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Vaccinations

Vaccines for COVID-19 This page gives information about COVID-19 vaccinations in Ireland. Find out how to get a COVID-19 vaccine or COVID-19 booster vaccine.

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Travelling abroad and vaccinations Compulsory vaccinations are required to enter some countries. Information for people normally living in Ireland on vaccinations if going abroad. This document is in: Travel abroad

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Walk-in Covid vaccines: Locations and times confirmed across Ireland | Kildare Nationalist

National News >

Walk-in Covid vaccines: Locations and times confirmed across Ireland

Sarah Mooney

Walk-in Covid-19 vaccine centres are set to open their doors across the country this bank holiday weekend to encourage uptake among younger people.

Anyone aged 16 or older can attend for their first dose without a prior appointment when the centres open on specific days at certain times.

Here we have everything you need to know – from what vaccines are on offer, to the location of the centres in each county.

What vaccines are on offer?

You will be offered either the Pfizer/BioNTech or Moderna vaccine at the walk-in centres.

What if I have already registered for a vaccine appointment?

If you have already registered online and are waiting on an appointment for your first dose, you can choose to go to a walk-in clinic instead.

Do I have to attend a walk-in centre near my home?

You can go to any of the walk-in clinics – so feel free to get jabbed while on staycation.

Do I need to do anything before attending a walk-in centre?

You don’t have to register online beforehand but the HSE said doing so may speed up your time in the vaccination centre.

If you have already registered online, you will need to bring photo ID that shows your date of birth.

If you have not registered online, you will be registered at the walk-in clinic. For this, you will need your Personal Public Service (PPS) number, Eircode, mobile phone number, email address and photo ID that has your date of birth.

Is there any reason I should not attend a walk-in centre?

You should delay getting your Covid-19 vaccine if you currently have Covid-19 (wait until it has been four weeks since you first tested positive), if you have symptoms of Covid-19 or if you are restricting your movements.

What are the locations, dates and times of the walk-in centres?

Carlow Institute of Technology

Walk-in vaccination:

Saturday July 31st, 2pm to 4.15pm
Monday August 2nd, 9.15am to 12.15pm and 1.15pm to 4.15pm

Kilmore Hotel, Cavan

Saturday July 31st, 8.30am to 12.30pm
Sunday August 1st, 8.30am to 12.30pm
Monday August 2nd, 8.30am to 12.30pm

West County Hotel, Ennis

Saturday July 31st, 8.30am to 12pm
Sunday August 1st, 8.30am to 12pm
Monday August 2nd, 1.30pm to 6pm

Páirc Uí Chaoimh

Walk-in vaccination is not available at this centre right now.

City Hall Cork

Sunday August 1st, 1pm to 4pm

Munster Technological University Campus

Monday August 2nd, 10am to 4pm

Mallow GAA Club, Co Cork

Clonakilty GAA Club

Saturday July 31st, 11am to 3pm

Bantry Primary Care Centre

Sunday August 1st, 11am to 3pm

Letterkenny Institute of Technology

Saturday July 31st, 8.30am to 5pm

Carndonagh Satellite Vaccination Clinic

Monday August 2nd, 9am to 12pm

Aviva Stadium, Dublin 4

Monday August 2nd, 8am to 6.30pm

UCD O’Reilly Hall, Dublin 4

Citywest Convention Centre, Saggart

Saturday July 31st, 8am to 12pm
Sunday August 1st, 12pm to 6.30pm

Croke Park, Dublin 3

Monday August 2nd, 8.30am to 12.30pm and 1.45pm to 6.30pm

National Show Centre, Swords

Saturday July 31st, 2.30pm to 6.30pm

Clifden Satellite Vaccination Clinic

Saturday July 31st, 10am to 2.30pm

Galway Racecourse

Killarney Sports & Leisure Centre

Kerry Sports Academy

Tuesday August 3rd, 11am to 3pm

Punchestown Racecourse

Saturday July 31st, 9am to 12.15pm
Sunday August 1st, 1.15pm to 4.30pm
Monday August 2nd, 9am to 12.15pm

Cillin Hill Conference Centre

Saturday July 31st, 8.15am to 12.30pm
Sunday August 1st, 8.15am to 12.30pm
Monday August 2nd, 8.15am to 12.30pm

Midlands Park Hotel

Monday August 2nd, 9am to 2pm

Primary Care Unit, Carrick on Shannon

Limerick Racecourse

Saturday July 31st, 1.30pm to 6pm
Sunday August 1st, 1.30pm to 6pm
Monday August 2nd, 8.30am to 12pm

Clonguish GAA Club

Friday July 30th, 8am to 8pm

DIFE Drogheda

Sunday August 1st, 1.15pm to 4.15pm

Fairways Hotel, Dundalk

Breaffy House Resort, Castlebar

Saturday July 31st, 12pm to 6pm
Sunday August 1st, 12pm to 6pm
Monday August 2nd, 12pm to 6pm

Fairyhouse Racecourse

Saturday July 31st, 9.30am to 4pm

Simonstown GAA Club Navan

Monday August 2nd, 8.30am to 12.30pm and 1.45pm to 4.15pm

Hillgrove Hotel, Latlorcan

Glencarn Hotel, Castleblayney

Saturday July 31st, 9am to 12.30pm
Sunday August 1st, 9am to 12.30pm
Monday August 2nd, 9am to 12.30pm

Tullamore Court Hotel

Sunday August 1st, 8am to 2pm
Monday August 2nd, 8am to 8pm

Abbey Hotel, Roscommon town

Saturday July 31st, 11am to 4pm
Sunday August 1st, 11am to 4pm
Monday August 2nd, 11am to 4pm

Sligo Institute of Technology

Saturday July 31st, 10am to 2pm
Sunday August 1st, 10am to 2pm
Monday August 2nd, 10am to 2pm

Abbeycourt Hotel, Nenagh

Clonmel Park Hotel

Friday July 30th, 9am to 1pm and 2pm to 5pm
Saturday July 31st, 8am to 1pm

Waterford Institute of Technology Arena

Saturday July 31st, 11.30am to 4.30pm
Sunday August 1st, 11.30am to 4.30pm
Monday August 2nd, 11.30am to 4.30pm

Athlone Institute of Technology International Arena

Sunday August 1st, 9am to 7pm

Bloomfield House Hotel, Mullingar

Saturday July 31st, 9am to 4pm
Monday August 2nd, 9am to 1pm

Kilanerin Community Centre, Gorey

Astro Active Centre, Enniscorthy

Shoreline Leisure Centre, Greystones

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Kildare Vaccination Centre Punchestown Racecourse

Punchestown, Naas, Kildare, W91 VCX4

Map and directions For Kildare Vaccination Centre Punchestown Racecourse

Walk-in clinic schedule

Children aged 5 to 11 (dose 1 and dose 2 only)

Wednesday 28 September, 8.15am to 5.45pm

Children aged 6 months to 4

How it works

Get dose 1, dose 2, or dose 3 at a walk-in clinic. These clinics are for children under 12.

Dose 3 is for children age 6 months to 4 years only.

Children must attend with a parent or legal guardian.

Your child will not be vaccinated if they have not waited the recommended time:

since their last vaccine
if they COVID-19 recently

How long to wait between vaccines

Free parking on site.

Page last reviewed: 02 February 2024 at 4:31 p.m.

Immunisation
Public Information
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History of Vaccines
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Immunisation websites
Contact the National Immunisation Office

Contact the Immunisation Office Kildare

Do you live or go to school in Kildare?

Do you need a copy of your vaccination records or do you have a question

Please phone 045 920 633

or write to Immunisation Department, St Marys Community Services, Hospital Campus, Craddockstown Rd, Naas, Co Kildare

Do you need to contact us about the 4 in 1 and MMR school programme in Junior Infants

Please phone 045 920 635 or 045 920 636

Do you need to contact us about the HPV, Tdap and MenACWY programme for first-year students

Please phone 045 920 635 or 045 920 628

This page was updated 5th of March 2024

Travel vaccination advice

If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fever , typhoid and hepatitis A .

In the UK, the NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

When should I start thinking about the vaccines I need?

If possible, see the GP or a private travel clinic at least 6 to 8 weeks before you're due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you're:

travelling in rural areas
backpacking
staying in hostels or camping
on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

Which travel vaccines do I need?

You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these websites:

Travel Health Pro
NHS Fit for Travel

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it's still a good idea to take a record of the vaccinations you have had with you.

Find out more about the vaccines available for travellers abroad

Where do I get my travel vaccines?

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

written information on what vaccines are needed
the cost of each dose or course
any other charges you may have to pay, such as for some certificates of vaccination

You can also get travel vaccines from:

private travel vaccination clinics
pharmacies offering travel healthcare services

Which travel vaccines are free?

The following travel vaccines are available free on the NHS from your GP surgery:

polio (given as a combined diphtheria/tetanus/polio jab )
hepatitis A

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?

You'll have to pay for travel vaccinations against:

hepatitis B
Japanese encephalitis
tick-borne encephalitis
tuberculosis (TB)
yellow fever

Yellow fever vaccines are only available from designated centres .

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.

Other things to consider

There are other things to consider when planning your travel vaccinations, including:

your age and health – you may be more vulnerable to infection than others; some vaccines cannot be given to people with certain medical conditions
working as an aid worker – you may come into contact with more diseases in a refugee camp or helping after a natural disaster
working in a medical setting – a doctor, nurse or another healthcare worker may require additional vaccinations
contact with animals – you may be more at risk of getting diseases spread by animals, such as rabies

If you're only travelling to countries in northern and central Europe, North America or Australia, you're unlikely to need any vaccinations.

But it's important to check that you're up-to-date with routine vaccinations available on the NHS.

Pregnancy and breastfeeding

Speak to a GP before having any vaccinations if:

you're pregnant
you think you might be pregnant
you're breastfeeding

In many cases, it's unlikely a vaccine given while you're pregnant or breastfeeding will cause problems for the baby.

But the GP will be able to give you further advice about this.

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised.

This may be the case if:

you have a condition that affects your body's immune system, such as HIV or AIDS
you're receiving treatment that affects your immune system, such as chemotherapy
you have recently had a bone marrow or organ transplant

A GP can give you further advice about this.

Non-travel vaccines

As well as getting any travel vaccinations you need, it's also a good opportunity to make sure your other vaccinations are up-to-date and have booster vaccines if necessary.

Although many routine NHS vaccinations are given during childhood, you can have some of them (such as the MMR vaccine ) as an adult if you missed getting vaccinated as a child.

There are also some extra NHS vaccinations for people at higher risk of certain illnesses, such as the flu vaccine , the hepatitis B vaccine and the BCG vaccine for tuberculosis (TB) .

Your GP can advise you about any NHS vaccinations you might need.

Find out about NHS vaccinations and when to have them

Page last reviewed: 16 March 2023 Next review due: 16 March 2026

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Belgian and Dutch tour operators and travel agents with Cara Jeffrey, Tourism Ireland (sixth left), during their visit to Ireland

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03 Jun 2024 9:10 AM

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Published: 24 May 2024

Continuing development of vaccines and monoclonal antibodies against Zika virus

Sara E. Woodson 1 na1 &
Kaitlyn M. Morabito ORCID: orcid.org/0000-0002-4849-4690 1 na1

npj Vaccines volume 9 , Article number: 91 ( 2024 ) Cite this article

495 Accesses

4 Altmetric

Metrics details

Biotechnology

The 2016 Zika virus (ZIKV) epidemic catalyzed a global effort to develop diagnostic tests, vaccines, and therapeutic treatments. However, the rapid waning epidemiology of ZIKV stalled many countermeasure development efforts. On January 31 and February 1, 2023, the National Institute of Allergy and Infectious Diseases (NIAID) hosted “Continuing Development of Vaccines and Monoclonal Antibodies Against Zika Virus,” a workshop of assembled experts from multiple fields and sectors to review the latest ZIKV research findings and develop recommendations for advancing vaccines and monoclonal antibodies. This report describes the workshop proceedings and summarizes the key challenges and major recommendations identified at the workshop. While the current incidence and testing for ZIKV are low globally, ZIKV has not disappeared, and future large-scale outbreaks are possible. Developing an effective vaccine and monoclonal antibody treatment is still a public health priority, especially for persons who can become pregnant and who live or travel in ZIKV-endemic regions.

Introduction

The Zika virus (ZIKV) was brought to global attention in 2016 when scientists discovered that ZIKV infections were linked to microcephaly and Guillain-Barre syndrome (GBS) 1 , 2 , 3 . ZIKV infection during pregnancy was later appreciated to cause a range of other congenital malformations 4 , 5 , 6 . ZIKV infection is also linked to Guillain-Barré syndrome, neuropathy, and myelitis in both children and adults. When an epidemic of ZIKV disease emerged in Brazil and other countries in the Americas between April 2015 and November 2016, the World Health Organization (WHO) declared ZIKV infection a Public Health Emergency of International Concern. By 2018, ZIKV had been listed as a priority disease in WHO’s R&D Blueprint regarding preparedness for infectious disease outbreaks. The 2016 ZIKV epidemic catalyzed a global effort to develop vaccines and therapeutic treatments 7 , 8 . Despite the unprecedented speed of countermeasure development for ZIKV, the epidemic waned before efficacy could be evaluated in human clinical trials and there is currently no approved treatment or vaccine against ZIKV. Countermeasures that can prevent ZIKV infection and disease remain a public health priority, particularly for persons who can become pregnant and who live or travel in ZIKV-endemic regions.

On January 31 and February 1, 2023, the National Institute of Allergy and Infectious Diseases (NIAID) hosted the workshop “Continuing Development of Vaccines and Monoclonal Antibodies Against Zika Virus,” which assembled experts in epidemiology, immunology, virology, healthcare, industry, non-profit administration, and government with the goals of updating countermeasure developers on the latest scientific information, encouraging new collaborations between academic researchers and industry, and providing a regulatory perspective on the development of countermeasures for ZIKV. The workshop participants aimed to assess the current state of knowledge of Zika virus infection and immunity, the development status and landscape of vaccines and monoclonal antibodies, and the challenges for advancing vaccines and monoclonal antibodies (mAb) (Supplemental Table 1 ). Session 1: “Zika Epidemiology” reviewed what is currently known about ZIKV epidemiology globally and reported findings from human natural history studies. Session 2: “Zika Infection and Immunity” highlighted recent scientific findings about ZIKV infection, pathogenesis, and the immune responses that confer protection. Session 3: “Zika and Dengue Immune Interactions” examined the relationship between ZIKV and DENV infections and the implications of this cross-reactivity for vaccine research. Session 4: “Vaccines and Antibody-based Countermeasures” surveyed the latest ZIKV vaccine and mAb landscape and updated participants on the most advanced development efforts. Wrapping up the two-day event, session 5: “Pathways for Advanced Countermeasure Development” offered considerations for advancing clinical development of ZIKV vaccines and mAbs, including regulatory pathways.

ZIKV has a high probability to reemerge on a broad scale like many other arboviruses, and scientists, clinicians, and public health experts need to be prepared to address future significant outbreaks or epidemics. This report highlights key findings and discussion points during the two-day workshop and concludes with a description of proposed next steps for vaccine and mAb development (Box 1 ).

Box 1 Summary of key takeaways and recommendations

Key takeaways and recommendations from Zika Virus Epidemiology and Congenital Infection Session:

• ZIKV is still present in many regions and there is a need to restore diagnostic testing and surveillance globally. The full burden of ZIKV is unknown, in part because robust testing is not being conducted at local or national levels.

• Countries should prioritize differential diagnostic testing and focus on tests that are suitable for use in low incidence situations (i.e., tests that give fewer false positives).

• Natural history study protocols should be tailored for smaller outbreaks and positioned for rapid launch as soon as new outbreaks appear. Master protocols should also be considered to maximize efficiencies.

• Data should be gathered on baseline rates of neurodevelopmental abnormalities to provide a more accurate portrait of Zika-related birth defects.

• Investigators should collaborate and pool data from human cohort studies. Especially in the absence of a widespread outbreak that brings high case numbers, partnerships will be key to advancing the epidemiological landscape. More cohort studies are needed before efficacy trials for vaccines or monoclonal antibodies can likely proceed.

• Development of specific and sensitive diagnostics and reliable testing algorithms should continue.

• The effect of an outbreak, exposure, or infection on women’s behavior and choices regarding sexual activity, fertility, family planning, and pregnancy should be evaluated.

• Factors affecting early pregnancy loss are complicated and should be studied in more detail, including both virus-specific, such as virus strain, and host-specific factors such as gestational age, comorbidities, pregnancy history, etc.

• Surveillance resources should be directed toward comprehensively understanding ZIKV incidence and prevalence in humans, animals, and vectors in the Americas, Asia, and Africa, given the low transmission levels and periodic, but limited outbreaks in certain regions.

• Cost-effective surveillance options, especially in low-and-middle-income countries (LMICs), should be developed. For example, incorporation of ZIKV surveillance into wastewater surveillance planning or efforts should be considered.

• Re-establishing or continuing surveillance programs for ZIKV may face challenges for continued investment without having prevention or treatment candidates that can be implemented once infection incidence has increased.

Key takeaways and recommendations from Zika Virus Infection and Immunity and the DENV and ZIKV Immune Interactions Sessions:

• Focusing solely on antibody responses is an incomplete portrait of ZIKV immunity and T cell responses warrant further study.

• The limited access to NHPs has a particular impact on ZIKV research. Research into vaccinating pregnant persons remains challenging in the absence of these available animal populations or alternative models.

• Consider expanding the exploration and use of humanized rodent models, which have shown promise for ZIKV research and could provide a path forward should NHP accessibility remain a significant challenge.

• A comprehensive approach, including both innate and adaptive immune responses, to studying the immune response in ZIKV, particularly in the absence of clearly defined surrogates or correlates of protection, will be required.

• A better understanding of flavivirus maturation, including examining the potential impact of changes to the E protein sequence on flavivirus maturation and antigen structure could inform vaccine development.

• Continue to address the complexity of potential ZIKV and DENV cross-reactivity using cohort studies and refined, well-characterized assays.

Key takeaways and recommendations from Vaccines and Antibody-based Countermeasures Session:

• Vaccine and monoclonal development has stalled due to both the waning ZIKV incidence and limited resources to continue the development of countermeasures.

• Additional research is needed to understand the complexity of interactions between ZIKV and DENV immunity to ensure safe deployment of ZIKV vaccine(s) in DENV endemic regions.

• The target population and label indication need to be defined for each product.

• Because the vaccines and mAbs in clinical development have not yet been approved by regulatory authorities and have limited quantities of manufactured product, they would not be available for rapid mobilization to large populations in a future ZIKV outbreak.

• A key logistical obstacle for further development of vaccines and mAbs include the lack of available NHPs for research.

• Existential concerns about enhanced disease, in the context of DENV, should not slow ZIKV vaccine development efforts. Research to better understand the potential risk(s) can be done in parallel with development efforts.

• Vaccine deployment strategies, such as deploying ZIKV vaccines in conjunction with DENV vaccines, or vaccinating DENV seropositive individuals, could mitigate potential risks of enhanced disease from subsequent DENV infections.

Key takeaways and recommendations from Pathways for Advanced Countermeasure Development:

• Identifying a surrogate endpoint for accelerated approval for a ZIKV vaccine is a significant challenge that will likely require data from nonclinical and clinical studies, human challenge models, and seroprevalence surveillance.

• Product developers should engage the FDA early and often to discuss the potential pathways and requirements for their individual products.

• The clinical endpoints for trials and label indication for the product needs to be carefully considered and may include prevention of infection, prevention of disease, and prevention of congenital infection or disease.

• Prevention of infection or disease in vaccinees does not necessarily mean ZIKV vaccines will prevent congenital abnormalities or infection. More research is needed to understand the parameters that influence congenital infection.

• Indications for prevention of congenital infection or disease are unlikely for initial licensure given the logistical challenges of demonstrating this endpoint in phase 3 efficacy studies and it is anticipated that post-licensure or phase 4 studies would likely be needed.

• Vaccinating or treating pregnant or lactating persons has logistical and cultural challenges. Even strategies aimed at protecting persons of reproductive age before they become pregnant need to consider the safety of administration during pregnancy given the high number of unplanned pregnancies annually.

• Product developers should consider conducting development and reproductive toxicology (DART) studies early in the regulatory process and enrolling pregnant persons in phase 3 trials to help address safety in pregnant populations.

• When preparing for the next epidemic, it would be ideal to have an IRB-approved phase 3 protocol with an adequate supply of investigational product ready for distribution at key locations. Assuming those elements are in place, this level of preparedness would mark a significant and hopeful step forward in ZIKV epidemic readiness and response.

Current state of knowledge regarding Zika virus epidemiology and congenital infection

The goal of this session was to provide an update on current ZIKV epidemiology and key findings from natural history studies.

As of December 2021, autochthonous mosquito borne transmission of ZIKV had been detected in 89 countries and territories globally, with 61 countries and territories reporting evidence of Aedes aegypti (the mosquito thought to primarily transmit ZIKV) but no documented autochthonous ZIKV transmission 9 . Currently, diagnostic testing and surveillance for ZIKV is low globally and the true prevalence of disease remains unknown. The COVID-19 pandemic hampered ZIKV diagnostic testing and surveillance efforts by diverting resources and modifying individual healthcare seeking behaviors, neither of which have rebounded as the pandemic has waned. Pan American Health Organization (PAHO) continues to actively collate and report ZIKV disease cases ( https://www3.paho.org/data/index.php/en/mnu-topics/zika.html ), but outside of the Americas, little new data are being reported, which may indicate low transmission or a lack of testing. Sporadic cases have been reported in the European Union and the Western Pacific, and India has reported several small outbreaks since 2016, with most recently 150 cases in Utter Pradesh state in October 2021 9 , 10 . In Brazil, the real burden of ZIKV disease remains unknown and is likely underreported, despite strong surveillance and diagnostic testing infrastructure. Brazil continues to see human cases, including some acute ZIKV disease, suggesting that the virus continues to have low-level circulation 11 . However, the full picture of ZIKV’s maintenance and circulation in Brazil remains to be elucidated as non-human primate and mosquito surveillance has sometimes shown discordant results (i.e., evidence of Zika infection or maintenance in either non-human primates or mosquitos, but not both populations in the same time or space) and is largely incomplete in many states 12 , 13 , 14 . More research is needed to explain ZIKV’s maintenance and circulation across many geographical regions.

The continental United States has seen no new reports of mosquito-borne ZIKV transmission since 2018, and few cases have been reported among travelers in the last 3 years. In the US territories, an average of 35 cases annually have been reported over the last 3 years, with recent cases only probable, not confirmed 15 . In a rare move, in May 2021 the FDA removed its requirement for routine ZIKV screening of US blood donations, citing the global decline in ZIKV incidence.

ZIKV-related congenital impacts are also not sufficiently understood. The US Zika Pregnancy and Infant Registry (USZPIR) is a US national surveillance system that tracks pregnant people within the US who have laboratory confirmed ZIKV infections and collects information from medical records about these pregnant people and their infants. This information includes physical examinations, neurodevelopmental screenings, assessments and evaluations, neuroimaging, hearing screenings, audiological evaluations, and ophthalmology examination. Using data from the USZPIR, investigators found that 4.6% of the infants tracked between 1 December 2015 and 31 March 2018 had a Zika-associated birth defect (ZBD), with no difference in outcome based on maternal symptom status (asymptomatic versus symptomatic). Among pregnancies with confirmed ZIKV infection, 6.2% of infants had a ZBD. In areas with widespread local transmission of the virus, ZBDs were 9 times higher than in areas without local transmission 4 , 5 , 6 . A limitation of findings from the USZPIR is a lack of a control group of pregnant persons who were not exposed to ZIKV during pregnancy. There are multiple challenges to the successful surveillance of ZBD and congenital Zika syndrome (CZS): a high proportion of ZIKV infections are asymptomatic, making surveillance difficult; laboratory serological testing is complicated by cross-reactivity with other flaviviruses and a lack of correlation between IgM and PCR test results; and consistent case definitions of microcephaly and other congenital abnormalities are still needed. The addition of congenital ZIKV infection to the Centers for Disease Control and Prevention’s (CDC) Birth Defects Surveillance Toolkit may help position public health and healthcare workers for better detection of ZBD in the future. Several human cohort studies launched when the 2016 outbreak was already peaking and were forced to adapt their endpoints or proceed with lower numbers after the infection rate waned. For example, the ZIP (Zika in Infants and Pregnancy) Trial (NCT02856984), initiated in June 2016, planned to enroll 10,000 pregnant persons but only enrolled 6,461 owing to the declining infection rate, which not only affected the number of cases but also led to missing data attributed to dwindling participant interest in the study and corresponding loss to follow-up. ZIKAlliance that consisted of eight Latin American partner countries at 14 sites, conducted its study when the outbreak peak had just passed, enrolling 3852 pregnant subjects before cohort numbers and samples dropped off rapidly (as presented at the workshop) 16 , 17 .

Considering the limited ZIKV cases, data from multiple cohort studies may need to be pooled or shared to reach sufficient case numbers for endpoints which will require harmonized or comparable testing algorithms. In preparation for future outbreaks, universal or master protocols should be put into place where possible, including standard definitions for key outcomes and terms such as ‘exposed pregnancy’. A master protocol is a single protocol that is designed to address multiple questions and could be used to directly compare multiple interventions as was done during the Ebola outbreak 18 .

Decision-makers will need to remain blinded in cohort studies is needed to facilitate flexibility and adaptability without bias. Questions that are still to be addressed include which testing strategy or algorithm is most efficient to detect ZIKV infection reliably with high confidence, what the role of seroconversion should have in surveillance studies, and how best to determine a baseline frequency for adverse pregnancy outcomes. The field should continue to pursue these research questions and elements in order to be prepared for future outbreaks.

Current state of knowledge regarding Zika virus infection and immunity and the potential interactions between dengue virus and ZIKV immunity

The goals of these sessions were to set the baseline of what is known about ZIKV infection and protective immune responses, correlates of protection, and what basic research gaps remain. These sessions also assessed what is known about the impact of ZIKV immunity on dengue virus (DENV) disease severity and discussed considerations for Zika vaccines and mAbs.

A genome-wide approach to studying flavivirus-host interactions using primary human cells and patient-derived viruses has allowed researchers to characterize and compare transcriptional and epigenetic changes in infected versus uninfected cells. By separating out these different cell populations, researchers found that ZIKV targets transcription to block macrophage responses 19 . In addition, ZIKV infection increases the expression of genes enriched for lipid metabolism-related functions. In particular, researchers identified sterol regulatory element-binding protein (SREBP)-activated transcription as a mechanism for promoting ZIKV infection that could be agreeable to therapeutic targeting 20 .

DH1017.IgM is a novel pentameric ZIKV-specific IgM that was isolated from a pregnant woman infected with ZIKV. DH1017.IgM targets envelope (E) dimer epitope and provides new insights into potential effective and safe therapeutic candidates. The increased potency of the IgM antibody is related to the polyvalency of the IgM molecule; IgM appears more protective than an IgG with the same specificity 21 .

A study of two ZIKV DNA vaccine candidates found that while both vaccines elicited similar levels of neutralizing antibodies, only one vaccine was completely protective against a viral challenge in animal studies. This demonstrated that different vaccines can elicit qualitative differences in the composition of antibody responses 22 , 23 . Analysis of sera from non-human primates (NHP) and humans found differences in the vaccines’ capacities to elicit antibodies that can neutralize the structurally mature form of the ZIKV virion 23 . This discovery further suggests that the capacity to neutralize mature virions could be critically important for vaccine-induced immunity. A more comprehensive understanding of virion structure and dynamics could make it possible to generate vaccine candidates that direct immune responses to epitopes available on the mature viral particle.

Recent lessons applied from DENV research also support the idea that in vitro neutralization does not always equal protection. Historically, most flavivirus vaccine research has relied substantially on the presence of neutralizing antibodies measured by in vitro assays, but recent DENV studies suggest that serotype-specific neutralization may correlate better with protection of a given DENV serotype 24 , 25 , 26 . This highlights that both the quality and the type of neutralizing antibodies appear to matter for protection against disease, which is an important lesson to apply to ZIKV. In discussion, participants noted that the adoption of international standards for neutralization assays would allow studies to be better compared—such standards were not available in 2016 but could potentially be generated before the next major outbreak.

While scientists have made progress in understanding humoral immunity to ZIKV, T cells also play important roles in protection. One study examined whether prior dengue virus immunity impacted the kinetics and viral epitopes targeted by T cells elicited by ZIKV infection 27 , 28 , 29 . Memory T cell responses brought out either by prior infection with DENV or by immunization with a tetravalent live-attenuated DENV vaccine formulation recognize ZIKV-derived peptides 27 , 28 , 29 . Assessing such T cell reactivity could shed light on beneficial versus poor or harmful immune responses.

While structural proteins are typically the primary focus for studying humoral immunity, NS1 is also a potential vaccine antigen with a low risk for antibody-dependent enhancement (ADE), with some studies showing its potential to prevent severe flavivirus disease 30 . However, NS1 has not yet been explored as a broad-spectrum therapeutic antibody target and is not yet sufficiently understood. Structure-based vaccine and therapy design for NS1 are areas ripe for continued research.

NHP studies have provided important proof of concept that antibodies and vaccines can protect against congenital ZIKV infection. Using a rhesus macaque model of congenital ZIKV infection and mimicking real-world infection conditions, a ZIKV DNA vaccine was able to protect against prolonged maternal viremia and fetal pathology 31 . In the same model, two monoclonal antibodies did not eliminate maternal viremia but did limit vertical transmission, protecting the fetus from neurological damage 32 . Similarly, human IgG treatment controlled Zika viremia in pregnant rhesus macaques 33 . Development of suitable animal models has been widely challenged by the lack of available NHP colonies for research.

Infection with a low-passage African lineage ZIKV during pregnancy in mice more significantly affects fetal outcomes compared to Asian lineage ZIKV. Comparisons across seven ZIKV strains showed African-based strains had higher transmissibility in mosquitos and higher lethality in young and adult mice, compared to their Asian counterparts 34 . This finding could signal the higher epidemic potential of African ZIKV strains, and it also suggests that outbreaks caused by them could go undetected longer. Related research showed that high-dose exposure to African-lineage ZIKV caused pregnancy loss in macaques rather than birth defects 35 , 36 . More research is needed on gestational ZIKV infection in Africa to help understand the implications of these findings. African-lineage ZIKV strains could also be used to develop more stringent and consistent animal models, with endpoints based in pregnancy loss rather than the array of congenital abnormalities seen in live births.

Finally, ZIKV and DENV cross-reactive immunity is complex and needs further study. Lessons from natural infection studies—in particular, cohort studies in Nicaragua and Brazil—have shown that the immune response against ZIKV affect immune responses and disease outcomes during subsequent infections with DENV, and vice versa 37 , 38 . DENV infection appears to protect against uncomplicated ZIKV disease, but depending on the incoming DENV serotype, a prior ZIKV infection appears capable of one of several outcomes: it can increase the risk of symptomatic DENV infection; it can enhance DENV disease severity; or it can potentially protect against DENV 39 . Cross-reactive antibodies were stable or rose after a primary dengue and ZIKV infection and waned gradually after a secondary infection 40 . These findings complicate existing understandings of the interplay between anti-DENV and anti-ZIKV antibodies and disease outcomes. More research is needed to understand the immunological mechanisms of protection and risk across both diseases and to determine whether the findings from human cohort studies apply more broadly.

Flaviviruses are structurally heterogeneous and dynamic, constituting complex immunogenic targets. Recent research has further revealed this complexity, raising questions and generating insights for the development of vaccines and therapeutic treatments. Since no clear surrogates or correlates of protection have been identified, examining both innate and adaptive immune responses to ZIKV infection and vaccination will be important. Defining immunodominant epitopes and the ways in which neutralizing antibodies bind these epitopes will provide insights for vaccine development. With multiple immunological components contributing to ZIKV protection and immunity, and with multiple antibody functions likely contributing to protection, additional research is needed to broaden and strengthen understanding of ZIKV structure, transmission, and antigenicity. Working together will enable the field to continue advancing vaccines and therapeutic treatments in preparation for future outbreaks.

Current development landscape of vaccines and monoclonal antibodies

The goal of this session was to hear from product developers on the status of their countermeasures in development and their plans, if any, to advance them in the future.

When the ZIKV epidemic emerged in 2016, the global research community leaped into action, mobilizing to develop safe and effective vaccines and therapeutics. Scientists made significant progress within an expedited time frame, identifying over 45 vaccine candidates in 2016–2017, with more than 25 candidates moved to preclinical studies and 12 candidates advanced to Phase 1 clinical trials (including DNA, mRNA, inactivated, live-attenuated, and vectored vaccine platforms) 7 , 8 , 41 , 42 . Currently, four vaccine candidates have moved or are moving into phase 2 clinical trials. Updates on three of the most advanced vaccine candidates were provided during this session. Research into potently neutralizing human mAbs also advanced during the same period and shows strong promise for treating and potentially preventing ZIKV infection. Now with low ZIKV incidence globally, advancing these medical countermeasures beyond phase II will be challenging, particularly given the difficulty of launching large clinical trials in the absence of a sustained outbreak or reliable prevalence data 42 , 43 .

Moderna’s investigational ZIKV vaccine, mRNA-1893, has successfully completed a phase 1 trial 44 . The vaccine induces a strong neutralizing antibody response comparable to levels observed during the acute phase of a ZIKV infection, and a detectable neutralizing antibody response was maintained one year following vaccination 45 . A phase 2 clinical trial is moving forward (NCT04917861) with 809 participants from the United States and Puerto Rico. This study will evaluate two administrations of mRNA vaccines at day 1 and day 29 at two dose levels (30 µg or 100 µg) compared to a single 100 µg dose administration and placebo 1 .

Takeda’s purified inactivated Zika vaccine PIZV (TAK-426), currently undergoing clinical development, successfully completed a phase 1 clinical trial evaluating the safety, tolerability, and immunogenicity of three doses of PIZV. TAK-426 was well tolerated and immunogenic in both flavivirus-naive and flavivirus-primed adults. The magnitude and the kinetics of the high-dose (10-µg) PIZV-induced nAbs were comparable with those observed in convalescent ZIKV patients. Based on the safety and immunogenicity profiles of all TAK-426 doses assessed, the 10 μg TAK-426 dose was selected for further clinical development 46 , 47 .

In preclinical studies, two ZIKV DNA vaccine candidates developed by NIAID’s Vaccine Research Center, VRC5283 and VRC5288, were found to be immunogenic in mice and non-human primates 22 , 23 . Phase 1 clinical trials (VRC 319 and VRC 320) demonstrated that candidate VRC5283 had superior immunogenicity, with greatest T cell responses seen four weeks after a needle-free administration of the vaccine 48 . A Phase 2/2b clinical trial (VRC 705) of the VRC5283 candidate vaccine was initiated to assess safety, immunogenicity, and efficacy in endemic populations, but ZIKV incidence waned and despite implementing an adaptive enrollment approach, not enough cases were captured to assess vaccine efficacy. Interim data and epidemiological reviews concluded that there was a low possibility of documenting additional ZIKV infections and the trial was stopped early. Overall, only 3 out of 2338 subjects had virologically confirmed ZIKV infection (PCR). Assessment of the immunogenicity results from this trial are ongoing.

The identification of a subset of antibodies targeting the conformational epitope spanning the E dimer (EDE antibodies) that can potently neutralize both DENV and ZIKV have opened the door for next-generation flavivirus vaccine approaches 49 . Comparing the ZIKV and DENV immunologic structures opens a pathway for epitope-focused vaccine design that could elicit potent cross-neutralizing antibodies sufficient to protect against both ZIKV and DENV and the potential to mitigate antibody-dependent enhancement (ADE) 50 , 51 .

Potently neutralizing mAbs show promise as a tool for potentially preventing and/or treating ZIKV infection and recent capability demonstrations have shown proof-of-concept that mAb products could be rapidly identified and developed in response to future outbreaks 52 . ZIKV-117 (Vanderbilt University) has been shown to be highly potent and effective in preclinical studies, preventing fetal infection and demise in mice, protecting from and treating viremia in macaques, and has activity against both the Asian and African lineages of ZIKV 53 , 54 . Based on ID Biologics’ in silico and experimental biophysical analyses, ZIKV-117’s predicted half-life is 60–90 days, making it a strong candidate for further development. Currently, ZIKV-117 is moving forward in chemistry, manufacturing, and controls (CMC) development, in conjunction with relevant elements from WHO’s preferred product characteristics .

Further development of candidate vaccine and mAb products remain a challenge. Waiting for a widespread ZIKV outbreak to evaluate efficacy of candidate products will mean that a product will likely not be available in time for those who need it most, even when moving at highest possible capacity or speed. Barriers include the logistics of rapid manufacture and supply, product availability, the time requirements of clinical trial applications, and the unresolved question of the appropriate clinical endpoint (prevention of viremia in persons of child-bearing age versus reduction in incidence of congenital ZIKV syndrome). In addition to logistical barriers due to the current low circulation of ZIKV, this session identified key immunological, epidemiological, and regulatory questions that need to be addressed to further develop vaccines and mAbs against ZIKV. While neutralizing antibodies are commonly assumed to be a surrogate of protection, the mechanisms of protective immunity and the role of T cells for flavivirus vaccines are not fully understood. Most workshop discussants agreed that a desirable goal of vaccination or mAb treatment is prevention of congenital infection, which is a relatively rare outcome based on current data and likely not practical to assess in traditional phase 3 efficacy trials. A common theme of discussion among product developers and meeting discussants was what the appropriate endpoint(s) for efficacy and label indication would be for a given candidate product: prevention of disease in adults, prevention of infection in adults, or prevention of congenital infection or abnormalities. Safety issues for medical countermeasures also pose challenges to countermeasure development including concerns about ADE, Guillain-Barre syndrome, and issues specific to pregnant and lactating persons. Additional question about deployment strategies were also raised, including whether routine vaccinations should be used only in outbreak settings and which target populations should be prioritized for immunization.

Pathways for advanced countermeasure development

The goals of this session were to identify considerations for advancing ZIKV vaccine and mAb development and explore the regulatory pathways for countermeasure development.

The final session of the workshop outlined potential licensure and approval pathways, focusing on research gaps that need to be filled and identifying opportunities and barriers to successful medical countermeasure development. Safety considerations and monitoring of outcomes will be crucial to the success of a ZIKV vaccine or mAb in all intended populations, which may include individuals of child-bearing age and pregnant or lactating persons. The longstanding exclusion of pregnant and lactating persons from clinical trial participation has given rise to their widespread reluctance to be immunized. If the target population for a ZIKV vaccine or mAb becomes persons who can become pregnant but who are not yet pregnant, safety remains a pressing concern since a large number of all pregnancies are unintended. In the USA, approximately half of all pregnancies are unintended. Without adequate safety information about ZIKV vaccines and mAbs during pregnancy, even strong medical countermeasure candidates will struggle to advance and critical target population will potentially be excluded from most of the clinical discussion.

There are ongoing efforts to provide evidence-based information about medications, vaccines, infections, and other exposures during pregnancy including MotherToBaby , a US network that collaborates with the Vaccines in Medications in Pregnancy Surveillance System (VAMPSS) to identify the circumstances in which a drug or immunization could cause harm 55 , 56 , 57 , 58 . Experience with other vaccines utilized during pregnancy can be leveraged to identify considerations for ZIKV vaccines and mAbs.

Even if ZIKV countermeasures are recommended solely for persons of reproductive age who can become pregnant and not for those who are pregnant, inadvertent pregnancy exposures are likely to occur since many pregnancies are unplanned. Data on safety in pregnancy and during lactation is still needed. In the absence of substantial trial data in pregnancy or lactation, a priori planned mechanisms for capturing observational data in a timely and systematic manner are important and should be a priority for public health and scientific experts.

Vaccine safety considerations become even more challenging outside the United States, especially in lower-resource settings. Microcephaly has been shown to have a higher prevalence in these settings, though how much can be attributed to ZIKV infection is unclear. A recent Guatemala-based study found a high prevalence of microcephaly or reduced head circumference in infants and young children, where a major risk factor was the presence of ZIKV antibodies in infancy, suggesting the possibility of either congenital or post-natal infection with ZIKV 59 . Determining clinical and safety endpoints beyond symptomatic infection for Phase III trials will be important and may also be key to encouraging vaccine uptake and the use of mAbs for prophylaxis and/or treatment. Safety endpoints of special interest in low-resource settings and LMICs include acute febrile illness, flavivirus-like illness hospitalizations, microcephaly, and developmental delays 60 . Such endpoints, especially in pediatric populations, are complicated, usually rare, and long term and will likely mean that researchers may need to follow infants through the major developmental years to monitor for adverse effects. These logistical factors must be taken into consideration for medical countermeasures when planning phase III or post-licensure trials, whether in the USA or elsewhere.

In the absence of substantial ZIKV transmission, there is a role for a controlled human infection model (CHIM) for ZIKV, an idea originally discussed in 2016 and published as an initial report . At the peak of the 2016 ZIKV epidemic when incidence was high, experts struggled to justify administering volunteers with infectious ZIKV 61 . When the epidemic rapidly waned, WHO announced support of the proposed CHIM study, noting that human challenge models could play a role in the regulatory pathway toward vaccines and therapeutics 62 . Researchers at NIAID and John Hopkins University isolated two clinical viral isolates from patients who presented with an uncomplicated Zika infection and evaluated them in NHPs for suitability in the CHIM. A clinical trial (NCT05123222) to establish a ZIKV CHIM has now begun, with extensive risk mitigation in place through the enrollment of flavivirus-naïve female subjects between ages 18 and 40, through the provision of reliable and confirmed birth control, and through the monitoring of subjects on an in-patient basis (initially until day 14, subsequently lowered to 8 days). The ZIKV CHIM appears promising to date and may provide efficacy data to support licensure.

From a regulatory perspective, several considerations must be in place for a ZIKV vaccine to advance along a regulatory pathway toward approval or licensure. Vaccine approval will follow the same paradigm as with other preventive vaccines, though unique considerations may apply if development occurs during a Public Health Emergency of International Concern (PHEIC). Depending on the licensure or approval pathway pursued, demonstration of clinical benefit for a ZIKV vaccine could be shown in disease endpoint efficacy studies, in studies that show an effect on a surrogate marker reasonably likely to predict clinical benefit, or in animal studies. Multiple challenges remain to be addressed: conducting a large phase 3 trial is difficult if not impossible in the absence of a widespread outbreak, a surrogate marker has not yet been established for ZIKV, and animal rule approval is very unlikely as a pathway for ZIKV vaccines to advance. Possible regulatory pathways forward for access to a ZIKV vaccine include accelerated approval, IND utilizing Expanded Access Regulations, and Emergency Use Authorization. For Accelerated Approval, a defined surrogate endpoint must be identified. Possible studies could include passive transfer of antibodies in animal models, challenge studies in animal models, or sero-epidemiologic studies. Assay precision, validation, and performance would need to be demonstrated and confirmatory trial design would need to be in place. For Investigational New Drug Application (IND) utilizing Expanded Access Regulations, there is a requirement of informed consent and IRB approval for all persons receiving an investigational vaccine. Emergency Use Authorization is unlikely in the absence of another large-scale outbreak. Product developers are encouraged to communicate early and often with the FDA’s Center for Biologics Evaluation and Research (CBER), and regulatory mechanisms are available to permit access to investigational ZIKV vaccines in the case of an outbreak.

A similar regulatory process applies to the approval of monoclonal antibody through the FDA’s Center for Drug Evaluation and Research (CDER). Important considerations for ZIKV-specific mAbs include identification of the target population and determination of appropriate endpoints for that target population. If multiple target populations are identified, efficacy endpoints could differ significantly between them and decisions will need to be made regarding prophylactic versus therapeutic treatment indication. Special consideration must be paid to any drug trials involving pregnant individuals, fetuses, and/or neonates. The design of the clinical program must take into account the indication(s) being pursued. For instance, there is a different risk/benefit analysis with prophylaxis versus treatment indications for ZIKV mAbs. In addition, the question of how to measure efficacy within the pregnant population has not yet been adequately answered—nor do researchers yet know if there a role for antiviral treatment in the management of congenital Zika syndrome. Product developers should engage early and frequently in dialogue with the FDA to discuss possible paths forward, working on a development plan in the context of an evolving understanding of ZIKV mechanism and structure, finalizing a plan for product use and indication, and mapping out proposed studies or trials to support that indication.

Looking ahead: next steps for vaccines and monoclonal antibodies against Zika virus

ZIKV presents unique challenges from many of the other pathogens with epidemic potential: it is found on multiple continents; it has multiple clinical syndromes and is associated with several outcomes; it is largely asymptomatic in adults but causes significant congenital morbidity; it cross-reacts with other flaviviruses; and it lacks a licensed or approved product to prevent or treat infection. Additionally, advanced vaccine and mAb development is made exceptionally difficult owing to the current low global ZIKV incidence. An ideal and effective ZIKV vaccine or mAb must be capable of protecting fetuses from abnormalities, but its administration must also avoid causing potentially adverse side effects in this vulnerable population. While the ultimate goal is to prevent congenital disease, this endpoint is impractical to assess in phase 3 clinical trials currently, and so a more realistic indication and surrogate endpoint, such as prevention of infection in adults, will likely be required for licensure. Post-licensure studies will likely be required to monitor safety and effectiveness in pregnant and lactating people. More research is imperative to pinpoint the precise nature of the relationship between ZIKV and DENV infections. But the complex nature of these interactions should not prevent the advancement of potentially beneficial ZIKV vaccines and/or mAbs.

Despite these challenges, there are opportunities to advance the development of ZIKV vaccines and mAbs so that we will be better prepared for the next resurgence of ZIKV. Multiple vaccine candidates have been evaluated in phase 2 clinical studies. A newly established ZIKV CHIM shows significant promise for demonstrating efficacy of vaccines and mAbs in the absence of sustained ZIKV incidence and may provide additional insights into ZIKV disease and correlates of protection. There is now a better understanding of the immune responses generated by vaccination and infection and the broad spectrum of disease symptomologies. While many of these areas need additional research, the field is significantly more advanced than when ZIKV initially garnered an international response in 2016. International engagement not only of scientists and regulators but also of public health experts, civil society, and communities invested in the thriving and health of their populations will be required to continue advancement. Collective action and cooperative engagement, with a willingness to hear and listen to those with different experiences and expertise, will be essential to preventing the devastating health impacts of a new ZIKV outbreak on tomorrow’s children.

Data availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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Acknowledgements

We would like to thank the presenters, panelists, and discussants for sharing their expertise, research, and insights on Zika virus and medical countermeasure development. We would also like to thank Dr. Theodore Pierson (NIAID) and Ms. Tanima Sinha (BARDA) for their consultation on the workshop agenda, Ms. Christina McCormick (NIAID) and the NIAID Meet team for their assistance with workshop logistics, Dr. Stacia Pelletier (freelance writer and editor) for her assistance with workshop notes and this report, and Drs. Emily Erbelding, M. Cristina Cassetti, Mark Challberg, and L. Jean Patterson (all of NIAID) for their unwavering support of this workshop, report, and Zika virus research and medical countermeasures development. The findings and conclusions in this report are the summary of the workshop meeting and discussions and do not represent the official views or positions of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health. The “Continuing Development of Vaccines and Monoclonal Antibodies Against Zika Virus” workshop and this report were supported by the National Institute of Allergy and Infectious Diseases, National Institutes of Health.

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All authors contributed to the conception of the workshop, drafted and revised the manuscript, approved the final version and are accountable for all aspects of the work relating to accuracy and integrity. Authors contributed equally to this work.

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Local disparities may prevent national vaccination efforts for rubella

When public health officials make policies about when and how vaccination programs are implemented, they must weigh the benefits and risks of how infectious diseases spread throughout the country. However, these analyses are often based on national-level data and, in some countries, may overlook nuances at the local level.

A new analysis by an international team, including Penn State researchers, revealed that the resulting recommendations may keep some countries from realizing the benefits of vaccination and globally eradicating diseases, such as rubella -- a contagious viral infection that causes mild symptoms in children. The team examined data from Nigeria, one of 19 countries that hasn't yet introduced rubella vaccination, as a case study. Their findings were published in the journal Vaccine.

"It's this interesting challenge where rubella is a mild disease if you get it as a kid, but it's high risk if you get it as an adult," said senior author Matthew Ferrari, professor of biology and director of the Center for Infectious Disease Dynamics at the Huck Institutes of Life Sciences at Penn State. "All of the policy surrounding rubella vaccination has been guided by that risk in adults, which has been holding back the benefit of rubella vaccination in some countries."

The primary concern among adults is the potential risk for congenital rubella syndrome (CRS), a serious health condition that can occur if a pregnant person contracts the virus. When an infectious disease like rubella is common, people are more likely to contract it earlier in life. And because the rubella virus is immunizing, those who are infected as children won't have pregnancies at risk of CRS when they are older.

Vaccination, on the other hand, reduces the amount of circulating virus, meaning individuals who were not vaccinated as children are less likely to be infected with rubella by adolescence or adulthood, Ferrari explained. As a result, even as the total number of rubella cases goes down with vaccination, the number of rubella infections in people of reproductive age -- who were neither infected nor vaccinated as children -- increases, putting those pregnancies at risk of CRS. Because of this complex dynamic, the World Health Organization (WHO) recommends that countries demonstrate that they can achieve a coverage level of 80% or greater, through either routine immunization or supplemental campaigns, before introducing rubella vaccination. The conventional wisdom has been that when vaccination coverage is above this threshold, the reduced risk of CRS due to less rubella virus offsets the paradoxical increase in CRS risk because infections tend to happen later in life, Ferrari explained.

The research team, working in partnership with the U.S. Centers of Disease Control and Prevention and the Nigeria Centre for Disease Control and Prevention, studied the epidemiology of rubella in Nigeria. Rubella is a comparatively rare disease, so it's difficult to quantify the potential harm and risk of CRS. These assessments are further complicated by the fact that Nigeria, Ferrari said, is a country with disparate ranges of wealth, vaccination coverage, health care access and birth rates, all of which play a role in infection and CRS risk.

To gain a better understanding of the factors at play, the team analyzed data from a nationally representative serosurvey, which detects the presence of antibodies in blood. The data allowed the researchers to see how many people, particularly women of reproductive age, had rubella antibodies, how many were potentially at risk of rubella infection and where the infection risk was greatest geographically. They identified regional differences in transmission between the northern versus southern part of the country, finding that transmission in the north was two-times higher compared to the south. They were also able to estimate the number of pregnancies affected by rubella infection today.

"We grounded the current infection risk and potential pregnancies at risk in strong empirical data and real-world phenomena," Ferrari said. "Parts of the country can already vaccinate more than 80% of kids, based on their current rate of measles vaccination, but low vaccination coverage in the north is a barrier to introduction across the whole country under the current recommendation."

What's more, the concern about increased CRS cases may not be as bad as conventionally believed, Ferrari noted. The team's new estimates of transmission rates show that the 80% threshold is conservative and that introducing a rubella vaccination program in Nigeria today could reduce the number of CRS cases by thousands in the first five years. "Some states could see CRS risk increase by hundreds of cases," he said, "but that increased risk would not come to fruition until 10 years down the road" -- providing a decade for public health officials to implement policies and programs to prevent this possibility.

"Strengthening and improving routine immunization programs and advancing them everywhere in the world is a benefit to everyone in the world. The more we do this, the elimination of rubella as a virus on this planet is entirely feasible," Ferrari said.

Mumps, Measles, Rubella
Infectious Diseases
Diseases and Conditions
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Materials provided by Penn State . Original written by Christine Yu. Note: Content may be edited for style and length.

Journal Reference :

Taishi Nakase, Tenley Brownwright, Oyeladun Okunromade, Abiodun Egwuenu, Oladipo Ogunbode, Bola Lawal, Kayode Akanbi, Gavin Grant, Orji O. Bassey, Melissa M. Coughlin, Bettina Bankamp, Ifedayo Adetifa, C. Jessica E. Metcalf, Matthew Ferrari. The impact of sub-national heterogeneities in demography and epidemiology on the introduction of rubella vaccination programs in Nigeria . Vaccine , 2024; DOI: 10.1016/j.vaccine.2024.05.030

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Uganda tackles yellow fever with new travel requirement, vaccination campaign for millions

A man receives a shot of yellow fever vaccine at Kiswa Health Center III in Kampala, Uganda Tuesday, April. 2, 2024. Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat. (AP Photo)

Ugandans queue to receive yellow fever vaccine at Kiswa Health Center III in Kampala, Uganda Tuesday, April 2, 2024. Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat. (AP Photo)

A man holds a vaccination card that proves he has received the yellow fever vaccine, at Kiswa Health Center III in Kampala, Uganda Tuesday, April 2, 2024. Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat. (AP Photo)

A Ugandan man holds a vaccination card that proves he has received the yellow fever vaccine, at Kiswa Health Center III in Kampala, Uganda Tuesday, April 2, 2024. Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat. (AP Photo)

A Ugandan woman receives a dose of yellow fever vaccine at Kiswa Health Center III in Kampala, Uganda Tuesday, April 2, 2024. Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat. (AP Photo)

A nurse prepares to administer yellow fever vaccine at Kiswa Health Center III in Kampala, Uganda Tuesday, April 2, 2024. Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat. (AP Photo)

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KAMPALA, Uganda (AP) — Uganda has rolled out a nationwide yellow fever vaccination campaign to help safeguard its population against the mosquito-borne disease that has long posed a threat.

By the end of April, Ugandan authorities had vaccinated 12.2 million of the 14 million people targeted, said Dr. Michael Baganizi, an official in charge of immunization at the health ministry.

Uganda will now require everyone traveling to and from the country to have a yellow fever vaccination card as an international health regulation, Baganizi said.

Ugandan authorities hope the requirement will compel more people to get the yellow fever shot amid a general atmosphere of vaccine hesitancy that worries healthcare providers in the East African nation.

The single-dose vaccine has been offered free of charge to Ugandans between the ages of 1 and 60. Vaccination centers in the capital, Kampala, and elsewhere included schools, universities, hospitals and local government units.

Before this, Ugandans usually paid to get the yellow fever shot at private clinics, for the equivalent of $27.

Uganda, with 45 million people, is one of 27 countries on the African continent classified as at high risk for yellow fever outbreaks. According to the World Health Organization, there are about 200,000 cases and 30,000 deaths globally each year from the disease.

FILE - Cows stand in the milking parlor of a dairy farm in New Vienna, Iowa, on Monday, July 24, 2023. The bird flu outbreak in U.S. dairy cows is prompting development of new, next-generation mRNA vaccines — akin to COVID-19 shots — that are being tested in both animals and people. In June 2024, the U.S. Agriculture Department is to begin testing a vaccine developed by University of Pennsylvania researchers by giving it to calves. (AP Photo/Charlie Neibergall, File)

Uganda’s most recent outbreak was reported earlier this year in the central districts of Buikwe and Buvuma.

Yellow fever is caused by a virus transmitted by the bite of infected mosquitoes. The majority of infections are asymptomatic. Symptoms can include fever, muscle pain, headache, loss of appetite and nausea or vomiting, according to the WHO.

Uganda’s vaccination initiative is part of a global strategy launched in 2017 by the WHO and partners such as the U.N. children’s agency to eliminate yellow fever by 2026. The goal is to protect almost one billion people in Africa and the Americas.

A midterm evaluation of that strategy, whose results were published last year, found that 185 million people in high-risk African countries had been vaccinated by August 2022.

In Uganda, most people get the yellow fever shot when they are traveling to countries such as South Africa that demand proof of vaccination on arrival.

James Odite, a nurse working at a private hospital which has been designated as a vaccination center in a suburb of the capital, Kampala, told the AP that hundreds of doses remained unused after the yellow fever vaccination campaign closed. They will be used in a future mass campaign.

Among the issues raised by vaccine-hesitant people was the question of whether “the government wants to give them expired vaccines,” Odite said.

Baganizi, the immunization official, said Uganda’s government has invested in community “sensitization” sessions during which officials tell people that vaccines save lives.

The Associated Press receives financial support for global health and development coverage in Africa from the Bill & Melinda Gates Foundation Trust. The AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org .

Q&A on Trump’s Criminal Conviction

By Robert Farley , D'Angelo Gore , Lori Robertson and Eugene Kiely

Posted on May 31, 2024

Este artículo estará disponible en español en El Tiempo Latino .

Donald Trump became the first U.S. president, current or former, to be convicted of a criminal offense when a 12-person jury in New York on May 30 found him guilty on 34 felony counts of business fraud as part of an illegal scheme to influence the 2016 election by making payments to suppress a sordid tale of sex with a porn star.

The unprecedented conviction raises questions about what’s next for the 77-year-old man who is in line to become the Republican Party’s nominee for president in 2024.

In remarks at Trump Tower a day after his conviction, Trump called the United States “ a corrupt country ” and declared that he would be “ appealing this scam .”

(Trump also repeated many of the false, misleading and unsupported claims he has made about the judge, the judge’s rulings, the district attorney and other issues related to the trial. For more about Trump’s talking points, see our May 30 article, “ Trump’s Repeated Claims on His New York Hush Money Trial .” He also repeated false and unsubstantiated claims on other issues, such as taxes and migrants .)

Here, we answer some of the questions raised by the former president’s conviction:

What are the next steps in the case? What punishment could Trump face? Will he go to prison? Can Trump vote in the 2024 election? Can a felon run for president, hold office? Can Trump pardon himself on this conviction, if he wins?

What are the next steps in the case?

Sentencing and an appeal are up next in this case.

Sentencing by Justice Juan Merchan is scheduled for July 11. Before that date, a probation officer or someone in that department will interview Trump, and potentially others involved in the case or connected to Trump, and prepare a pre-sentence report for the judge. The report includes the personal history and criminal record of the defendant, and it recommends what sentence the defendant should receive, according to the New York State Unified Court System.

“The pre-sentence interview is a chance for the defendant to try to make a good impression and explain why he or she deserves a lighter punishment,” the state court system explains.

Trump’s lawyers have to wait until after the sentencing to appeal the conviction. First, Trump’s lawyers will file motions before the judge “in a couple weeks” saying why they found the trial to be “unfair,” Trump’s defense attorney Todd Blanche told CNN hours after the guilty verdict.

Cheryl Bader , a clinical associate professor of law at Fordham University School of Law, said these motions are typical when a defendant is convicted. The defense attorneys will ask the judge to overturn the jury’s conviction. “It’s rarely, rarely granted, and I don’t think there’s a chance that will happen in this case,” she told us in a phone interview.

Blanche told CNN that if the motions aren’t successful, “then as soon as we can appeal, we will. And the process in New York is there’s a sentencing, and then — and then we appeal from there.”

Bader, a former assistant U.S. attorney for the District of New Jersey, walked us through the appeals process. “The case is considered completed at sentencing,” she said. “At that point, his lawyers file a notice of appeal … letting the court know that he intends to appeal.”

At that point, they will also request a “stay” on the sentence, meaning a pause on imposing the sentence while the case is being appealed.

This appeal goes to the Appellate Division, First Judicial Department in Manhattan. The appeals court doesn’t retry the case. “They’re not going to substitute their judgment on the facts for the jury’s judgment,” Bader explained. Instead, “they’re looking for where there was error that would have led to an improper prosecution or an unfair trial.”

The appeals process would take several months to a year, she said. After the notice of appeal is given, the record of the case is gathered, including trial transcripts, the indictment, pretrial motions, evidentiary rulings, jury selection and instructions, and more. Trump could also appeal the sentencing. The lawyers need to write their arguments for all of the issues they’re objecting to, and that takes time, Bader said.

And then the appeals court needs to consider the case and write a decision on it.

If Trump ultimately isn’t successful at the appellate level, he can appeal to the highest court in New York state, which is called the Court of Appeals . But the court decides whether or not it takes the case.

After such an appeal to the highest state court, the case would be over — unless Trump tries to appeal to the U.S. Supreme Court. But there has to be a U.S. constitutional issue for that. “I don’t see one,” Bader said, but perhaps Trump’s lawyers would try to make an argument.

What punishment could Trump face? Will he go to prison?

Whether Trump is sentenced to any time in prison is up to the judge.

Each of the 34 counts of falsifying business records in the first degree , a class E felony, carries a maximum sentence of up to four years in prison . The judge could decide to impose the sentences consecutively or simultaneously. However, under New York law, 20 years is the maximum prison time that Trump could get — not 187 years, as Trump falsely claimed in his May 31 remarks.

Norman Eisen , a CNN legal analyst and a senior fellow in governance studies for the Brookings Institution, said that “in the most serious” cases of business records falsification in New York that he studied, “a sentence of imprisonment was routinely imposed.” Trump’s case “is the most serious one in NY history,” he wrote on X, predicting that Manhattan District Attorney Alvin “Bragg will likely ask for incarceration & Merchan will consider it.”

While possible, Bader, with Fordham’s School of Law, told us she doesn’t think incarceration will happen.

For a first-time convicted felon, with a low-level, nonviolent felony and a person of advanced age, “under any circumstance like that, there’d be a relatively low chance of incarceration,” she said.

“On the other hand, I could see the prosecutor arguing that here’s a man who has shown disrespect for the court system and the rule of law and has violated the court’s orders on numerous occasions. He is not remorseful. And that in order to promote general deterrence, he needs to be punished,” she said in describing a possible argument from the prosecutor.

Bader said any incarceration sentence “would be only a token amount of time to make the point that Trump is not above the law.” Other sentencing possibilities include probation or a “conditional discharge” with conditions other than incarceration or probation.

The “simplest” option might be for the judge to fine Trump, she said.

Can Trump vote in the 2024 election?

Yes, Trump can vote as long as he is not in jail on Election Day, which this year is on Nov. 5.

Trump owns homes in New York and Florida, but in 2019 he changed his primary residence to Florida. However, Florida law does not apply in Trump’s case because he was convicted in New York. Instead, New York law applies.

“If you were convicted outside Florida, your voting rights are governed by the state where you were convicted,” as the American Civil Liberties Union of Florida explains on its website.

In 2021, New York state enacted a law that “restores the right to vote for a person convicted of a felony upon release from incarceration, regardless of if they are on parole or have a term of post-release supervision,” the New York State Board of Elections says . “If a convicted felon is not incarcerated, they are eligible to register to vote.”

Can a felon run for president, hold office?

Yes. According to Article II, Section 1, Clause 5 of the U.S. Constitution, there are three qualifications to serve as president: He or she must be at least 35 years old upon taking office, a U.S. resident for at least 14 years and a “natural born Citizen, or a Citizen of the United States.”

“These qualifications are understood to be exclusive,” Josh Chafetz , a Georgetown University law professor, told us last year when we were writing about Trump’s federal indictment related to allegations of mishandling sensitive classified documents after he left office. “Anyone can be president so long as they meet the constitutional qualifications and do not trigger any constitutional disqualifications.”

“Someone can run for president while under indictment or even having been convicted and serving prison time,” said Chafetz, who pointed to the example of Eugene V. Debs, the late labor leader, who, in 1920, ran for president from prison on the Socialist Party ticket and got almost 1 million votes.

There is an exception to that rule. The Constitution says in Section 3 of the 14th Amendment that no U.S. officeholder, including the president, can serve if they are convicted of “engag[ing] in insurrection or rebellion” against the U.S. — something Trump has not been charged with either in this case or the three others he faces.

Six Colorado voters successfully sued in state court to prevent Trump from appearing on that state’s ballot, citing the constitutional amendment barring insurrectionists from holding federal office. But the U.S. Supreme Court reversed the state ruling, “[b]ecause the Constitution makes Congress, rather than the States, responsible for enforcing Section 3 against federal officeholders and candidates.”

Can Trump pardon himself on this conviction, if he wins?

The short answer is no.

Trump was convicted in New York for offenses in violation of state law. Article II, Section 2 of the U.S. Constitution states that a president has the “[p]ower to grant reprieves and pardons for offences against the United States.” According to Constitution Annotated , a government-sanctioned record of the interpretations of the Constitution, that means the power extends to “federal crimes but not state or civil wrongs.”

In a case decided in 1925, Ex parte Grossman , the U.S. Supreme Court confirmed that interpretation, writing that the Constitution’s language specifying presidential pardon power for offenses “against the United States” was “presumably to make clear that the pardon of the President was to operate upon offenses against the United States as distinguished from offenses against the States.”

The New York governor has the power to pardon Trump for his conviction of crimes under state law. That’s currently Gov. Kathy Hochul, a Democrat. After the verdict, Republican Rep. Nick LaLota called on Hochul “to immediately announce her intention to pardon President Trump and pre-emptively commute any sentence. To not do so is to allow America to become a banana republic.” Hochul released a statement on May 30 saying, “Today’s verdict reaffirms that no one is above the law.”

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People travel for a multitude of reasons; short sun holidays, business trips, trekking across continents or just stopping off in the tropics on the way to their final destination. The Tropical Medical Bureau provides a comprehensive pre-departure vaccination and travel health advice programme, including Yellow Fever Vaccination.
Travel vaccination service
To get your travel vaccinations, you'll need to complete a Travel Health Consultation with your doctor and then book an appointment at a selected Boots store**. You can complete this online* at Health Hero ^† (if aged 16 years plus) or at Webdoctor.ie ^† (if aged 17 years plus. Excludes rabies vaccine).
Travelling abroad and vaccinations
The BCG vaccination against tuberculosis (TB), for example, should be given at least 3 months before your child travels. Certain vaccinations are compulsory. In these cases, you will need to show an International Certificate of Vaccination (record of your vaccines) to gain access to the country in question. Other vaccinations are recommended ...
Travel Vaccines
For specific travel advice, including vaccinations and malarial prophylaxis you should contact your GP or travel clinic. Read the NIAC - Immunisation Guidelines for Ireland (www.rcpi.ie) for the most up to date advice. (you will be directed to the RCPI website) Other Useful Websites include. Health information provided by the NHS (Scotland).
Vaccinations
The flu vaccine can protect you against influenza each winter. The vaccine is available free of charge to at-risk groups. The pneumococcal vaccine (also called the pneumonia vaccine) is available free of charge to at-risk groups. Vaccination and immunisation services for children are free of charge. Compulsory vaccinations are required to enter ...
gov
From Department of Health. Published on 15 November 2021. Last updated on 17 November 2021. The Minister for Health, Stephen Donnelly TD, has signed regulations amending requirements around international travel to Ireland. Since 31 October, home quarantine has no longer been required of any category of international traveller.
Need travel vaccines? Plan ahead.
Find out which travel vaccines you may need to help you stay healthy on your trip. Before Travel. Make sure you are up-to-date on all of your routine vaccines. Routine vaccinations protect you from infectious diseases such as measles that can spread quickly in groups of unvaccinated people. Many diseases prevented by routine vaccination are not ...
Kildare Vaccination Centre Clane
Map and directions For Kildare Vaccination Centre Clane. Walk-in clinic schedule. Children aged 5 to 11 (dose 1 and dose 2 only) Wednesday 28 September, 8.15am to 5.45pm; Children aged 6 months to 4. Wednesday 28 September, 8.15am to 5.45pm; How it works. Get dose 1, dose 2, or dose 3 at a walk-in clinic. ...
Find a Clinic
Find a COVID-19 testing clinic. CDC provides these links as a convenience to international travelers. CDC does not endorse, recommend, or favor any clinics on these lists, nor does the appearance of a clinic on these lists imply a guarantee of service quality. Page last reviewed: August 11, 2022.
Travelers' Health
More. Learn about CDC's Traveler Genomic Surveillance Program that detects new COVID-19 variants entering the country. Sign up to get travel notices, clinical updates, & healthy travel tips. CDC Travelers' Health Branch provides updated travel information, notices, and vaccine requirements to inform international travelers and provide ...
Walk-in COVID-19 vaccination clinics
Walk-in COVID-19 vaccination clinics. Walk-in clinics are for children under 12. If you are age 12 or older, you can get your vaccine at a participating GP or find a pharmacy giving COVID-19 vaccines.
COVID vaccines to be administered at pharmacies in Kildare
Pharmacists, including in Kildare, will begin administering COVID-19 vaccines from this week. People over the age of 50 who haven't yet received a vaccine will be able to get one in their local pharmacy. ... shingles and travel vaccinations. We look forward to applying this expertise and experience to vaccinating people against COVID-19 as ...
Kildare Nationalist
Citywest and Punchestown COVID 19 Vaccination Centres clinics are available to book appointments as part of the HSE's Winter Vaccination Programme offering primary vaccinations and adapted bivalent mRNA booster doses to eligible cohorts. ... More Kildare News. St Farnan's battle back to claim Larry Doyle Cup Thursday, 16/05/24 - 8:24pm.
Kildare Nationalist
Walk-in vaccination: Saturday July 31st, 8.30am to 5pm; Sunday August 1st, 8.30am to 12.30pm; Carndonagh Satellite Vaccination Clinic. Walk-in vaccination: Monday August 2nd, 9am to 12pm; Dublin. Aviva Stadium, Dublin 4. Walk-in vaccination: Monday August 2nd, 8am to 6.30pm; UCD O'Reilly Hall, Dublin 4. Walk-in vaccination is not available at ...
Travel Vaccinations & Health Advice Service
1. Book an appointment. Six to eight weeks before you travel you will need to have your travel health appointment to assess what vaccinations you need. 2. Attend a personalised risk assessment 23. During the 40 minute travel health appointment our specially-trained pharmacist will advise on any vaccinations and antimalarials you need for your ...
Kildare Vaccination Centre Punchestown Racecourse
Get dose 1, dose 2, or dose 3 at a walk-in clinic. These clinics are for children under 12. Dose 3 is for children age 6 months to 4 years only. Children must attend with a parent or legal guardian. Your child will not be vaccinated if they have not waited the recommended time: since their last vaccine. if they COVID-19 recently.
Contact the Immunisation Office Kildare
Please phone 045 920 633. or write to Immunisation Department, St Marys Community Services, Hospital Campus, Craddockstown Rd, Naas, Co Kildare. Do you need to contact us about the 4 in 1 and MMR school programme in Junior Infants. Please phone 045 920 635 or 045 920 636.
Travel vaccination advice
Travel vaccination advice. If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world. Vaccinations are available to protect you against infections such as yellow fever, typhoid and hepatitis A. In the UK, the NHS routine immunisation (vaccination) schedule ...
Travel experts visiting tourist attractions in Kildare
Kildare Reporter. Fifteen Belgian and Dutch tour operators and travel agents have been visiting Ireland as guests of Tourism Ireland and Fáilte Ireland. The aim of the visit was to educate and enthuse the travel professionals about some of the many great things to see and do in Ireland's Ancient East, so they are better equipped to sell the ...
Continuing development of vaccines and monoclonal antibodies ...
On January 31 and February 1, 2023, the National Institute of Allergy and Infectious Diseases (NIAID) hosted the workshop "Continuing Development of Vaccines and Monoclonal Antibodies Against ...
Local disparities may prevent national vaccination efforts for rubella
The impact of sub-national heterogeneities in demography and epidemiology on the introduction of rubella vaccination programs in Nigeria. Vaccine , 2024; DOI: 10.1016/j.vaccine.2024.05.030
New cycle route officially opens in Co Kildare
A high-quality cycle route has been officially opened in Co Kildare. The Kilcullen Road Active Travel Scheme in Naas cost over €5m to complete and has been fully funded by the National Transport ...
Vaccinations for Ireland
The Tropical Medical Bureau was established by Dr Graham Fry in Dublin in 1988. Since then it has expanded greatly and today TMB is the largest travel vaccination organisation in Ireland with over 20 clinics nationwide. As medical director, Dr Fry plays a pivotal role in the organisation, whether consulting with patients, lecturing medical ...
Uganda tackles yellow fever with new travel requirement, vaccination
Uganda's vaccination initiative is part of a global strategy launched in 2017 by the WHO and partners such as the U.N. children's agency to eliminate yellow fever by 2026. The goal is to protect almost one billion people in Africa and the Americas. A midterm evaluation of that strategy, whose results were published last year, found that 185 ...
19 Best Travel Credit Cards Of June 2024
Travel lovers now have another great credit card option with the launch of the Wells Fargo Autograph Journey℠ Card in March 2024. This new card earns 5 points per dollar on hotels, 4 points per ...
Q&A on Trump's Criminal Conviction
Donald Trump became the first U.S. president, current or former, to be convicted of a criminal offense when a 12-person jury in New York on May 30 found him guilty on 34 felony counts of business ...
CDC urges meningococcal disease vaccination ahead of Hajj travel
Saudi Arabia requires all Umrah or Hajj pilgrims age 1 and older to have gotten the quadrivalent meningococcal vaccine, also known as the meningococcal conjugate or MenACWY vaccine. It protects ...