Publications by authors named "Hanne Nøkleby"

32 Publications

Immunisation of healthcare workers in the Nordic countries: Variation in recommendations and practices and a lack of assessment.

Euro Surveill 2021 Jan;26(4)

Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.

Healthcare workers (HCWs) are at increased risk of both exposure and transmission of infectious disease. Two European Union (EU) directives state that health services are responsible for assessing their employees' potential exposure to infectious diseases and offering immunisation free of charge. We assessed current policy for immunisation of HCWs and the availability of vaccine coverage data in the Nordic countries by surveying national vaccination experts in Denmark, Finland, Iceland, Norway and Sweden, as well as Swedish county medical officers (CMOs). All national experts and 17 of 21 Swedish CMOs responded. All EU countries had transposed the European directives into national law, while Norway and Iceland had similar national legislation. Recommendations or guidelines were issued in Denmark, Finland, Iceland, Norway and 15 of 17 responding Swedish counties. The range of diseases covered differed by countries and Swedish counties. HCW vaccine coverage data were not systematically collected; incomplete estimates were only available for Finland and two Swedish counties. In conclusion, recommendations or guidelines exist in the Nordic countries, but their impact cannot be assessed, as vaccine uptake among HCWs is not currently measured. Systematic collection of data is a necessary step towards improving HCW immunisation policy and practice in the Nordic countries.
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http://dx.doi.org/10.2807/1560-7917.ES.2021.26.4.1900555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848784PMC
January 2021

Misled on influenza vaccination in 2009.

Tidsskr Nor Laegeforen 2019 08 19;139(11). Epub 2019 Aug 19.

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http://dx.doi.org/10.4045/tidsskr.19.0443DOI Listing
August 2019

Bacille Calmette-Guérin vaccination of healthcare personnel: changing epidemiology calls for new recommendations in Norway.

Eur Respir J 2019 01 10;53(1). Epub 2019 Jan 10.

Norwegian Institute of Public Health, Oslo, Norway.

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http://dx.doi.org/10.1183/13993003.01123-2018DOI Listing
January 2019

Response to third rubella vaccine dose.

Hum Vaccin Immunother 2018 21;14(10):2472-2477. Epub 2018 Jun 21.

a Division for Infection Control and Environmental Health, Norwegian Institute of Public Health (NIPH) , Oslo , Norway.

Limited data exist on the immunogenicity of a third dose of the measles, mumps, and rubella vaccine (MMR). In this study, our aim was to evaluate the long-term rubella immunogenicity afforded by two childhood MMR doses of the Norwegian vaccination program in a cohort of conscripts and to determine the effect of an additional dose of MMR vaccine, in order to inform vaccination policy. Blood samples from Norwegian conscripts (n = 495) taken both before and eight months after administration of a dose of MMR vaccine were tested using an enzyme immunoassay to measure anti-rubella IgG. Concentrations <5 IU/mL were regarded as negative, 5.0-9.9 IU/mL as equivocal, and ≥10 IU/mL as positive. Overall, the seropositivity before vaccination was 84.6%, and 99.0% of the conscripts had anti-rubella IgG concentrations ≥5 IU/mL. The seropositivity after vaccination was 94.5%, and 99.8% of the conscripts had antibody concentrations ≥5 IU/mL. The geometrical mean IgG concentrations increased from 21.4 IU/mL before vaccination to 28.9 IU/mL after. Four out of five conscripts, with seronegative concentrations before administrations of an additional MMR dose, had equivocal or seropositive results following vaccination. The cohort of young adults in Norway, which was eligible for two childhood MMR doses, was protected against rubella, and efforts should be made to maintain high vaccine coverage to ensure immunity in the future. A third dose of MMR administered in early adulthood led to an increase in the antibody concentration in our cohort and seroconversion for the majority of seronegative persons.
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http://dx.doi.org/10.1080/21645515.2018.1475814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284511PMC
May 2019

Do selective immunisation against tuberculosis and hepatitis B reach the targeted populations? A nationwide register-based study evaluating the recommendations in the Norwegian Childhood Immunisation Programme.

Vaccine 2016 Apr 3;34(17):2015-20. Epub 2016 Mar 3.

Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway. Electronic address:

Background: Selective immunisation is an alternative to universal vaccination if children at increased risk of disease can be identified. Within the Norwegian Childhood Immunisation Programme, BCG vaccine against tuberculosis and vaccine against hepatitis B virus (HBV) are offered only to children with parents from countries with high burden of the respective disease. We wanted to study whether this selective immunisation policy reaches the targeted groups.

Methods: The study population was identified through the Norwegian Central Population Registry and consisted of all children born in Norway 2007-2010 and residing in Norway until their second birthday, in total 240,484 children. Information on vaccinations from the Norwegian Immunisation Registry, and on parental country of birth from Statistics Norway, was linked to the population registry by personal identifiers. The coverage of BCG and HBV vaccine was compared with the coverage of vaccines in the universal programme.

Results: Among the study population, 16.1% and 15.9% belonged to the target groups for BCG and HBV vaccine, respectively. Among children in the BCG target group the BCG vaccine coverage was lower than the coverage of pertussis and measles vaccine (83.6% vs. 98.6% and 92.3%, respectively). Likewise, the HBV vaccine coverage was lower than the coverage of pertussis and measles vaccine in the HBV target group (90.0% vs. 98.6% and 92.3%, respectively). The coverage of the targeted vaccines was highest among children with parents from South Asia and Sub-Saharan Africa. The coverage of vaccines in the universal programme was similar in targeted and non-targeted groups.

Conclusions: Children targeted by selective vaccination had lower coverage of the target vaccines than of vaccines in the universal programme, indicating that selective vaccination is challenging. Improved routines for identifying eligible children and delivering the target vaccines are needed. Universal vaccination of all children with these vaccines could be considered.
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http://dx.doi.org/10.1016/j.vaccine.2016.02.060DOI Listing
April 2016

Monitoring of timely and delayed vaccinations: a nation-wide registry-based study of Norwegian children aged < 2 years.

BMC Pediatr 2015 Nov 13;15:180. Epub 2015 Nov 13.

Division of Infectious Disease Control, Department of Vaccines, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, NO-0403, Oslo, Norway.

Background: Delayed vaccinations increase the risk for vaccine preventable diseases (VPDs). Monitoring of delayed vaccinations by using a national immunisation registry has not been studied in countries recommending a two-dose (3 and 5 months of age) primary series of e.g., pertussis vaccine. Surveillance/monitoring of all vaccinations may improve vaccination programmes functioning.

Methods: We obtained information from the Norwegian immunisation registry (SYSVAK) on all programme vaccinations received at age up to 730 days in children born in 2010 (n = 63,382). Timely vaccinations were received up to 7 days after the recommended age. Vaccinations were considered delayed if they were received more than one month after the recommended age in the schedule.

Results: In vaccinated children, timely administration of the subsequent three doses of pertussis and one dose of measles occurred in 73.8, 47.6, 53.6 and 43.5 % respectively. Delay for one or more programme vaccinations (diphtheria, tetanus, pertussis, polio, Haemophilus influenza type B, invasive pneumococcal disease, measles, mumps or rubella) was present in 28,336 (44.7 %) children. Among those who were delayed the mean duration was 139 days. The proportion of children that had vaccinations delayed differed among counties (range 37.4 %-57.8 %). Immigrant children were more frequently delayed 52.3 % vs. 43.1 %, RR 1.21 (95 % CI 1.19, 1.24). Children scheduled for vaccines in the summer holiday month (July) were more frequently delayed than others (1(st) dose pertussis vaccine 6.5 % vs. 3.9 % RR 1.65 (95 % CI 1.48, 1.85). Priming against pertussis (2(nd) dose), pneumococcal (2(nd) dose) and measles (1(st) dose) was delayed in 16.8, 18.6 and 29.3 % respectively.

Conclusion: Vaccinations were frequently delayed. Delayed vaccinations differed among counties and occurred more frequently during the summer vacation (July) and in the immigrant population. Monitoring improves programme surveillance and may be used on an annual basis.
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http://dx.doi.org/10.1186/s12887-015-0487-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643514PMC
November 2015

Susceptibility to cytomegalovirus, parvovirus B19 and age-dependent differences in levels of rubella antibodies among pregnant women.

J Med Virol 2014 May 30;86(5):820-6. Epub 2013 Sep 30.

Department of Virology, Norwegian Institute of Public Health, Oslo, Norway.

Infections caused by cytomegalovirus (CMV), parvovirus B19 (B19), and rubella can lead to serious complications in pregnant women. The aim of this study was to determine the susceptibility to CMV, B19, and rubella antibodies in pregnant women in Norway. Consecutive sera samples were collected from pregnant women in two different regions in Norway. Sera were collected from age groups; ≤19, 20-24, 25-29, 30-34, 35-39, and ≥40 years old. Of the 2,000 pregnant women tested, anti-CMV IgG was positive in 62.8% anti-parvovirus B19 IgG in 59.7% and anti-rubella IgG in 94.4%. CMV IgG susceptibility has decreased in pregnant women less than 30 years of age, from 60% in a study conducted in 1973-1974 to 37.2% in present study. There was a significant difference in CMV IgG seropositivity rate between the two regions (58.6% and 67.1%). Serum levels of rubella IgG was lowest in age group 25-29 years with a positivity rate of 91.0%. Women born before vaccination with two doses of MMR started, had both a higher positivity rate and significantly higher levels of rubella antibody titre, 96.1% and 82.2 IU/ml compared to those born after 92.9% and 41.7 IU/ml. Significantly lower anti-rubella IgG titre found in the youngest age groups highlights the need for continued antenatal screening. A considerable increase in anti-CMV-IgG seropositivity rate was observed and might be associated with higher rate of breastfeeding and a higher percentage attending day-care centres.
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http://dx.doi.org/10.1002/jmv.23757DOI Listing
May 2014

Risk of fetal death after pandemic influenza virus infection or vaccination.

N Engl J Med 2013 Jan 16;368(4):333-40. Epub 2013 Jan 16.

Norwegian Institute of Public Health, Oslo, Norway.

Background: During the 2009 influenza A (H1N1) pandemic, pregnant women were at risk for severe influenza illness. This concern was complicated by questions about vaccine safety in pregnant women that were raised by anecdotal reports of fetal deaths after vaccination.

Methods: We explored the safety of influenza vaccination of pregnant women by linking Norwegian national registries and medical consultation data to determine influenza diagnosis, vaccination status, birth outcomes, and background information for pregnant women before, during, and after the pandemic. We used Cox regression models to estimate hazard ratios for fetal death, with the gestational day as the time metric and vaccination and pandemic exposure as time-dependent exposure variables.

Results: There were 117,347 eligible pregnancies in Norway from 2009 through 2010. Fetal mortality was 4.9 deaths per 1000 births. During the pandemic, 54% of pregnant women in their second or third trimester were vaccinated. Vaccination during pregnancy substantially reduced the risk of an influenza diagnosis (adjusted hazard ratio, 0.30; 95% confidence interval [CI], 0.25 to 0.34). Among pregnant women with a clinical diagnosis of influenza, the risk of fetal death was increased (adjusted hazard ratio, 1.91; 95% CI, 1.07 to 3.41). The risk of fetal death was reduced with vaccination during pregnancy, although this reduction was not significant (adjusted hazard ratio, 0.88; 95% CI, 0.66 to 1.17).

Conclusions: Pandemic influenza virus infection in pregnancy was associated with an increased risk of fetal death. Vaccination during pregnancy reduced the risk of an influenza diagnosis. Vaccination itself was not associated with increased fetal mortality and may have reduced the risk of influenza-related fetal death during the pandemic. (Funded by the Norwegian Institute of Public Health.).
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http://dx.doi.org/10.1056/NEJMoa1207210DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602844PMC
January 2013

Considerations for controlling invasive meningococcal disease in high income countries.

Vaccine 2012 May;30 Suppl 2:B57-62

Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway.

The development of conjugate vaccines has enabled the prevention and control of Neisseria meningitidis caused by serogroups A, C, W-135 and Y. Vaccines that provide protection against a broad number of serogroup B strains likely will be available soon to enable greater control of meningococcal disease in high income countries. We present an argument for adequate post-marketing surveillance to monitor epidemiological shifts and to provide a context for the safety and reactogenicity of serogroup B vaccines, including the newer recombinant vaccines. We also offer a series of recommendations to address possible concerns about vaccine safety.
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http://dx.doi.org/10.1016/j.vaccine.2011.12.093DOI Listing
May 2012

[A woman in her 40s with rash and spots on the oral mucosa].

Tidsskr Nor Laegeforen 2012 Mar;132(5):534-6

Indremedisinsk avdeling, Sykehuset Innlandet, Elverum, Norway.

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http://dx.doi.org/10.4045/tidsskr.10.1132DOI Listing
March 2012

[The pandemic in Austevoll].

Tidsskr Nor Laegeforen 2011 Jun;131(12):1180

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http://dx.doi.org/10.4045/tidsskr.11.0524DOI Listing
June 2011

Vaccination as teenagers against meningococcal disease and the risk of the chronic fatigue syndrome.

Vaccine 2009 Jan 5;27(1):23-7. Epub 2008 Nov 5.

Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.

The etiology of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is unknown. In Norway, a vaccine against Neisseria meningitides group B was administered to teenagers in 1988--1989 in a protection trial. In order to estimate the relative risk of CFS/ME according to vaccine history, we conducted a case-control study in 2007, with 201 cases diagnosed at one of two hospitals and 389 controls. The adjusted odds ratio for CFS/ME was 1.06 (95% CI: 0.67-1.66) for subjects who received the active vaccine contrasted to subjects who did not. Using this design, no statistically significant association between vaccination against meningococcal disease in teenagers and occurrence of CFS/ME could be observed.
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http://dx.doi.org/10.1016/j.vaccine.2008.10.043DOI Listing
January 2009

Neurological adverse events of immunization: experience with an aluminum adjuvanted meningococcal B outer membrane vesicle vaccine.

Authors:
Hanne Nøkleby

Expert Rev Vaccines 2007 Oct;6(5):863-9

Norwegian Institute of Public Health, Division of Infectious Disease Control, PO Box 4404 Nydalen, N-0403 Oslo, Norway.

Throughout the history of vaccination, vaccines have been accused of harmful side effects. Adverse events following immunization may be caused by the active antigen in the vaccine or other constituents, such as adjuvants, or may merely be coincidental. Possible neurological side effects have always obtained high attention. However, the risk of serious events caused by existing vaccines or aluminum adjuvants is very small. Currently, there are several new vaccines and adjuvants in the pipeline. Of these vaccines, many will be offered mainly to adolescents or adults. When taken into general use, some of them will probably be associated with serious adverse events. Although coincidence will be the most probable explanation in most cases, causality will have to be discussed in many situations. Preparing to address the causes of these adverse events is important.
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http://dx.doi.org/10.1586/14760584.6.5.863DOI Listing
October 2007

Immunogenicity and safety of a combination of two serogroup B meningococcal outer membrane vesicle vaccines.

Clin Vaccine Immunol 2007 Sep 18;14(9):1062-9. Epub 2007 Jul 18.

Division of Infectious Disease Control, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway.

MenBvac and MeNZB are safe and efficacious vaccines against serogroup B meningococcal disease. MenBvac is prepared from a B:15:P1.7,16 meningococcal strain (strain 44/76), and MeNZB is prepared from a B:4:P1.7-2,4 strain (strain NZ98/254). At 6-week intervals, healthy adults received three doses of MenBvac (25 microg), MeNZB (25 microg), or the MenBvac and MeNZB (doses of 12.5 microg of each vaccine) vaccines combined, followed by a booster 1 year later. Two-thirds of the subjects who received a monovalent vaccine in the primary schedule received the other monovalent vaccine as a booster dose. The immune responses to the combined vaccine were of the same magnitude as the homologous responses to each individual vaccine observed. At 6 weeks after the third dose, 77% and 87% of the subjects in the combined vaccine group achieved serum bactericidal titers of > or = 4 against strains 44/76 and NZ98/254, respectively, and 97% and 93% of the subjects achieved a fourfold or greater increase in opsonophagocytic activity against strains 44/76 and NZ98/254, respectively. For both strains, a trend of higher responses after the booster dose was observed in all groups receiving at least one dose of the respective strain-specific vaccine. Local and systemic reactions were common in all vaccine groups. Most reactions were mild or moderate in intensity, and there were no vaccine-related serious adverse events. The safety profile of the combined vaccine was not different from those of the separate monovalent vaccines. In conclusion, use of either of the single vaccines or the combination of MenBvac and MeNZB may have a considerable impact on the serogroup B meningococcal disease situation in many countries.
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http://dx.doi.org/10.1128/CVI.00094-07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2043307PMC
September 2007

[The HPV vaccine--a tested and approved reality].

Tidsskr Nor Laegeforen 2007 Jun;127(12):1674-5

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June 2007

[50 years with polio vaccine in Norway].

Tidsskr Nor Laegeforen 2006 Dec;126(24):3251

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December 2006

[Adverse events after vaccination].

Tidsskr Nor Laegeforen 2006 Oct;126(19):2541-4

Divisjon for smittevern, Nasjonalt folkehelseinstitutt, Oslo, Norway.

When the diseases we try to prevent through vaccination are rare, we tend to focus more on the associated risks. Vaccination has led to unfortunate consequences, mainly due to production failure and inadequate control in earlier years. The requirements for vaccine control are now so rigorous that the risk for such occurrences is close to zero. Local and mild systemic reactions to vaccines are rather common, and are usually well known and described in detail when a vaccine is licensed. Some vaccine reactions are however so rare that they only will be discovered through surveillance after the vaccine has become available for routine use. Suspicion of adverse events will now normally arise through the official notification systems for adverse events. Large epidemiological studies are often necessary to decide whether there is a causal relationship or only a coincidence. Recording of adverse events following vaccination and transparency about their existence, are important issues in the work to maintain the credibility of vaccines.
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October 2006

[The Norwegian vaccination program].

Tidsskr Nor Laegeforen 2006 Oct;126(19):2538-40

Nasjonalt folkehelseinstitutt, Oslo, Norway.

Development of vaccines has in many ways been the art of the possible, using current knowledge about infections and microbes to devise new products. The aim of every vaccination is to prevent disease, but use of vaccines within vaccination programs is usually targeted not only to protect the individual, but also to changing the epidemiology of the disease. Several new vaccines will become available during the next decade, but the vaccination program will probably not be dramatically changed. Increased knowledge about the immune system might, in a longer time perspective, make it possible to rebuild a vaccination program on a new basis. Immunisations can perhaps be used for targeting the immune system in ways that still give protection against the specific infections, but in addition lead to better health through general protection against diseases, less allergy and less autoimmune diseases than we have today.
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October 2006

Persisting immune responses indicating long-term protection after booster dose with meningococcal group B outer membrane vesicle vaccine.

Clin Vaccine Immunol 2006 Jul;13(7):790-6

Division of Infectious Disease Control, Norwegian Institute of Public Health (NIPH), P.O. Box 4404, Nydalen, N-0403 Oslo, Norway.

MenBvac is an outer membrane vesicle vaccine against systemic meningococcal disease caused by serogroup B Neisseria meningitidis. In this placebo-controlled double-blind study including 374 healthy adolescents, the safety and immunogenicity of a schedule of three primary doses 6 weeks apart followed by a fourth dose a year later were evaluated. Antibody responses to the vaccine strain and heterologous strains (non-vaccine-type strains) and the persistence of these antibodies were measured by the serum bactericidal assay (SBA) and enzyme-linked immunosorbent assay up to 1 year after the last dose. The proportion of subjects with SBA titers of > or = 4 against the vaccine strain increased from 3% prevaccination to 65% after the third dose. Ten months later, this proportion had declined to 28%. The fourth dose induced a booster response demonstrated by 93% of subjects achieving a titer of > or = 4. One year after the booster dose, 64% still showed SBA titers of > or = 4. Cross-reacting antibodies were induced against all heterologous strains tested, although the magnitude of SBA titers differed widely between the different strains. All four doses of MenBvac were safe. Both MenBvac and the placebo had reactogenicity profiles of mild to moderate local and systemic reactions. Pain, the most common reaction, was reported with similar frequencies in both groups. No serious adverse events occurred in the MenBvac group. This study confirmed the good immunogenicity of the primary course of MenBvac and demonstrated prolonged persistence and increased cross-reactivity of functional antibodies elicited by a booster dose.
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http://dx.doi.org/10.1128/CVI.00047-06DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489568PMC
July 2006

Vaccination and anaphylaxis.

Authors:
Hanne Nokleby

Curr Allergy Asthma Rep 2006 Feb;6(1):9-13

Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway.

The incidence of anaphylactic or severe allergic reactions to vaccines is very low, less than one case per million vaccine doses. Larger studies from later years report no deaths. The cause of the reaction is usually not the immunizing antigen itself, but rather some other vaccine ingredient such as egg protein from the production process or gelatin added as a stabilizer. Most people with egg allergy can be vaccinated without any reaction. Vasovagal reactions with or without hyperventilation are common after vaccination. They can be rather dramatic and are often mistaken for anaphylactic reactions. Correct diagnosis is important in making it possible to vaccinate those who might otherwise run the risk of serious infections.
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http://dx.doi.org/10.1007/s11882-006-0003-xDOI Listing
February 2006

[Whooping cough--an old disease of current interest].

Tidsskr Nor Laegeforen 2006 Jan;126(3):295

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January 2006

Is there an association between SV40 contaminated polio vaccine and lymphoproliferative disorders? An age-period-cohort analysis on Norwegian data from 1953 to 1997.

Int J Cancer 2006 Apr;118(8):2035-9

The Cancer Registry of Norway-Institute of Population-based Cancer Research, Montebello, Oslo, Norway.

Between 1955 and 1963, an estimated number of 150 million people in various parts of the world, including Norway, received poliomyelitis vaccine possibly contaminated with infectious simian virus 40 (SV40). Human studies have investigated the hypothesised association between SV40 and various cancers, but the results have so far been contradicting. The aim of the present study was to examine Norwegian cancer incidence data to assess a possible association between birth cohorts assumed to have been subjected to the vaccine and the incidence rate of lymphoproliferative disorders (excluding Hodgkin's lymphoma), further subdivided into non-Hodgkin's lymphoma (NHL), lymphocytic leukemia and plasma cell neoplasms. Between 1953 and 1997, the incidence rate of lymphoproliferative diseases combined increased about 3-fold in both males and females. Subgroup analysis showed that this increase was largely attributable to NHL. Age-period-cohort modelling of the subgroups, as well as of all groups combined, showed that the cohort effect was more prominent than the period effect. However, the variations in incidence patterns across the birth cohorts did not fit with the trends that would be expected if a SV40 contaminated vaccine did play a causative role. Thus, our data do not support the hypothesis of an association between the vaccine and any subgroup of lymphoproliferative diseases.
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http://dx.doi.org/10.1002/ijc.21603DOI Listing
April 2006

Prevention of viral hepatitis in the Nordic countries and Germany.

Scand J Infect Dis 2005 ;37(8):549-60

World Health Organization, Geneva, Switzerland.

The Viral Hepatitis Prevention Board (VHPB) convened a meeting of international experts from the public and private sectors in the Nordic countries and Germany, in order to review the epidemiological situation, the surveillance systems for infectious diseases, the immunization programmes and policy, and the monitoring of adverse events after hepatitis vaccination in those countries, to evaluate prevention and control measures, and to identify the issues that arose and the lessons learnt. Considerable progress has been made in the past decades in the prevention and control of viral hepatitis in the respective countries. Vaccination programmes have been set up, blood products' safety has significantly been improved, and outbreak investigations remain the basis for the implementation of control measures. However, additional work remains to be done. Awareness of viral hepatitis among the public and professionals should further be raised, and more political support is needed regarding the value of prevention efforts and vaccination programmes.
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http://dx.doi.org/10.1080/00365540510043284DOI Listing
September 2005

Combined administration of meningococcal serogroup B outer membrane vesicle vaccine and conjugated serogroup C vaccine indicated for prevention of meningococcal disease is safe and immunogenic.

Clin Diagn Lab Immunol 2005 May;12(5):599-605

Division of Infectious Disease Control, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway.

MenBvac and Menjugate are safe and efficacious vaccines. The purpose of this study was to evaluate safety and immunogenicity of the combination (MenB/C) of the lyophilized active components of the conjugated group C vaccine Menjugate when reconstituted with the full liquid group B outer membrane vesicle vaccine MenBvac compared to MenBvac and Menjugate given separately. At 6-week intervals, healthy adults were given one dose of MenB/C followed by two doses of MenBvac (MenB/C group), three doses of MenBvac (MenB group), or one dose of Menjugate and two doses of placebo (MenC group). Injection site reactions were frequent in all groups. However, most reactions were short lasting and mild or moderate in intensity, and the vaccines were found to be well tolerated, with no vaccine-related serious adverse events. MenB/C was immunogenic with regard to both serogroup B and C meningococci. Both the serum bactericidal assay and the enzyme-linked immunosorbent assay analyses showed that the immune responses of the combination vaccine were similar to the immune responses of its separate components MenBvac and Menjugate for both serogroup B and C. In conclusion, the combined MenB/C vaccine is safe and immunogenic. The two vaccines do not interact negatively with each other and can easily be administered in the same syringe. The induced immune responses suggest that the combined vaccine is likely to confer protection against systemic group B disease caused by the vaccine strain as well as against group C meningococcal disease.
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http://dx.doi.org/10.1128/CDLI.12.5.599-605.2005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112071PMC
May 2005

[Vaccination of persons with allergy].

Authors:
Hanne Nøkleby

Tidsskr Nor Laegeforen 2003 Dec;123(23):3400-1

Avdeling for vaksinasjon og immunitet, Divisjon for smittevern, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo.

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December 2003

The conjugate vaccine and invasive pneumococcal disease.

N Engl J Med 2003 Aug;349(7):714-6; author reply 714-6

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August 2003

[Will a vaccine save us from SARS?].

Authors:
Hanne Nøkleby

Tidsskr Nor Laegeforen 2003 Jun;123(13-14):1818

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June 2003