推荐表的出现，这些因素共同促成了美国学龄儿童高达90%的疫苗接种率。相比之下，成人疫苗常常面临诸如认知不足、可及性差、疫苗价格通常较贵、疫苗犹豫等挑战，导致疫苗接种率仅在20-62%之间。然而最近的柳叶刀子刊指出，全球正经历着生育率低潮期，人口老龄化快速发展，似乎儿童疫苗研发优先的情况将成为历史。尽管挑战重重，成人疫苗市场仍然正经历着快速扩张——预计将有各种产品针对流感、肺炎球菌病、带状疱疹、肝炎和HPV等疾病。成人疫苗市场在2022年估值为194.8亿美元，预计到2028年将达到276.5亿美元，年复合增长率约6.1%，其增长驱动受到成人VPDs（疫苗可预防疾病）流行率的增加、RNA疫苗等技术进步以及对预防性医疗保健关注度的提高。03    |疫苗产品将扩展到4个疾病类别目前有35种产品用于预防13个疾病领域，未来10年的疫苗产品预计将增加3倍旨在保护40个不同的疾病领域。目前的疫苗主要分为两个疾病类别：那些针对众所周知的疾病，如流感、肺炎、带状疱疹和COVID-19等，以及那些为旅行或地方性疾病设计的疫苗，如乙肝、埃博拉、黄热病、蜱传脑炎和日本脑炎等。展望未来，预期这些类别将扩展到包括医院医疗场所应用的疫苗以应对在医疗环境中获得的感染，如艰难梭菌（C. diff）和金黄色葡萄球菌（Staph A）。以及针对高需求但未满足疾病预防的疫苗，如人类免疫缺陷病毒（HIV），可能在未来10年内将进入成人疫苗市场。此外，因为成年群体的免疫反应存在差异，为获得最佳保护效果，未来的疫苗可能需要针对不同的风险群体进行定制。尤其是对于老年人来说，他们通常由于免疫衰老而表现出较弱的免疫反应，因此老年人的疫苗可能需要更高的剂量或专利佐剂来弥补这一缺陷。比如赛诺菲巴斯德针对老年人设计的高剂量重组流感疫苗，GSK的佐剂RSV疫苗。不同年龄组流行的疾病可能由同一病原体的不同菌株/血清型导致，这就需要疫苗研发时考虑如何平衡某些年龄组的优先次序。比如肺炎球菌疾病，不同年龄组之间最重要的血清型各不相同，因此疫苗制造商可能更愿意在研发疫苗时优先考虑那些与儿科人群最相关的血清型。04    |全球成人疫苗竞争格局进一步加剧除了疫苗产品的扩展，预计全球疫苗市场竞争将加剧，尽管疫苗领域内的四位历史领导者——葛兰素史克、默克、辉瑞和赛诺菲正在取得重大进展，但COVID-19大流行可能已经重新洗牌了成人疫苗市场，该市场已成为制药行业中最具竞争力的空间之一。新的参与者带来了差异化的技术平台（如Moderna的mRNA产品组合和Dynavax的佐剂产品，后者主要是重组佐剂乙肝成人疫苗），以及低利润、大供应量的全球参与者（如印度血清研究所、巴拉特生物技术公司和中国科兴）带来的市场压力。此外，由于单个最佳产品可能不足以占领市场，疫苗制造商预计将采取差异化的产品组合策略，而非单个产品来区分自己。比如GSK的带状疱疹疫苗和RSV疫苗，都用于老年群体预防。随着越来越多的成人疫苗进入市场，成人疫苗推荐免疫程序表预计将在未来10年内得到大幅扩展。目前美国的免疫实践咨询委员会（ACIP）成人疫苗免疫程序推荐表建议≥18岁者接种流感和COVID-19疫苗，50岁及以上的成人接种带状疱疹疫苗，65岁及以上的人接种肺炎球菌疫苗。此外，对于免疫系统受损的18岁及以上的成人，也推荐这两种疫苗，65岁以下的人建议接种乙肝疫苗。最近，两种新的RSV疫苗已获批准，根据SCDM指和ACIP建议，为60岁及以上的成人接种。展望未来10年，预计大多数新疫苗将专门针对某些高风险群体开发，而不考虑他们的年龄。例如，可能会建议65岁及以上的住院或长期护理设施的人接种艰难梭菌疫苗。此外也预计COVID-19和RSV疫苗将像流感疫苗一样发展为季节性疫苗——这意味着成人可能要被建议在一个季度内接种完这些疫苗，这种潜在现象称之为强制季节性免疫，然而这需要实施联合接种的策略以提高接种率。05    |成人疫苗市场扩大对接种门诊的挑战虽然目前强制季节性免疫尚未给预防接种基础设施带来负担，但随着成人疫苗市场的增长，有限的时间内需要努力适应更多新的受种群体和新的疫苗，未来可能给预防接种基础设施带来负担。如果保持当前疫苗接种率不变（当前每年约接种2亿剂次），到2032年美国成人疫苗的全年接种量就将超过5亿剂。假设实施强制季节性免疫并且保持美国当前的疫苗接种趋势和行为，我们会发现——美国将需要在三个月的时间内使用掉相当于目前全球流感疫苗市场的全年接种量，这对当前美国的免疫生产力是一个巨大的挑战。在2022-2023年的流感疫苗季，根据CDC的Flu VaxView统计，9-12月份接种了整个流感季总数的76%（1.73亿剂次）。根据同一数据库，在2021-2022流感季结束时，65岁及以上接种疫苗的人中约有85%的人在11月底之前接种了流感疫苗——相当于每天接种110万剂。从目前的接种量来看，9-12月底将需要每天接种190万剂（每周1310万剂），这一数字甚至显著高于COVID-19疫苗接种高峰时期的每天接种的40万剂（每周310万剂），到2032年可能会增加到每天440万剂（每周3070万剂）。为了满足到2032年超过5亿剂疫苗的预期年度量，我们将不得不采取方法来显著提高疫苗接种效率。将接种窗口向前推移是一个解决方案，但实际上这种方法可能受到公众接种习惯的影响，因为公众通常更喜欢在9-12月份开始接种。这就需要扩大接种服务的获取途径、提高公众意识和教育，并实施有针对性的干预措施以推动行为改变。06    |药房对成人疫苗应用的关键作用通过访谈和调查成人疫苗市场的关键利益相关者，结果发现许多利益相关者可能没有充分意识到即将到来的成人疫苗浪潮。免疫工作者和消费者反而更关注这种即将到来的变化，但目前缺乏主动性。成人疫苗市场也出现了向新参与者转移的趋势，例如药房作为替代初级保健办公室的接种服务单位，便利性更高（营业时间更长、地点更近），目前在美国很流行并且这一趋势预期还将持续数十年。事实上美国的保健医生和药剂师之间通常存在一定程度的不和，医生通常不愿意授予药剂师为他们的患者接种疫苗或提供有关药物建议的权力。历史上，成人疫苗通过初级保健办公室、药房和疫苗诊所等提供疫苗接种，但既往模式下初级保健医生更倾向于优先考虑儿童免疫。此外，美国许多医疗保健专业人员在公众常规就诊时不会检查他们的疫苗接种情况，甚至把疫苗接种管理排除在他们的医疗实践范围之外，这可能限制了依赖于初级保健医生的成人获得免疫接种的机会。中国的免疫服务大多是基于国家基本公共卫生服务的预防接种，初级保健医生也更愿意为0-6岁儿童服务。在HPV疫苗的推广中，私立门诊或妇科门诊发挥了重大作用，但数量和便利性依旧不足。07    |疫苗接种的限制——“胳膊之战”所有年龄和风险组的消费者在接受调查时称，他们愿意每年接受4次疫苗接种，但更愿意将注射次数限制在每次预约只接种2剂，也就是每只胳膊只打一针，这显然低于接种工作者的预估。也意味着需要在一年内进行多次预约，以达到他们每年接受4次疫苗接种的意愿。该研究中公众和接种工作者可能高估了预约接种次数，2018年的调查数据显示，平均而言，所有年龄组群体与医生进行的预防性医疗服务的预约每年不足1次，而该研究的意愿是至少每年2次。美国的联合接种策略似乎也没有想象中的那么好推荐——在衡量公众对未来接种疫苗剂次的安排时，33%的消费者仍然表示愿意在每次预约中接受多种疫苗，但28%的人表示强烈偏好于安排更多的接种预约，而不是在单次预约中采取联合接种策略，51%的人群强烈同意每年进行多次预约以便接种更多疫苗。目前，50岁和65岁的成年人在一次访问中最多分别接种2.8种、3.5种ACIP推荐的疫苗。估计10年内，50岁和65岁成年人的推荐剂量数量预计将分别增加到每年5.6个和6.4个。随着可用疫苗数量的增加，接种工作者将帮助公众在疫苗的优先级和管理方面做出复杂的决定，医生的建议已被证明可以提高免疫接种率，它可以增加消费者对可用疫苗的知识。此外，开发适用于成人的联合疫苗也是一种缓解“胳膊”受限问题的方案。目前美国只有一种成人百白破疫苗是联合疫苗，但预计未来将有更多疫苗，包括流感&新冠联合疫苗、流感&RSV联合疫苗等。然而这些解决方案能否成功取决于公众的接受程度，随着疫苗接种犹豫程度的增加，公众接受度预计将成为成人疫苗接种的一个主要障碍。08   |总 结中国的成人疫苗市场无论是研发、销售还是公众观念，均远远落后于美国。全文研究的为未来十年美国的成人疫苗市场状况，对于中国来说以上预测或预期事件可能发生在未来10年以后，但一些迹象已经出现。无论如何，美国作为国际市场的风向标，已经给我们规划了未来方向——随着我国出生率持续低迷，儿童疫苗市场已经处于需求相对过剩状态，尽管有新的儿童疫苗上市，但也很难插入到原有拥挤的接种程序里。成人疫苗市场已经开始被市场所看好和布局，但市场的培育需要时间，预防接种服务模式、支付模式、医防融合等方面也都需要进行“腾笼换鸟”式的改革。内容出处：NPJ Vaccines. 2024 Feb 9;9(1):27. doi: 10.1038/s41541-024-00809-z.识别微信二维码，添加生物制品圈小编，符合条件者即可加入生物制品微信群！请注明：姓名+研究方向！版权声明本公众号所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，不希望被转载的媒体或个人可与我们联系(cbplib@163.com)，我们将立即进行删除处理。所有文章仅代表作者观点，不代表本站立场。

JEFFERSON CITY, Mo., March 21, 2024 (GLOBE NEWSWIRE) -- As vaccine uptake continues to decrease, measles cases or outbreaks have emerged in several states, including Missouri earlier this year. Nationally, the total number of measles cases has already reached the level that occurred during the entire year of 2023. With cases reported across the country, the Missouri Department of Health & Senior Services (DHSS) recommends parents and guardians check their child’s vaccination records to make sure they have received the measles, mumps and rubella (MMR) vaccine. This vaccine has been used in the United States since the 1970s and is a safe and effective way to protect children from measles. To be fully immunized, children are recommended to receive two doses of the MMR vaccine, with the first dose between ages 12-15 months and the second dose between ages 4-6 years old. Infants as young as 6 months can receive the first dose if traveling to areas where the measles infection rate is high. Families should consult their health care provider to discuss appropriate vaccine options for their children. Herd immunity, achieved through a measles vaccination rate of 95% or more, is crucial for preventing disease outbreaks in the community and protecting vulnerable populations who cannot receive vaccines. “Achieving this level of vaccination creates a barrier that limits the spread of infectious disease within a community, safeguarding those who are unable to be vaccinated due to their age or compromised immune systems,” said Dr. George Turabelidze, state epidemiologist with DHSS. Statewide, the MMR vaccination rate among kindergarteners has dropped steadily from 95.4% in the 2016-2017 school year to 90.5% at the start of the 2023-2024 school year, according to preliminary data reported by Missouri school districts. Religious (non-medical) exemptions have simultaneously increased from 1.9% to 3.5%. The measles vaccine, given as part of the MMR (measles, mumps and rubella) vaccine, is extremely effective, giving those vaccinated with just one dose 93% protection against measles infection. Both doses of the vaccine provide individuals with a 97% protection rate throughout their lifetime. Measles is a highly contagious and serious disease, especially serious for children under age five and those who are immunocompromised. Common symptoms include a rash that starts as flat red spots on the head and spreads to other parts of the body, high fever, cough, runny nose, red and watery eyes, and tiny white spots inside the mouth. But in some instances, individuals with measles will develop brain infection, which can lead to brain damage, and for some, the disease is fatal even with the best care. The virus spreads through coughing and sneezing and can live for up to two hours in an airspace after an infected person leaves an area. A person can spread measles without knowing they are infected. If not treated, complications can grow in severity. Most health insurance plans cover vaccines, but individuals should check with their insurance provider to verify coverage. For those without insurance, the Vaccines for Children Program, funded by the Centers for Disease Control and Prevention (CDC), provides free vaccines to children who qualify. Additionally, most local public health agencies throughout the state of Missouri offer vaccinations at affordable rates. To find a local public health agency near you and schedule an appointment, visit the Local Public Health Agency Directory. Mission of the Missouri Department of Health and Senior Services (DHSS): To promote health and safety through prevention, collaboration, education, innovation and response. MEDIA CONTACT:Lisa Cox (573-751-6062)Missouri Department of Health and Senior ServicesMedia Inquiry Form