551
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Jin Y, Hou C, Li Y, Zheng K, Wang C. mRNA Vaccine: How to Meet the Challenge of SARS-CoV-2. Front Immunol 2022; 12:821538. [PMID: 35126377 PMCID: PMC8813741 DOI: 10.3389/fimmu.2021.821538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/27/2021] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with high infectivity, pathogenicity, and variability, is a global pandemic that severely affected public health and the world economy. The development of safe and effective vaccines is crucial to the prevention and control of an epidemic. As an emerging technology, mRNA vaccine is widely used for infectious disease prevention and control and has significant safety, efficacy, and high production. It has received support and funding from many pharmaceutical enterprises and becomes one of the main technologies for preventing COVID-19. This review introduces the current status of SARS-CoV-2 vaccines, specifically mRNA vaccines, focusing on the challenges of developing mRNA vaccines against SARS-CoV-2, and discusses the relevant strategies.
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Affiliation(s)
- Yingqi Jin
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
| | - Chen Hou
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
| | - Yonghao Li
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
| | - Kang Zheng
- Department of Clinical Laboratory, Hengyang Central Hospital, Hengyang, China
| | - Chuan Wang
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
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552
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Lai FTT, Huang L, Chui CSL, Wan EYF, Li X, Wong CKH, Chan EWW, Ma T, Lum DH, Leung JCN, Luo H, Chan EWY, Wong ICK. Multimorbidity and adverse events of special interest associated with Covid-19 vaccines in Hong Kong. Nat Commun 2022; 13:411. [PMID: 35058463 PMCID: PMC8776841 DOI: 10.1038/s41467-022-28068-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
Prior research using electronic health records for Covid-19 vaccine safety monitoring typically focuses on specific disease groups and excludes individuals with multimorbidity, defined as ≥2 chronic conditions. We examine the potential additional risk of adverse events 28 days after the first dose of CoronaVac or Comirnaty imposed by multimorbidity. Using a territory-wide public healthcare database with population-based vaccination records in Hong Kong, we analyze a retrospective cohort of patients with chronic conditions. Thirty adverse events of special interest according to the World Health Organization are examined. In total, 883,416 patients are included and 2,807 (0.3%) develop adverse events. Results suggest vaccinated patients have lower risks of adverse events than unvaccinated individuals, multimorbidity is associated with increased risks regardless of vaccination, and the association of vaccination with adverse events is not modified by multimorbidity. To conclude, we find no evidence that multimorbidity imposes extra risks of adverse events following Covid-19 vaccination.
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Affiliation(s)
- Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Lei Huang
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Celine Sze Ling Chui
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric Yuk Fai Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xue Li
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Carlos King Ho Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Edward Wai Wa Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tiantian Ma
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Dawn Hei Lum
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Janice Ching Nam Leung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Department of Computer Science, Faculty of Engineering, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China.
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
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553
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Patil A, Goldust M, Wollina U. Herpes zoster: A Review of Clinical Manifestations and Management. Viruses 2022; 14:192. [PMID: 35215786 PMCID: PMC8876683 DOI: 10.3390/v14020192] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023] Open
Abstract
The Varicella-zoster virus (VZV) or human herpes virus 3 is a neurotropic human alpha herpes virus responsible for chickenpox/varicella and shingles/Herpes zoster (HZ). This review will focus on HZ. Since HZ is secondary to varicella, its incidence increases with age. In children and youngsters, HZ is rare and associated to metabolic and neoplastic disorders. In adults, advanced age, distress, other infections (such as AIDS or COVID-19), and immunosuppression are the most common risk factors. HZ reactivation has recently been observed after COVID-19 vaccination. The disease shows different clinical stages of variable clinical manifestations. Some of the manifestations bear a higher risk of complications. Among the possible complications, postherpetic neuralgia, a chronic pain disease, is one of the most frequent. HZ vasculitis is associated with morbidity and mortality. Renal and gastrointestinal complications have been reported. The cornerstone of treatment is early intervention with acyclovir or brivudine. Second-line treatments are available. Pain management is essential. For (secondary) prophylaxis, currently two HZV vaccines are available for healthy older adults, a live attenuated VZV vaccine and a recombinant adjuvanted VZV glycoprotein E subunit vaccine. The latter allows vaccination also in severely immunosuppressed patients. This review focuses on manifestations of HZ and its management. Although several articles have been published on HZ, the literature continues to evolve, especially in regard to patients with comorbidities and immunocompromised patients. VZV reactivation has also emerged as an important point of discussion during the COVID-19 pandemic, especially after vaccination. The objective of this review is to discuss current updates related to clinical presentations, complications, and management of HZ.
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Affiliation(s)
- Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai 400706, India;
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, 01067 Dresden, Germany
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554
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Jiang Y, Wu Q, Song P, You C. The Variation of SARS-CoV-2 and Advanced Research on Current Vaccines. Front Med (Lausanne) 2022; 8:806641. [PMID: 35118097 PMCID: PMC8804231 DOI: 10.3389/fmed.2021.806641] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/16/2021] [Indexed: 12/15/2022] Open
Abstract
Over the past 2 years, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) and rapidly spread worldwide. In the process of evolution, new mutations of SARS-CoV-2 began to appear to be more adaptable to the diverse changes of various cellular environments and hosts. Generally, the emerging SARS-CoV-2 variants are characterized by high infectivity, augmented virulence, and fast transmissibility, posing a serious threat to the prevention and control of the global epidemic. At present, there is a paucity of effective measurements to cure COVID-19. It is extremely crucial to develop vaccines against SARS-CoV-2 and emerging variants to enhance individual immunity, but it is not yet known whether they are approved by the authority. Therefore, we systematically reviewed the main characteristics of the emerging various variants of SARS-CoV-2, including their distribution, mutations, transmissibility, severity, and susceptibility to immune responses, especially the Delta variant and the new emerging Omicron variant. Furthermore, we overviewed the suitable crowd, the efficacy, and adverse events (AEs) of current vaccines.
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Affiliation(s)
| | | | | | - Chongge You
- Laboratory Medicine Center, Lanzhou University Second Hospital, Lanzhou, China
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555
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TÜRKOĞLU E, DİNDAR DEMİRAY EK, YILMAZ D, ALKAN S, ÖNTÜRK AKYÜZ H, DEMİR O. Sağlık Çalışanlarının COVID-19 Aşıları Hakkındaki Bilgi Düzeyi ve Tutumlarının Değerlendirilmesi. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1053968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Amaç: Sağlık çalışanları COVID-19 mücadelesinde ön saflarda yer almakta olup aşılanmaları hayati önem taşımaktadır. Üstelik hem konuşmaları hem davranışları ile pandeminin kontrolünde önemli rol üstlenmektedirler. Bu çalışmanın amacı sağlık çalışanlarının COVID-19 aşılanma durumları, bilgi düzeyleri ve bakış açılarının değerlendirilmesi amaçlanmıştır.
Materyal ve Yöntemler: Çalışma kesitsel ve tanımlayıcı bir tipte olup, 15-30 Temmuz 2021 tarihleri arasında Türkiye’deki tıp öğrencisi, asistan hekim, hemşirelik öğrencisi ve hemşirelere yönelik online bir anket formu üzerinden gerçekleştirilmiştir.
Bulgular: Toplam 822 sağlık çalışanında aşılanma oranı %79.2’ydi. Sağlık çalışanları aşılar hakkında yeterince bilgi sahibi değildi (Doğru cevaplama oranları %21.6-73 arasındaydı). En önemli bilgi edinme kaynakları sosyal medya (%41.9) ile Sağlık Bakanı-Bilim Kurulu açıklamalarıydı (%29.5). Aşılanma oranı; 25 yaş üstündekilerde, asistan hekimlerde, batı bölgelerinde yaşayanlarda, COVID-19 hastalarına sağlık hizmeti verenlerde, daha önce COVID-19 geçirmeyenlerde ve bilgi sorularını doğru yanıtlayanlarda daha yüksekti (p=0.019, p
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Affiliation(s)
| | | | | | - Sevil ALKAN
- CANAKKALE ONSEKIZ MART UNIVERSITY, SCHOOL OF MEDICINE
| | | | - Osman DEMİR
- GAZIOSMANPASA UNIVERSITY, SCHOOL OF MEDICINE
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556
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Dickerman BA, Gerlovin H, Madenci AL, Kurgansky KE, Ferolito BR, Figueroa Muñiz MJ, Gagnon DR, Gaziano JM, Cho K, Casas JP, Hernán MA. Comparative Effectiveness of BNT162b2 and mRNA-1273 Vaccines in U.S. Veterans. N Engl J Med 2022; 386:105-115. [PMID: 34942066 PMCID: PMC8693691 DOI: 10.1056/nejmoa2115463] [Citation(s) in RCA: 156] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The messenger RNA (mRNA)-based vaccines BNT162b2 and mRNA-1273 are more than 90% effective against coronavirus disease 2019 (Covid-19). However, their comparative effectiveness for a range of outcomes across diverse populations is unknown. METHODS We emulated a target trial using the electronic health records of U.S. veterans who received a first dose of the BNT162b2 or mRNA-1273 vaccine between January 4 and May 14, 2021, during a period marked by predominance of the SARS-CoV-2 B.1.1.7 (alpha) variant. We matched recipients of each vaccine in a 1:1 ratio according to their risk factors. Outcomes included documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, symptomatic Covid-19, hospitalization for Covid-19, admission to an intensive care unit (ICU) for Covid-19, and death from Covid-19. We estimated risks using the Kaplan-Meier estimator. To assess the influence of the B.1.617.2 (delta) variant, we emulated a second target trial that involved veterans vaccinated between July 1 and September 20, 2021. RESULTS Each vaccine group included 219,842 persons. Over 24 weeks of follow-up in a period marked by alpha-variant predominance, the estimated risk of documented infection was 5.75 events per 1000 persons (95% confidence interval [CI], 5.39 to 6.23) in the BNT162b2 group and 4.52 events per 1000 persons (95% CI, 4.17 to 4.84) in the mRNA-1273 group. The excess number of events per 1000 persons for BNT162b2 as compared with mRNA-1273 was 1.23 (95% CI, 0.72 to 1.81) for documented infection, 0.44 (95% CI, 0.25 to 0.70) for symptomatic Covid-19, 0.55 (95% CI, 0.36 to 0.83) for hospitalization for Covid-19, 0.10 (95% CI, 0.00 to 0.26) for ICU admission for Covid-19, and 0.02 (95% CI, -0.06 to 0.12) for death from Covid-19. The corresponding excess risk (BNT162b2 vs. mRNA-1273) of documented infection over 12 weeks of follow-up in a period marked by delta-variant predominance was 6.54 events per 1000 persons (95% CI, -2.58 to 11.82). CONCLUSIONS The 24-week risk of Covid-19 outcomes was low after vaccination with mRNA-1273 or BNT162b2, although risks were lower with mRNA-1273 than with BNT162b2. This pattern was consistent across periods marked by alpha- and delta-variant predominance. (Funded by the Department of Veterans Affairs and others.).
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Affiliation(s)
- Barbra A Dickerman
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Hanna Gerlovin
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Arin L Madenci
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Katherine E Kurgansky
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Brian R Ferolito
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Michael J Figueroa Muñiz
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - David R Gagnon
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - J Michael Gaziano
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Kelly Cho
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Juan P Casas
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
| | - Miguel A Hernán
- From CAUSALab (B.A.D., A.L.M., M.A.H.) and the Departments of Epidemiology (B.A.D., A.L.M., M.A.H.) and Biostatistics (M.A.H.), Harvard T.H. Chan School of Public Health, Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System (H.G., K.E.K., B.R.F., M.J.F.M., D.R.G., J.M.G., K.C., J.P.C.), the Department of Surgery (A.L.M.) and Division of Aging (J.M.G., K.C., J.P.C.), Brigham and Women's Hospital, Harvard Medical School, and the Department of Biostatistics (M.J.F.M., D.R.G.), Boston University School of Public Health - all in Boston
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Sodhi M, Samii A, Etminan M. A comparative safety study of reported neurological adverse events with three COVID-19 vaccines. J Neurol 2022; 269:2301-2303. [PMID: 34999959 PMCID: PMC8742704 DOI: 10.1007/s00415-021-10919-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Mohit Sodhi
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Ali Samii
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Mahyar Etminan
- Deparmtment of Ophthalmology and Visual Sciences, Faculty of Medicine, The University of British Columbia, The Eye Care Center, Room 323-2550 Willow Street, Vancouver, BC, V5Z 3N9, Canada. .,Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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558
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Al-Mallah MH. The Way Ahead: Life After COVID-19. Methodist Debakey Cardiovasc J 2022; 17:83-88. [PMID: 34992726 PMCID: PMC8680109 DOI: 10.14797/mdcvj.1056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
Much has changed in the 2 years since the start of the coronavirus disease 19 (COVID-19) pandemic. The need for social distancing catalyzed the digitization of healthcare delivery and medical education—from telemedicine and virtual conferences to online residency/fellowship interviews. Vaccine development, particularly in the field of mRNA technology, led to widespread availability of safe and effective vaccines. With improved survival from acute infection, the healthcare system is dealing with the ever-growing cohort of patients with lingering symptoms. In addition, social media platforms have fueled a plethora of misinformation campaigns that have adversely affected prevention and control measures. In this review, we examine how COVID-19 has reshaped the healthcare system, and gauge its potential effects on life after the pandemic.
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559
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Miller E. Rapid evaluation of the safety of Covid-19 vaccines: how well have we done? Clin Microbiol Infect 2022; 28:477-478. [PMID: 34999173 PMCID: PMC8733286 DOI: 10.1016/j.cmi.2021.12.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 12/31/2022]
Affiliation(s)
- Elizabeth Miller
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
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560
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Stein M, Ashkenazi-Hoffnung L, Greenberg D, Dalal I, Livni G, Chapnick G, Stein-Zamir C, Ashkenazi S, Hecht-Sagie L, Grossman Z. The Burden of COVID-19 in Children and Its Prevention by Vaccination: A Joint Statement of the Israeli Pediatric Association and the Israeli Society for Pediatric Infectious Diseases. Vaccines (Basel) 2022; 10:81. [PMID: 35062742 PMCID: PMC8781684 DOI: 10.3390/vaccines10010081] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/29/2021] [Indexed: 01/27/2023] Open
Abstract
As of October 2021, SARS-CoV-2 infections were reported among 512,613 children and adolescents in Israel (~33% of all COVID-19 cases). The 5-11-year age group accounted for about 43% (223,850) of affected children and adolescents. In light of the availability of the Pfizer-BioNTech BNT162b2 vaccine against COVID-19 for children aged 5-11 years, we aimed to write a position paper for pediatricians, policymakers and families regarding the clinical aspects of COVID-19 and the vaccination of children against COVID-19. The first objective of this review was to describe the diverse facets of the burden of COVID-19 in children, including the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the indirect effects of social isolation and interruption in education. In addition, we aimed to provide an update regarding the efficacy and safety of childhood mRNA COVID-19 vaccination and to instill confidence in pediatricians regarding the benefits of vaccinating children against COVID-19. We reviewed up-to-date Israeli and international epidemiological data and literature regarding COVID-19 morbidity and its sequelae in children, vaccine efficacy in reducing COVID-19-related morbidity and SARS-CoV-2 transmission and vaccine safety data. We conducted a risk-benefit analysis regarding the vaccination of children and adolescents. We concluded that vaccines are safe and effective and are recommended for all children aged 5 to 11 years to protect them from COVID-19 and its complications and to reduce community transmissions. Based on these data, after weighing the benefits of vaccination versus the harm, the Israeli Ministry of Health decided to recommend vaccination for children aged 5-11 years.
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Affiliation(s)
- Michal Stein
- Infectious Diseases and Infection Control Unit, Hillel Yaffe Medical Center, Hadera 3810101, Israel
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel
| | - Liat Ashkenazi-Hoffnung
- Department of Day Care Hospitalization, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
| | - David Greenberg
- The Pediatric Infectious Disease Unit, Soroka Medical Center, Be’er Sheva 8458900, Israel;
- The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Ilan Dalal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
- Pediatric Department, E. Wolfson Medical Center, Holon 5822012, Israel
| | - Gilat Livni
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
- Department of Pediatrics A, Schneider Children’s Medical Center, Petah Tikva 4920245, Israel
| | - Gil Chapnick
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
| | - Chen Stein-Zamir
- Jerusalem District Health Office, Jerusalem 9137001, Israel;
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Shai Ashkenazi
- Schneider Children’s Medical Center, Petah Tikva 4920235, Israel;
- Adelson School of Medicine, Ariel University, Ari’el 4070000, Israel
| | - Lior Hecht-Sagie
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
| | - Zachi Grossman
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
- Adelson School of Medicine, Ariel University, Ari’el 4070000, Israel
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561
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Gregory ME, MacEwan SR, Gaughan AA, Rush LJ, Powell JR, Kurth JD, Kenah E, Panchal AR, Scheck McAlearney A. Closing the Gap on COVID-19 Vaccinations in First Responders and Beyond: Increasing Trust. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:644. [PMID: 35055463 PMCID: PMC8776085 DOI: 10.3390/ijerph19020644] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/30/2021] [Accepted: 01/02/2022] [Indexed: 12/24/2022]
Abstract
Although COVID-19 vaccines are widely available in the U.S. and much of the world, many have chosen to forgo this vaccination. Emergency medical services (EMS) professionals, despite their role on the frontlines and interactions with COVID-positive patients, are not immune to vaccine hesitancy. Via a survey conducted in April 2021, we investigated the extent to which first responders in the U.S. trusted various information sources to provide reliable information about COVID-19 vaccines. Those vaccinated generally trusted healthcare providers as a source of information, but unvaccinated first responders had fairly low trust in this information source-a group to which they, themselves, belong. Additionally, regardless of vaccination status, trust in all levels of government, employers, and their community as sources of information was low. Free-response explanations provided some context to these findings, such as preference for other COVID-19 management options, including drugs proven ineffective. A trusted source of COVID-19 vaccination information is not readily apparent. Individuals expressed a strong desire for the autonomy to make vaccination decisions for themselves, as opposed to mandates. Potential reasons for low trust, possible solutions to address them, generalizability to the broader public, and implications of low trust in official institutions are discussed.
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Affiliation(s)
- Megan E. Gregory
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (S.R.M.); (A.A.G.); (L.J.R.)
| | - Sarah R. MacEwan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (S.R.M.); (A.A.G.); (L.J.R.)
| | - Alice A. Gaughan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (S.R.M.); (A.A.G.); (L.J.R.)
| | - Laura J. Rush
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (S.R.M.); (A.A.G.); (L.J.R.)
| | - Jonathan R. Powell
- National Registry of Emergency Medical Technicians, Columbus, OH 43210, USA; (J.R.P.); (J.D.K.); (A.R.P.)
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA
| | - Jordan D. Kurth
- National Registry of Emergency Medical Technicians, Columbus, OH 43210, USA; (J.R.P.); (J.D.K.); (A.R.P.)
| | - Eben Kenah
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH 43210, USA;
| | - Ashish R. Panchal
- National Registry of Emergency Medical Technicians, Columbus, OH 43210, USA; (J.R.P.); (J.D.K.); (A.R.P.)
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Ann Scheck McAlearney
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (S.R.M.); (A.A.G.); (L.J.R.)
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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562
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Jabagi MJ, Botton J, Bertrand M, Weill A, Farrington P, Zureik M, Dray-Spira R. Myocardial Infarction, Stroke, and Pulmonary Embolism After BNT162b2 mRNA COVID-19 Vaccine in People Aged 75 Years or Older. JAMA 2022; 327:80-82. [PMID: 34807248 PMCID: PMC8609457 DOI: 10.1001/jama.2021.21699] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This population-based study evaluates the short-term risk of severe cardiovascular events among French residents aged 75 years or older after receipt of the BNT162b2 mRNA COVID-19 vaccination.
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Affiliation(s)
- Marie Joelle Jabagi
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Jérémie Botton
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Marion Bertrand
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Alain Weill
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Paddy Farrington
- School of Mathematics and Statistics, the Open University, Milton Keynes, United Kingdom
| | - Mahmoud Zureik
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Rosemary Dray-Spira
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
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563
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First Identified Case of Fatal Fulminant Necrotizing Eosinophilic Myocarditis Following the Initial Dose of the Pfizer-BioNTech mRNA COVID-19 Vaccine (BNT162b2, Comirnaty): an Extremely Rare Idiosyncratic Hypersensitivity Reaction. J Clin Immunol 2022; 42:441-447. [PMID: 34978002 PMCID: PMC8720536 DOI: 10.1007/s10875-021-01187-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/25/2021] [Indexed: 12/16/2022]
Abstract
Rationale Transient myopericarditis has been recognised as an uncommon and usually mild adverse event predominantly linked to mRNA-based COVID-19 vaccines. These have mostly occurred in young males after the second dose of mRNA COVID-19 vaccines. Objectives Fulminant necrotising eosinophilic myocarditis triggered by a variety of drugs or vaccines is an extremely rare hypersensitivity reaction carrying a substantial mortality risk. Early recognition of this medical emergency may facilitate urgent hospital admission for investigation and treatment. Timely intervention can lead to complete cardiac recovery, but the non-specific clinical features and rarity make early diagnosis challenging. Findings The clinical and pathological observations from a case of fatal fulminant necrotising myocarditis in a 57-year-old woman, following the first dose of the Pfizer-BioNTech vaccine, are described. Other causes have been discounted with reasonable certainty. Conclusion These extremely rare vaccine-related adverse events are much less common than the risk of myocarditis and other lethal complications from COVID-19 infection. The benefits of vaccination far exceed the risks of COVID-19 infection.
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564
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Verd S, Fernández‐Bernabeu M, Cardo E. The controversy surrounding vaccination of young people against COVID-19. Acta Paediatr 2022; 111:187-188. [PMID: 34658059 PMCID: PMC8652587 DOI: 10.1111/apa.16156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Sergio Verd
- Pediatric Unit. La Vileta surgery Department of Primary Care Palma de Mallorca Spain
- Balearic Islands Health Research Institute (IdISBa) Palma de Mallorca Spain
| | | | - Esther Cardo
- Balearic Islands Health Research Institute (IdISBa) Palma de Mallorca Spain
- Department of Pediatrics Son Llatzer University Hospital Palma de Mallorca Spain
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565
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Higuchi T, Hoshi T, Nakajima A, Haruki K. OUP accepted manuscript. Lab Med 2022; 53:540-541. [PMID: 35640881 PMCID: PMC9384157 DOI: 10.1093/labmed/lmac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pseudothrombocytopenia is an in vitro phenomenon of platelet aggregation due to conformational changes and exposure of cryptic antigens on the platelet surface caused by anticoagulants, leading to the aggregation of platelets and falsely lower automated platelet counts. Although it has no clinical relevance, it can lead to unnecessary fear, diagnostic errors, or unnecessary tests and interventions when unrecognized. Pseudothrombocytopenia was detected in a 25-year-old woman 8 months after the second dose of mRNA COVID-19 vaccine, BNT162b2. The pseudothrombocytopenia was transient and the duration was shorter than 3 months. As pseudothromobocytopenia is not detected unless blood is drawn for other objectives, it is difficult to determine its true occurrence among recipients of vaccines. This case shows that pseudothrombocytopenia may develop transiently even months after COVID-19 vaccination and should be considered when thrombocytopenia is found in recipients of the vaccine to avoid unnecessary fear, diagnostic errors, or unnecessary tests and interventions.
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Affiliation(s)
| | - Takao Hoshi
- Clinical Laboratory, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Astuko Nakajima
- Clinical Laboratory, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Kosuke Haruki
- Clinical Laboratory, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
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566
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Chow KW, Pham NV, Ibrahim BM, Hong K, Saab S. Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: A Systematic Review of the Literature. Dig Dis Sci 2022; 67:4574-4580. [PMID: 35486203 PMCID: PMC9052185 DOI: 10.1007/s10620-022-07504-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/15/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVES During the summer of 2021, case reports began to emerge documenting a small number of individuals who developed autoimmune hepatitis (AIH) following COVID-19 vaccination. These cases are rare and novel, and very little is known. In our systematic review, we analyzed every published case of AIH and reviewed their characteristic findings, treatment, and outcomes. METHODS We searched PubMed, Embase, and Web of Science from December 1, 2019, to November 1, 2021. Two researchers independently extracted information from the articles about vaccine type, patient history, laboratory values, histology results, treatment regimens, and disease course. RESULTS Thirty-two patients developed AIH-like syndromes after receiving a COVID-19 vaccine. Jaundice was the most frequently reported symptom (81%), and 19% of patients were initially asymptomatic and presented with elevated liver enzymes found during routine bloodwork. Mean alanine transaminase, aspartate transaminase, and total bilirubin were 1231 U/L, 921 U/L, and 14 mg/dL, respectively. Anti-nuclear antibody was positive in 56%, and anti-smooth muscle antibody in 28% of patients. Steroids were used in 75% of patients. Improvement or complete resolution was seen in 97% of patients. One patient died despite aggressive steroid treatment. CONCLUSION COVID-19 vaccine-induced AIH is an uncommon association with just 32 documented cases in the literature. Clinicians should be vigilant for AIH in patients who present with liver injury following vaccination. These new findings should under not deter individuals from getting vaccinated, as the benefits of vaccination far outweigh the risks. Fortunately, COVID-19 vaccine-induced AIH appears amendable to corticosteroid therapy and appears to have a favorable outcome.
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Affiliation(s)
- Kenneth W. Chow
- Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA USA
| | - Nguyen V. Pham
- Departments of Surgery, UCLA Medical Center, Pfleger Liver Institute, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095 USA
| | - Britney M. Ibrahim
- Departments of Surgery, UCLA Medical Center, Pfleger Liver Institute, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095 USA
| | - Kimberly Hong
- Departments of Surgery, UCLA Medical Center, Pfleger Liver Institute, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095 USA
| | - Sammy Saab
- Departments of Surgery, UCLA Medical Center, Pfleger Liver Institute, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095 USA ,Departments of Medicine, UCLA Medical Center, Pfleger Liver Institute, University of California at Los Angeles, 200 Medical Plaza, Suite 214, Los Angeles, CA 90095 USA
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567
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Scendoni R, Petrelli C, Giustozzi M, Logullo FO. Multiple sites of thrombosis without thrombocytopenia after a second dose of Pfizer-BioNTech COVID-19 vaccine. Int J Immunopathol Pharmacol 2022; 36:3946320221128534. [PMID: 36123789 PMCID: PMC9486676 DOI: 10.1177/03946320221128534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In the current international scientific panorama, rare cases of venous thrombotic complications following mRNA vaccine administration have been reported, consisting mainly of cerebral sinus thromboses and acute venous thromboembolism. The present paper describes the case of a 75-year-old woman in good health who developed cerebral venous thrombosis, deep venous thrombosis, and bilateral pulmonary emboli after receiving a second dose of Pfizer-BioNTech COVID-19 vaccine. A series of laboratory tests performed during hospitalization yielded interesting results, allowing us to exclude thrombophilic risk factors and to certify the absence of thrombocytopenia in the patient. Although COVID-19 vaccination is the most important tool in stopping the pandemic, pharmacovigilance is crucial for detecting potential multisystem thrombotic events, even for mRNA vaccines.
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568
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Rodríguez Lucas JM, Fernández López AJ, González Valverde FM, Tamayo Rodríguez ME, Albarracín Marín-Blázquez A. Surgical acute abdomen and COVID-19 vaccination. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2022; 114:440. [DOI: 10.17235/reed.2022.8721/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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569
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Chin SE, Bhavsar SM, Corson A, Ghersin ZJ, Kim HS. Cardiac Complications Associated with COVID-19, MIS-C, and mRNA COVID-19 Vaccination. Pediatr Cardiol 2022; 43:483-488. [PMID: 35258639 PMCID: PMC8902276 DOI: 10.1007/s00246-022-02851-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/12/2022] [Indexed: 12/29/2022]
Abstract
The COVID-19 vaccine is now approved for individuals greater than 5 years of age, but vaccination rates remain lower than expected in the pediatric age group. Misinformation and widespread reporting of vaccine-related myocarditis are contributing to vaccine hesitancy. When compared to severe cardiac complications that are associated with COVID-19, vaccine-related myocarditis has a milder presentation, is easily treated, and has a good prognosis. Acute COVID-19 has been associated with higher rates of myocarditis and myocardial injury. Multisystem inflammatory syndrome in children occurs weeks after initial infection with SARS-CoV-2 and can be associated with severe cardiovascular complications and death. Cardiac complications associated with acute COVID-19 and MIS-C are more severe and occur more frequently than myocarditis after mRNA COVID-19 vaccination. Furthermore, some of the academic and social disruptions caused by the pandemic expect to be eased by widespread vaccination. For all these reasons, COVID-19 vaccination is strongly recommended for all eligible age groups.
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Affiliation(s)
- Stephanie E Chin
- K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, USA.
- Hackensack Meridian School of Medicine, Nutley, NJ, USA.
- Alpert Zales Castro Pediatric Cardiology, 1623 Route 88, Brick, NJ, 08724, USA.
| | - Sejal M Bhavsar
- Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Andrew Corson
- K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Zelda J Ghersin
- K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Hannah S Kim
- Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
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570
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Lipsitch M, Krammer F, Regev-Yochay G, Lustig Y, Balicer RD. SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact. Nat Rev Immunol 2022; 22:57-65. [PMID: 34876702 PMCID: PMC8649989 DOI: 10.1038/s41577-021-00662-4] [Citation(s) in RCA: 180] [Impact Index Per Article: 90.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 02/04/2023]
Abstract
Breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in fully vaccinated individuals are receiving intense scrutiny because of their importance in determining how long restrictions to control virus transmission will need to remain in place in highly vaccinated populations as well as in determining the need for additional vaccine doses or changes to the vaccine formulations and/or dosing intervals. Measurement of breakthrough infections is challenging outside of randomized, placebo-controlled, double-blind field trials. However, laboratory and observational studies are necessary to understand the impact of waning immunity, viral variants and other determinants of changing vaccine effectiveness against various levels of coronavirus disease 2019 (COVID-19) severity. Here, we describe the approaches being used to measure vaccine effectiveness and provide a synthesis of the burgeoning literature on the determinants of vaccine effectiveness and breakthrough rates. We argue that, rather than trying to tease apart the contributions of factors such as age, viral variants and time since vaccination, the rates of breakthrough infection are best seen as a consequence of the level of immunity at any moment in an individual, the variant to which that individual is exposed and the severity of disease being considered. We also address key open questions concerning the transition to endemicity, the potential need for altered vaccine formulations to track viral variants, the need to identify immune correlates of protection, and the public health challenges of using various tools to counter breakthrough infections, including boosters in an era of global vaccine shortages.
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Affiliation(s)
- Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology and Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gili Regev-Yochay
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaniv Lustig
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Central Virology Laboratory, Public Health Services, Ministry of Health, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ran D Balicer
- Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel
- The School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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571
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Howard‐Jones AR, Bowen AC, Danchin M, Koirala A, Sharma K, Yeoh DK, Burgner DP, Crawford NW, Goeman E, Gray PE, Hsu P, Kuek S, McMullan BJ, Tosif S, Wurzel D, Britton PN. COVID-19 in children: I. Epidemiology, prevention and indirect impacts. J Paediatr Child Health 2022; 58:39-45. [PMID: 34643307 PMCID: PMC8662210 DOI: 10.1111/jpc.15791] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/21/2021] [Accepted: 09/30/2021] [Indexed: 01/06/2023]
Abstract
Children globally have been profoundly impacted by the coronavirus disease 2019 (COVID-19) pandemic. This review explores the direct and indirect public health impacts of COVID-19 on children. We discuss in detail the transmission dynamics, vaccination strategies and, importantly, the 'shadow pandemic', encompassing underappreciated indirect impacts of the pandemic on children. The indirect effects of COVID-19 will have a long-term impact beyond the immediate pandemic period. These include the mental health and wellbeing risks, disruption to family income and attendant stressors including increased family violence, delayed medical attention and the critical issue of prolonged loss of face-to-face learning in a normal school environment. Amplification of existing inequities and creation of new disadvantage are likely additional sequelae, with children from vulnerable families disproportionately affected. We emphasise the responsibility of paediatricians to advocate on behalf of this vulnerable group to ensure the longer-term effects of COVID-19 public health responses on the health and wellbeing of children are fully considered.
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Affiliation(s)
- Annaleise R Howard‐Jones
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,NSW Health Pathology‐NepeanNepean HospitalSydneyNew South WalesAustralia
| | - Asha C Bowen
- Department of Infectious DiseasesPerth Children's HospitalPerthWestern AustraliaAustralia,Wesfarmers Centre for Vaccines and Infectious DiseasesTelethon Kids Institute, University of Western AustraliaPerthWestern AustraliaAustralia
| | - Margie Danchin
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Archana Koirala
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,National Centre for Immunisation Research and SurveillanceThe Children's Hospital at WestmeadSydneyNew South WalesAustralia,Department of Infectious DiseasesNepean HospitalPenrithNew South WalesAustralia
| | - Ketaki Sharma
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,National Centre for Immunisation Research and SurveillanceThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Daniel K Yeoh
- Department of Infectious DiseasesPerth Children's HospitalPerthWestern AustraliaAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - David P Burgner
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Infectious Diseases Unit, Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Nigel W Crawford
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Emma Goeman
- Department of Infectious Diseases and MicrobiologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Paul E Gray
- Department of Immunology and Infectious DiseasesSydney Children's HospitalSydneyNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Peter Hsu
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,Department of ImmunologyThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Stephanie Kuek
- Department of Respiratory and Sleep MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Brendan J McMullan
- Department of Immunology and Infectious DiseasesSydney Children's HospitalSydneyNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Shidan Tosif
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Danielle Wurzel
- Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of Respiratory and Sleep MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia,School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Philip N Britton
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,Department of Infectious Diseases and MicrobiologyThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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572
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Ishida T, Suzuki K, Koyama S, Shinohara T, Saitoh S. Acute myocarditis following coronavirus disease 2019 vaccination in a 14-year-old Japanese boy. Pediatr Int 2022; 64:e15256. [PMID: 35938599 DOI: 10.1111/ped.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Takayuki Ishida
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazutaka Suzuki
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoshi Koyama
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tsutomu Shinohara
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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573
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Brüssow H. mRNA vaccines against COVID-19: a showcase for the importance of microbial biotechnology. Microb Biotechnol 2022; 15:135-148. [PMID: 34788497 PMCID: PMC8652446 DOI: 10.1111/1751-7915.13974] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 12/17/2022] Open
Abstract
Pfizer-BioNTech and Moderna developed in record time mRNA vaccines against COVID-19 of high efficacy. The modest protection achieved with a similarly designed mRNA from CureVac underlines the importance of biotechnological details in formulation such as replacement of uridine by pseudouridine in the mRNA encoding the SARS-CoV-2 spike protein or the lipid composition of the nanoparticle coating the mRNA. Phase 3 vaccine trials and vaccine studies in special subject groups as well observational studies in whole populations confirmed the real-world vaccine efficacy against symptomatic disease, particularly against severe COVID-19 cases and to a lesser extent against mild SARS-CoV-2 infections. mRNA vaccine protection extended also to the alpha and beta variant viruses. The surge of delta variants led to an increase of infections and cases even in populations which achieved high vaccine coverage. This efficacy decline resulted to a lesser extent from a weaker neutralization of the delta variant but mostly from a waning vaccine protection over time. Data from Israel documented the efficacy of a third 'booster' injection 5 months after the second injection in older segments of the population. Adverse reactions consisted of transient injection site pain, headache, muscle pain, fatigue, fever and chills. Extensive surveillance studies documented a good safety profile revealing only a non-significant increase in transient facial nerve paralysis and a significant, but modest increase in myocarditis in vaccinated young males that was lower than the myocarditis risk induced by SARS-CoV-2 infection.
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Affiliation(s)
- Harald Brüssow
- Laboratory of Gene TechnologyDepartment of BiosystemsKU LeuvenLeuvenBelgium
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574
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Abstract
This article is a narrative review of the rapidly moving coronavirus disease 2019 vaccine field with an emphasis on clinical efficacy established in both randomized trials and postmarketing surveillance of clinically available vaccines. We review the major clinical trials that supported authorization for general use of the Janssen (Ad.26.CoV2), Pfizer-BioNTech (BNT162b2), and Moderna (mRNA-1273) vaccines and the publicly available postmarketing information with the goal of providing a broad, clinically relevant comparison of efficacy and safety. This review is primarily focused on the US market.
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Affiliation(s)
- William O Hahn
- Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
| | - Zanthia Wiley
- Division of Infectious Diseases, Department of Medicine, Emory University, Infectious Diseases Clinic, 550 Peachtree Street NE, 7th Floor - Medical Office Tower, Atlanta, GA 30308, USA
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575
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Goldman RD. La myocardite et la péricardite après un vaccin à ARN messager contre la COVID-19. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2022; 68:19-21. [PMID: 35063976 PMCID: PMC9810057 DOI: 10.46747/cfp.680119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Question À la suite de l’approbation d’un vaccin contre la maladie à coronavirus 2019 (COVID-19) pour les enfants de 5 à 11 ans et compte tenu de préoccupations de parents au cours de la dernière année face à des cas rapportés de myocardite et de péricardite chez des adolescents, ma clinique devrait-elle continuer à encourager tous les enfants et les jeunes adultes à recevoir le vaccin à ARN messager contre la COVID-19? Réponse Depuis avril 2021, des rapports ont documenté des cas de myocardite et de péricardite chez des adolescents et des jeunes adultes ayant reçu un vaccin à ARN messager contre la COVID-19, et plusieurs centaines de signalements semblables ont été documentés au Canada. Les schémas cliniques étaient majoritairement bénins, avec quelques rares hospitalisations, et les cas touchaient habituellement des adolescents masculins de 16 ans et plus dans les quelques jours suivant la deuxième dose du vaccin. Après la vaccination, les enfants et les adolescents qui présentent des symptômes comme des douleurs thoraciques, de la dyspnée ou des palpitations devraient être évalués en procédant à un examen physique et à un électrocardiogramme, et en mesurant les taux de troponines cardiaques. Si les résultats sont anormaux, il y a lieu d’envisager un échocardiogramme ou une imagerie cardiaque par résonance magnétique. La myocardite et la péricardite subséquentes à la vaccination sont bien moins courantes et beaucoup moins graves que les complications cardiaques d’une infection à la COVID-19, et les vaccins devraient continuer à être recommandés auprès de toutes les personnes admissibles.
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576
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Brunello A, Guarneri V, Coppola M, Bernardi M, Ottolitri K, Ghi MG, Mioranza E, Vianello F, Gottardi M, Lonardi S, Zagonel V. OUP accepted manuscript. Oncologist 2022; 27:e203-e205. [PMID: 35641217 PMCID: PMC8895736 DOI: 10.1093/oncolo/oyab037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022] Open
Abstract
Background Few data are available on the safety of COVID-19 vaccines in cancer patients undergoing active cancer-directed treatment. Patients and Methods This case series analyzes outcomes in terms of adverse events in 5297 patients undergoing anti-cancer treatment who were vaccinated with anti-SARS-CoV-2 Pfizer-BioNTech vaccine at a single cancer center from March 6, 2021 to May 9, 2021. Adverse events were retrieved from the national Italian pharmacovigilance platform (http://www.vigicovid.it). Results Of the 5297 patients treated for either solid tumors (87%) or onco-hematologic malignancies (13%) who were vaccinated, 8 adverse drug reactions (ADRs) were reported. One was a severe ADR and 7 were non-severe ADRs. Non-severe ADRs resolved within 48 hours. Conclusion BNT162b2 Pfizer-BioNTech vaccine was safely administered in the largest cohort of cancer patients reported to date.
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Affiliation(s)
- Antonella Brunello
- Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
- Corresponding author: Antonella Brunello, MD PhD, UOC Oncologia 1, Dipartimento di Oncologia, Istituto Oncologico Veneto, IOV, IRCCS, via Gattamelata 64, 35128 Padova, Italy. Tel: +39 0498215953; Email
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Medical Oncology 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Marina Coppola
- Pharmacy, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Matteo Bernardi
- Healthcare Professions, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Ketti Ottolitri
- Risk Management, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Maria Grazia Ghi
- Medical Oncology 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Eleonora Mioranza
- Medical Oncology 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Federica Vianello
- Radiotherapy, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Michele Gottardi
- Onco Hematology, Veneto Institute of Oncology IOV – IRCCS, Castelfranco Veneto, Italy
| | - Sara Lonardi
- Medical Oncology 3, Veneto Institute of Oncology IOV – IRCCS, Castelfranco Veneto, Italy
| | - Vittorina Zagonel
- Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
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577
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COVID-19 vaccination induced myopericarditis: an imager’s perspective. CJC Open 2022; 4:497-500. [PMID: 35128370 PMCID: PMC8800170 DOI: 10.1016/j.cjco.2022.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/21/2022] [Indexed: 12/21/2022] Open
Abstract
COVID-19 vaccine-induced myocarditis is a rare adverse event in the current pandemic. The following is a case series of 10 individuals with COVID-19 vaccine-related myocarditis confirmed by cardiac magnetic resonance imaging. In this cohort of predominantly male patients, with a mean age of 23 years, chest discomfort and positive cardiac biomarkers occurred at a median of 3 days after the second COVID-19 vaccine dose. Although systolic function was relatively preserved on noninvasive cardiac imaging, evidence was seen of delayed enhancement on cardiac magnetic resonance imaging, confirming myocarditis. As COVID-19 vaccine-induced myocarditis has a relatively benign clinical course, the benefits of vaccination still, by far, outweigh this small risk.
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578
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Goldman RD. Myocarditis and pericarditis after COVID-19 messenger RNA vaccines. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2022; 68:17-18. [PMID: 35063975 PMCID: PMC9810064 DOI: 10.46747/cfp.680117] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
QUESTION With the approval of coronavirus disease 2019 (COVID-19) vaccine for children 5 to 11 years of age and concerns among parents in the past year following reported cases of myocarditis and pericarditis in adolescents, should my office continue to encourage all children and young adults to receive the COVID-19 messenger RNA vaccine? ANSWER Since April 2021 reports have documented cases of myocarditis and pericarditis in adolescents and young adults after messenger RNA COVID-19 vaccination, and several hundred such reports were documented in Canada. Clinical presentations were mostly mild, with rare instances of admission to the hospital, and were typically among male adolescents 16 years of age and older within several days after the second dose of the vaccine. After vaccination, children and adolescents with symptoms of chest pain, shortness of breath, or palpitations should be evaluated with a physical examination, an electrocardiogram, and measurement of cardiac troponin levels. If results are abnormal, an echocardiogram or cardiac magnetic resonance imaging should be considered. Myocarditis and pericarditis after vaccination are much less common, and much milder, than cardiac complications of COVID-19 infection, and vaccines should continue to be recommended to all those eligible.
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579
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Paran Y, Saiag E, Spitzer A, Angel Y, Yakubovsky M, Padova H, Ben-Ami R, Goldinger I, Gamzu R, Sprecher E, Zeltser D, Henig O. Short term safety of booster immunization with BNT162b2 mRNA COVID-19 vaccine in healthcare workers. Open Forum Infect Dis 2021; 9:ofab656. [PMID: 35165656 PMCID: PMC8755369 DOI: 10.1093/ofid/ofab656] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
This study demonstrated good short-term safety profile after a third dose of BNT162b2 vaccine among HCWs.
There were more frequent local reactions and less systemic reactions compared to the second dose.
HCW's who reported reactions had higher pre-booster titer of anti-S1 antibodies compared to those reported no reactions.
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Affiliation(s)
- Yael Paran
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Esther Saiag
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Information Systems and Operations, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avishay Spitzer
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Yoel Angel
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Division of Anesthesiology, Intensive Care, and Pain Management, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Yakubovsky
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hagit Padova
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Patient Safety, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ilana Goldinger
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Laboratory Medicine Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronni Gamzu
- Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Eli Sprecher
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Division of Research and Development, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - David Zeltser
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Internal Medicine "D", Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Oryan Henig
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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580
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Knowlton KU, Knight S, Muhlestein JB, Le VT, Horne BD, May HT, Stenehjem EA, Anderson JL. A small but significantly greater incidence of inflammatory heart disease identified after vaccination for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Open Forum Infect Dis 2021; 9:ofab663. [PMID: 35141346 PMCID: PMC8755376 DOI: 10.1093/ofid/ofab663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/29/2021] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
SARS-CoV-2 vaccines are being administered on an unprecedented scale. Assessing the risks of side effects is needed to aid clinicians in early detection and treatment. This study examined the risk of inflammatory heart disease, including pericarditis and myocarditis, following SARS-CoV-2 vaccination.
Methods
Intermountain Healthcare patients with inflammatory heart disease from December 15, 2020, to June 15, 2021, and with or without preceding SARS-CoV-2 vaccinations were studied. Relative rates of inflammatory heart disease were examined for vaccinated patients compared to unvaccinated patients.
Results
Of 67 identified inflammatory heart disease patients, 21 (31.3%) had a SARS-Cov-2 vaccination within the previous 60 days. Overall, 914,611 Intermountain Healthcare patients received a SARS-CoV-2 vaccine, resulting in an inflammatory heart disease rate of 2.30 per 100,000 vaccinated patients. The relative risk of inflammatory heart disease for the vaccinated patients compared to the unvaccinated patients was 2.05 times higher rate within the 30-day window (p=0.01) and had a trend toward increase in the 60-day window (relative rate=1.63; p=0.07). All vaccinated patients with inflammatory heart disease were treated successfully with one death related to a pre-existing condition.
Conclusions
Though rare, the rate of inflammatory heart disease was greater in a SARS-CoV-2 vaccinated population than the unvaccinated population. This risk is eclipsed by the risk of contracting COVID-19 and its associated, commonly severe outcomes. Nevertheless, clinicians and patients should be informed of this risk to facilitate earlier recognition and treatment.
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Affiliation(s)
- Kirk U Knowlton
- Intermountain Medical Center, Salt Lake City, Utah, USA
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Stacey Knight
- Intermountain Medical Center, Salt Lake City, Utah, USA
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joseph B Muhlestein
- Intermountain Medical Center, Salt Lake City, Utah, USA
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Viet T Le
- Intermountain Medical Center, Salt Lake City, Utah, USA
- Rocky Mountain University of Health Professions Physician Assistant Program, Provo, Utah, USA
| | - Benjamin D Horne
- Intermountain Medical Center, Salt Lake City, Utah, USA
- Stanford University School of Medicine, Stanford, CA, USA
| | - Heidi T May
- Intermountain Medical Center, Salt Lake City, Utah, USA
| | | | - Jeffrey L Anderson
- Intermountain Medical Center, Salt Lake City, Utah, USA
- University of Utah School of Medicine, Salt Lake City, Utah, USA
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581
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Vaccination Hesitancy among Health-Care-Workers in Academic Hospitals Is Associated with a 12-Fold Increase in the Risk of COVID-19 Infection: A Nine-Month Greek Cohort Study. Viruses 2021; 14:v14010026. [PMID: 35062230 PMCID: PMC8779273 DOI: 10.3390/v14010026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/11/2021] [Accepted: 12/20/2021] [Indexed: 01/02/2023] Open
Abstract
Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, Greece. Vaccinated by BNT162b2 Pfizer-BioNTech COVID-19 mRNA vaccine and unvaccinated HCWs were included and data were collected between 1 January 2021 and 15 September 2021. Overall, 2921 of 3219 HCWs without a history of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were fully vaccinated during the study period (90.7% at each Hospital). Demographic characteristics were comparable between 102/2921 (3.5%) vaccinated and 88/298 (29.5%) unvaccinated HCWs with COVID-19, although age and occupation differed significantly. None were in need of hospital admission in the vaccinated Group, whereas in the unvaccinated Group 4/88 (4.5%) were hospitalized and one (1.1%) died. Multivariable logistic regression analysis revealed that lack of vaccination was an independent risk factor for COVID-19 with an odds ratio 11.54 (95% CI: 10.75-12.40). Vaccination hesitancy among HCWs resulted to highly increased COVID-19 rates; almost one in three unvaccinated HCWs was SARS-CoV-2 infected during the 9-month period. The absolute need of vaccination of HCWs, including boosting dose, is highlighted. Evidence should be used appropriately to overcome any hesitancy.
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582
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Prugger C, Spelsberg A, Keil U, Erviti J, Doshi P. Evaluating covid-19 vaccine efficacy and safety in the post-authorisation phase. BMJ 2021; 375:e067570. [PMID: 34949587 DOI: 10.1136/bmj-2021-067570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Christof Prugger
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ulrich Keil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Juan Erviti
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | - Peter Doshi
- University of Maryland School of Pharmacy, Baltimore, Maryland, USA
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583
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Arbel R, Hammerman A, Sergienko R, Friger M, Peretz A, Netzer D, Yaron S. BNT162b2 Vaccine Booster and Mortality Due to Covid-19. N Engl J Med 2021; 385:2413-2420. [PMID: 34879190 PMCID: PMC8728797 DOI: 10.1056/nejmoa2115624] [Citation(s) in RCA: 224] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND The emergence of the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 and the reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a resurgence of coronavirus disease 2019 (Covid-19) cases in populations that had been vaccinated early. On July 30, 2021, the Israeli Ministry of Health approved the use of a third dose of BNT162b2 (booster) to cope with this resurgence. Evidence regarding the effectiveness of the booster in lowering mortality due to Covid-19 is still needed. METHODS We obtained data for all members of Clalit Health Services who were 50 years of age or older at the start of the study and had received two doses of BNT162b2 at least 5 months earlier. The mortality due to Covid-19 among participants who received the booster during the study period (booster group) was compared with that among participants who did not receive the booster (nonbooster group). A Cox proportional-hazards regression model with time-dependent covariates was used to estimate the association of booster status with death due to Covid-19, with adjustment for sociodemographic factors and coexisting conditions. RESULTS A total of 843,208 participants met the eligibility criteria, of whom 758,118 (90%) received the booster during the 54-day study period. Death due to Covid-19 occurred in 65 participants in the booster group (0.16 per 100,000 persons per day) and in 137 participants in the nonbooster group (2.98 per 100,000 persons per day). The adjusted hazard ratio for death due to Covid-19 in the booster group, as compared with the nonbooster group, was 0.10 (95% confidence interval, 0.07 to 0.14; P<0.001). CONCLUSIONS Participants who received a booster at least 5 months after a second dose of BNT162b2 had 90% lower mortality due to Covid-19 than participants who did not receive a booster.
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Affiliation(s)
- Ronen Arbel
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
| | - Ariel Hammerman
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
| | - Ruslan Sergienko
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
| | - Michael Friger
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
| | - Alon Peretz
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
| | - Doron Netzer
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
| | - Shlomit Yaron
- From the Community Medical Services Division, Clalit Health Services, Tel Aviv (R.A., A.H., A.P., D.N., S.Y.), the Maximizing Health Outcomes Research Lab, Sapir College, Sderot (R.A.), and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba (R.S., M.F.) - all in Israel
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584
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Borroni E, Consonni D, Cugno M, Lombardi A, Mangioni D, Bono P, Oggioni M, Uceda Renteria S, Bordini L, Nava CD, Letzgus M, Gentiloni Silverj F, Castaldi S, Rognoni M, Cavallieri D'Oro L, Carugno M, Riboldi L, Ceriotti F, Bandera A, Gori A, Pesatori AC. Side effects among healthcare workers from a large Milan university hospital after second dose of BNT162b2 mRNA COVID-19 vaccine. LA MEDICINA DEL LAVORO 2021; 112:477-485. [PMID: 34939617 PMCID: PMC8759050 DOI: 10.23749/mdl.v112i6.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Italy, healthcare workers (HCWs) were among the first to receive COVID-19 vaccination. Aim of the present study is to evaluate frequency and severity of adverse events (AEs) following the second dose of BNT162b2 vaccine among HCWs of a large university hospital in Milan, Italy. METHODS One month after having received the second dose of vaccine, HCWs filled-in a form about type, severity, and duration of post-vaccination local and systemic symptoms. We calculated the overall frequency of AEs and used multivariable Poisson regression models (adjusted for sex, age, BMI, smoking, allergy history, previous SARS-CoV-2 infection, anti-hypertensive therapy, and occupation) to calculate risk ratios (RR) and 95% confidence intervals (CI) of AEs according to selected variables. RESULTS We included 3659 HCWs. Overall, 2801 (76.6%) experienced at least one local event, with pain at injection site being the most frequent (2788, 76.2%). Systemic events were reported by 2080 (56.8%) HCWs, with fatigue (52.3%), muscle pain (42.2%), headache (37.7%), joint pain (31.9%), and fever (26.2%) being the most frequent. Risks of systemic events were associated with female gender (RR=1.14, CI: 1.06-1.23), age (strong decrease with increasing age, p-trend<0.001), allergy history (RR=1.13, CI: 1.05-1.20), and current smoking (RR=0.90, CI: 0.84-0.97). HCWs with previous SARS-CoV-2 infection (even if symptomatic) were not at increased risk. CONCLUSIONS Both local and systemic acute effects after second dose of BNT162b2 vaccine were frequently reported. However, symptoms were mostly light/mild and of short duration. Thus, our findings support the safety of COVID-19 vaccination in adults in relatively good health.
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Affiliation(s)
- Elisa Borroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Massimo Cugno
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Andrea Lombardi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Davide Mangioni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara Uceda Renteria
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Bordini
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo Domenico Nava
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Matteo Letzgus
- Medical Direction, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | | | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Alessandra Bandera
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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585
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Fillon A, Sautenet B, Barbet C, Moret L, Thillard EM, Jonville-Béra AP, Halimi JM. De novo and relapsing necrotizing vasculitis after COVID-19 vaccination. Clin Kidney J 2021; 15:560-563. [PMID: 35211310 PMCID: PMC8862065 DOI: 10.1093/ckj/sfab285] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
We describe 5 cases of severe necrotizing vasculitis following the RNA-based vaccine for SARS-COV2, including 4 relapsing ANCA vasculitis, 27 days (1-60) after vaccination and 1 patient with quiescent chronic hepatitis B and de novo polyarteritis nodosa (PAN) 21 days after vaccination. Ten other cases were reported to the French national pharmacovigilance database: 6 patients with ANCA-associated vasculitis and 4 patients with PAN (first symptoms 19 days on average after vaccination). Five of these 10 patients developed kidney dysfunction. In conclusion, COVID-19-vaccines can be associated with de novo or recurrent ANCA vasculitis or PAN. Attention should be paid to patients with known ANCA vasculitis or patients with history of hepatitis B infection.
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Affiliation(s)
- Alexandre Fillon
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
| | - Benedicte Sautenet
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
- SPHERE INSERM 1246, Université de Tours, Université de Nantes, Tours, France
- Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), France
| | - Christelle Barbet
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
| | - Léa Moret
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
| | - Eve Marie Thillard
- CHRU de Tours, Centre Régional de Pharmacovigilance Centre Val de Loire, Tours, France
| | - Annie Pierre Jonville-Béra
- SPHERE INSERM 1246, Université de Tours, Université de Nantes, Tours, France
- CHRU de Tours, Centre Régional de Pharmacovigilance Centre Val de Loire, Tours, France
| | - Jean Michel Halimi
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
- Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), France
- EA 4245, Université François-Rabelais, Tours, France
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586
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Ibuchi Y, Tamayose F, Katayama H, Saeki H, Osada SI. Varicella zoster virus reactivation after coronavirus disease 2019 vaccination in Japanese patients: A series of 14 cases. J Dermatol 2021; 49:e151-e153. [PMID: 34927289 DOI: 10.1111/1346-8138.16287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/27/2021] [Accepted: 12/11/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Yoshiaki Ibuchi
- Department of Dermatology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
| | - Fumiko Tamayose
- Department of Dermatology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
| | - Hiroki Katayama
- Department of Dermatology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Shin-Ichi Osada
- Department of Dermatology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
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587
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Shimodaira Y, Watanabe K, Takahashi S, Koizumi S, Iijima K. Inflammatory Bowel Disease Triggered by BNT162b2 mRNA Vaccination for SARS-CoV-2. Inflamm Bowel Dis 2021; 28:e75. [PMID: 34922342 PMCID: PMC9383187 DOI: 10.1093/ibd/izab297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Yosuke Shimodaira
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita City, Japan,Address correspondence to: Yosuke Shimodaira, MD, PhD, Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita City, 0108543, Japan ()
| | - Kenta Watanabe
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita City, Japan
| | - So Takahashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita City, Japan
| | - Shigeto Koizumi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita City, Japan
| | - Katsunori Iijima
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita City, Japan
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588
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Fazlollahi A, Zahmatyar M, Noori M, Nejadghaderi SA, Sullman MJM, Shekarriz-Foumani R, Kolahi AA, Singh K, Safiri S. Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series. Rev Med Virol 2021; 32:e2318. [PMID: 34921468 DOI: 10.1002/rmv.2318] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 12/21/2022]
Abstract
There have been several local and systemic adverse events associated with mRNA COVID-19 vaccines. Pericarditis, myocarditis and myocardial infarction are examples of cardiac complications related to these vaccines. In this article, we conducted a systematic review of case reports and case series to identify the clinical profile, investigations, and management of reported cardiac complications post-mRNA COVID-19 vaccines. We systematically searched PubMed, Scopus, Web of Science, and Google Scholar, as well as the medRxiv preprint server, with terms including: 'SARS-CoV-2', 'COVID-19', 'messenger RNA vaccine*', 'mRNA-1273 vaccine', 'BNT162 vaccine', 'myocarditis', 'pericarditis', 'stroke' and 'Myocardial Ischemia' up to 25 September 2021. Studies were excluded if they were not case reports or case series, or reported cases from non-mRNA vaccines. Case reports and case series were included that investigated the potential cardiac complications associated with mRNA COVID-19 vaccines. The JBI checklist was used to assess quality and data synthesis was conducted using a qualitative methodology called narrative synthesis. Sixty-nine studies, including 43 case reports and 26 case series, were included. Myocarditis/myopericarditis and pericarditis were the most common adverse events among the 243 reported cardiac complications, post mRNA COVID-19 vaccination. Males with a median age of 21 years had the highest frequency of myocarditis. Almost three quarters (74.4%) of cases with myocarditis had received the BNT162b2 vaccine and 87.7% had received the second dose of the vaccine. Chest pain (96.1%) and fever (38.2%) were the most common presentations. CK-MB, troponin, and NT-proBNP were elevated in 100%, 99.5% and 78.3% of subjects, respectively. ST-segment abnormality was the most common electrocardiogram feature. Cardiac magnetic resonance imaging, which is the gold-standard approach for diagnosing myocarditis, was abnormal in all patients diagnosed with myocarditis. Non-steroidal anti-inflammatory drugs were the most prescribed medication for the management of myocarditis. Apart from inflammatory conditions, some rare cases of Takotsubo cardiomyopathy, myocardial infarction, myocardial infarction with non-obstructive coronary arteries, and isolated tachycardia were also reported following immunisation with mRNA COVID-19 vaccines. We acknowledge that only reviewing case reports and case series studies is one potential limitation of our study. We found that myocarditis was the most commonly reported adverse cardiac event associated with mRNA COVID-19 vaccines, which presented as chest pain with a rise in cardiac biomarkers. Further large-scale observational studies are recommended.
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Affiliation(s)
- Asra Fazlollahi
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Zahmatyar
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus.,Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Reza Shekarriz-Foumani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kuljit Singh
- Department of Medicine, Griffith University, Gold Coast, Queensland, Australia.,Department of Cardiology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Saeid Safiri
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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589
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Husby A, Hansen JV, Fosbøl E, Thiesson EM, Madsen M, Thomsen RW, Sørensen HT, Andersen M, Wohlfahrt J, Gislason G, Torp-Pedersen C, Køber L, Hviid A. SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study. BMJ 2021; 375:e068665. [PMID: 34916207 PMCID: PMC8683843 DOI: 10.1136/bmj-2021-068665] [Citation(s) in RCA: 137] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the association between SARS-CoV-2 vaccination and myocarditis or myopericarditis. DESIGN Population based cohort study. SETTING Denmark. PARTICIPANTS 4 931 775 individuals aged 12 years or older, followed from 1 October 2020 to 5 October 2021. MAIN OUTCOME MEASURES The primary outcome, myocarditis or myopericarditis, was defined as a combination of a hospital diagnosis of myocarditis or pericarditis, increased troponin levels, and a hospital stay lasting more than 24 hours. Follow-up time before vaccination was compared with follow-up time 0-28 days from the day of vaccination for both first and second doses, using Cox proportional hazards regression with age as an underlying timescale to estimate hazard ratios adjusted for sex, comorbidities, and other potential confounders. RESULTS During follow-up, 269 participants developed myocarditis or myopericarditis, of whom 108 (40%) were 12-39 years old and 196 (73%) were male. Of 3 482 295 individuals vaccinated with BNT162b2 (Pfizer-BioNTech), 48 developed myocarditis or myopericarditis within 28 days from the vaccination date compared with unvaccinated individuals (adjusted hazard ratio 1.34 (95% confidence interval 0.90 to 2.00); absolute rate 1.4 per 100 000 vaccinated individuals within 28 days of vaccination (95% confidence interval 1.0 to 1.8)). Adjusted hazard ratios among female participants only and male participants only were 3.73 (1.82 to 7.65) and 0.82 (0.50 to 1.34), respectively, with corresponding absolute rates of 1.3 (0.8 to 1.9) and 1.5 (1.0 to 2.2) per 100 000 vaccinated individuals within 28 days of vaccination, respectively. The adjusted hazard ratio among 12-39 year olds was 1.48 (0.74 to 2.98) and the absolute rate was 1.6 (1.0 to 2.6) per 100 000 vaccinated individuals within 28 days of vaccination. Among 498 814 individuals vaccinated with mRNA-1273 (Moderna), 21 developed myocarditis or myopericarditis within 28 days from vaccination date (adjusted hazard ratio 3.92 (2.30 to 6.68); absolute rate 4.2 per 100 000 vaccinated individuals within 28 days of vaccination (2.6 to 6.4)). Adjusted hazard ratios among women only and men only were 6.33 (2.11 to 18.96) and 3.22 (1.75 to 5.93), respectively, with corresponding absolute rates of 2.0 (0.7 to 4.8) and 6.3 (3.6 to 10.2) per 100 000 vaccinated individuals within 28 days of vaccination, respectively. The adjusted hazard ratio among 12-39 year olds was 5.24 (2.47 to 11.12) and the absolute rate was 5.7 (3.3 to 9.3) per 100 000 vaccinated individuals within 28 days of vaccination. CONCLUSIONS Vaccination with mRNA-1273 was associated with a significantly increased risk of myocarditis or myopericarditis in the Danish population, primarily driven by an increased risk among individuals aged 12-39 years, while BNT162b2 vaccination was only associated with a significantly increased risk among women. However, the absolute rate of myocarditis or myopericarditis after SARS-CoV-2 mRNA vaccination was low, even in younger age groups. The benefits of SARS-CoV-2 mRNA vaccination should be taken into account when interpreting these findings. Larger multinational studies are needed to further investigate the risks of myocarditis or myopericarditis after vaccination within smaller subgroups.
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Affiliation(s)
- Anders Husby
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | | | - Emil Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Morten Madsen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Reimar W Thomsen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Morten Andersen
- Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Jan Wohlfahrt
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - Gunnar Gislason
- Danish Heart Foundation, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anders Hviid
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
- Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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590
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Szarpak L, Pruc M, Koda M, Chirico F. Heart inflammation risk after COVID-19 vaccine. Cardiol J 2021; 28:1001-1002. [PMID: 34897637 PMCID: PMC8747813 DOI: 10.5603/cj.a2021.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/04/2021] [Accepted: 12/04/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Institute of Research Outcomes, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Mariusz Koda
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
| | - Francesco Chirico
- Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, Italian State Police, Milan, Italy
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591
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Milano G, Gal J, Creisson A, Chamorey E. Myocarditis and COVID-19 mRNA vaccines: a mechanistic hypothesis involving dsRNA. Future Virol 2021. [PMID: 34887937 PMCID: PMC8647997 DOI: 10.2217/fvl-2021-0280] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/24/2021] [Indexed: 12/18/2022]
Abstract
While tolerance to COVID-19 vaccination is considered satisfactory, a phenomenon of myocarditis, although rare, is becoming a safety concern in mRNA COVID-19 vaccination. The presence of low residual levels of double-strand RNA (dsRNA) has been reported in mRNA COVID-19 vaccine preparations. dsRNA is a known inducer of immune-inflammatory reactions. dsRNA present in vaccine nanoparticles may be suspected to be at the origin of the still unexplained cases of myocarditis.
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Affiliation(s)
- Gerard Milano
- Centre Antoine Lacassagne, Unité Propre de Recherche 7497, Université Côte d'Azur, 06100, Nice, France.,Centre Antoine Lacassagne, UNS EA 7497 Nice University, 33 Avenue de Valombrose, 06189, Nice, France
| | - Jocelyn Gal
- Centre Antoine Lacassagne, UNS EA 7497 Nice University, 33 Avenue de Valombrose, 06189, Nice, France.,Epidemiology & Biostatistics Department, Centre Antoine Lacassagne, University Côte d'Azur, 33 Avenue de Valombrose, 06189, Nice, France
| | - Anne Creisson
- Medical oncology Department, Centre Antoine Lacassagne, University Côte d'Azur, 33 Avenue de Valombrose, 06189, Nice, France
| | - Emmanuel Chamorey
- Centre Antoine Lacassagne, UNS EA 7497 Nice University, 33 Avenue de Valombrose, 06189, Nice, France.,Epidemiology & Biostatistics Department, Centre Antoine Lacassagne, University Côte d'Azur, 33 Avenue de Valombrose, 06189, Nice, France
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592
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Barda N, Dagan N. The role of observational studies based on secondary data in studying SARS-CoV-2 vaccines. Clin Microbiol Infect 2021; 28:313-314. [PMID: 34906720 PMCID: PMC8665840 DOI: 10.1016/j.cmi.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/04/2021] [Accepted: 12/05/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Noam Barda
- Software and Information Systems Engineering, Ben Gurion University, Be'er Sheva, Israel; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
| | - Noa Dagan
- Software and Information Systems Engineering, Ben Gurion University, Be'er Sheva, Israel; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA; Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel; The Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute, Boston, MA, USA
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593
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Pageaud S, Pothier C, Rigotti C, Eyraud-Loisel A, Bertoglio JP, Bienvenüe A, Leboisne N, Ponthus N, Gauchon R, Gueyffier F, Vanhems P, Iwaz J, Loisel S, Roy P. Expected Evolution of COVID-19 Epidemic in France for Several Combinations of Vaccination Strategies and Barrier Measures. Vaccines (Basel) 2021; 9:1462. [PMID: 34960207 PMCID: PMC8708137 DOI: 10.3390/vaccines9121462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022] Open
Abstract
The outbreak of the SARS-CoV-2 virus, enhanced by rapid spreads of variants, has caused a major international health crisis, with serious public health and economic consequences. An agent-based model was designed to simulate the evolution of the epidemic in France over 2021 and the first six months of 2022. The study compares the efficiencies of four theoretical vaccination campaigns (over 6, 9, 12, and 18 months), combined with various non-pharmaceutical interventions. In France, with the emergence of the Alpha variant, without vaccination and despite strict barrier measures, more than 600,000 deaths would be observed. An efficient vaccination campaign (i.e., total coverage of the French population) over six months would divide the death toll by 10. A vaccination campaign of 12, instead of 6, months would slightly increase the disease-related mortality (+6%) but require a 77% increase in ICU bed-days. A campaign over 18 months would increase the disease-related mortality by 17% and require a 244% increase in ICU bed-days. Thus, it seems mandatory to vaccinate the highest possible percentage of the population within 12, or better yet, 9 months. The race against the epidemic and virus variants is really a matter of vaccination strategy.
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Affiliation(s)
- Simon Pageaud
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
- Fondation du Risque, Groupe Louis Bachelier, F-75002 Paris, France
| | - Catherine Pothier
- CNRS UMR 5205, Laboratoire d’InfoRmatique en Image et Systèmes d’Information (LIRIS), F-69621 Villeurbanne, France; (C.P.); (C.R.)
- Institut National des Sciences Appliquées de Lyon (INSA), F-69621 Villeurbanne, France
| | - Christophe Rigotti
- CNRS UMR 5205, Laboratoire d’InfoRmatique en Image et Systèmes d’Information (LIRIS), F-69621 Villeurbanne, France; (C.P.); (C.R.)
- Institut National des Sciences Appliquées de Lyon (INSA), F-69621 Villeurbanne, France
- INRIA Grenoble-Rhône-Alpes, F-38334 Montbonnot, France
| | - Anne Eyraud-Loisel
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Jean-Pierre Bertoglio
- CNRS UMR 5509, Laboratoire de Mécanique des Fluides et d’Acoustique (LMFA), F-69130 Ecully, France;
- École Centrale de Lyon, F-69130 Lyon, France;
| | - Alexis Bienvenüe
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Nicolas Leboisne
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Nicolas Ponthus
- École Centrale de Lyon, F-69130 Lyon, France;
- CNRS UMR 5513, Laboratoire de Tribologie et Dynamique des Systèmes (LTDS), F-69130 Ecully, France
- École Nationale des Travaux Publics de l’État (ENTPE), F-69120 Vaulx-en-Velin, France
| | - Romain Gauchon
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - François Gueyffier
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Philippe Vanhems
- Service d’Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, F-69003 Lyon, France;
- Centre International de Recherche en Infectiologie (CIRI: Inserm U1111, CNRS UMR 5308, École Nationale Supérieure de Lyon), F-69007 Lyon, France
| | - Jean Iwaz
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Stéphane Loisel
- Laboratoire de Sciences Actuarielle et Financière (LSAF), Institut de Science Financière et d’Assurances (ISFA), Université Claude Bernard Lyon 1, F-69007 Lyon, France; (A.E.-L.); (A.B.); (N.L.); (R.G.); (S.L.)
| | - Pascal Roy
- Université de Lyon, F-69000 Lyon, France; (S.P.); (F.G.); (J.I.)
- Université Claude Bernard Lyon 1, F-69100 Villeurbanne, France
- CNRS UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, F-69100 Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, F-69003 Lyon, France
- CNRS UMR 5513, Laboratoire de Tribologie et Dynamique des Systèmes (LTDS), F-69130 Ecully, France
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Dagan N, Barda N, Balicer RD. Adverse Effects after BNT162b2 Vaccine and SARS-CoV-2 Infection, According to Age and Sex. N Engl J Med 2021; 385:2299. [PMID: 34706169 PMCID: PMC8609601 DOI: 10.1056/nejmc2115045] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Noa Dagan
- Clalit Research Institute, Tel Aviv, Israel
| | - Noam Barda
- Clalit Research Institute, Tel Aviv, Israel
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595
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Lee TJ, Lu CH, Hsieh SC. Herpes zoster reactivation after mRNA-1273 vaccination in patients with rheumatic diseases. Ann Rheum Dis 2021; 81:595-597. [PMID: 34876461 DOI: 10.1136/annrheumdis-2021-221688] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 11/26/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Tai-Ju Lee
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Hsun Lu
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Song-Chou Hsieh
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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596
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Mevorach D, Anis E, Cedar N, Bromberg M, Haas EJ, Nadir E, Olsha-Castell S, Arad D, Hasin T, Levi N, Asleh R, Amir O, Meir K, Cohen D, Dichtiar R, Novick D, Hershkovitz Y, Dagan R, Leitersdorf I, Ben-Ami R, Miskin I, Saliba W, Muhsen K, Levi Y, Green MS, Keinan-Boker L, Alroy-Preis S. Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel. N Engl J Med 2021; 385:2140-2149. [PMID: 34614328 PMCID: PMC8531987 DOI: 10.1056/nejmoa2109730] [Citation(s) in RCA: 387] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Approximately 5.1 million Israelis had been fully immunized against coronavirus disease 2019 (Covid-19) after receiving two doses of the BNT162b2 messenger RNA vaccine (Pfizer-BioNTech) by May 31, 2021. After early reports of myocarditis during adverse events monitoring, the Israeli Ministry of Health initiated active surveillance. METHODS We retrospectively reviewed data obtained from December 20, 2020, to May 31, 2021, regarding all cases of myocarditis and categorized the information using the Brighton Collaboration definition. We analyzed the occurrence of myocarditis by computing the risk difference for the comparison of the incidence after the first and second vaccine doses (21 days apart); by calculating the standardized incidence ratio of the observed-to-expected incidence within 21 days after the first dose and 30 days after the second dose, independent of certainty of diagnosis; and by calculating the rate ratio 30 days after the second dose as compared with unvaccinated persons. RESULTS Among 304 persons with symptoms of myocarditis, 21 had received an alternative diagnosis. Of the remaining 283 cases, 142 occurred after receipt of the BNT162b2 vaccine; of these cases, 136 diagnoses were definitive or probable. The clinical presentation was judged to be mild in 129 recipients (95%); one fulminant case was fatal. The overall risk difference between the first and second doses was 1.76 per 100,000 persons (95% confidence interval [CI], 1.33 to 2.19), with the largest difference among male recipients between the ages of 16 and 19 years (difference, 13.73 per 100,000 persons; 95% CI, 8.11 to 19.46). As compared with the expected incidence based on historical data, the standardized incidence ratio was 5.34 (95% CI, 4.48 to 6.40) and was highest after the second dose in male recipients between the ages of 16 and 19 years (13.60; 95% CI, 9.30 to 19.20). The rate ratio 30 days after the second vaccine dose in fully vaccinated recipients, as compared with unvaccinated persons, was 2.35 (95% CI, 1.10 to 5.02); the rate ratio was again highest in male recipients between the ages of 16 and 19 years (8.96; 95% CI, 4.50 to 17.83), with a ratio of 1 in 6637. CONCLUSIONS The incidence of myocarditis, although low, increased after the receipt of the BNT162b2 vaccine, particularly after the second dose among young male recipients. The clinical presentation of myocarditis after vaccination was usually mild.
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Affiliation(s)
- Dror Mevorach
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Emilia Anis
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Noa Cedar
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Michal Bromberg
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Eric J Haas
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Eyal Nadir
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Sharon Olsha-Castell
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Dana Arad
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Tal Hasin
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Nir Levi
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Rabea Asleh
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Offer Amir
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Karen Meir
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Dotan Cohen
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Rita Dichtiar
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Deborah Novick
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Yael Hershkovitz
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Ron Dagan
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Iris Leitersdorf
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Ronen Ben-Ami
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Ian Miskin
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Walid Saliba
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Khitam Muhsen
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Yehezkel Levi
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Manfred S Green
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Lital Keinan-Boker
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
| | - Sharon Alroy-Preis
- From the Department of Internal Medicine B, Division of Immunology-Rheumatology, and Wohl Institute for Translational Medicine (D.M.) and the Departments of Cardiology (R.A., O.A.), Pathology (K. Meir), and Radiology (D.C.), Hadassah Medical Center, Braun School of Public Health (E.A.), Jesselson Integrated Heart Center, Shaare Zedek Medical Center (T.H., N.L.), and the Department of Family Medicine (I.M.), Faculty of Medicine, Hebrew University of Jerusalem, the Divisions of Epidemiology (E.A., N.C., E.J.H., E.N.), Patient Safety (S.O.-C., D.A.), and Medicine (I.L.), Israeli Ministry of Health (M.B., R. Dichtiar, D.N., Y.H., Y.L., L.K.-B., S.A.-P.), and Clalit Health Services (E.N., I.M.), Jerusalem, Israel Center for Disease Control, and Azrieli Faculty of Medicine, Bar-Ilan University (O.A.), Ramat Gan, the Department of Epidemiology and Preventive Medicine, School of Public Health (M.B., K. Muhsen), and Tel Aviv Sourasky Medical Center (R.B.-A.), Tel Aviv University, Tel Aviv, Ben Gurion University of the Negev, Beer Sheva (E.J.H., R. Dagan), and the Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Technion-Israel Institute of Technology (W.S.), and the School of Public Health, University of Haifa (M.S.G., L.K.-B.), Haifa - all in Israel
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Witberg G, Barda N, Hoss S, Richter I, Wiessman M, Aviv Y, Grinberg T, Auster O, Dagan N, Balicer RD, Kornowski R. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. N Engl J Med 2021; 385:2132-2139. [PMID: 34614329 PMCID: PMC8531986 DOI: 10.1056/nejmoa2110737] [Citation(s) in RCA: 397] [Impact Index Per Article: 132.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Reports have suggested an association between the development of myocarditis and the receipt of messenger RNA (mRNA) vaccines against coronavirus disease 2019 (Covid-19), but the frequency and severity of myocarditis after vaccination have not been extensively explored. METHODS We searched the database of Clalit Health Services, the largest health care organization (HCO) in Israel, for diagnoses of myocarditis in patients who had received at least one dose of the BNT162b2 mRNA vaccine (Pfizer-BioNTech). The diagnosis of myocarditis was adjudicated by cardiologists using the case definition used by the Centers for Disease Control and Prevention. We abstracted the presentation, clinical course, and outcome from the patient's electronic health record. We performed a Kaplan-Meier analysis of the incidence of myocarditis up to 42 days after the first vaccine dose. RESULTS Among more than 2.5 million vaccinated HCO members who were 16 years of age or older, 54 cases met the criteria for myocarditis. The estimated incidence per 100,000 persons who had received at least one dose of vaccine was 2.13 cases (95% confidence interval [CI], 1.56 to 2.70). The highest incidence of myocarditis (10.69 cases per 100,000 persons; 95% CI, 6.93 to 14.46) was reported in male patients between the ages of 16 and 29 years. A total of 76% of cases of myocarditis were described as mild and 22% as intermediate; 1 case was associated with cardiogenic shock. After a median follow-up of 83 days after the onset of myocarditis, 1 patient had been readmitted to the hospital, and 1 had died of an unknown cause after discharge. Of 14 patients who had left ventricular dysfunction on echocardiography during admission, 10 still had such dysfunction at the time of hospital discharge. Of these patients, 5 underwent subsequent testing that revealed normal heart function. CONCLUSIONS Among patients in a large Israeli health care system who had received at least one dose of the BNT162b2 mRNA vaccine, the estimated incidence of myocarditis was 2.13 cases per 100,000 persons; the highest incidence was among male patients between the ages of 16 and 29 years. Most cases of myocarditis were mild or moderate in severity. (Funded by the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute.).
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Affiliation(s)
- Guy Witberg
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Noam Barda
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Sara Hoss
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Ilan Richter
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Maya Wiessman
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Yaron Aviv
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Tzlil Grinberg
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Oren Auster
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Noa Dagan
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Ran D Balicer
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
| | - Ran Kornowski
- From the Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), the Faculty of Medicine, Tel Aviv University (G.W., S.H., I.R., M.W., Y.A., T.G., R.K.), and the Innovation Division, Clalit Research Institute, Clalit Health Services (N.B., O.A., N.D., R.D.B.), Tel Aviv, and the Department of Software and Information Systems Engineering (N.B., N.D.) and the School of Public Health, Faculty of Health Sciences (R.D.B.), Ben Gurion University, Be'er Sheva - all in Israel; and the Department of Biomedical Informatics, Harvard Medical School (N.B., N.D.), and the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute (N.B., N.D., R.D.B.) - both in Boston
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598
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Niculescu AG, Bîrcă AC, Grumezescu AM. New Applications of Lipid and Polymer-Based Nanoparticles for Nucleic Acids Delivery. Pharmaceutics 2021; 13:2053. [PMID: 34959335 PMCID: PMC8708541 DOI: 10.3390/pharmaceutics13122053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023] Open
Abstract
Nucleic acids represent a promising lead for engineering the immune system. However, naked DNA, mRNA, siRNA, and other nucleic acids are prone to enzymatic degradation and face challenges crossing the cell membrane. Therefore, increasing research has been recently focused on developing novel delivery systems that are able to overcome these drawbacks. Particular attention has been drawn to designing lipid and polymer-based nanoparticles that protect nucleic acids and ensure their targeted delivery, controlled release, and enhanced cellular uptake. In this respect, this review aims to present the recent advances in the field, highlighting the possibility of using these nanosystems for therapeutic and prophylactic purposes towards combatting a broad range of infectious, chronic, and genetic disorders.
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Affiliation(s)
- Adelina-Gabriela Niculescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, 011061 Bucharest, Romania; (A.-G.N.); (A.C.B.)
| | - Alexandra Cătălina Bîrcă
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, 011061 Bucharest, Romania; (A.-G.N.); (A.C.B.)
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, University Politehnica of Bucharest, 011061 Bucharest, Romania; (A.-G.N.); (A.C.B.)
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov No. 3, 50044 Bucharest, Romania
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599
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Cummins NW. Yes, It Does. Mayo Clin Proc 2021; 96:2934-2935. [PMID: 34863388 PMCID: PMC8633938 DOI: 10.1016/j.mayocp.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022]
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600
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Jaffal K, Mascitti H. Grippe et Covid-19. Infect Dis Now 2021. [PMCID: PMC8704829 DOI: 10.1016/s2666-9919(21)00555-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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