Steven B. Black, MD

The Risk of Narcolepsy following Adjuvanted Pandemic Influenza Vaccine

In this U.S. Center for Disease Control and Prevention (CDC) funded study, Dr. Steven Black, MD, (Pl) evaluated the possible association of narcolepsy and adjuvanted 2009 pandemic H1N1 influenza vaccine in a global collaborative study including Taiwan, Argentina, Canada, the Netherlands, Switzerland, and Spain. The study did not identify evidence for an increased risk of narcolepsy following adjuvanted vaccines. This finding will inform the use of adjuvants for future epidemics. Dr. Black submitted a manuscript of the study results for publication.

Steven B. Black, MD

Global Vaccine Initiative Pilot Data Linkage Project

This project was a World Health Organization (WHO) sponsored pilot to evaluate the feasibility of multi-national data linkage studies to identify and evaluate vaccine safety concerns. Participating sites included eight sites in Latin America plus sites in Iran, Albania, India, South Africa, Singapore, China and Australia. The collaboration was successful with publications developed both on the methods and the results. Three publications related to this work are in press in the journal Vaccine.

Adekunle Dawodu, MBBS, FRCPCH

Racial disparities in cord blood vitamin D levels and its association with small-for-gestational age infants

Vitamin D is commonly known for its role in calcium metabolism and bone health but recently has gained attention for its role in pregnancy outcome. Small-for-gestational age status in observational studies links to maternal vitamin D status. Racial disparity in maternal and neonatal vitamin D deficiency described in pregnancy and suggested as possible explanation for disparity regarding fetal growth and small-for-gestational age status.

Dr. Dawodu and his colleagues in the Divisions of Neonatology, and Biostatistics and Epidemiology at Cincinnati Children’s Hospital Medical Center evaluated the relationship between race and maternal characteristics and the association with cord vitamin D levels and small-for-gestational age. Black infants have greater risk of vitamin D deficiency compared to white infants and black infants but not white infants with vitamin D deficiency had higher odds of small-for-gestational age. The study suggests that identification of risk factors can lead to opportunity to target vitamin D supplementation during pregnancy among at risk population to reduce the risk of vitamin D deficiency and small-for-gestational age.

Mark C. Steinhoff, MD

Dr. Mark Steinhoff, and colleagues at Johns Hopkins University, Seattle Children's Hospital, and Tribhuvan University in Kathmandu, have published a prospective randomized placebo-controlled trial of influenza vaccine in pregnant women in rural Nepal.

Randomized 3693 women received placebo or influenza vaccine throughout the year, as influenza A virus circulates for most of the year in this tropical setting. The vaccine significantly reduced maternal and infant influenza episodes, and increased birth weight of a subset of infants (Lancet Infectious Diseases, May 2017). The Bill & Melinda Gates Foundation generously supports this project.

We are planning to evaluate the cognitive development of the infants with increased birth weights.

We have also published eight additional papers from this project, describing infant and maternal infections related to metapneumovirus, rhinovirus, pertussis, respiratory syncytial virus and other infections.