Finally, applications of this delivery mechanism to vaccines for

Finally, applications of this delivery mechanism to vaccines for other pathogens where CTL targeting is potentially relevant, such as hepatitis C [35], [36], [37] and [38], and influenza [39] and [40], should be investigated. We thank Darrell Irvine of the Ragon Institute for helping us review previous research in the area, Nicole Frahm of the Fred Hutchinson Cancer Research Center for immunochemistry advice, Dan Barouch of the Beth Israel Hospital for his interest and support, Niraj Patil for assistance with illustration preparation, Craig Rouskey for

helpful comments and Jonathan Carlson of Microsoft Research who helped review the manuscript. This work was supported in part by a Qualifying Therapeutic Drug Discovery Project Grant from the United States Government and a grant from Microsoft Research. Conflict of interest: RMR, CVH, and PML are employees of shareholders of Flow Pharma Inc., and DEH is an employee and shareholder of Microsoft. “
“All children worldwide should be fully vaccinated against polio, and every country should seek to achieve and maintain high levels of coverage with polio vaccine in support of the global commitment to eradicate polio.

WHO no longer recommends an OPV-only vaccination schedule. For all countries currently using OPV only, at least 1 dose of IPV should be added to the schedule. The primary purpose of the IPV dose is to maintain immunity against type 2 poliovirus during almost and after the planned global withdrawal SCH727965 purchase of OPV2 and switch from tOPV to bOPV. Depending on the timing of the IPV administration, the introduction of IPV may reduce VAPP risks. Adding an IPV dose will boost

both humoral and mucosal immunity against poliovirus types 1 and 3, which may also hasten the eradication of these WPVs. In polio-endemic countries and in countries at high risk for importation and subsequent spread [3], WHO recommends an OPV birth dose (a zero dose) followed by a primary series of 3 OPV and at least 1 IPV doses. The birth dose of OPV should be administered at birth, or as soon as possible after birth, to maximize the seroconversion rates with subsequent doses and to induce mucosal protection before enteric pathogens may interfere with the immune response. Also, administering the first dose of OPV while infants are still protected by maternally derived antibodies may, at least theoretically, prevent VAPP. Even in cases of perinatal HIV infection, early OPV vaccination seems to be well tolerated, and no additional risk of VAPP has been documented in such children. The primary series consisting of 3 OPV doses plus 1 IPV dose can be initiated from the age of 6 weeks with a minimum interval of 4 weeks between the OPV doses. If 1 dose of IPV is used, it should be given from 14 weeks of age (when maternal antibodies have diminished and immunogenicity is significantly higher) and can be co-administered with an OPV dose.

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