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Vaccination, the transmission of “vaccine”, a benign disease of cows, to immunize human beings against smallpox, was invented by Jenner at the end of the eighteenth century. Pasteur, convinced that the vaccine microbe was an attenuated form of the smallpox microbe, showed that, similarly, attenuated forms of other microbes immunized against animal diseases. When applying this principle to rabies, he realized that, in this case, the vaccine was in fact composed of dead microbes. One of his students immediately exploited this result to devise a vaccine against typhoid. The vaccines against diphtheria and tetanus, in 1921, opened a new route, that of immunization with molecules from the pathogenic microbes. Molecular biology then allowed the production of the immunogenic molecules by microorganisms such as yeast, or immunization by genetically modified viruses or messenger RNA inducing our own cells to produce these molecules.

VACCINATION OF SENIORS. In France, the vaccination schedule for seniors (people aged 65 and over) recommends 4 vaccinations (Covid-19, flu, DTP [diphtheria, tetanus, poliomyelitis] and shingles), plus 3 others in the event of a particular risk (pneumococcus, whooping cough, hepatitis A). Nevertheless, vaccination coverage for these infectious diseases remains insufficient, making an increasingly heavy medical and economic burden in an aging population. Vaccination of seniors must become a priority public health objective and involve all health professionals, first and foremost treating physicians. It must be improved by integrating advances in vaccinology and digital technologies into a program aimed at maintaining vaccination coverage throughout life., Competing Interests: L’auteur déclare n'avoir aucun lien d'intérêts.

Diptheria is commonly caused by the aerobic gram-positive bacteria, corynebacterium diphtheria. We herein report an unusual case of diphtheria outbreak in Indonesia in 2017 and its possible causes and current management.

Résumé: La diphtérie est une pathologie infectieuse transmise par voie aérienne ou par contact. Il existe trois espèces de Cornybacterium : Corynebacterium diphteriae , Cornybacterium ulcerans et Cornybacterium pseudotuberculosis. Elles sont sécrétrices ou non de toxine responsable des complications cardiaques ou neurologiques. Les présentations cliniques fréquentes sont l'angine diphtérique et la diphtérie cutanée. En cas de suspicion, l'urgence est d'envoyer les prélèvements cutanés ou pharyngés au centre national de référence. En cas de présence de toxine, une sérothérapie doit être instituée et le cas doit être déclaré. L'antibiothérapie par amoxicilline ou azithromycine constitue le traitement de référence. La prévention vaccinale mise en place au milieu du 20e siècle a permis de ralentir les épidémies. Diphtheria is an infectious disease transmitted by air or by contact. There are three main species of corynebacterium: diphtheriae, ulcerans, and pseudotuberculosis. They may or may not secrete a toxin responsible for serious cardiac or neurological complications. The frequent clinical presentations are diphtheria angina and cutaneous diphtheria. When it is suspected, it is urgent to send cutaneous or pharyngeal samples to the National Reference Center. If toxin is present, serotherapy should be instituted and the case should be reported. Antibiotic therapy with amoxicillin or azithromycin is the standard treatment. Vaccine prevention begun in the middle of the 20th century has helped to slow epidemics. [ABSTRACT FROM AUTHOR]

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Les vaccins figurent parmi les armes présentant le meilleur rapport coût/efficacité dans l’arsenal de la médecine moderne. Les politiques volontaristes et les stratégies rationnelles de vaccination ont un fort impact en santé publique. Grâce aux vaccins, l’éradication de la variole a été obtenue, la poliomyélite a disparu de la plus grande partie du monde et un net recul d’un certain nombre d’infections de l’enfant, telles que rougeole, diphtérie, tétanos et coqueluche, a été obtenu. En France, comme dans la plupart des pays, on dispose de comités d’experts dépendant du Ministère de la Santé (Conseil Supérieur d’Hygiène Publique de France et Comité Technique des Vaccinations) qui sont chargés de proposer des modifications du calendrier vaccinal ou l’intégration de nouveaux vaccins dans le programme national de vaccination. Les décisions sont publiées annuellement dans le Bulletin Epidémiologique Hebdomadaire.Mots clés : vaccins, calendrier vaccinal, maladies infectieuses @SUMMARY HD2 = Abstract Vaccines are among the most cost-effective preventive measures against infectious diseases in the armamentarium of modern medicine. When used aggressively with a rational epidemiological strategy, vaccines achieve great success. Vaccines have eradicated smallpox globally, eliminated poliomyelitis from the Western hemisphere, and have drastically diminished the incidence of a number of childhood infections, such as measles, diphtheria, tetanus and pertussis. As is the situation in most countries, in France the Ministry of Health (Conseil Supérieur d’Hygiène Publique de France and Comité Technique des Vaccinations) has appointed committees of experts, with a mandate to assess proposals for the modification or inclusion of new vaccines into the national immunisation programme. The decisions are published annually in the Bulletin Epidémiologique Hebdomadaire.Keywords: vaccine, immunisation programme, infectious diseases [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to describe the vaccinal status of adult French patients consulting general practitioners and to identify the reasons justifying the absence and/or the delay of a booster injection from both patient and physician’s point of view.Methodology: A cross sectional epidemiological study was made on the first 3 patients consulting for vaccination against diphtheria, tetanus, and poliomyelitis.Results: Six thousand and two hundred sixty nine patients, 44 ± 15 years of age, were included in the study by 2,122 general practitioners, a representative sample 90,5%, 94,4%, and 92,6% of their patients had been vaccinated against diphtheria, tetanus, and poliomyelitis but only 58,4%, 66,1%, and 63,4% had received the required booster injection. This means that 40% of the adult French population is not properly protected. This situation appears essentially linked to negligence rather than to reluctance: only 3,6% of the patients were really reluctant. The low coverage rate was greater among underprivileged classes and the elderly.Conclusion: These results show the limits of prevention campaigns and underline the necessity of a better involvement of occupational medicine and general practitioners. [Copyright &y& Elsevier]