Comments were made on misinterpretations concerning the natural resistance and natural immunization against tetanus. Arguments were given explaining why the disease itself did not determine adequate immunity. When, however, adequate conditions appear, tetanus toxin is known to stimulate the immune system and produce detectable humoral antibodies. Various possibilities resulting from the postulated harboring of tetanus bacilli by the human body and their eventual toxin production were analyzed and related to the human tetanus pathology. The existence of natural immunization was unquestionably demonstrated by presence of protective levels of tetanus antitoxin in the blood of the majority of 59 surveyed subjects considering that none of them had ever received any tetanus toxoid and most of them never received a single shot of any drug. The results of this survey originated a few arguments that may support the answer to some still intriguing phenomenona such as: 1. The relatively small number of cases of overt disease among people and animals born and living in large tetanus-risk regions all over the world. 2. The existence of "poor responders" and "good responders" to the primary tetanus toxoid stimulus. 3. The age distribution of tetanus showing evident prevalence among newborns and children. 4. The wide individual variations in the clinical picture of human tetanus as indicated by the localization and limitation of the symptoms and their severity.

• MeSH
• anaerobióza MeSH
• buněčná imunita MeSH
• Clostridium tetani imunologie   izolace a purifikace   MeSH
• dítě MeSH
• dospělí MeSH
• imunizace MeSH
• isoprotilátky analýza   MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• půdní mikrobiologie MeSH
• sekundární imunizace MeSH
• senioři MeSH
• skot MeSH
• tetanový antitoxin analýza   MeSH
• tetanový toxin MeSH
• tetanus imunologie   MeSH
• zvířata MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři MeSH
• skot MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• isoprotilátky MeSH
• tetanový antitoxin MeSH
• tetanový toxin MeSH

OBJECTIVES: Vaccine preventable diseases (VPDs) continue to pose a significant threat to healthcare workers (HCWs) while immunization among this group remains low. HCWs' behaviours as well as facilitators and barriers towards their vaccination for a number of VPDs were explored through an EU-wide survey. METHODS: HCWs across the EU answered online survey that explored attitudes and behaviours towards vaccination for a number of VPDs. Response data were adjusted based on weights estimated by HCWs' country and working profession according to WHO statistics. The survey was delivered between October 2012 and April 2014. RESULTS: Analysis was based on responses from 5,424 HCWs from 14 European countries. The majority (86.7%) had a positive attitude regarding immunizations. HCWs considered influenza (86.4%), viral hepatitis type B (71.9%) and tuberculosis (59.1%) as higher risk diseases for occupational exposure in the workplace. However, 43.8% reported not receiving a seasonal influenza vaccine in the last 10 years and 65.6% reported not receiving the pandemic influenza vaccine in 2009. Main enablers towards immunizations included believing in vaccine protection and easy, free of charge access to vaccines in the workplace. Barriers to up-to-date immunizations differed according to disease but included concerns about short- and long-term effects. CONCLUSION: Although the concept of mandatory vaccination seems to be favoured by many health professionals in Europe, it remains a controversial subject both among HCWs' profession categories and also among different countries. Interventions to increase vaccination among HCWs would benefit by tailoring their approach according to disease and target group.

• Klíčová slova
• Europe, healthcare workers, immunization, vaccines,
• MeSH
• imunizace * MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• vakcinace MeSH
• vakcíny proti chřipce * MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• vakcíny proti chřipce * MeSH

• MeSH
• imunita získaná od matky MeSH
• injekce intraperitoneální MeSH
• myši MeSH
• očkovací schéma MeSH
• tsutsugamushi mikrobiologie   prevence a kontrola   MeSH
• vakcíny MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• vakcíny MeSH

BACKGROUND: Pertussis immunization during pregnancy is recommended in many countries. Data from large randomized controlled trials are needed to assess the immunogenicity, reactogenicity and safety of this approach. METHODS: This phase IV, observer-blind, randomized, placebo-controlled, multicenter trial assessed immunogenicity, transplacental transfer of maternal pertussis antibodies, reactogenicity and safety of a reduced-antigen-content diphtheria-tetanus-three-component acellular pertussis vaccine (Tdap) during pregnancy. Women received Tdap or placebo at 27-36 weeks' gestation with crossover ≤ 72-hour-postpartum immunization. Immune responses were assessed before the pregnancy dose and 1 month after, and from the umbilical cord at delivery. Superiority (primary objective) was reached if the lower limits of the 95% confidence intervals (CIs) of the pertussis geometric mean concentration (GMC) ratios (Tdap/control) in cord blood were ≥ 1.5. Solicited and unsolicited adverse events (AEs) and pregnancy-/neonate-related AEs of interest were recorded. RESULTS: 687 pregnant women were vaccinated (Tdap: N = 341 control: N = 346). Superiority of the pertussis immune response (maternally transferred pertussis antibodies in cord blood) was demonstrated by the GMC ratios (Tdap/control): 16.1 (95% CI: 13.5-19.2) for anti-filamentous hemagglutinin, 20.7 (15.9-26.9) for anti-pertactin and 8.5 (7.0-10.2) for anti-pertussis toxoid. Rates of pregnancy-/neonate-related AEs of interest, solicited general and unsolicited AEs were similar between groups. None of the serious AEs reported throughout the study were considered related to maternal Tdap vaccination. CONCLUSIONS: Tdap vaccination during pregnancy resulted in high levels of pertussis antibodies in cord blood, was well tolerated and had an acceptable safety profile. This supports the recommendation of Tdap vaccination during pregnancy to prevent early-infant pertussis disease. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT02377349.

• Klíčová slova
• Adult formulation acellular pertussis vaccine, Maternal immunization, Tdap,
• MeSH
• imunita získaná od matky * MeSH
• jednoduchá slepá metoda MeSH
• lidé MeSH
• matka - expozice noxám * MeSH
• novorozenec MeSH
• pertuse * prevence a kontrola   MeSH
• protilátky bakteriální krev   MeSH
• těhotenství MeSH
• vakcína proti záškrtu, tetanu a černému kašli aplikace a dávkování   škodlivé účinky   MeSH
• vakcinace MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze IV MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• protilátky bakteriální MeSH
• vakcína proti záškrtu, tetanu a černému kašli MeSH

• Klíčová slova
• BRUCELLA ABORTUS/immunology *,
• MeSH
• Brucella abortus imunologie   MeSH
• imunizace * MeSH
• ovce domácí * MeSH
• ovce MeSH
• vakcinace * MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• alkalická fosfatasa krev   MeSH
• bakteriální vakcíny farmakologie   MeSH
• BCG vakcína farmakologie   MeSH
• dítě MeSH
• imunizace * MeSH
• lidé MeSH
• neutrofily enzymologie   MeSH
• novorozenec MeSH
• pertusová vakcína farmakologie   MeSH
• sekundární imunizace MeSH
• vakcína proti pravým neštovicím farmakologie   MeSH
• vakcíny proti tyfu a paratyfu farmakologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• alkalická fosfatasa MeSH
• bakteriální vakcíny MeSH
• BCG vakcína MeSH
• pertusová vakcína MeSH
• vakcína proti pravým neštovicím MeSH
• vakcíny proti tyfu a paratyfu MeSH

A study was performed on human subjects to assess the effectiveness of single-dose immunization with 20 CU (1 ml) of adsorbed tetanus toxoid followed by revaccination with 10 CU (0.5 ml) 1 year later. Out of 1187 students, only those were selected for observation whose blood serum did not contain tetanus antitoxin (titre less than 0.001 IU/ml); this group counted 283 students. After administering the 20 CU (1 ml) of toxoid the antitoxin titre was repeatedly checked on days 10--15 and persons whose titre had risen to over 0.01 IU/ml were excluded from observation. The remaining 109 persons were tested for the antitoxin level 1 year later and revaccinated with 10 CU of tetanus toxoid. After 10--15 days their postrevaccination titre was determined. The single-dose immunization with 20 CU of tetanus toxoid in human subjects not given tetanus antigen previously was accompanied by a gradul rise in the antitoxin titre up to the protective level and its maintenance for 1 year (observation time) until revaccination. Revaccination with 10 CU of toxoid provided in 10--15 days a multiple (100--197fold) increase of the antitoxin titre, many times exceeding the protective level. The usefulness of transition to the shortened immunization scheme for tetanus prophylaxis of the adult population is discussed.

• MeSH
• časové faktory MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• očkovací schéma * MeSH
• tetanový antitoxin analýza   MeSH
• tetanový toxoid terapeutické užití   MeSH
• tetanus prevence a kontrola   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• tetanový antitoxin MeSH
• tetanový toxoid MeSH

• Klíčová slova
• PREGNANCY *, RH FACTORS *,
• MeSH
• imunizace * MeSH
• krevní skupiny - systém Rh-Hr * MeSH
• těhotenství MeSH
• vakcinace * MeSH
• Check Tag
• těhotenství MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• krevní skupiny - systém Rh-Hr * MeSH

Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant.

• Klíčová slova
• group B Streptococcus vaccines, influenza, maternal immunization, pertussis, pregnant women, respiratory syncytial virus, tetanus,
• MeSH
• celosvětové zdraví MeSH
• hodnocení rizik MeSH
• hodnocení vlivů na zdraví MeSH
• imunizace * škodlivé účinky   etika   metody   trendy   MeSH
• imunogenicita vakcíny MeSH
• infekční komplikace v těhotenství epidemiologie   prevence a kontrola   MeSH
• klinické zkoušky jako téma etika   MeSH
• konsensus MeSH
• lékařská etika MeSH
• lidé MeSH
• matka - expozice noxám MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• vakcinace MeSH
• vakcíny aplikace a dávkování   škodlivé účinky   imunologie   MeSH
• výzkum MeSH
• zdravotní priority MeSH
• zpožděný efekt prenatální expozice MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• vakcíny MeSH

BACKGROUND: Pertussis immunization during pregnancy results in high pertussis antibody concentrations in young infants but may interfere with infant immune responses to post-natal immunization. METHODS: This phase IV, multi-country, open-label study assessed the immunogenicity and safety of infant primary vaccination with DTaP-HepB-IPV/Hib and 13-valent pneumococcal conjugate vaccine (PCV13). Enrolled infants (6-14 weeks old) were born to mothers who were randomized to receive reduced-antigen-content diphtheria-tetanus-three-component acellular pertussis vaccine (Tdap group) or placebo (control group) during pregnancy (270/7-366/7 weeks' gestation) with crossover immunization postpartum. All infants received 2 or 3 DTaP-HepB-IPV/Hib and PCV13 doses according to national schedules. Immunogenicity was assessed in infants pre- and 1 month post-primary vaccination. The primary objective was to assess seroprotection/vaccine response rates for DTaP-HepB-IPV/Hib antigens 1 month post-primary vaccination. RESULTS: 601 infants (Tdap group: 296; control group: 305) were vaccinated. One month post-priming, seroprotection rates were 100% (diphtheria; tetanus), ≥98.5% (hepatitis B), ≥95.9% (polio) and ≥94.5% (Hib) in both groups. Vaccine response rates for pertussis antigens were significantly lower in infants whose mothers received pregnancy Tdap (37.5-77.1%) versus placebo (90.0-99.2%). Solicited and unsolicited adverse event rates were similar between groups. Serious adverse events occurred in 2.4% (Tdap group) and 5.6% (control group) of infants, none were vaccination-related. CONCLUSIONS: Pertussis antibodies transferred during pregnancy may decrease the risk of pertussis infection in the first months of life but interfere with the infant's ability to produce pertussis antibodies, the clinical significance of which remains unknown. Safety and reactogenicity results were consistent with previous experience. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT02422264.

• Klíčová slova
• Blunting, Infants, Maternal immunization, Pertussis, Tdap vaccine,
• MeSH
• hemofilové vakcíny imunologie   MeSH
• kojenec MeSH
• kombinované vakcíny imunologie   MeSH
• lidé MeSH
• následné studie MeSH
• pneumokokové vakcíny imunologie   MeSH
• poliovirová vakcína inaktivovaná imunologie   MeSH
• protilátky bakteriální krev   MeSH
• těhotenství MeSH
• vakcína proti diftérii, tetanu a pertusi imunologie   MeSH
• vakcína proti hepatitidě B imunologie   MeSH
• vakcína proti záškrtu, tetanu a černému kašli aplikace a dávkování   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze IV MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• 13-valent pneumococcal vaccine MeSH Prohlížeč
• diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae b conjugate-hepatitis B vaccine MeSH Prohlížeč
• hemofilové vakcíny MeSH
• kombinované vakcíny MeSH
• pneumokokové vakcíny MeSH
• poliovirová vakcína inaktivovaná MeSH
• protilátky bakteriální MeSH
• vakcína proti diftérii, tetanu a pertusi MeSH
• vakcína proti hepatitidě B MeSH
• vakcína proti záškrtu, tetanu a černému kašli MeSH