Influenza at Christ's Hospital: March, 1974

Hoskins, T. W.; Davies, Joan R.; Smith, Alyson; Allchin, A.; Miller, C.; Pollock, T.M.

doi:10.1016/s0140-6736(76)93151-2

Cited by 71 publications

(37 citation statements)

References 3 publications

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“…A subsequent 1974 outbreak of A/Port Chalmers/1/73 demonstrated that vaccination in an earlier season can indirectly affect the risk of infection in a future season [7]. The H3N2 attack rate in 1974 was significantly higher in boys who had previously received the A/Hong Kong vaccine in 1970-1972 compared with those who had not.…”

Section: British Boarding School Outbreaksmentioning

confidence: 99%

“…This has poorly understood effects that may vary depending on whether the vaccine strain has been changed compared to the prior season (s), changes in the genetic and antigenic characteristics of circulating viruses, and the unique 'antibody landscape' determined by cumulative lifetime experience with influenza infection or vaccination [42]. As noted in the 1974 British boarding school outbreak [7], natural infection appears to convey broader and more durable immunity relative to vaccination [43]. As proposed by Hoskins et al, vaccine-induced protection in a given season may block the greater infection-induced immunity and thereby contribute to higher risk in a subsequent season (infection block hypothesis).…”

Section: Possible Immune Mechanisms For Repeated Vaccination Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Belongia

Skowronski

McLean

et al. 2017

Expert Review of Vaccines

234

185

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Introduction: Studies in the 1970s and 1980s signaled concern that repeated influenza vaccination could affect vaccine protection. The antigenic distance hypothesis provided a theoretical framework to explain variability in repeat vaccination effects based on antigenic similarity between successive vaccine components and the epidemic strain. Areas covered: A meta-analysis of vaccine effectiveness studies from 2010-11 through 2014-15 shows substantial heterogeneity in repeat vaccination effects within and between seasons and subtypes. When negative effects were observed, they were most pronounced for H3N2, especially in 2014-15 when vaccine components were unchanged and antigenically distinct from the epidemic strain. Studies of repeated vaccination across multiple seasons suggest that vaccine effectiveness may be influenced by more than one prior season. In immunogenicity studies, repeated vaccination blunts the hemagglutinin antibody response, particularly for H3N2. Expert commentary: Substantial heterogeneity in repeated vaccination effects is not surprising given the variation in study populations and seasons, and the variable effects of antigenic distance and immunological landscape in different age groups and populations. Caution is required in the interpretation of pooled results across multiple seasons, since this can mask important variation in repeat vaccination effects between seasons. Multi-season clinical studies are needed to understand repeat vaccination effects and guide recommendations. ARTICLE HISTORY

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Section: British Boarding School Outbreaksmentioning

confidence: 99%

Section: Possible Immune Mechanisms For Repeated Vaccination Effectsmentioning

confidence: 99%

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Belongia

Skowronski

McLean

et al. 2017

Expert Review of Vaccines

234

185

View full text Add to dashboard Cite

show abstract

“…Influenza virus infection in this population has been studied extensively for many years and various aspects of the epidemiology and outcome of infection with different serotypes have been published (5)(6)(7).…”

Section: Discussionmentioning

confidence: 99%

Concurrent outbreaks of influenza and parvovirus B19 in a boys' boarding school

Grilli

Anderson²,

Hoskins³

1989

Epidemiol. Infect.

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SUMMARYIn the spring term of 1985 there was a protracted outbreak of upper respiratory tract febrile illness consistent with a clinical diagnosis of influenza in a boys' boarding school, which lasted from 23 January to 29 March. Although influenza virus infection was confirmed in 89 % of cases in the first half of the term, 53 % of the cases which occurred in the second half of the term had no evidence of infection with influenza virus. Between 5 February and 31 March 28 boys presented with skin rashes consistent with a clinical diagnosis of erythema infectiosum; 68 % of these were associated with parvovirus B19. Investigation of the cases of clinical influenza with no identified respiratory pathogen revealed a 58% infection rate with B19. B19 DNA was identified in either throat swabs or acute stage bloods of nine pupils with influenza-like symptoms.Cohort studies revealed that 44% of pupils aged 15-16 years were immune before the outbreak compared with only 17 % of pupils aged 11-12 years. Infection in the younger group was common and was associated with influenzalike illnesses as well as rashes. Forty-eight per cent of those who did not report any symptoms were also infected with B19.

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“…Seminal studies were done through the 1960s to the 1980s, establishing key principles of human influenza immunology. In 1976, Hoskins and coworkers found that influenza infection in a boarding school for boys allowed for longer-lasting immunity than did the killed virus vaccine (7). Another vaccine study found that vaccination by killed whole virus was able to elicit induction of memory cytotoxic T lymphocytes (CTLs), whereas the subunit vaccine was not (8).…”

Section: Immunity To Influenza Preventing Infection and Regulating DImentioning

confidence: 99%

Immunity to Influenza. Preventing Infection and Regulating Disease

Allen

Thomas²

2015

Am J Respir Crit Care Med

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Although mortality is less, two recent reports indicate that contemporary characterization of children with sepsis may be insufficient (11, 12). In one study, protocolized fluid boluses such as those commonly recommended in the developed world increased mortality compared with usual care by local practitioners (11). In the other study, protocolized fluid regimens appeared to increase mortality in children with concomitant respiratory failure (12). The reasons for these unfortunate outcomes are not understood, but it is precisely that knowledge gap (and its consequences) that should direct us away from consensus-type definitions of fatal illness and point us instead toward placing our patients on the potentially firmer footing of biologic insight.In summary, the big lesson from the paper by Wong and colleagues is that biologic insights into how (and who) septic shock can kill might soon be applied to the advantage of individual patients (1). In an age of consensus, guidelines, and big data, it is easy to forget that the biology of the individual patient matters; important work such as this reminds us that in pediatric septic shock, it almost certainly does. n Author disclosures are available with the text of this article at www.atsjournals.org.

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Influenza at Christ's Hospital: March, 1974

Cited by 71 publications

References 3 publications

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Concurrent outbreaks of influenza and parvovirus B19 in a boys' boarding school

Immunity to Influenza. Preventing Infection and Regulating Disease

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