Vaccines combinations

Twinrix is a vaccine combining hepatitis A virus units and hepatitis B surface antigen, thereby protecting against hepatitis A and B. 

According to one study, children were undervaccinated a mean of 172 days for aU vaccines combined during the first two years of life and more than one-third of children were undervaccinated for more than six months. Among factors associated with the delay were having two or more vaccination providers and using public vaccination provider(s) (human et al 2005). 

Conjugate vaccines combine toxoids with polysaccharides and attempt to train the immune system to recognize the polysaccharides as being foreign. Young children cannot react to pathogens covered with polysaccharide and Hib conjugates have lowered the infection rate in children from 1 60 to 1 100,000, a worthwhile achievement. 

Nakayama, T., Aizawa, C., and Kuno-Sakai, H. 1999. A clinical analysis of gelatine allergy and determination of its causal relationship to the previous administration of gelatin-containing acellular pertussis vaccine combined with diphtheria and tetanus toxoids. J Allergy Clin Immunol 103(2) 321—325. 

A plant-based vaccine combines the concepts of a subunit vaccine and the use of plant as an expression system. Several advantages including inexpensive means of expressing proteins, elimination of the risk of contamination with animal... 

No adjuvant is licensed as a medicinal product in its own right, but only as a component of a particular vaccine. Therefore preclinical and toxicology studies need to be designed on a case-by-case basis to evaluate the safety profile of the adjuvant and adjuvant/ vaccine combination [60], Evaluation in preclinical studies is important for identifying the optimum composition and formulation process and also for allowing development of tests for quality control [61]. Data from these studies also helps plan protocols for subsequent clinical trials from which safety and efficacy in humans can be evaluated. 

Immunological interference, particularly to the Hib response, has been assessed in 135 infants at 2, 4, 6, and 18 months of age in studies of two different types of administration of DTaP and Hib vaccines combined administration of the two vaccines mixed in the same syringe and simultaneous administration of separate injections at different sites (7). The vaccines were well tolerated and there were no differences in the rates of local and systemic reactions. Immune responses were also comparable between the two groups. 

Minutello M, Senatore F, CecchineUi G, Bianchi M, Andreani T, Podda A, Crovari P. Safety and immunogeni-city of an inactivated subunit influenza virus vaccine combined with MF59 adjuvant emulsion in elderly subjects, immunized for three consecutive influenza seasons. Vaccine 1999 17(2) 99-104. 

One evaluation of the results of two studies in a total of 182 children primed either with acellular or with wholecell pertussis vaccines at 2, 4, and 6 months of age and boosted with an acellular vaccine has shown that booster doses of acellular vaccine are safe and immunogenic (16). Local adverse reactions after booster immunization with acellular vaccine were more common in children primed with acellular vaccine than in those primed with wholecell pertussis vaccine (68 versus 33%). In another and similar study, children primed with acellular or whole cell pertussis combined with DT vaccine have been boosted with a recombinant acellular pertussis vaccine combined with DT vaccine. The vaccine was highly immunogenic and safe (17). 

Diphtheria and pertussis vaccines are seldom used as single-component vaccines but as components of diphtheria/tetanus vaccines and diphtheria/tetanus/pertussis vaccines. Combined diphtheria/tetanus/pertussis/Hib and diphtheria/tetanus/pertus-sis/Hep B vaccines with or without inactivated polio vaccine are available. 

As polysaccharide vaccines were shown to elicit only limited protection in infants and young children, conjugated polysaccharide vaccines were developed to provide a more potent and sustained immune response [2]. Many of these traditional vaccines target childhood diseases, and are used in combinations for pediatric applications in order to reduce the number of injections during the first years of life. Currently, vaccine combinations can prevent against between three to six different diseases, such as the measles-mumps-rubella (MMR) vaccine or the diphtheria-tetanus-pertussis combination, which may be administered together with Haemophilus influenzae, hepatitis B, or poliovirus vac-... 

To identify the ideal precursor and vaccine combination for this strategy, a series of W-acyl derivatives of ManNAc and KLH conjugates of W-acyl sialic acids or TACA analogs containing unnatural A -acyl sialic acids were synthesized and examined as cell glycoengineering precursors and vaccines, respec-... 

DIPHTHERIA AND TETANUS TOXOIDS AND ACELLULAR PERTUSSIS ADSORBED, HEPATITIS B (RECOMBINANT) AND INACTIVATED POLIOVIRUS VACCINE COMBINED (Pediarix injection 25 Lf diphtheria toxoid, 10 Lf tetanus toxoid, 25 meg inactivated pertussis toxin (PT), 25 meg filamentous hemagglutinin (FHA), 8 meg pertactin,... 

Ha S-J, Jeon B-Y, Kim S-C, et al. (2003). Therapeutic effect of DNA vaccines combined with chemotherapy in a latent infection model after aerosol infection of mice with Mycobacterium tuberculosis. Gene Ther. 10(18) 1592-1599. 

Sinkovics JG, Horvath JC. Evidence accumulating in support of canctrt vaccines combined with chemotherapy a pragmatic review of past and present efforts, hrt J Oncol. 2006 29 765-77. 

Rousseau, R. F., Haight, A. E., Hirschmaim-Jax, C., Yvon, E. S., Rill, D. R., Mel, Z., Smith, S. C., Inman, S., Cooper, K., Alcoser, P., Grilley, B., Gee, Popek, E., Davidoff, A., Bowman, L. C., Brenner, M. K., and Strother, D. (2003). Local and systematic effects of an allogeneic tumor cell vaccine combining transgenic human lymphotactin with interleukin-2 in patients with advanced or refractory neuroblastoma. Blood 101, 1718-1726. 

Fig. 8. Serum neutralizing antibody response by immunoglobulin class of rhesus monkeys inoculated on days 0 and 28 with (A) inactivated VEE virus vaccine (n=4), or (B) vaccine combined with 200 yg of poly(ICLC)/kg (n=4). Symbols (A) whole serum antibody titers, (o) antibody from IgG fraction, ( ) antibody from IgM fractions.

In conclusion, the future for gene electrotransfer for clinical use is bright. Based on many clinical trials in human and veterinary medicine that showed positive results and safety of the approaches, especially two fields, prophylactic vaccination for infectious disease and curative vaccination combined with standard treatments for cancer will benefit in the future. Further technical developments of electrodes and generators of electric pulses on one hand and further optimization of plasmids DNA regarding the controlled expression and safety on the other hand will bring gene electrotransfer into wider use. 

Hirabayashi Y, Knrata H, Funato H, Nagamine T, Aizawa C, Tamura S, Shimada K, Kurata T. 1990. Comparkon of intranasal inoculation of influenza HA vaccine combined with cholera toxin B subunit with oral or parenteral vaccination. Vaccine 8(3) 243-248. 

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