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Xu J, Lan X, Zhang L, Zhang X, Zhang J, Song M, Liu J. The effectiveness of the first dose COVID-19 booster vs. full vaccination to prevent SARS-CoV-2 infection and severe COVID-19 clinical event: a meta-analysis and systematic review of longitudinal studies. Front Public Health 2023; 11:1165611. [PMID: 37325336 PMCID: PMC10267329 DOI: 10.3389/fpubh.2023.1165611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Background The effectiveness of full Coronavirus Disease 2019 (COVID-19) vaccination against COVID-19 wanes over time. This study aimed to synthesize the clinical effectiveness of the first dose of COVID-19 booster by comparing it to the full vaccination. Methods Studies in PubMed, Web of Science, Embase, and clinical trials databases were searched from 1 January 2021 to 10 September 2022. Studies were eligible if they comprised general adult participants who were not ever or currently infected with SARS-CoV-2, did not have impaired immunity or immunosuppression, and did not have severe diseases. The seroconversion rate of antibodies to S and S subunits and antibody titers of SARS-CoV-2, frequency, phenotype of specific T and B cells, and clinical events involving confirmed infection, admission to the intensive care unit (ICU), and death were compared between the first booster dose of COVID-19 vaccination group and full vaccination group. The DerSimonian and Laird random effects models were used to estimate the pooled risk ratios (RRs) and corresponding 95% confidence intervals (CIs) for the outcomes of clinical interest. While a qualitative description was mainly used to compare the immunogenicity between the first booster dose of COVID-19 vaccination group and full vaccination group. Sensitivity analysis was used to deal with heterogenicity. Results Of the 10,173 records identified, 10 studies were included for analysis. The first dose COVID-19 booster vaccine could induce higher seroconversion rates of antibodies against various SAS-CoV-2 fragments, higher neutralization antibody titers against various SARS-CoV-2 variants, and robust cellular immune response compared to the full vaccination. The risk of SARS-CoV-2 infection, the risk of admission to the ICU, and the risk of death were all higher in the non-booster group than those in the booster group, with RRs of 9.45 (95% CI 3.22-27.79; total evaluated population 12,422,454 vs. 8,441,368; I2 = 100%), 14.75 (95% CI 4.07-53.46; total evaluated population 12,048,224 vs. 7,291,644; I2 = 91%), and 13.63 (95% CI 4.72-39.36; total evaluated population 12,385,960 vs. 8,297,037; I2 = 85%), respectively. Conclusion A homogenous or heterogeneous booster COVID-19 vaccination could elicit strong humoral and cellular immune responses to SARS-CoV-2. Furthermore, it could significantly reduce the risk of SARS-CoV-2 infection and severe COVID-19 clinical events on top of two doses. Future studies are needed to investigate the long-term clinical effectiveness of the first booster dose of the COVID-19 vaccine and compare the effectiveness between homogenous and heterogeneous booster COVID-19 vaccination. Systematic review registration https://inplasy.com/inplasy-2022-11-0114/, identifier: INPLASY2022110114.
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Affiliation(s)
- Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xinquan Lan
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Liangyuan Zhang
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xiangjun Zhang
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Jiaqi Zhang
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Moxin Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Jiaye Liu
- School of Public Health, Shenzhen University Medical School, Shenzhen, China
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Ng HM, Lei CL, Fu S, Li E, Leong SI, Nip CI, Choi NM, Lai KS, Tang XJ, Lei CL, Xu RH. Heterologous vaccination with inactivated vaccine and mRNA vaccine augments antibodies against both spike and nucleocapsid proteins of SARS-CoV-2: a local study in Macao. Front Immunol 2023; 14:1131985. [PMID: 37251391 PMCID: PMC10213252 DOI: 10.3389/fimmu.2023.1131985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
The mRNA vaccines (RVs) can reduce the severity and mortality of severe acute respiratory syndrome coronavirus (SARS-CoV-2). However, almost only the inactivated vaccines (IVs) but no RVs had been used in mainland China until most recently, and the relaxing of its anti-pandemic strategies in December 2022 increased concerns about new outbreaks. In comparison, many of the citizens in Macao Special Administrative Region of China received three doses of IV (3IV) or RV (3RV), or 2 doses of IV plus one booster of RV (2IV+1RV). By the end of 2022, we recruited 147 participants with various vaccinations in Macao and detected antibodies (Abs) against the spike (S) protein and nucleocapsid (N) protein of the virus as well as neutralizing antibodies (NAb) in their serum. We observed that the level of anti-S Ab or NAb was similarly high with both 3RV and 2IV+1RV but lower with 3IV. In contrast, the level of anti-N Ab was the highest with 3IV like that in convalescents, intermediate with 2IV+1RV, and the lowest with 3RV. Whereas no significant differences in the basal levels of cytokines related to T-cell activation were observed among the various vaccination groups before and after the boosters. No vaccinees reported severe adverse events. Since Macao took one of the most stringent non-pharmaceutical interventions in the world, this study possesses much higher confidence in the vaccination results than many other studies from highly infected regions. Our findings suggest that the heterologous vaccination 2IV+1RV outperforms the homologous vaccinations 3IV and 3RV as it induces not only anti-S Ab (to the level as with 3RV) but also anti-N antibodies (via the IV). It combines the advantages of both RV (to block the viral entry) and IV (to also intervene the subsequent pathological processes such as intracellular viral replication and interference with the signal transduction and hence the biological functions of host cells).
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Affiliation(s)
- Hoi Man Ng
- Laboratory Department, Kiang Wu Hospital, Macao, Macao SAR, China
| | - Chon Lok Lei
- Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Siyi Fu
- Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Enqin Li
- Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Sek In Leong
- Laboratory Department, Kiang Wu Hospital, Macao, Macao SAR, China
| | - Chu Iong Nip
- Laboratory Department, Kiang Wu Hospital, Macao, Macao SAR, China
| | - Nga Man Choi
- Laboratory Department, Kiang Wu Hospital, Macao, Macao SAR, China
| | - Kai Seng Lai
- Laboratory Department, Kiang Wu Hospital, Macao, Macao SAR, China
| | - Xi Jun Tang
- Laboratory Department, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Chon Leng Lei
- Laboratory Department, Kiang Wu Hospital, Macao, Macao SAR, China
| | - Ren-He Xu
- Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
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53
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Atanasov V, Barreto N, Whittle J, Meurer J, Weston BW, Luo QE, Yuan AY, Franchi L, Zhang R, Black B. Selection Effects and COVID-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records. Vaccines (Basel) 2023; 11:vaccines11050971. [PMID: 37243075 DOI: 10.3390/vaccines11050971] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Prior research generally finds that the Pfizer-BioNTech (BNT162b2) and Moderna (mRNA1273) COVID-19 vaccines provide similar protection against mortality, sometimes with a Moderna advantage due to slower waning. However, most comparisons do not address selection effects for those who are vaccinated and with which vaccine. We report evidence on large selection effects, and use a novel method to control for these effects. Instead of directly studying COVID-19 mortality, we study the COVID-19 excess mortality percentage (CEMP), defined as the COVID-19 deaths divided by non-COVID-19 natural deaths for the same population, converted to a percentage. The CEMP measure uses non-COVID-19 natural deaths to proxy for population health and control for selection effects. We report the relative mortality risk (RMR) for each vaccine relative to the unvaccinated population and to the other vaccine, using linked mortality and vaccination records for all adults in Milwaukee County, Wisconsin, from 1 April 2021 through 30 June 2022. For two-dose vaccinees aged 60+, RMRs for Pfizer vaccinees were consistently over twice those for Moderna, and averaged 248% of Moderna (95% CI = 175%,353%). In the Omicron period, Pfizer RMR was 57% versus 23% for Moderna. Both vaccines demonstrated waning of two-dose effectiveness over time, especially for ages 60+. For booster recipients, the Pfizer-Moderna gap is much smaller and statistically insignificant. A possible explanation for the Moderna advantage for older persons is the higher Moderna dose of 100 μg, versus 30 μg for Pfizer. Younger persons (aged 18-59) were well-protected against death by two doses of either vaccine, and highly protected by three doses (no deaths among over 100,000 vaccinees). These results support the importance of a booster dose for ages 60+, especially for Pfizer recipients. They suggest, but do not prove, that a larger vaccine dose may be appropriate for older persons than for younger persons.
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Affiliation(s)
- Vladimir Atanasov
- Mason College of Business, William & Mary, Williamsburg, VA 23185, USA
| | - Natalia Barreto
- Department of Economics, University of Illinois, Urbana-Champaign, Champaign, IL 61820, USA
| | - Jeff Whittle
- Medical College of Wisconsin; Milwaukee, WI 53226, USA
| | - John Meurer
- Medical College of Wisconsin; Milwaukee, WI 53226, USA
| | | | - Qian Eric Luo
- Department of Health Policy and Management, George Washington University, Washington, DC 20052, USA
| | - Andy Ye Yuan
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
| | - Lorenzo Franchi
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
| | - Ruohao Zhang
- Department of Agricultural Economics, Pennsylvania State University, State College, PA 16803, USA
| | - Bernard Black
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
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54
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van der Klaauw AA, Horner EC, Pereyra-Gerber P, Agrawal U, Foster WS, Spencer S, Vergese B, Smith M, Henning E, Ramsay ID, Smith JA, Guillaume SM, Sharpe HJ, Hay IM, Thompson S, Innocentin S, Booth LH, Robertson C, McCowan C, Kerr S, Mulroney TE, O'Reilly MJ, Gurugama TP, Gurugama LP, Rust MA, Ferreira A, Ebrahimi S, Ceron-Gutierrez L, Scotucci J, Kronsteiner B, Dunachie SJ, Klenerman P, Park AJ, Rubino F, Lamikanra AA, Stark H, Kingston N, Estcourt L, Harvala H, Roberts DJ, Doffinger R, Linterman MA, Matheson NJ, Sheikh A, Farooqi IS, Thaventhiran JED. Accelerated waning of the humoral response to COVID-19 vaccines in obesity. Nat Med 2023; 29:1146-1154. [PMID: 37169862 PMCID: PMC10202802 DOI: 10.1038/s41591-023-02343-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/07/2023] [Indexed: 05/13/2023]
Abstract
Obesity is associated with an increased risk of severe Coronavirus Disease 2019 (COVID-19) infection and mortality. COVID-19 vaccines reduce the risk of serious COVID-19 outcomes; however, their effectiveness in people with obesity is incompletely understood. We studied the relationship among body mass index (BMI), hospitalization and mortality due to COVID-19 among 3.6 million people in Scotland using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. We found that vaccinated individuals with severe obesity (BMI > 40 kg/m2) were 76% more likely to experience hospitalization or death from COVID-19 (adjusted rate ratio of 1.76 (95% confidence interval (CI), 1.60-1.94). We also conducted a prospective longitudinal study of a cohort of 28 individuals with severe obesity compared to 41 control individuals with normal BMI (BMI 18.5-24.9 kg/m2). We found that 55% of individuals with severe obesity had unquantifiable titers of neutralizing antibody against authentic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus compared to 12% of individuals with normal BMI (P = 0.0003) 6 months after their second vaccine dose. Furthermore, we observed that, for individuals with severe obesity, at any given anti-spike and anti-receptor-binding domain (RBD) antibody level, neutralizing capacity was lower than that of individuals with a normal BMI. Neutralizing capacity was restored by a third dose of vaccine but again declined more rapidly in people with severe obesity. We demonstrate that waning of COVID-19 vaccine-induced humoral immunity is accelerated in individuals with severe obesity. As obesity is associated with increased hospitalization and mortality from breakthrough infections, our findings have implications for vaccine prioritization policies.
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Affiliation(s)
- Agatha A van der Klaauw
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Emily C Horner
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Pehuén Pereyra-Gerber
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Utkarsh Agrawal
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Sarah Spencer
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Bensi Vergese
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- NIHR Cambridge Clinical Research Facility, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Miriam Smith
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Elana Henning
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Isobel D Ramsay
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jack A Smith
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | | | - Iain M Hay
- Babraham Institute, Babraham Research Campus, Cambridge, UK
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Sam Thompson
- Babraham Institute, Babraham Research Campus, Cambridge, UK
| | | | - Lucy H Booth
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Colin McCowan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Steven Kerr
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | | | | | - Maria A Rust
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Alex Ferreira
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Soraya Ebrahimi
- Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Lourdes Ceron-Gutierrez
- Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jacopo Scotucci
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Barbara Kronsteiner
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Susanna J Dunachie
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK
| | - Adrian J Park
- Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Francesco Rubino
- Department of Diabetes, King's College London and King's College Hospital NHS Foundation Trust, London, UK
| | - Abigail A Lamikanra
- NHS Blood and Transplant, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Hannah Stark
- NIHR BioResource, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Nathalie Kingston
- NIHR BioResource, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Lise Estcourt
- NHS Blood and Transplant, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | - David J Roberts
- NHS Blood and Transplant, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Rainer Doffinger
- Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Clinical Biochemistry, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Nicholas J Matheson
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- NHS Blood and Transplant, Cambridge, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - I Sadaf Farooqi
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome-Medical Research Council (MRC) Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
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Tani Y, Takita M, Kobashi Y, Wakui M, Zhao T, Yamamoto C, Saito H, Kawashima M, Sugiura S, Nishikawa Y, Omata F, Shimazu Y, Kawamura T, Sugiyama A, Nakayama A, Kaneko Y, Kodama T, Kami M, Tsubokura M. Varying Cellular Immune Response against SARS-CoV-2 after the Booster Vaccination: A Cohort Study from Fukushima Vaccination Community Survey, Japan. Vaccines (Basel) 2023; 11:vaccines11050920. [PMID: 37243024 DOI: 10.3390/vaccines11050920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Booster vaccination reduces the incidence of severe cases and mortality related to COVID-19, with cellular immunity playing an important role. However, little is known about the proportion of the population that has achieved cellular immunity after booster vaccination. Thus, we conducted a Fukushima cohort database and assessed humoral and cellular immunity in 2526 residents and healthcare workers in Fukushima Prefecture in Japan through continuous blood collection every 3 months from September 2021. We identified the proportion of people with induced cellular immunity after booster vaccination using the T-SPOT.COVID test, and analyzed their background characteristics. Among 1089 participants, 64.3% (700/1089) had reactive cellular immunity after booster vaccination. Multivariable analysis revealed the following independent predictors of reactive cellular immunity: age < 40 years (adjusted odds ratio: 1.81; 95% confidence interval: 1.19-2.75; p-value: 0.005) and adverse reactions after vaccination (1.92, 1.19-3.09, 0.007). Notably, despite IgG(S) and neutralizing antibody titers of ≥500 AU/mL, 33.9% (349/1031) and 33.5% (341/1017) of participants, respectively, did not have reactive cellular immunity. In summary, this is the first study to evaluate cellular immunity at the population level after booster vaccination using the T-SPOT.COVID test, albeit with several limitations. Future studies will need to evaluate previously infected subjects and their T-cell subsets.
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Affiliation(s)
- Yuta Tani
- Medical Governance Research Institute, Tokyo 108-0074, Japan
| | - Morihito Takita
- Medical Governance Research Institute, Tokyo 108-0074, Japan
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yurie Kobashi
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of General Internal Medicine, Hirata Central Hospital, Fukushima 963-8202, Japan
| | - Masatoshi Wakui
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo 160-0016, Japan
| | - Tianchen Zhao
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Chika Yamamoto
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Hiroaki Saito
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Internal Medicine, Soma Central Hospital, Fukushima 976-0016, Japan
| | - Moe Kawashima
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Sota Sugiura
- Medical Governance Research Institute, Tokyo 108-0074, Japan
| | - Yoshitaka Nishikawa
- Department of General Internal Medicine, Hirata Central Hospital, Fukushima 963-8202, Japan
| | - Fumiya Omata
- Department of General Internal Medicine, Hirata Central Hospital, Fukushima 963-8202, Japan
| | - Yuzo Shimazu
- Department of General Internal Medicine, Hirata Central Hospital, Fukushima 963-8202, Japan
| | - Takeshi Kawamura
- Proteomics Laboratory, Isotope Science Center, The University of Tokyo, Tokyo 113-0032, Japan
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 153-8904, Japan
| | - Akira Sugiyama
- Proteomics Laboratory, Isotope Science Center, The University of Tokyo, Tokyo 113-0032, Japan
| | - Aya Nakayama
- Proteomics Laboratory, Isotope Science Center, The University of Tokyo, Tokyo 113-0032, Japan
| | - Yudai Kaneko
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 153-8904, Japan
- Medical and Biological Laboratories Co., Ltd., Tokyo 105-0012, Japan
| | - Tetsuhiko Kodama
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 153-8904, Japan
| | - Masahiro Kami
- Medical Governance Research Institute, Tokyo 108-0074, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of General Internal Medicine, Hirata Central Hospital, Fukushima 963-8202, Japan
- Department of Internal Medicine, Soma Central Hospital, Fukushima 976-0016, Japan
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56
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Yalcin D, Bennett SJ, Sheehan J, Trauth AJ, Tso FY, West JT, Hagensee ME, Ramsay AJ, Wood C. Longitudinal Variations in Antibody Responses against SARS-CoV-2 Spike Epitopes upon Serial Vaccinations. Int J Mol Sci 2023; 24:ijms24087292. [PMID: 37108460 PMCID: PMC10138620 DOI: 10.3390/ijms24087292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted healthcare, the workforce, and worldwide socioeconomics. Multi-dose mono- or bivalent mRNA vaccine regimens have shown high efficacy in protection against SARS-CoV-2 and its emerging variants with varying degrees of efficacy. Amino acid changes, primarily in the receptor-binding domain (RBD), result in selection for viral infectivity, disease severity, and immune evasion. Therefore, many studies have centered around neutralizing antibodies that target the RBD and their generation achieved through infection or vaccination. Here, we conducted a unique longitudinal study, analyzing the effects of a three-dose mRNA vaccine regimen exclusively using the monovalent BNT162b2 (Pfizer/BioNTech) vaccine, systematically administered to nine previously uninfected (naïve) individuals. We compare changes in humoral antibody responses across the entire SARS-CoV-2 spike glycoprotein (S) using a high-throughput phage display technique (VirScan). Our data demonstrate that two doses of vaccination alone can achieve the broadest and highest magnitudes of anti-S response. Moreover, we present evidence of novel highly boosted non-RBD epitopes that strongly correlate with neutralization and recapitulate independent findings. These vaccine-boosted epitopes could facilitate multi-valent vaccine development and drug discovery.
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Affiliation(s)
- Dicle Yalcin
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Sydney J Bennett
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68516, USA
| | - Jared Sheehan
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Amber J Trauth
- Departments of Medicine, Section of Infectious Diseases, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - For Yue Tso
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - John T West
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Michael E Hagensee
- Departments of Medicine, Section of Infectious Diseases, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Alistair J Ramsay
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Charles Wood
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68516, USA
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57
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Wu Y, Pan Y, Su K, Zhang Y, Jia Z, Yi J, Lv H, Zhang L, Xue M, Cao D, Jiang J. Elder and booster vaccination associates with decreased risk of serious clinical outcomes in comparison of Omicron and Delta variant: A meta-analysis of SARS-CoV-2 infection. Front Microbiol 2023; 14:1051104. [PMID: 37125157 PMCID: PMC10140352 DOI: 10.3389/fmicb.2023.1051104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
Background The COVID-19 pandemic brings great pressure to the public health systems. This meta-analysis aimed to compare the clinical outcomes among different virus variants, to clarify their impact on medical resources and to provide evidence for the formulation of epidemic prevention policies. Methods A systematic literature search was performed in the PubMed, Embase, and Cochrane Library databases using the key words "Omicron" and "Delta." The adjusted Risk ratios (RRs), Odds ratios (ORs) and Hazard ratios (HRs) were extracted, and RRs and Rate difference % (RD%) were used to interpret the risk estimates of the outcomes ultimately. Results Forty-three studies were included, with 3,812,681 and 14,926,841 individuals infected with SARS-CoV-2 Delta and Omicron variant, respectively. The relative risks of hospitalization, death, ICU admission, and mechanical ventilation use after infection with the Omicron variant were all significantly reduced compared those after infection with the Delta variant (RRhospitalization = 0.45, 95%CI: 0.40-0.52; RRdeath = 0.37, 95%CI: 0.30-0.45; RRICU = 0.35, 95%CI: 0.29-0.42; RRmechanical ventilation = 0.33, 95%CI: 0.25-0.44). The change of both absolute and relative risks for hospitalization was more evident (RR = 0.47, 95%CI: 0.42-0.53;RD% =10.61, 95%CI: 8.64-12.59) and a significant increase was observed for the absolute differences in death in the elderly (RD% = 5.60, 95CI%: 4.65-6.55); the change of the absolute differences in the risk of hospitalization and death were most markedly observed in the patients with booster vaccination (RD%hospitalization = 8.60, 95CI%: 5.95-11.24; RD%death = 3.70, 95CI%: 0.34-7.06). Conclusion The ability of the Omicron variant to cause severe clinical events has decreased significantly, as compared with the Delta variant, but vulnerable populations still need to be vigilant. There was no interaction between the vaccination doses and different variants.
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Affiliation(s)
- Yanhua Wu
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yuchen Pan
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Kaisheng Su
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yangyu Zhang
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Zhifang Jia
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Jiaxin Yi
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Haiyong Lv
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Lihuan Zhang
- The Second Hospital of Jilin University, Changchun, China
| | - Mingyang Xue
- School of Public Health, Jilin University, Changchun, China
| | - Donghui Cao
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Jing Jiang
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
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Nakayama EE, Shioda T. SARS-CoV-2 Related Antibody-Dependent Enhancement Phenomena In Vitro and In Vivo. Microorganisms 2023; 11:microorganisms11041015. [PMID: 37110438 PMCID: PMC10145615 DOI: 10.3390/microorganisms11041015] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Antibody-dependent enhancement (ADE) is a phenomenon in which antibodies produced in the body after infection or vaccination may enhance subsequent viral infections in vitro and in vivo. Although rare, symptoms of viral diseases are also enhanced by ADE following infection or vaccination in vivo. This is thought to be due to the production of antibodies with low neutralizing activity that bind to the virus and facilitate viral entry, or antigen-antibody complexes that cause airway inflammation, or a predominance of T-helper 2 cells among the immune system cells which leads to excessive eosinophilic tissue infiltration. Notably, ADE of infection and ADE of disease are different phenomena that overlap. In this article, we will describe the three types of ADE: (1) Fc receptor (FcR)-dependent ADE of infection in macrophages, (2) FcR-independent ADE of infection in other cells, and (3) FcR-dependent ADE of cytokine production in macrophages. We will describe their relationship to vaccination and natural infection, and discuss the possible involvement of ADE phenomena in COVID-19 pathogenesis.
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Affiliation(s)
- Emi E Nakayama
- Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Japan
| | - Tatsuo Shioda
- Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Japan
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Arbel R, Peretz A, Sergienko R, Friger M, Beckenstein T, Duskin-Bitan H, Yaron S, Hammerman A, Bilenko N, Netzer D. Effectiveness of a bivalent mRNA vaccine booster dose to prevent severe COVID-19 outcomes: a retrospective cohort study. THE LANCET. INFECTIOUS DISEASES 2023:S1473-3099(23)00122-6. [PMID: 37062302 PMCID: PMC10156150 DOI: 10.1016/s1473-3099(23)00122-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND In late 2022, the SARS-CoV-2 omicron (B.1.1.529) BA.5 sublineage accounted for most of the sequenced viral genomes worldwide. Bivalent mRNA vaccines contain an ancestral SARS-CoV-2 strain component plus an updated component of the omicron BA.4 and BA.5 sublineages. Since September, 2022, a single bivalent mRNA vaccine booster dose has been recommended for adults who have completed a primary SARS-CoV-2 vaccination series and are at high risk of severe COVID-19. We aimed to evaluate the effectiveness of a bivalent mRNA vaccine booster dose to reduce hospitalisations and deaths due to COVID-19. METHODS We did a retrospective, population-based, cohort study in Israel, using data from electronic medical records in Clalit Health Services (CHS). We included all members of CHS who were aged 65 years or older and eligible for a bivalent mRNA COVID-19 booster vaccination. We used hospital records to identify COVID-19-related hospitalisations and deaths. The primary endpoint was hospitalisation due to COVID-19, which we compared between participants who received a bivalent mRNA booster vaccination and those who did not. A Cox proportional hazards regression model with time-dependent covariates was used to estimate the association between the bivalent vaccine and hospitalisation due to COVID-19 while adjusting for demographic factors and coexisting illnesses. FINDINGS Between Sept 27, 2022, and Jan 25, 2023, 569 519 eligible participants were identified. Of those, 134 215 (24%) participants received a bivalent mRNA booster vaccination during the study period. Hospitalisation due to COVID-19 occurred in 32 participants who received a bivalent mRNA booster vaccination and 541 who did not receive a bivalent booster vaccination (adjusted hazard ratio 0·28, 95% CI 0·19-0·40). The absolute risk reduction for hospitalisations due to COVID-19 in bivalent mRNA booster recipients versus non-recipients was 0·089% (95% CI 0·075-0·101), and the number needed to vaccinate to prevent one hospitalisation due to COVID-19 was 1118 people (95% CI 993-1341). INTERPRETATION Participants who received a bivalent mRNA booster vaccine dose had lower rates of hospitalisation due to COVID-19 than participants who did not receive a bivalent booster vaccination, for up to 120 days after vaccination. These findings highlight the importance of bivalent mRNA booster vaccination in populations at high risk of severe COVID-19. Further studies with longer observation times are warranted. FUNDING None.
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Affiliation(s)
- Ronen Arbel
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel; Maximizing Health Outcomes Research Lab, Sapir College, Sderot, Israel.
| | - Alon Peretz
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel; School of Public Health, University of Haifa, Haifa, Israel
| | - Ruslan Sergienko
- Department of Health Policy and Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Michael Friger
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Tanya Beckenstein
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
| | - Hadar Duskin-Bitan
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Institute of Endocrinology Rabin Medical Center, Petach Tikva, Israel
| | - Shlomit Yaron
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
| | - Ariel Hammerman
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
| | - Natalya Bilenko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Doron Netzer
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
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Lam K, Leung A, Martin A, Wood M, Schreiner P, Palmer L, Daly O, Zhao W, McClintock K, Heyes J. Unsaturated, Trialkyl Ionizable Lipids are Versatile Lipid-Nanoparticle Components for Therapeutic and Vaccine Applications. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2209624. [PMID: 36680477 DOI: 10.1002/adma.202209624] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/17/2023] [Indexed: 06/17/2023]
Abstract
Lipid nanoparticles (LNPs) have proven a successful platform for the delivery of nucleic acid (NA)-based therapeutics and vaccines, with the ionizable lipid component playing a key role in modulating potency and tolerability. Here, a library of 16 novel ionizable lipids is screened hypothesizing that short, branched trialkyl hydrophobic domains can improve LNP fusogenicity or endosomal escape, and potency. LNPs formulated with the top-performing trialkyl lipid (Lipid 10) encapsulating transthyretin siRNA elicit significantly greater gene silencing and are better tolerated than those with the benchmark Onpattro lipid DLin-MC3-DMA. Lipid 10 also demonstrates superior liver delivery of mRNA when compared to other literature ionizable lipids, is well tolerated, and successfully repeat-doses in nonhuman primates. In a prime-boost hemagglutinin rodent vaccine model, intramuscular administration of Lipid-10 LNP elicits comparable or better antibody titers to the SM-102 and ALC-0315 lipid compositions used in the U.S. Food and Drug Administration approved mRNA COVID vaccines. These data suggest that Lipid 10 is a particularly versatile ionizable lipid, well-suited for both systemic therapeutic and intramuscular vaccine applications and able to successfully deliver diverse NA payloads.
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Affiliation(s)
- Kieu Lam
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Ada Leung
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Alan Martin
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Mark Wood
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Petra Schreiner
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Lorne Palmer
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Owen Daly
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Wenchen Zhao
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - Kevin McClintock
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
| | - James Heyes
- Genevant Sciences Corporation, 887 Great Northern Way, Vancouver, BC, V5T 4T5, Canada
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61
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Watanabe A, Kani R, Iwagami M, Takagi H, Yasuhara J, Kuno T. Assessment of Efficacy and Safety of mRNA COVID-19 Vaccines in Children Aged 5 to 11 Years: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:384-394. [PMID: 36689319 PMCID: PMC9871947 DOI: 10.1001/jamapediatrics.2022.6243] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/15/2022] [Indexed: 01/24/2023]
Abstract
Importance Evidence of the efficacy and safety of messenger RNA (mRNA) COVID-19 vaccines in children aged 5 to 11 years has been emerging. Collecting these data will inform clinicians, families, and policy makers. Objective To evaluate the efficacy and safety of mRNA COVID-19 vaccines in children aged 5 to 11 years in a systematic review and meta-analysis. Data Sources PubMed and Embase databases were searched on September 29, 2022, without language restrictions. Study Selection Randomized clinical trials and observational studies comparing vaccinated vs unvaccinated children aged 5 to 11 years and reporting efficacy or safety outcomes were included. Studies reporting safety outcomes in vaccinated children only (ie, no control group) were also included. Data Extraction and Synthesis Two investigators independently extracted relevant data from each study. Odds ratios (ORs) for efficacy and safety outcomes and incidences of adverse events (AEs) following vaccination were synthesized using a random-effects model. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology reporting guidelines. Main Outcomes and Measures The primary outcome was SARS-CoV-2 infections with or without symptoms. The secondary outcomes included symptomatic SARS-CoV-2 infections, hospitalizations, and multisystem inflammatory syndrome in children. The incidences of each AE following vaccination were also evaluated. Results Two randomized clinical trials and 15 observational studies involving 10 935 541 vaccinated children (median or mean age range, 8.0-9.5 years) and 2 635 251 unvaccinated children (median or mean age range, 7.0-9.5 years) were included. Two-dose mRNA COVID-19 vaccination compared with no vaccination was associated with lower risks of SARS-CoV-2 infections with or without symptoms (OR, 0.47; 95% CI, 0.35-0.64), symptomatic SARS-CoV-2 infections (OR, 0.53; 95% CI, 0.41-0.70), hospitalizations (OR, 0.32; 95% CI, 0.15-0.68), and multisystem inflammatory syndrome in children (OR, 0.05; 95% CI, 0.02-0.10). Two randomized clinical trials and 5 observational studies investigated AEs among vaccinated children. Most vaccinated children experienced at least 1 local AE following the first injection (32 494 of 55 959 [86.3%]) and second injection (28 135 of 46 447 [86.3%]). Vaccination was associated with a higher risk of any AEs compared with placebo (OR, 1.92; 95% CI, 1.26-2.91). The incidence of AEs that prevented normal daily activities was 8.8% (95% CI, 5.4%-14.2%) and that of myocarditis was estimated to be 1.8 per million (95% CI, 0.000%-0.001%) following the second injection. Conclusions and Relevance In this systematic review and meta-analysis, COVID-19 mRNA vaccines among children aged 5 to 11 years were associated with measures of efficacy in preventing SARS-CoV-2 infection and severe COVID-19-related illnesses. While most children developed local AEs, severe AEs were rare, and most of AEs resolved within several days. These data provide evidence for future recommendations.
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Affiliation(s)
- Atsuyuki Watanabe
- Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Ryoma Kani
- School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
| | - Jun Yasuhara
- Center for Cardiovascular Research, The Abigail Wexner Research Institute and The Heart Center, Nationwide Children’s Hospital, Columbus, Ohio
| | - Toshiki Kuno
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
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Lücke J, Nawrocki M, Schnell J, Meins N, Heinrich F, Zhang T, Bertram F, Sabihi M, Böttcher M, Blankenburg T, Pfaff M, Notz S, Kempski J, Reeh M, Wolter S, Mann O, Izbicki JR, Lütgehetmann M, Duprée A, Giannou AD, Ondruschka B, Huber S. TNFα aggravates detrimental effects of SARS-CoV-2 infection in the liver. Front Immunol 2023; 14:1151937. [PMID: 37063909 PMCID: PMC10102423 DOI: 10.3389/fimmu.2023.1151937] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus does not only lead to pulmonary infection but can also infect other organs such as the gut, the kidney, or the liver. Recent studies confirmed that severe cases of COVID-19 are often associated with liver damage and liver failure, as well as the systemic upregulation of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNFα). However, the impact these immune mediators in the liver have on patient survival during SARS-CoV-2 infection is currently unknown. Here, by performing a post-mortem analysis of 45 patients that died from a SARS-CoV-2 infection, we find that an increased expression of TNFA in the liver is associated with elevated mortality. Using publicly available single-cell sequencing datasets, we determined that Kupffer cells and monocytes are the main sources of this TNFα production. Further analysis revealed that TNFα signaling led to the upregulation of pro-inflammatory genes that are associated with an unfavorable outcome. Moreover, high levels of TNFA in the liver were associated with lower levels of interferon alpha and interferon beta. Thus, TNFα signaling in the infected SARS-CoV-2 liver correlates with reduced interferon levels and overall survival time.
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Affiliation(s)
- Jöran Lücke
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Samuel Huber, ; Jöran Lücke,
| | - Mikolaj Nawrocki
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Josa Schnell
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicholas Meins
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabian Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tao Zhang
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Bertram
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Morsal Sabihi
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marius Böttcher
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tom Blankenburg
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie Pfaff
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sara Notz
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Kempski
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- The Calcium Signaling Group, Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Reeh
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Wolter
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Mann
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob R. Izbicki
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Lütgehetmann
- Institute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Duprée
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anastasios D. Giannou
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Samuel Huber
- Section of Molecular Immunology and Gastroenterology, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Translational Immunology (HCTI), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Samuel Huber, ; Jöran Lücke,
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Buscot M, Cremoni M, Graça D, Brglez V, Courjon J, Allouche J, Teisseyre M, Boyer L, Barrière J, Chamorey E, Carles M, Seitz-Polski B. Breakthrough infections due to SARS-CoV-2 Delta variant: relation to humoral and cellular vaccine responses. Front Immunol 2023; 14:1145652. [PMID: 37063916 PMCID: PMC10101330 DOI: 10.3389/fimmu.2023.1145652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionCOVID-19 vaccines are expected to provide effective protection. However, emerging strains can cause breakthrough infection in vaccinated individuals. The immune response of vaccinated individuals who have experienced breakthrough infection is still poorly understood.MethodsHere, we studied the humoral and cellular immune responses of fully vaccinated individuals who subsequently experienced breakthrough infection due to the Delta variant of SARS-CoV-2 and correlated them with the severity of the disease.ResultsIn this study, an effective humoral response alone was not sufficient to induce effective immune protection against severe breakthrough infection, which also required effective cell-mediated immunity to SARS-CoV-2. Patients who did not require oxygen had significantly higher specific (p=0.021) and nonspecific (p=0.004) cellular responses to SARS-CoV-2 at the onset of infection than those who progressed to a severe form.DiscussionKnowing both humoral and cellular immune response could allow to adapt preventive strategy, by better selecting patients who would benefit from additional vaccine boosters.Trial registration numbershttps://clinicaltrials.gov, identifier NCT04355351; https://clinicaltrials.gov, identifier NCT04429594.
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Affiliation(s)
- Matthieu Buscot
- Infectious Diseases Department, Nice University Hospital, Nice, France
| | - Marion Cremoni
- Immunology Laboratory, Archet 1 Hospital, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Daisy Graça
- Immunology Laboratory, Archet 1 Hospital, Nice University Hospital, Nice, France
| | - Vesna Brglez
- Immunology Laboratory, Archet 1 Hospital, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Johan Courjon
- Infectious Diseases Department, Nice University Hospital, Nice, France
- Mediterranean Center for Molecular Medicine (C3M), Côte d’Azur University, Nice, France
| | - Jonathan Allouche
- Clinical Research Unit Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Maxime Teisseyre
- Clinical Research Unit Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
| | - Laurent Boyer
- Mediterranean Center for Molecular Medicine (C3M), Côte d’Azur University, Nice, France
| | - Jérôme Barrière
- Department of Oncology, Clinique St Jean, Cagnes sur Mer, France
| | - Emmanuel Chamorey
- Department of Biostatistics, Centre Antoine Lacassagne, Nice, France
| | - Michel Carles
- Infectious Diseases Department, Nice University Hospital, Nice, France
| | - Barbara Seitz-Polski
- Immunology Laboratory, Archet 1 Hospital, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d’Azur (UR2CA), Côte d’Azur University, Nice, France
- *Correspondence: Barbara Seitz-Polski,
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Hansen BT, Labberton AS, Kour P, Kraft KB. Coverage of primary and booster vaccination against COVID-19 by socioeconomic level: A nationwide cross-sectional registry study. Hum Vaccin Immunother 2023; 19:2188857. [PMID: 36941785 PMCID: PMC10072069 DOI: 10.1080/21645515.2023.2188857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
High and equitable COVID-19 vaccination coverage is important for pandemic control and prevention of health inequity. However, little is known about socioeconomic correlates of booster vaccination coverage. In this cross-sectional study of all Norwegian adults in the national vaccination program (N = 4,190,655), we use individual-level registry data to examine coverage by levels of household income and education of primary (≥2 doses) and booster (≥3 doses) vaccination against COVID-19. We stratify the analyses by age groups with different booster recommendations and report relative risk ratios (RR) for vaccination by 25 August 2022. In the 18-44 y group, individuals with highest vs. lowest education had 94% vs. 79% primary coverage (adjusted RR (adjRR) 1.15, 95%CI 1.14-1.15) and 67% vs. 38% booster coverage (adjRR 1.55, 95% CI 1.55-1.56), while individuals with highest vs. lowest income had 94% vs. 81% primary coverage (adjRR 1.10, 95%CI 1.10-1.10) and 60% vs. 43% booster coverage (adjRR 1.23, 95%CI 1.22-1.24). In the ≥45 y group, individuals with highest vs. lowest education had 96% vs. 92% primary coverage (adjRR 1.02, 95%CI 1.02-1.02) and 88% vs. 80% booster coverage (adjRR 1.09, 95%CI 1.09-1.09), while individuals with highest vs. lowest income had 98% vs. 82% primary coverage (adjRR 1.16, 95%CI 1.16-1.16) and 92% vs. 64% booster coverage (adjRR 1.33, 95%CI 1.33-1.34). In conclusion, we document large socioeconomic inequalities in COVID-19 vaccination coverage, especially for booster vaccination, even though all vaccination was free-of-charge. The results highlight the need to tailor information and to target underserved groups for booster vaccination.
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Affiliation(s)
- Bo T Hansen
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Angela S Labberton
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Prabhjot Kour
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristian B Kraft
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
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Safety and efficacy of COVID-19 prime-boost vaccinations: Homologous BBIBP-CorV versus heterologous BNT162b2 boosters in BBIBP-CorV-primed individuals. Vaccine 2023; 41:1925-1933. [PMID: 36725431 PMCID: PMC9868355 DOI: 10.1016/j.vaccine.2023.01.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/12/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Booster vaccine doses against SARS-CoV-2 have been advocated to address evidence of waning immunity, breakthrough infection, and the emergence of immune-evasive variants. A heterologous prime-boost vaccine strategy may offer advantages over a homologous approach, but the safety and efficacy of this approach with the mRNA vaccine BNT162b2 (BNT: Pfizer) and inactivated BBIBP-CorV (BBIBT: Sinopharm) vaccines have not been studied. METHODS We conducted a non-randomized, non-blinded phase II observational community trial acrossBahrain, investigating the reactogenic and immunogenic responseof participants who had previously received two doses of BBIBP, followed by a third booster dose of either BBIBP (homologous booster) or BNT (heterologous booster). Immunogenicity through serological statuswas determined at baseline and on the following 8thweek. Reactogenicity data (safety and adverse events) were collected throughout study period, in addition to participant-led electronic journaling. RESULTS 305 participants (152 BBIBP and 153 BNT booster) were enrolled in the study,with 246 (127 BBIBP and 119 BNT booster) included in the final analysis. There was a significant increase in anti-SARS-CoV-2 antibody levels post booster administration in both groups; however, the heterologous BNT arm demonstrated a significantly larger mean increase in the level of spike (S) antigen-specific antibodies (32.7-fold increase versus 2.6, p < 0.0001) and sVNT neutralising antibodies (3.4-fold increase versus 1.8, p < 0.0001), whereas the homologous arm demonstrated a significant increase in the levels of nucleocapsid (N) antigen-specific antibodies (3.8-fold increase versus none). Non-serious adverse events (injection site pain, fever, and fatigue) were more commonly reported in the heterologous arm, but no serious adverse events occurred. CONCLUSION Heterologous prime-boost vaccination with the mRNA BNT162b2 (Pfizer) vaccine in those who had received two doses of inactivated virus BBIBP-CorV (Sinopharm) vaccine demonstrated a more robust immune response against SARS-CoV-2 than the homologous BBIBP booster and appears safe and well tolerated. Clinical Trial Registry Number (ClinicalTrials.gov): NCT04993560.
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66
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Kawaura F, Kishi T, Yamamoto T, Nakayama S, Goto T, Tsurusawa R, Katagiri T, Yamanouchi K, Matsuo A, Kobayashi-Watanabe N, Imamura T, Hirooka Y, Takagi K, Umemura T, Fujimoto K, Hayashi S, Takamori A. Age distribution and disease severity of COVID-19 patients continued to change in a time-dependent manner from May 2021 to April 2022 in the regional core hospital in Japan. Drug Discov Ther 2023; 17:60-65. [PMID: 36843034 DOI: 10.5582/ddt.2022.01111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The present retrospective study aimed to examine the real-world data regarding time-dependent changes in the age distribution of patients with coronavirus disease 2019 (COVID-19) as well as the severity and infectivity in a regional core hospital in Japan. Patients with COVID-19 who visited the fever outpatient branch in Takagi Hospital during phase I (May 1 to December 31, 2021), and during phase II (January 1 to April 30, 2022) were evaluated. The age distribution of outpatients and the characteristics of inpatients aged > 75 years were compared between phases I and II. The age distribution of outpatients shifted from the older generation in phase I to the younger generation in phase II (p < 0.01). Disease severity might be reduced in a time-dependent manner with a decrease in the hospitalization rate (phase I: 145/368 (39.4%); phase II: 104/1496 (7.0%); p < 0.01) and mortality rate (phase I: 10/368 (2.7%); phase II: 7/1496 (0.5%); p < 0.01). The number of patients increased in phase II (374.0/month) compared to that in phase I (36.8/month). Regarding the older inpatients, the disease severity of COVID-19 and hospitalization days were reduced in phase II compared to those in phase I (p < 0.01, each). In conclusion, the present study suggests a change in the age distribution of patients with COVID-19, a decrease in toxicity, and an increase in infectivity of severe acute respiratory syndrome coronavirus 2 in a time-dependent manner.
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Affiliation(s)
- Futoshi Kawaura
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Takuya Kishi
- International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Tadashi Yamamoto
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Shiki Nakayama
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Taku Goto
- The Kouhou-kai Takagi Hospital, Okawa, Japan
| | | | - Toshio Katagiri
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Kohei Yamanouchi
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | | | | | - Tomohiro Imamura
- International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Yoshitaka Hirooka
- International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Kuniyasu Takagi
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Tsukuru Umemura
- The Kouhou-kai Takagi Hospital, Okawa, Japan.,International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | - Kazuma Fujimoto
- International University of Health and Welfare Graduate School of Medicine, Okawa, Japan
| | | | - Ayako Takamori
- Clinical Research Center, Saga University Hospital, Saga, Japan
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Ikeda D, Terao T, Fukumoto A, Uesugi Y, Tabata R, Kuzume A, Tsushima T, Miura D, Narita K, Takeuchi M, Yamashita T, Takamatsu H, Matsue K. Antibody status following booster vaccination against SARS-CoV-2 virus in patients with haematologic malignancies. Br J Haematol 2023; 200:568-572. [PMID: 36345272 PMCID: PMC9878231 DOI: 10.1111/bjh.18549] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
Antibody titres in 462 patients with haematological malignancies after the second (D2) and third (D3) SARS-CoV-2 vaccine were compared with those of healthy controls (HCs). Significant decay of antibody titre was observed pre D3, but titre surged post D3. The number of seronegative patients decreased from 79 (17.1%) to 44 (9.5%) from post D2 to post D3, and patients with adequate antibody titre increased from 204 (44.2%) to 358 (77.5%). Of the patients who received B-cell-targeted therapy, 80% were seronegative and 71% remained seronegative after D3. CD19+, CD4+, CD8+ cell counts, and immunoglobulin G (IgG) levels were identified as independent predictors for adequate serologic response.
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Affiliation(s)
- Daisuke Ikeda
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Toshiki Terao
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Ami Fukumoto
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Yuka Uesugi
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Rikako Tabata
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Ayumi Kuzume
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Takafumi Tsushima
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Daisuke Miura
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Kentaro Narita
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Masami Takeuchi
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Takeshi Yamashita
- Division of Internal Medicine, Keiju Kanazawa Hospital, Ishikawa, Japan
| | - Hiroyuki Takamatsu
- Faculty of Medicine, Department of Haematology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Kosei Matsue
- Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
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Amati R, Piumatti G, Franscella G, Buttaroni P, Camerini AL, Corna L, Levati S, Fadda M, Fiordelli M, Annoni AM, Bezani K, Amendola A, Fragoso Corti C, Sabatini S, Kaufmann M, Frei A, Puhan MA, Crivelli L, Albanese E. Trajectories of Seroprevalence and Neutralizing Activity of Antibodies against SARS-CoV-2 in Southern Switzerland between July 2020 and July 2021: An Ongoing, Prospective Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3703. [PMID: 36834397 PMCID: PMC9964112 DOI: 10.3390/ijerph20043703] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The COVID-19 pandemic continues, and evidence on infection- and vaccine-induced immunity is key. We assessed COVID-19 immunity and the neutralizing antibody response to virus variants across age groups in the Swiss population. STUDY DESIGN We conducted a cohort study in representative community-dwelling residents aged five years or older in southern Switzerland (total population 353,343), and we collected blood samples in July 2020 (in adults only, N = 646), November-December 2020 (N = 1457), and June-July 2021 (N = 885). METHODS We used a previously validated Luminex assay to measure antibodies targeting the spike (S) and the nucleocapsid (N) proteins of the virus and a high-throughput cell-free neutralization assay optimized for multiple spike protein variants. We calculated seroprevalence with a Bayesian logistic regression model accounting for the population's sociodemographic structure and the test performance, and we compared the neutralizing activity between vaccinated and convalescent participants across virus variants. RESULTS The overall seroprevalence was 7.8% (95% CI: 5.4-10.4) by July 2020 and 20.2% (16.4-24.4) by December 2020. By July 2021, the overall seroprevalence increased substantially to 72.5% (69.1-76.4), with the highest estimates of 95.6% (92.8-97.8) among older adults, who developed up to 10.3 more antibodies via vaccination than after infection compared to 3.7 times more in adults. The neutralizing activity was significantly higher for vaccine-induced than infection-induced antibodies for all virus variants (all p values < 0.037). CONCLUSIONS Vaccination chiefly contributed to the reduction in immunonaive individuals, particularly those in older age groups. Our findings on the greater neutralizing activity of vaccine-induced antibodies than infection-induced antibodies are greatly informative for future vaccination campaigns.
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Affiliation(s)
- Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | | | - Giovanni Franscella
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Peter Buttaroni
- Faculty of Informatics, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Anne-Linda Camerini
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Laurie Corna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Sara Levati
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Department of Health Sciences, University of Lucerne, 6002 Lucerne, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Kleona Bezani
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Antonio Amendola
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Cristina Fragoso Corti
- Institute of Microbiology, University of Applied Sciences and Arts of Southern Switzerland, 6501 Bellinzona, Switzerland
| | - Serena Sabatini
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Luca Crivelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland
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Kuo HC, Kuo KC, Du PX, Keskin BB, Su WY, Ho TS, Tsai PS, Pau CH, Shih HC, Huang YH, Weng KP, Syu GD. Profiling humoral immunity after mixing and matching COVID-19 vaccines using SARS-CoV-2 variant protein microarrays. Mol Cell Proteomics 2023; 22:100507. [PMID: 36787877 PMCID: PMC9922205 DOI: 10.1016/j.mcpro.2023.100507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
In November 2022, 68% of the population received at least one dose of COVID-19 vaccines. Due to the ongoing mutations, especially for the variants of concern (VOCs), it is important to monitor the humoral immune responses after different vaccination strategies. In this study, we developed a SARS-CoV-2 variant protein microarray that contained the spike proteins from the VOCs, e.g., alpha, beta, gamma, delta, and omicron, to quantify the binding antibody and surrogate neutralizing antibody. Plasmas were collected after two doses of matching AZD1222 (AZx2), two doses of matching mRNA-1273 (Mx2), or mixing AZD1222 and mRNA-1273 (AZ+M). The results showed a significant decrease of surrogate neutralizing antibodies against the receptor-binding domain in all VOCs in AZx2 and Mx2 but not AZ+M. A similar but minor reduction pattern of surrogate neutralizing antibodies against the extracellular domain was observed. While Mx2 exhibited a higher surrogate neutralizing level against all VOCs compared to AZx2, AZ+M showed an even higher surrogate neutralizing level in gamma and omicron compared to Mx2. It is worth noting that the binding antibody displayed a low correlation to the surrogate neutralizing antibody (R-square 0.130-0.382). This study delivers insights into humoral immunities, SARS-CoV-2 mutations, and mixing and matching vaccine strategies, which may provide a more effective vaccine strategy especially in preventing omicron.
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Affiliation(s)
- Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan 33302
| | - Kuang-Che Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Pin-Xian Du
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Batuhan Birol Keskin
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Wen-Yu Su
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Tzong-Shiann Ho
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan R.O.C.,Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan 701, Taiwan R.O.C.,Department of Pediatrics, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan R.O.C
| | - Pei-Shan Tsai
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Chi Ho Pau
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Hsi-Chang Shih
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Ying-Hsien Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan 33302
| | - Ken-Pen Weng
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Guan-Da Syu
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan; International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan.
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Atanasov V, Barreto N, Whittle J, Meurer J, Weston BW, Luo Q(E, Franchi L, Yuan AY, Zhang R, Black B. Understanding COVID-19 Vaccine Effectiveness against Death Using a Novel Measure: COVID Excess Mortality Percentage. Vaccines (Basel) 2023; 11:379. [PMID: 36851256 PMCID: PMC9959409 DOI: 10.3390/vaccines11020379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
COVID-19 vaccines have saved millions of lives; however, understanding the long-term effectiveness of these vaccines is imperative to developing recommendations for booster doses and other precautions. Comparisons of mortality rates between more and less vaccinated groups may be misleading due to selection bias, as these groups may differ in underlying health status. We studied all adult deaths during the period of 1 April 2021-30 June 2022 in Milwaukee County, Wisconsin, linked to vaccination records, and we used mortality from other natural causes to proxy for underlying health. We report relative COVID-19 mortality risk (RMR) for those vaccinated with two and three doses versus the unvaccinated, using a novel outcome measure that controls for selection effects. This measure, COVID Excess Mortality Percentage (CEMP), uses the non-COVID natural mortality rate (Non-COVID-NMR) as a measure of population risk of COVID mortality without vaccination. We validate this measure during the pre-vaccine period (Pearson correlation coefficient = 0.97) and demonstrate that selection effects are large, with non-COVID-NMRs for two-dose vaccinees often less than half those for the unvaccinated, and non-COVID NMRs often still lower for three-dose (booster) recipients. Progressive waning of two-dose effectiveness is observed, with an RMR of 10.6% for two-dose vaccinees aged 60+ versus the unvaccinated during April-June 2021, rising steadily to 36.2% during the Omicron period (January-June, 2022). A booster dose reduced RMR to 9.5% and 10.8% for ages 60+ during the two periods when boosters were available (October-December, 2021; January-June, 2022). Boosters thus provide important additional protection against mortality.
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Affiliation(s)
- Vladimir Atanasov
- Mason College of Business, William & Mary, Williamsburg, VA 23185, USA
| | - Natalia Barreto
- Department of Economics, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA
| | - Jeff Whittle
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - John Meurer
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Qian (Eric) Luo
- Department of Health Policy and Management, George Washington University, Washington, DC 20052, USA
| | - Lorenzo Franchi
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
| | - Andy Ye Yuan
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
| | - Ruohao Zhang
- Department of Data Science, Centre College, Danville, KY 40422, USA
| | - Bernard Black
- Pritzker School of Law, Northwestern University, Chicago, IL 60611, USA
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One-Year Post-Vaccination Longitudinal Follow-Up of Quantitative SARS-CoV-2 Anti-Spike Total Antibodies in Health Care Professionals and Evaluation of Correlation with Surrogate Neutralization Test. Vaccines (Basel) 2023; 11:vaccines11020355. [PMID: 36851233 PMCID: PMC9966239 DOI: 10.3390/vaccines11020355] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 02/08/2023] Open
Abstract
Numerous vaccines have been generated to decrease the morbidity and mortality of COVID-19. This study aims to evaluate the immunogenicity of the heterologous boosts by BioNTech against homologous boosts by CoronaVac at three-month intervals in two health care worker (HCW) cohorts, with or without prior COVID-19, for one year post-vaccination. This is a prospective cohort study in which the humoral responses of 386 HCWs were followed-up longitudinally in six main groups according to their previous COVID-19 exposure and vaccination status. Anti-SARS-CoV-2 spike-RBD total antibody levels were measured and SARS-CoV-2 neutralization antibody (NAbs) responses against the ancestral Wuhan and the Omicron variant were evaluated comparatively using international standard serum for Wuhan and Omicron, as well as with the aid of a conversion tool. The anti-SARS-CoV-2 spike-RBD total Ab and Nab difference between with and without prior COVID-19, three months after two-dose primary vaccination with CoronaVac, was statistically significant (p = 0.001). In the subsequent follow-ups, this difference was not observed between the groups. Those previously infected (PI) and non-previously infected (NPI) groups receiving BioNTech as the third dose had higher anti-SARS-CoV-2 spike total Ab levels (14.2-fold and 17.4-fold, respectively, p = 0.001) and Nab responses (against Wuhan and Omicron) than those receiving CoronaVac. Ab responses after booster vaccination decreased significantly in all groups at the ninth-month follow-up (p < 0.05); however, Abs were still higher in all booster received groups than that in the primary vaccination. Abs were above the protective level at the twelfth-month measurement in the entire of the second BioNTech received group as the fourth dose of vaccination. In the one-year follow-up period, the increased incidence of COVID-19 in the groups vaccinated with two or three doses of CoronaVac compared with the groups vaccinated with BioNTech as a booster suggested that continuing the heterologous CoronaVac/BioNTech vaccination, revised according to current SARS-CoV-2 variants and with at least a six-month interval booster would be an effective and safe strategy for protection against COVID-19, particularly in health care workers.
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72
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Wanchaijiraboon P, Sainamthip P, Teeyapun N, Luangdilok S, Poovorawan Y, Wanlapakorn N, Tanasanvimon S, Sriuranpong V, Susiriwatananont T, Zungsontiporn N, Pakvisal N. Safety Following COVID-19 Booster Vaccine with BNT162b2 Compared to mRNA-1273 in Solid Cancer Patients Previously Vaccinated with ChAdOx1 or CoronaVac. Vaccines (Basel) 2023; 11:vaccines11020356. [PMID: 36851234 PMCID: PMC9965854 DOI: 10.3390/vaccines11020356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/08/2023] Open
Abstract
Safety data following the COVID-19 booster mRNA vaccine in solid cancer patients are scarce. We prospectively evaluated adverse events after a booster dose of the BNT162b2 vaccine as compared to the mRNA-1273 vaccine in solid malignancy patients who had previously received two doses of ChAdOx1 or heterogenous CoronaVac/ChAdOx1. Data regarding solicited and unsolicited adverse events were collected using questionnaires. The primary endpoint was the difference in incidence and severity of adverse events between BNT162b2 and mRNA-1273 vaccines. A total of 370 subjects were enrolled, including 172 (47%) and 198 (54%) patients receiving booster doses of BNT162b2 and mRNA-1273 vaccines, respectively. The overall incidence of adverse events in the two groups was comparable (BNT162b2 vs. mRNA-1273; 63% vs. 66%, p = 0.6). There was no significant difference in severity, and the majority of adverse events reported were classed as mild to moderate. Tenderness at the injection site was the only reaction that had a statistically higher reported incidence after the mRNA-1273 vaccine than after the BNT162b2 vaccine (56% vs. 41%, p = 0.003). In conclusion, a booster dose of the mRNA vaccine, either BNT162b2 or mRNA-1273, in solid cancer patients previously vaccinated with ChAdOx1 and CoronaVac appears safe, and no new safety concerns were observed.
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Affiliation(s)
- Passakorn Wanchaijiraboon
- Phrapokklao Cancer Center of Excellence, Phrapokklao Clinical Research Center, Phrapokklao Genomic Laboratories, Phrapokklao Hospital, Mueang District, Chantaburi 22000, Thailand
| | - Panot Sainamthip
- Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Nattaya Teeyapun
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Sutima Luangdilok
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Suebpong Tanasanvimon
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Virote Sriuranpong
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Thiti Susiriwatananont
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Nicha Zungsontiporn
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Nussara Pakvisal
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
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Lai FTT, Yan VKC, Ye X, Ma T, Qin X, Chui CSL, Li X, Wan EYF, Wong CKH, Cheung CL, Li PH, Cheung BMY, Lau CS, Wong ICK, Chan EWY. Booster vaccination with inactivated whole-virus or mRNA vaccines and COVID-19-related deaths among people with multimorbidity: a cohort study. CMAJ 2023; 195:E143-E152. [PMID: 36717123 PMCID: PMC9888544 DOI: 10.1503/cmaj.221068] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Multimorbidity is a prevalent risk factor for COVID-19-related complications and death. We sought to evaluate the association of homologous booster vaccination using BNT162b2 (Pfizer-BioNTech) or CoronaVac (Sinovac) with COVID-19-related deaths among people with multimorbidity during the initial Omicron wave of the COVID-19 pandemic. METHODS Using routine clinical records from public health care facilities in Hong Kong, we conducted a territory-wide retrospective cohort study comparing people aged 18 years or older with 2 or more chronic conditions who received a homologous booster (third) dose with those who received only 2 doses, between Nov. 11, 2021, and Mar. 31, 2022. The primary outcome was death related to COVID-19. RESULTS We included 120 724 BNT162b2 recipients (including 87 289 who received a booster), followed for a median of 34 (interquartile range [IQR] 20-63) days and 127 318 CoronaVac recipients (including 94 977 who received a booster), followed for a median of 38 (IQR 22-77) days. Among BNT162b2 recipients, booster-vaccinated people had fewer COVID-19-related deaths than those who received 2 doses (5 v. 34, incidence rate 1.3 v. 23.4 per million person-days, weighted incidence rate ratio [IRR] 0.05, 95% confidence interval [CI] 0.02-0.16). We observed similar results among recipients of CoronaVac booster vaccination compared with those who received only 2 doses (26 v. 88, incidence rate 5.3 v. 53.1 per million person-days, weighted IRR 0.08, 95% CI 0.05-0.12). INTERPRETATION Among people with multimorbidity, booster vaccination with BNT162b2 or CoronaVac was associated with reductions of more than 90% in COVID-19-related mortality rates compared with only 2 doses. These results highlight the crucial role of booster vaccination for protecting vulnerable populations as the COVID-19 pandemic continues to evolve.
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Affiliation(s)
- Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Vincent Ka Chun Yan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Xuxiao Ye
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Tiantian Ma
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Xiwen Qin
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Celine Sze Ling Chui
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Xue Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Eric Yuk Fai Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Carlos King Ho Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Ching Lung Cheung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Philip Hei Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Bernard Man Yung Cheung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Chak Sing Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy (Lai, Yan, Ye, Ma, Qin, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Li Ka Shing Faculty of Medicine, The University of Hong Kong; Laboratory of Data Discovery for Health (Lai, Ma, Chui, X. Li, Wan, C.K.H. Wong, C.L. Cheung, I.C.K. Wong, Chan), Hong Kong Science and Technology Park; School of Nursing (Chui) and of Public Health (Chui) and Departments of Medicine (X. Li, P.H. Li, B.M.U. Cheung, Lau) and of Family Medicine and Primary Care, School of Clinical Medicine (Wan, C.K.H. Wong), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Aston Pharmacy School (I.C.K. Wong), Aston University, Birmingham, UK
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Effectiveness of mRNA Vaccine Booster against SARS-CoV-2 Infection and COVID-19 in the Adult Population during the First Three Months of the Omicron Wave in Sicily. Healthcare (Basel) 2023; 11:healthcare11030305. [PMID: 36766880 PMCID: PMC9914041 DOI: 10.3390/healthcare11030305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In Italy, the administration of the COVID-19 vaccine booster dose started on 27 September 2021, supported by clinical trials corroborating its efficacy. Given the paucity of real-world effectiveness data, this study aims to estimate the vaccine effectiveness of the booster dose against SARS-CoV-2 infection, severe disease, and death in the adult Sicilian population. METHODS This retrospective cohort study was carried out from 1 January to 31 March 2022 and included all residents in Sicily aged ≥ 18 years without previous SARS-CoV-2 infection and with a complete mRNA vaccine primary cycle. The cohort was split into two groups (booster and primary cycle) matched by age, gender, vaccine type, and month of completion of the primary vaccination cycle. RESULTS 913,382 subjects were observed in the study: 456,690 (50%) were vaccinated with two doses and 456,692 (50%) with three doses. There were 43,299 cases of SARS-CoV-2 among the two-doses vaccinees (9.5%) and 10,262 (2.2%) among the three-doses counterpart. Vaccine effectiveness in the booster cohort was 76.5% and 74.4% against SARS-CoV-2 infection, 85.7% and 79.7% against severe disease, and 84.1% and 73.1% against intubation or death, for BNT162b2 and mRNA-1273, respectively. CONCLUSIONS This study confirmed the remarkable efficacy profile of the SARS-CoV-2 vaccine booster dose against infection, severe disease, and death attributable to the virus. Overall, the results of this study provide important real-world data to support the continued roll-out of the COVID-19 booster dose and have the potential to inform public health policy and guide decisions on vaccination strategies in countries around the world.
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75
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Richard SA, Pollett SD, Fries AC, Berjohn CM, Maves RC, Lalani T, Smith AG, Mody RM, Ganesan A, Colombo RE, Lindholm DA, Morris MJ, Huprikar N, Colombo CJ, Madar C, Jones M, Larson DT, Bazan SE, Mende K, Saunders D, Livezey J, Lanteri CA, Scher AI, Byrne C, Rusiecki J, Ewers E, Epsi NJ, Rozman JS, English C, Simons MP, Tribble DR, Agan BK, Burgess TH. Persistent COVID-19 Symptoms at 6 Months After Onset and the Role of Vaccination Before or After SARS-CoV-2 Infection. JAMA Netw Open 2023; 6:e2251360. [PMID: 36652247 PMCID: PMC9857077 DOI: 10.1001/jamanetworkopen.2022.51360] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
IMPORTANCE Understanding the factors associated with post-COVID conditions is important for prevention. OBJECTIVE To identify characteristics associated with persistent post-COVID-19 symptoms and to describe post-COVID-19 medical encounters. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases With Pandemic Potential (EPICC) study implemented in the US military health system (MHS); MHS beneficiaries aged 18 years or older who tested positive for SARS-CoV-2 from February 28, 2020, through December 31, 2021, were analyzed, with 1-year follow-up. EXPOSURES SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The outcomes analyzed included survey-reported symptoms through 6 months after SARS-CoV-2 infection and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis categories reported in medical records 6 months following SARS-CoV-2 infection vs 3 months before infection. RESULTS More than half of the 1832 participants in these analyses were aged 18 to 44 years (1226 [66.9%]; mean [SD] age, 40.5 [13.7] years), were male (1118 [61.0%]), were unvaccinated at the time of their infection (1413 [77.1%]), and had no comorbidities (1290 [70.4%]). A total of 728 participants (39.7%) had illness that lasted 28 days or longer (28-89 days: 364 [19.9%]; ≥90 days: 364 [19.9%]). Participants who were unvaccinated prior to infection (risk ratio [RR], 1.39; 95% CI, 1.04-1.85), reported moderate (RR, 1.80; 95% CI, 1.47-2.22) or severe (RR, 2.25; 95% CI, 1.80-2.81) initial illnesses, had more hospitalized days (RR per each day of hospitalization, 1.02; 95% CI, 1.00-1.03), and had a Charlson Comorbidity Index score of 5 or greater (RR, 1.55; 95% CI, 1.01-2.37) were more likely to report 28 or more days of symptoms. Among unvaccinated participants, postinfection vaccination was associated with a 41% lower risk of reporting symptoms at 6 months (RR, 0.59; 95% CI, 0.40-0.89). Participants had higher risk of pulmonary (RR, 2.00; 95% CI, 1.40-2.84), diabetes (RR, 1.46; 95% CI, 1.00-2.13), neurological (RR, 1.29; 95% CI, 1.02-1.64), and mental health-related medical encounters (RR, 1.28; 95% CI, 1.01-1.62) at 6 months after symptom onset than at baseline (before SARS-CoV-2 infection). CONCLUSIONS AND RELEVANCE In this cohort study, more severe acute illness, a higher Charlson Comorbidity Index score, and being unvaccinated were associated with a higher risk of reporting COVID-19 symptoms lasting 28 days or more. Participants with COVID-19 were more likely to seek medical care for diabetes, pulmonary, neurological, and mental health-related illness for at least 6 months after onset compared with their pre-COVID baseline health care use patterns. These findings may inform the risk-benefit ratio of COVID-19 vaccination policy.
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Affiliation(s)
- Stephanie A. Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Simon D. Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | | | - Catherine M. Berjohn
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Naval Medical Center San Diego, San Diego, California
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Ryan C. Maves
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Naval Medical Center San Diego, San Diego, California
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Naval Medical Center Portsmouth, Portsmouth, Virginia
| | | | - Rupal M. Mody
- William Beaumont Army Medical Center, Fort Bliss, Texas
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Rhonda E. Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington
| | - David A. Lindholm
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
| | - Michael J. Morris
- Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
| | - Nikhil Huprikar
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Christopher J. Colombo
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington
| | | | - Milissa Jones
- Tripler Army Medical Center, Honolulu, Hawaii
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Derek T. Larson
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | | | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
| | - David Saunders
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jeffrey Livezey
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Charlotte A. Lanteri
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | | | | | - Evan Ewers
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | - Nusrat J. Epsi
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Julia S. Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Caroline English
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Mark P. Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David R. Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Brian K. Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Timothy H. Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Sanz-Muñoz I, López-Mongil R, Sánchez-Martínez J, Sánchez-de Prada L, González MDG, Pérez-SanJose D, Rojo-Rello S, Hernán-García C, Fernández-Espinilla V, de Lejarazu-Leonardo RO, Castrodeza-Sanz J, Eiros JM. Evolution of antibody profiles against SARS-CoV-2 in experienced and naïve vaccinated elderly people. Front Immunol 2023; 14:1128302. [PMID: 36911673 PMCID: PMC9992205 DOI: 10.3389/fimmu.2023.1128302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The third dose of the COVID-19 vaccine is especially necessary in people over 65 years of age due to their lower immune response. Methods We designed a multicentre, prospective observational study including 98 people ≤65 years old who lived in two nursing homes in Valladolid, Spain. One of the groups had previous experience with SARS-CoV-2 (n=68;69.4%) and the other was naïve (n=30;30.6%). We evaluated the response to the three doses of the Comirnaty vaccine and the dynamics of antibodies during 5 consecutive serum samplings: 2 after the first two doses of vaccination, one three months after the first dose, another at 6 months and the last one month after the third dose. IgG antibodies against SARS-CoV-2 S1, RBD and N antigens were analysed. Results Both groups increased the level of Abs against S1 and RBD, but the experienced group showed a 130-fold higher humoral response due to hybrid immunisation (infection+vaccination). The response to vaccination with Comirnaty against COVID-19 was higher in those ≤65 years with previous experience than those who were naïve. However, the amount of antibodies against S1 and RBD equalised at 6 months. After the third dose, both groups raised the amount of antibodies to a similar level. The reinfections suggested by the analysis of antibodies against N were frequent in both groups. Discussion The third dose showed a clear benefit for elderly people, with the reinforcement of the antibody levels after the decline suffered after six months of the first two doses.
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Affiliation(s)
- Iván Sanz-Muñoz
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Instituto de Estudios de Ciencias de la Salud de Castilla y León, (ICSCYL), Soria, Spain
| | | | - Javier Sánchez-Martínez
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Instituto de Estudios de Ciencias de la Salud de Castilla y León, (ICSCYL), Soria, Spain
| | - Laura Sánchez-de Prada
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Marta Domínguez-Gil González
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | - Diana Pérez-SanJose
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Silvia Rojo-Rello
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Cristina Hernán-García
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Virginia Fernández-Espinilla
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Javier Castrodeza-Sanz
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - José María Eiros
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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77
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Alaniz AJ, Carvajal MA, Carvajal JG, Vergara PM. Effects of air pollution and weather on the initial COVID-19 outbreaks in United States, Italy, Spain, and China: A comparative study. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:8-18. [PMID: 36509703 PMCID: PMC9877606 DOI: 10.1111/risa.14080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/03/2022] [Accepted: 11/05/2022] [Indexed: 06/17/2023]
Abstract
Contrasting effects have been identified in association of weather (temperature and humidity) and pollutant gases with COVID-19 infection, which could be derived from the influence of lockdowns and season change. The influence of pollutant gases and climate during the initial phases of the pandemic, before the closures and the change of season in the northern hemisphere, is unknown. Here, we used a spatial-temporal Bayesian zero-inflated-Poisson model to test for short-term associations of weather and pollutant gases with the relative risk of COVID-19 disease in China (first outbreak) and the countries with more cases during the initial pandemic (the United States, Spain and Italy), considering also the effects of season and lockdown. We found contrasting association between pollutant gases and COVID-19 risk in the United States, Italy, and Spain, while in China it was negatively associated (except for SO2 ). COVID-19 risk was positively associated with specific humidity in all countries, while temperature presented a negative effect. Our findings showed that short-term associations of air pollutants with COVID-19 infection vary strongly between countries, while generalized effects of temperature (negative) and humidity (positive) with COVID-19 was found. Our results show novel information about the influence of pollution and weather on the initial outbreaks, which contribute to unravel the mechanisms during the beginning of the pandemic.
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Affiliation(s)
- Alberto J. Alaniz
- Departamento de Ingeniería Geoespacial y Ambiental, Facultad de IngenieríaUniversidad de Santiago de ChileSantiagoChile
- Facultad de Ciencias BiológicasPontificia Universidad Católica de ChileSantiagoChile
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
- Centro de Estudios en Ecología Espacial y Medio AmbienteEcogeografíaSantiagoChile
| | - Mario A. Carvajal
- Facultad de Ciencias BiológicasPontificia Universidad Católica de ChileSantiagoChile
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
| | - Jorge G. Carvajal
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
- Centro de Estudios en Ecología Espacial y Medio AmbienteEcogeografíaSantiagoChile
| | - Pablo M. Vergara
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
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78
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Perico L, Todeschini M, Casiraghi F, Mister M, Pezzotta A, Peracchi T, Tomasoni S, Trionfini P, Benigni A, Remuzzi G. Long-term adaptive response in COVID-19 vaccine recipients and the effect of a booster dose. Front Immunol 2023; 14:1123158. [PMID: 36926327 PMCID: PMC10011096 DOI: 10.3389/fimmu.2023.1123158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
We examined the immune response in subjects previously infected with SARS-CoV2 and infection-naïve 9 months after primary 2-dose COVID-19 mRNA vaccination and 3 months after the booster dose in a longitudinal cohort of healthcare workers. Nine months after primary vaccination, previously infected subjects exhibited higher residual antibody levels, with significant neutralizing activity against distinct variants compared to infection-naïve subjects. The higher humoral response was associated with higher levels of receptor binding domain (RBD)-specific IgG+ and IgA+ memory B cells. The booster dose increased neither neutralizing activity, nor the B and T cell frequencies. Conversely, infection-naïve subjects needed the booster to achieve comparable levels of neutralizing antibodies as those found in previously infected subjects after primary vaccination. The neutralizing titer correlated with anti-RBD IFNγ producing T cells, in the face of sustained B cell response. Notably, pre-pandemic samples showed high Omicron cross-reactivity. These data show the importance of the booster dose in reinforcing immunological memory and increasing circulating antibodies in infection-naïve subjects.
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Affiliation(s)
- Luca Perico
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Marta Todeschini
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Federica Casiraghi
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Marilena Mister
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Anna Pezzotta
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Tobia Peracchi
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Susanna Tomasoni
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Piera Trionfini
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Ariela Benigni
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Giuseppe Remuzzi
- Department of Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
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Dal-Ré R, Porcher R, Rosendaal FR, Schwarzer-Daum B. Regulatory agencies disregard real-world effectiveness evidence on product labels beyond what is reasonable. J Clin Epidemiol 2023; 153:83-90. [PMID: 36371045 DOI: 10.1016/j.jclinepi.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/19/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Rafael Dal-Ré
- Epidemiology Unit, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Raphaël Porcher
- Université de Paris, Centre of Research in Epidemiology and Statistics (CRESS-UMR1153), Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Yuan A, Atanasov V, Parra PNB, Whittle J, Meurer J, Weston B, Luo QE, Franchi L, Zhang R, Black B. Understanding COVID-19 Vaccine Effectiveness Against Death Using a Novel Measure: COVID Excess Mortality Percentage. RESEARCH SQUARE 2022:rs.3.rs-2359020. [PMID: 36561183 PMCID: PMC9774224 DOI: 10.21203/rs.3.rs-2359020/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
COVID-19 vaccines have saved millions of lives and prevented countless adverse patient disease outcomes. Understanding the long-term effectiveness of these vaccines is imperative to developing recommendations for precautions and booster doses. Comparisons between more and less vaccinated groups may be misleading due to selection bias, as these groups may differ in underlying health status and thus risk of adverse COVID-19 outcomes. We study all adult deaths over April 1, 2021-June 30, 2022 in Milwaukee County, Wisconsin, linked to vaccination records, use mortality from other natural causes to proxy for underlying health, and report relative COVID-19 mortality risk (RMR) for vaccinees versus the unvaccinated, using a novel outcome measure that controls for selection effects. This measure, COVID Excess Mortality Percentage (CEMP) uses the non-COVID natural mortality rate (Non-Covid-NMR) as a measure of population risk of COVID mortality without vaccination. We validate this measure during the pre-vaccine period (r = 0.97) and demonstrate that selection effects are large, with Non-Covid-NMRs for two-dose vaccinees less than half those for the unvaccinated, and Non-COVID NMRs still lower for three dose (booster) recipients. Progressive waning of two-dose effectiveness is observed, with relative mortality risk (RMR) for two-dose vaccinees aged 60 + versus the unvaccinated of 11% during April-June 2021, rising steadily to 36% during the Omicron period (January-June, 2022). Notably, a booster dose reduced RMR to 10-11% for ages 60+. Boosters thus provide important additional protection against mortality.
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81
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Kirsebom FCM, Andrews N, Sachdeva R, Stowe J, Ramsay M, Lopez Bernal J. Effectiveness of ChAdOx1-S COVID-19 booster vaccination against the Omicron and Delta variants in England. Nat Commun 2022; 13:7688. [PMID: 36509743 PMCID: PMC9744366 DOI: 10.1038/s41467-022-35168-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Despite the availability of the ChAdOx1-S booster vaccine, little is known about the real-world effectiveness although clinical trials have demonstrated enhanced immunity following a ChAdOx1-S booster. In England 43,171 individuals received a ChAdOx1-S booster whilst 13,038,908 individuals received BNT162b2 in the same period. ChAdOx1-S booster recipients were more likely to be female (adjusted odds ratio (OR) 1.67 (1.64-1.71)), in a clinical risk group (adjusted OR 1.58 (1.54-1.63)), in the clinically extremely vulnerable group (adjusted OR 1.84 (1.79-1.89)) or severely immunosuppressed (adjusted OR 2.05 (1.96-2.13)). The effectiveness of the ChAdOx1-S and BNT162b2 boosters is estimated here using a test-negative case-control study. Protection against symptomatic disease with the Omicron variant peaks at 66.1% (16.6 to 86.3%) and 68.5% (65.7 to 71.2%) for the ChAdOx1-S and BNT162b2 boosters in older adults. Protection against hospitalisation peaks at 82.3% (64.2 to 91.3%) and 90.9% (88.7 to 92.7%). For Delta, effectiveness against hospitalisation is 80.9% (15.6% to 95.7%) and 93.9% (92.8% to 94.9%) after ChAdOx1-S and BNT162b2 booster vaccination. This study supports the consideration of ChAdOx1-S booster vaccination for protection against severe COVID-19 in settings yet to offer boosters and suggests that individuals who received a ChAdOx1-S booster do not require re-vaccination ahead of others.
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Affiliation(s)
| | - Nick Andrews
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK ,grid.8991.90000 0004 0425 469XNIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, UK
| | - Ruchira Sachdeva
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK
| | - Julia Stowe
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK
| | - Mary Ramsay
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK ,grid.8991.90000 0004 0425 469XNIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, UK
| | - Jamie Lopez Bernal
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK ,grid.8991.90000 0004 0425 469XNIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, UK ,grid.7445.20000 0001 2113 8111NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK
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82
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Humoral Responses in the Omicron Era Following 3-Dose SARS-CoV-2 Vaccine Series in Kidney Transplant Recipients. Transplant Direct 2022; 9:e1401. [DOI: 10.1097/txd.0000000000001401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 12/13/2022] Open
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83
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Robilotti EV, Whiting K, Lucca A, Poon C, Jani K, McMillen T, Freeswick S, Korenstein D, Babady NE, Seshan VE, Kamboj M. Effectiveness of MRNA booster vaccine among healthcare workers in New York City during the Omicron surge, December 2021 to January 2022. Clin Microbiol Infect 2022; 28:1624-1628. [PMID: 35931373 PMCID: PMC9345790 DOI: 10.1016/j.cmi.2022.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/23/2022] [Accepted: 07/18/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To describe effectiveness of mRNA vaccines by comparing 2-dose (2D) and 3-dose (3D) healthcare worker (HCW) recipients in the setting of Omicron variant dominance. Performance of 2D and 3D vaccine series against SARS-CoV-2 variants and the clinical outcomes of HCWs may inform return-to-work guidance. METHODS In a retrospective study from December 15, 2020 to January 15, 2022, SARS-CoV-2 infections among HCWs at a large tertiary cancer centre in New York City were examined to estimate infection rates (aggregated positive tests / person-days) and 95% CIs over the Omicron period in 3D and 2D mRNA vaccinated HCWs and were compared using rate ratios. We described the clinical features of post-vaccine infections and impact of prior (pre-Omicron) COVID infection on vaccine effectiveness. RESULTS Among the 20857 HCWs in our cohort, 20,660 completed the 2D series with an mRNA vaccine during our study period and 12461 had received a third dose by January 15, 2022. The infection rate ratio for 3D versus 2D vaccinated HCWs was 0.667 (95% CI 0.623, 0.713) for an estimated 3D vaccine effectiveness of 33.3% compared to two doses only during the Omicron dominant period from December 15, 2021 to January 15, 2022. Breakthrough Omicron infections after 3D + 14 days occurred in 1,315 HCWs. Omicron infections were mild, with 16% of 3D and 11% 2D HCWs being asymptomatic. DISCUSSION Study demonstrates improved vaccine-derived protection against COVID-19 infection in 3D versus 2D mRNA vaccinees during the Omicron surge. The advantage of 3D vaccination was maintained irrespective of prior COVID-19 infection status.
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Affiliation(s)
- Elizabeth V. Robilotti
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA,Corresponding author. Elizabeth Robilotti, 1275 York Avenue, New York, NY, 10065
| | - Karissa Whiting
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anabella Lucca
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA,Employee Health Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chester Poon
- Division of Digital Informatics and Technology Solutions, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Krupa Jani
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tracy McMillen
- Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Scott Freeswick
- Division of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Deborah Korenstein
- Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - N. Esther Babady
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA,Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Venkatraman E. Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mini Kamboj
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA,Division of Quality and Safety, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Corresponding author. Mini Kamboj, 1275 York Avenue, New York, NY, 10065. USA
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84
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Mallah N, Pardo-Seco J, López-Pérez LR, González-Pérez JM, Rosón B, Otero-Barrós MT, Durán-Parrondo C, Nartallo-Penas V, Mirás-Carballal S, Rodríguez-Tenreiro C, Rivero-Calle I, Gómez-Carballa A, Salas A, Martinón-Torres F. Effectiveness of COVID-19 vaccine booster in the general population and in subjects with comorbidities. A population-based study in Spain. ENVIRONMENTAL RESEARCH 2022; 215:114252. [PMID: 36096168 PMCID: PMC9462926 DOI: 10.1016/j.envres.2022.114252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Research on the effectiveness of COVID-19 booster-based vaccine schedule is ongoing and real-world data on vaccine effectiveness (VE) in comorbid patients are limited. We aimed to estimate booster dose VE against SARS-CoV-2 infection and COVID-19 severity in the general population and in comorbid patients. METHOD A retrospective test-negative control study was undertaken in Galicia-Spain (December 2020-November 2021). VE and 95% confidence interval (CI) were estimated using multivariate logistic regression models. RESULTS 1,512,415 (94.13%) negative and 94,334 (5.87%) positive SARS-CoV-2 test results were included. A booster dose of COVID-19 vaccine is associated with substantially higher protection against SARS-CoV-2 infection than vaccination without a booster [VEboosted = 87% (95%CI: 83%; 89%); VEnon-boosted = 66% (95%CI: 65%; 67%)]. The high VE was observed in all ages, but was more pronounced in subjects older than 65 years. VE against COVID-19 severity was analyzed in a mixed population of boosted and non-boosted individuals and considerable protection was obtained [VE: hospitalization = 72% (95%CI: 68%; 75%); intensive care unit administration = 83% (95%CI: 78%; 88%), in-hospital mortality = 66% (95%CI: 53%; 75%)]. Boosted comorbid patients are more protected against SARS-CoV-2 infection than those who were non-boosted. This was observed in a wide range of major diseases including cancer (81% versus 54%), chronic obstructive pulmonary disease (84% versus 61%), diabetes (84% versus 65%), hypertension (82% versus 65%) and obesity (91% versus 67%), among others. CONCLUSIONS A booster dose of COVID-19 vaccine increases the protection against SARS-CoV-2 infection and COVID-19 severity in the general population and in comorbid patients.
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Affiliation(s)
- Narmeen Mallah
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jacobo Pardo-Seco
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis-Ricardo López-Pérez
- Subdirección de Sistemas y Tecnologías de La Información, Servizo Galego de Saude, Galicia, Spain
| | | | - Benigno Rosón
- Subdirección de Sistemas y Tecnologías de La Información, Servizo Galego de Saude, Galicia, Spain
| | | | - Carmen Durán-Parrondo
- Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | | | - Susana Mirás-Carballal
- Servicio de Enfermedades Transmisibles, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Carmen Rodríguez-Tenreiro
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Irene Rivero-Calle
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela (USC), Galicia, Spain
| | - Alberto Gómez-Carballa
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Salas
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, And GenPoB Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clìnico Universitario de Santiago, Servizo Galego de Saúde, Galicia, Spain
| | - Federico Martinón-Torres
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela (USC), Galicia, Spain.
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85
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Ioannou GN, Bohnert ASB, O'Hare AM, Boyko EJ, Maciejewski ML, Smith VA, Bowling CB, Viglianti E, Iwashyna TJ, Hynes DM, Berry K. Effectiveness of mRNA COVID-19 Vaccine Boosters Against Infection, Hospitalization, and Death: A Target Trial Emulation in the Omicron (B.1.1.529) Variant Era. Ann Intern Med 2022; 175:1693-1706. [PMID: 36215715 PMCID: PMC9575390 DOI: 10.7326/m22-1856] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The effectiveness of a third mRNA COVID-19 vaccine dose (booster dose) against the Omicron (B.1.1.529) variant is uncertain, especially in older, high-risk populations. OBJECTIVE To determine mRNA booster vaccine effectiveness (VE) against SARS-CoV-2 infection, hospitalization, and death in the Omicron era by booster type, primary vaccine type, time since primary vaccination, age, and comorbidity burden. DESIGN Retrospective matched cohort study designed to emulate a target trial of booster vaccination versus no booster, conducted from 1 December 2021 to 31 March 2022. SETTING U.S. Department of Veterans Affairs health care system. PARTICIPANTS Persons who had received 2 mRNA COVID-19 vaccine doses at least 5 months earlier. INTERVENTION Booster monovalent mRNA vaccination (Pfizer-BioNTech's BNT162b2 or Moderna's mRNA-1273) versus no booster. MEASUREMENTS Booster VE. RESULTS Each group included 490 838 well-matched persons, who were predominantly male (88%), had a mean age of 63.0 years (SD, 14.0), and were followed for up to 121 days (mean, 79.8 days). Booster VE more than 10 days after a booster dose was 42.3% (95% CI, 40.6% to 43.9%) against SARS-CoV-2 infection, 53.3% (CI, 48.1% to 58.0%) against SARS-CoV-2-related hospitalization, and 79.1% (CI, 71.2% to 84.9%) against SARS-CoV-2-related death. Booster VE was similar for different booster types (BNT162b2 or mRNA-1273), age groups, and primary vaccination regimens but was significantly higher with longer time since primary vaccination and higher comorbidity burden. LIMITATION Predominantly male population. CONCLUSION Booster mRNA vaccination was highly effective in preventing death and moderately effective in preventing infection and hospitalization for up to 4 months after administration in the Omicron era. Increased uptake of booster vaccination, which is currently suboptimal, should be pursued to limit the morbidity and mortality of SARS-CoV-2 infection, especially in persons with high comorbidity burden. PRIMARY FUNDING SOURCE U.S. Department of Veterans Affairs.
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Affiliation(s)
- George N Ioannou
- Division of Gastroenterology, University of Washington, and Research and Development and Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (G.N.I.)
| | - Amy S B Bohnert
- Department of Anesthesiology, University of Michigan Medical School, and Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan (A.S.B.B.)
| | - Ann M O'Hare
- Nephrology, Veterans Affairs Puget Sound Health Care System, and University of Washington, Seattle, Washington (A.M.O.)
| | - Edward J Boyko
- General Internal Medicine, Veterans Affairs Puget Sound Health Care System, and University of Washington, Seattle, Washington (E.J.B.)
| | - Matthew L Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, and Department of Population Health Sciences, Duke-Margolis Center for Health Policy, and Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina (M.L.M.)
| | - Valerie A Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, and Department of Population Health Sciences and Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina (V.A.S.)
| | - C Barrett Bowling
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), and Department of Medicine, Duke University, Durham, North Carolina (C.B.B.)
| | - Elizabeth Viglianti
- Center for Clinical Management Research, VA Ann Arbor Health System, and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (E.V., T.J.I.)
| | - Theodore J Iwashyna
- Center for Clinical Management Research, VA Ann Arbor Health System, and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (E.V., T.J.I.)
| | - Denise M Hynes
- Center of Innovation to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, Oregon, and Health Management and Policy, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, and Health Data and Informatics Program, Center for Quantitative Life Sciences, Oregon State University, Corvallis, Oregon (D.M.H.)
| | - Kristin Berry
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (K.B.)
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86
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Toussia-Cohen S, Nir O, Peretz-Machluf R, Bookstein-Peretz S, Segal O, Asraf K, Doolman R, Regev-Yochay G, Yinon Y. Maternal and Neonatal Immune Responses Following COVID-19 Infection and Vaccinations in Pregnancy. Vaccines (Basel) 2022; 10:vaccines10122019. [PMID: 36560429 PMCID: PMC9782019 DOI: 10.3390/vaccines10122019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The objective of the study was to compare the maternal and neonatal humoral immune responses among different groups of women, namely those vaccinated by the BNT162b2 vaccine, not vaccinated, and COVID-19-recovered parturient women at the time of delivery. This is a prospective cohort study of pregnant women, divided into four groups: Group A "Recovered"-recovered and not vaccinated. Group B "Second Vaccination"-first and second doses only. Group C "Third Vaccination"-third dose. Group D "No Third Vaccination"-women eligible for the third dose of the vaccine but did not receive it. Maternal and umbilical cord blood were sampled and tested for SARS-CoV-2 IgG antibodies on admittance to labor and immediately postpartum, respectively. Maternal serum SARS-CoV-2 IgG levels were significantly higher among Group C compared to Group B (741.6 (514.5-1069) vs. 333.5 (327-340.2), respectively). Both groups had higher antibody levels compared to Groups A and D (113.5 (61.62-209.1) and 57.99 (32.93-102.1), respectively). Similarly, umbilical cord blood SARS-CoV-2 IgG levels were also highest among Group C compared to the other three groups (1269 (953.4-1690) vs. Group B, 322.6 (305.6-340.5), Group A, 109 (49.01-242.6), and Group D, 103.9 (48.59-222), respectively). In conclusion, pregnant women who were fully vaccinated with three dosages before delivery generated the highest levels of maternal and neonatal SARS-CoV-2 IgG antibodies.
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Affiliation(s)
- Shlomi Toussia-Cohen
- The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Correspondence: ; Tel.: +972-546-308521
| | - Omer Nir
- The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Ravit Peretz-Machluf
- The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Shiran Bookstein-Peretz
- The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Omri Segal
- The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Keren Asraf
- The Dworman Automated-Mega Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
| | - Ram Doolman
- The Dworman Automated-Mega Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
| | - Gili Regev-Yochay
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Infection Prevention & Control Unit, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
| | - Yoav Yinon
- The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
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87
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Chia TRT, Young BE, Chia PY. The Omicron-transformer: Rise of the subvariants in the age of vaccines. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022. [DOI: 10.47102/annals-acadmedsg.2022294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction: Omicron is the latest SARS-CoV-2 variant of concern, the pathogen that causes COVID-19. Since its emergence in late 2021, Omicron has displaced other circulating variants and caused successive waves of infection worldwide throughout 2022. Omicron is characterised by the rapid emergence of many subvariants and high rates of infection in people with vaccine- and/or infection-induced immunity. This review article will consolidate current knowledge regarding Omicron subvariants, the role of boosters, and future vaccine development. Method: This narrative review is based on a literature search using PubMed. Search terms related to Omicron were used and priority was given to published peer-reviewed articles over pre-prints. Results: Studies indicate that vaccinations and boosters are important to reduce disease severity, hospitalisation and death from Omicron. A variety of factors, such as differing host factors, circulating variants, and forces of infection, can influence the benefit of repeated booster administration. Next-generation bivalent vaccines have now been approved in some countries including Singapore and have demonstrated the ability to induce broad variant protection. Future third-generation vaccines involving mucosal vaccines and/or pan-sarbecovirus vaccines may provide broader and longer-lasting protection. Conclusion: Due to current high levels of vaccine- and infection-induced immunity, it is likely that rates of severe illness, hospitalisation, and death due to Omicron will continue to moderate. Nevertheless, the virus is ever-changing, and public health policies, especially those related to vaccinations, will also have to continually evolve and adapt as COVID-19 transitions to endemicity.
Keywords: Booster, COVID-19, infectious diseases, Omicron, vaccine
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Affiliation(s)
| | | | - Po Ying Chia
- National Centre for Infectious Diseases, Singapore
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88
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Rosen B, Davidovitch N, Chodick G, Israeli A. The role of Israeli researchers in the scientific literature regarding COVID-19 vaccines. Isr J Health Policy Res 2022; 11:39. [PMID: 36419188 PMCID: PMC9684862 DOI: 10.1186/s13584-022-00548-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The accurate and timely publication of scientific findings is a key component of the global response to the COVID-19 pandemic. This article explores the role of Israeli researchers in the scientific literature regarding COVID-19 vaccines. METHODS Content and bibliometric analysis of articles included in the Web of Science database regarding COVID-19 vaccines, that were published between January 2020 and June 2022. RESULTS The Web of Science includes 18,596 articles regarding COVID-19 vaccines that were published between January 2020 and June 2022. 536 (3%) of those articles had at least one Israeli author. These "Israeli articles" accounted for 11% of the NEJM articles on COVID-19 vaccines, 9% of such articles in Nature Medicine, and 4% of such articles in the Lancet. 80 of the 536 Israeli articles (15%) were recognized as "Highly Cited Papers" (articles that rank in the top 1% by citations for field and publication year). Most of the Israeli Highly Cited Papers (HCPs) analyzed the safety and/or efficacy of the COVID-19 vaccine developed by Pfizer and BioNTech (BNT162b2). Most of the Israeli HCPs made use of detailed and comprehensive individual data available from Israel's health plans, hospitals, or Ministry of Health. The 15% HCP rate (i.e., the number of HCPs divided by the number of all articles) for the Israeli articles was triple the HCP rate for all articles on COVID-19 vaccines (5%). A key factor contributing to Israel's prominent role in rapid publication of vaccination impact studies was Israel's being a world leader in the initial vaccination rollout, the administration of boosters, and the vaccination of pregnant women. Other contributing factors include Israeli researchers' access to well-developed electronic health record systems linking vaccinations and outcomes, the analytic strengths of leading Israeli researchers and research institutions, collaborations with leading research institutions in other countries, and the ability to quickly identify emerging research opportunities and mobilize accordingly. Recent developments in the priorities and selection criteria of leading journals have also played a role; these include an increased openness to well-designed observational studies and to manuscripts from outside of Europe and North America. CONCLUSIONS Israeli researchers, Israeli research institutions, and the Israeli government can, and should, take concrete steps to build upon lessons learned in the course of the recent surge of high-quality publications related to COVID-19 vaccines (such as the value of linking data across organizations). These lessons can be applied to a wide range of fields, including fields that go well beyond vaccines and pandemic responses.
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Affiliation(s)
- Bruce Rosen
- Myers-JDC-Brookdale Institute, Jerusalem, Israel.
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem, Israel.
| | - Nadav Davidovitch
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, Israel
- Taub Center for Social Policy Studies in Israel, Jerusalem, Israel
| | - Gabriel Chodick
- Maccabi Healthcare Services, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Avi Israeli
- Hebrew University Hadassah Medical School, Jerusalem, Israel
- Ministry of Health, Jerusalem, Israel
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89
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COVID-19: Relative Risk of Non-Vaccinated to Vaccinated Individuals. Diseases 2022; 10:diseases10040113. [PMID: 36547199 PMCID: PMC9777237 DOI: 10.3390/diseases10040113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
Following the outbreak of the COVID-19 pandemic, Italy has implemented an extensive vaccination campaign involving individuals above the age of 12, both sexes. The public opinion and the medical community alike questioned the usefulness and efficacy of the vaccines against SARS-CoV-2. The widespread opinion was that the vaccines protected individuals especially against serious conditions which could require intensive care and may lead to the death of the patient rather than against the possibility of infection. In order to quantify the effect of the vaccination campaign, we calculated the relative risks of non-vaccinated and vaccinated individuals for all possible outcomes of the disease: infection, hospitalization, admission to intensive care and death. Relative risk was assessed by means of likelihood ratios, the ratios of the probability of an outcome in non-vaccinated individuals to the probability of the same outcome in vaccinated individuals. Results support the hypothesis that vaccination has an extensive protective effect against both critical conditions and death. Nonetheless, the relative magnitude of the protection in vaccinated individuals compared to those non-vaccinated appears to be higher against the former outcome than the latter, for reasons which need to be investigated further.
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90
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Brazer N, Morris MK, Servellita V, Anglin K, Saldhi P, Garcia-Knight M, Bethancourt S, Sotomayor-Gonzalez A, Wang B, Foresythe A, Nguyen J, Gliwa AS, Pineda-Ramirez J, Sanchez RD, Zhang Y, Ott M, Wadford DA, Andino R, Kelly JD, Hanson C, Chiu C. Neutralizing Immunity Induced Against the Omicron BA.1 and BA.2 Variants in Vaccine Breakthrough Infections. J Infect Dis 2022; 226:1688-1698. [PMID: 36134603 PMCID: PMC9619439 DOI: 10.1093/infdis/jiac384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/10/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As of early 2022, the Omicron variants are the predominant circulating lineages globally. Understanding neutralizing antibody responses against Omicron BA.1 and BA.2 after vaccine breakthrough infections will provide insights into BA.2 infectivity and susceptibility to subsequent reinfection. METHODS Live virus neutralization assays were used to study immunity against Delta and Omicron BA.1 and BA.2 variants in samples from 86 individuals, 24 unvaccinated (27.9%) and 62 vaccinated (72.1%), who were infected with Delta (n = 42, 48.8%) or BA.1 (n = 44, 51.2%). Among the 62 vaccinated individuals, 39 were unboosted (62.9%), whereas 23 were boosted (37.1%). RESULTS In unvaccinated infections, neutralizing antibodies (nAbs) against the three variants were weak or undetectable, except against Delta for Delta-infected individuals. Both Delta and BA.1 breakthrough infections resulted in strong nAb responses against ancestral wild-type and Delta lineages, but moderate nAb responses against BA.1 and BA.2, with similar titers between unboosted and boosted individuals. Antibody titers against BA.2 were generally higher than those against BA.1 in breakthrough infections. CONCLUSIONS These results underscore the decreased immunogenicity of BA.1 compared to BA.2, insufficient neutralizing immunity against BA.2 in unvaccinated individuals, and moderate to strong neutralizing immunity induced against BA.2 in Delta and BA.1 breakthrough infections.
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Affiliation(s)
- Noah Brazer
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Mary Kate Morris
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Khamal Anglin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Prachi Saldhi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Miguel Garcia-Knight
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA
| | - Sutana Bethancourt
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | | | - Baolin Wang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Abiodun Foresythe
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jenny Nguyen
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Amelia S Gliwa
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jesus Pineda-Ramirez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Ruth Diaz Sanchez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Yueyuan Zhang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Melanie Ott
- California Institute for Quantitative Biosciences (QB3), University of California, Berkeley, CA, USA
- Gladstone Institutes, San Francisco, CA, USA
- Innovative Genomics Institute, University of California Berkeley, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Debra A Wadford
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA
| | - J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Carl Hanson
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Charles Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Innovative Genomics Institute, University of California Berkeley, CA, USA
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Nicholson M, Goubran H, Chan N, Siegal D. No apparent association between mRNA COVID-19 vaccination and venous thromboembolism. Blood Rev 2022; 56:100970. [PMID: 35577626 PMCID: PMC9091073 DOI: 10.1016/j.blre.2022.100970] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 12/12/2022]
Abstract
By January 2022 over ten billion doses of COVID-19 vaccines had been administered worldwide. Concerns about COVID-19 vaccine-associated thrombosis arose after the characterization of a rare prothrombotic condition associated with adenoviral vector-based COVID-19 vaccines known as vaccine-induced immune thrombotic thrombocytopenia (VITT). Although mRNA COVID-19 vaccines have not been linked to VITT, concerns about thrombosis after vaccination persist despite safety data from hundreds of millions of recipients of mRNA COVID-19 vaccines. With widespread vaccination some VTE will occur shortly after vaccination by chance alone because VTE is a common condition that affects 1 to 2 in 1000 persons each year. Detailed analysis is required to determine whether these VTE events are coincidental or associated when they occur in close proximity to mRNA vaccine administration. This paper will review what is currently known about rates of VTE after mRNA vaccination in adults, discuss the reasons why uncertainty on this topic persists, and briefly review the implications of these findings for clinical practice and health policy.
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Affiliation(s)
- Matthew Nicholson
- Saskatoon Cancer Center, Saskatchewan Cancer Agency, and College of Medicine, University of Saskatchewan, SK, Canada.
| | - Hadi Goubran
- Saskatoon Cancer Center, Saskatchewan Cancer Agency, and College of Medicine, University of Saskatchewan, SK, Canada
| | - Noel Chan
- Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Deborah Siegal
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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COVID-19 vaccination is associated with reduced non-COVID in-hospital mortality. Prev Med 2022; 164:107326. [PMID: 36332771 PMCID: PMC9625845 DOI: 10.1016/j.ypmed.2022.107326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/25/2022] [Accepted: 10/29/2022] [Indexed: 11/11/2022]
Abstract
We retrieved data on a cohort of medical patients at a regional Israeli hospital. The dependent variable was non-COVID-19 hospital mortality; the independent variables were vaccination status, age, and laboratory data. Serum sodium, age, serum creatinine, and COVID-19 vaccination status were the main independent variables associated with non-COVID-19 mortality. The odds ratio for in-hospital deaths of non-vaccinated patients was 2.01 (1.65-2.44) (unadjusted) and 1.61 (1.29-2.03) after adjustment for the independent variables. This "healthy adherer effect" may confound observational assessments of the clinical efficacy of COVID-19 vaccines.
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93
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Pakki TR, Mariana N, Tampubolon ML, Rusli A, Romadhona S, Intan AD, Chohan Z, Widiantari AD, Herlina H, Puspitasari A, Mahardika M, Suliati S, Maemun S, Murtiani F, Syahril M. Side Effects after mRNA COVID-19 Vaccine as a Booster in Health Workers. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2504-2509. [PMID: 36561250 PMCID: PMC9745411 DOI: 10.18502/ijph.v51i11.11167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022]
Abstract
Background In Indonesia, around 400 health workers died due to Covid-19 between June-July 2021, therefore the health workers need to be given further immunity. Health workers were among the first to get a booster shoot. However, they may experience side effects after vaccination. We aimed to describe side effects of Moderna vaccine as a booster in health workers. Methods A cross sectional study was conducted on health workers who received mRNA Covid-19 vaccine booster (Moderna) at Sulianti Saroso Infectious Disease Hospital, Indonesia and had filled the questionnaire assessing side effects form. We associated the form of the questionnaire assessing side effects from the originating source of hospital immunization unit in September 2021. Results A total of 101 health workers who received mRNA Covid-19 vaccine booster in Jul-Aug 2021 were included. Most of health worker experienced more than 3 side effects. The side effects were sore arm (100%); chills (72%); fatigue (57%); headache (53%) and fever (51%), other symptoms (28%). The side effects mostly happened a day of receiving a booster shot (61.4%). There was no association between age, gender, comorbid to amount of side effects (P>0.05). Conclusion Since the public must fulfil the immunization program during pandemic, it is the responsibility of the healthcare provider to inform about the potential side effects and benefits of a new Covid-19 vaccine.
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Affiliation(s)
- Temmasonge Radi Pakki
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Nina Mariana
- Department of Research, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia,Corresponding Author:
| | | | - Adria Rusli
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Suci Romadhona
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Andi Dala Intan
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Zakir Chohan
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | | | - Herlina Herlina
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Anita Puspitasari
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Mahardika Mahardika
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Suliati Suliati
- Department of Research, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Siti Maemun
- Department of Research, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Farida Murtiani
- Department of Research, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
| | - Mohammad Syahril
- Directorate of Medical, Nursing and Support Services, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia
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Horváth JK, Ferenci T, Ferenczi A, Túri G, Röst G, Oroszi B. Real-Time Monitoring of the Effectiveness of Six COVID-19 Vaccines against Laboratory-Confirmed COVID-19 in Hungary in 2021 Using the Screening Method. Vaccines (Basel) 2022; 10:1824. [PMID: 36366334 PMCID: PMC9697606 DOI: 10.3390/vaccines10111824] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 08/15/2023] Open
Abstract
Several studies have reported the waning effectiveness of COVID-19 vaccines. This study aims to demonstrate the applicability of the screening method for estimating vaccine effectiveness (VE) in a pandemic. We report VE in Hungary, estimated with the screening method, in 2021, covering a period of Alpha and the Delta variant, including the booster dose roll-out. Hungary is in a unique position to use six different vaccines in the same population. All vaccines provided a high level of protection initially, which declined over time. While the picture is different in each age group, the waning of immunity is apparent for all vaccines, especially in the younger age groups and the Sinopharm, Sputnik-V, and AstraZeneca vaccines, which performed similarly. This is clearly reversed by booster doses, more prominent for those three vaccines, where the decline in protection is more evident. Overall, two vaccines, Pfizer/BioNTech and Moderna, tend to produce the best results in all age groups, even with waning immunity considered. Using the screening method in future pandemic waves is worthwhile, especially in countries struggling with a lack of resources or when there is a need to deliver VE results within a short timeframe due to urgent decision-making.
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Affiliation(s)
- Judit K. Horváth
- Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary
- Mathematical Modelling and Epidemiology Task Force, 1085 Budapest, Hungary
- National Laboratory for Health Security, 6720 Szeged, Hungary
| | - Tamás Ferenci
- Mathematical Modelling and Epidemiology Task Force, 1085 Budapest, Hungary
- National Laboratory for Health Security, 6720 Szeged, Hungary
- Physiological Controls Research Center, Óbuda University, 1034 Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, 1093 Budapest, Hungary
| | - Annamária Ferenczi
- Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary
- Mathematical Modelling and Epidemiology Task Force, 1085 Budapest, Hungary
- National Laboratory for Health Security, 6720 Szeged, Hungary
| | - Gergő Túri
- Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary
- Mathematical Modelling and Epidemiology Task Force, 1085 Budapest, Hungary
- National Laboratory for Health Security, 6720 Szeged, Hungary
| | - Gergely Röst
- Mathematical Modelling and Epidemiology Task Force, 1085 Budapest, Hungary
- National Laboratory for Health Security, 6720 Szeged, Hungary
- Bolyai Institute, University of Szeged, 6720 Szeged, Hungary
| | - Beatrix Oroszi
- Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary
- Mathematical Modelling and Epidemiology Task Force, 1085 Budapest, Hungary
- National Laboratory for Health Security, 6720 Szeged, Hungary
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95
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Ahi M, Hamidi Farahani R, Basiri P, Karimi Rahjerdi A, Sheidaei A, Gohari K, Rahimi Z, Gholami F, Moradi M, Ghafoori Naeeni F, Saffar KN, Ghasemi S, Barati B, Moradi S, Monazah A, Pouranvari F, Forooghizadeh M. Comparison of the Safety and Immunogenicity of FAKHRAVAC and BBIBP-CorV Vaccines when Administrated as Booster Dose: A Parallel Two Arms, Randomized, Double Blind Clinical Trial. Vaccines (Basel) 2022; 10:1800. [PMID: 36366308 PMCID: PMC9695457 DOI: 10.3390/vaccines10111800] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/13/2022] [Accepted: 10/21/2022] [Indexed: 09/29/2023] Open
Abstract
Purpose: This study was completed to assess the immunogenicity and safety of the FAKHRAVAC and BBIBP-CorV vaccines as a booster dose in the population with a history of receiving two doses of BBIBP-CorV vaccine. Methods: In this double-blind, parallel clinical trial, we randomly assigned healthy adults with a history of receiving two doses of the BBIBP-CorV vaccine, who then received either the FAKHRAVAC or BBIBP-CorV vaccine as a booster dose. The trial is registered in the Iranian Registry of Clinical Trial document depository (Code: IRCT20210206050259N4). Results: The outcomes that were monitored in this study were serum neutralizing antibody (Nab) activity, immunoglobulin G (IgG) level, local and systemic adverse reactions, serious adverse events, suspected unexpected serious adverse reactions, and medically attended adverse events. After administering vaccines to 435 participants, the most frequent local and systemic adverse reactions were tenderness and nausea in 23.7% and 1.4% of cases, respectively. All adverse events were mild, occurred at a similar incidence in the two groups, and were resolved within a few days. Conclusions: On the 14th day after the booster dose injection, the seroconversion rate (i.e., four-fold increase) of Nabs for seronegative participants were 87% and 84.6% in the FAKHRAVAC® and BBIBP-CorV groups, respectively. This study shows that the FAKHRAVAC® vaccine, as a booster dose, has a similar function to the BBIBP-CorV vaccine in terms of increasing the titer of virus-neutralizing antibodies, the amount of specific antibodies, and safety.
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Affiliation(s)
- Mohammadreza Ahi
- Clinical Trial Center of Iran University of Medical Sciences (IUMS), Tehran P.O. Box 14535, Iran
| | | | - Pouria Basiri
- Stem Cell Technology Research Center (STRC), Tehran P.O. Box 1997775555, Iran
| | - Ahmad Karimi Rahjerdi
- Stem Cell Technology Research Center (STRC), Tehran P.O. Box 1997775555, Iran
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Ali Sheidaei
- Clinical Trial Center of Iran University of Medical Sciences (IUMS), Tehran P.O. Box 14535, Iran
| | - Kimiya Gohari
- Clinical Trial Center of Iran University of Medical Sciences (IUMS), Tehran P.O. Box 14535, Iran
| | - Zahra Rahimi
- Clinical Trial Center of Iran University of Medical Sciences (IUMS), Tehran P.O. Box 14535, Iran
| | - Fatemeh Gholami
- Clinical Trial Center of Iran University of Medical Sciences (IUMS), Tehran P.O. Box 14535, Iran
| | - Milad Moradi
- Stem Cell Technology Research Center (STRC), Tehran P.O. Box 1997775555, Iran
| | | | - Kosar Naderi Saffar
- Stem Cell Technology Research Center (STRC), Tehran P.O. Box 1997775555, Iran
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Soheil Ghasemi
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Babak Barati
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Sohrab Moradi
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Arina Monazah
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Fatemeh Pouranvari
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
| | - Mohsen Forooghizadeh
- Milad Daro Noor Pharmaceutical (MDNP) Company, Tehran P.O. Box 1986936914, Iran
- Department of Passive Defence, Malek Ashtar University of Technology, P.O. Box Tehran 1678815611, Iran
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96
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Risk of SARS-CoV-2 infection following initial COVID-19 vaccination: Population-based cohort study. PLoS One 2022; 17:e0273903. [PMID: 36264950 PMCID: PMC9584446 DOI: 10.1371/journal.pone.0273903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/18/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Anecdotally there are reports of newly diagnosed SARS-CoV-2 infection shortly after vaccination. This has led some to speculate that vaccination itself might inadvertently increase the short-term risk of COVID potentially due to airborne spread at mass vaccination clinics or relaxation of precautions following vaccination. We explored whether receipt of vaccination was associated with a short-term increase in the risk of being diagnosed with COVID-19 and if differences exist between vaccination settings. METHODS We conducted a cohort study in Ontario, Canada to compare the risk of SARS-CoV-2 infection within 21 days of receiving a first vaccination, according to the setting in which vaccines were administered between March 1, 2021 and May 6, 2021. We used linked population-wide vaccination, laboratory testing, and health administrative databases. We created a 1:1 matched comparison group of unexposed individuals. We reported the overall risk of infection calculated at 3, 7, 10, 14, 18, and 21 days. This was completed overall and by setting of vaccine receipt. RESULTS We identified 4,798,430 Ontario residents who received their first dose of a COVID-19 vaccine. In the primary analysis, the rate of SARS-CoV-2 infection was significantly lower among vaccine recipients vs non-recipients at all the post-vaccination time points. Analysis stratified by vaccination setting found that mass vaccination clinics, pharmacies, and physician offices were consistent with the main findings. Individuals who received their first vaccine dose in congregate residential settings had a higher rate of SARS-CoV-2 infection at 7 days (HR 1.35, 95% CI 1.00-1.83) and 10 days (HR 1.49, 95% CI 1.03-2.15). CONCLUSION In this population-based cohort study, we found that there was no increased risk of SARS-CoV2 infection after vaccination suggesting no broad transmission of disease at time of vaccination. Some evidence of increased risk among those vaccinated in congregate settings, highlighting the need to consider opportunities for supporting safe vaccine administration in these settings. Given ongoing and future immunization programs, the results support the need for continued vigilance during any mass vaccination processes and education regarding the delayed nature of protection following vaccination.
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97
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Hussein K, Dabaja-Younis H, Szwarcwort-Cohen M, Almog R, Leiba R, Weissman A, Mekel M, Hyams G, Horowitz NA, Gepstein V, Cohen Saban H, Tarabeia J, Halberthal M, Shachor-Meyouhas Y. Third BNT162b2 Vaccine Booster Dose against SARS-CoV-2-Induced Antibody Response among Healthcare Workers. Vaccines (Basel) 2022; 10:vaccines10101741. [PMID: 36298606 PMCID: PMC9607254 DOI: 10.3390/vaccines10101741] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study assessed humoral response to the third BNT162b2 dose among healthcare workers (HCW). This prospective cohort study of HCW tested for anti-spike antibodies (LIAISON SARS-CoV-2 S1/S2 IgG assay) at 1, 3, 6, 9, and 12 months after receiving the second BNT162b2 vaccine dose (tests 1, 2, 3, 4, and 5, respectively). A third (booster) vaccination dose was introduced before test 4. Linear regression model was used to determine the humoral response following vaccine doses. For each serology test, changes in log-transformed antibody concentrations over time, adjusted for age, sex, underlying diseases, steroid treatment, and smoking were described using the general linear mix model. Serology tests were performed at 3, 6, 9, and 12 months after the second vaccine dose in 1113, 1058, 986, and 939 participants, respectively. The third dose was received by 964 participants before the 9-month tests, 797 of whom participated in the 9- and 12-month serology tests. A significant inverse correlation was noted between time from third dose and antibody concentrations (Spearman correlation −0.395; p < 0.001). Age (p < 0.0001; CI 95% −0.005−−0.004), heart disease (p < 0.0001; CI 95% −0.177−−0.052), immunodeficiency (p < 0.0001; CI 95% 0.251−−0.106), and smoking (p < 0.0001; CI 95% −0.122−−0.040) were significantly associated with decreased antibody concentrations. Female sex (p = 0.03; CI 95% 0.013−0.066) was associated with increased antibody concentrations. The third booster dose had a better effect on immunogenicity, with higher antibody concentrations among tested HCW. Heart disease, smoking, and other known risk factors were associated with decreased antibody concentrations.
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Affiliation(s)
- Khetam Hussein
- Infection Control Unit, Rambam Health Care Campus, Haifa 3109601, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3109601, Israel
- Rambam Health Care Campus, Haifa 3109601, Israel
- Correspondence: ; Tel.: +972-50-206-1980
| | - Halima Dabaja-Younis
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3109601, Israel
- Pediatric Infectious Disease Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa 3109601, Israel
| | | | - Ronit Almog
- Epidemiology Unit, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Ronit Leiba
- Epidemiology Unit, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Avi Weissman
- Rambam Health Care Campus, Haifa 3109601, Israel
| | - Michal Mekel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3109601, Israel
- Rambam Health Care Campus, Haifa 3109601, Israel
| | - Gila Hyams
- Nursing Management, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Nethanel A. Horowitz
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3109601, Israel
- Rambam Health Care Campus, Haifa 3109601, Israel
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Vardit Gepstein
- Rambam Health Care Campus, Haifa 3109601, Israel
- Department of Pediatrics B, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Hagar Cohen Saban
- Nursing Management, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Jalal Tarabeia
- Infection Control Unit, Rambam Health Care Campus, Haifa 3109601, Israel
- Nursing Faculty, The Max Stern Yezreel Valley College, Afula 30080, Israel
| | - Michael Halberthal
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3109601, Israel
- Rambam Health Care Campus, Haifa 3109601, Israel
| | - Yael Shachor-Meyouhas
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3109601, Israel
- Rambam Health Care Campus, Haifa 3109601, Israel
- Pediatric Infectious Disease Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa 3109601, Israel
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98
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COVID-19 Vaccine Booster Hesitancy (VBH) among Healthcare Professionals of Pakistan, a Nationwide Survey. Vaccines (Basel) 2022; 10:vaccines10101736. [PMID: 36298600 PMCID: PMC9610760 DOI: 10.3390/vaccines10101736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/05/2022] [Accepted: 10/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The waning vaccine immunity and emergence of new variants of SARS-CoV-2 led health authorities across the globe to administer booster doses (BDs) of the COVID-19 vaccine. Hence, the current study aimed to assess the COVID-19 vaccine booster hesitancy (VBH) amongst Pakistani healthcare professionals (HCPs). Methods: A nationwide survey-based study was carried out from April 2022 to May 2022. The online self-administered questionnaire was utilized to collect data regarding demographics (age, gender, marital status, profession, residential area, and province), COVID-19 infection history (infection history, onset, and clinical severity of disease), previous COVID-19 vaccination (type of vaccination and the number of doses), attitudes towards BDs (acceptance, rejection, and hesitancy), and psychological drivers of VBH (perceived effectiveness, vaccine safety, risk/benefit ratio, and vaccine type preference). We assessed the association between the dependent variable attitudes of study participants, regarding BDs and independent variables (demographics, COVID-19 infection history, previous COVID-19 vaccination, and psychological drivers of VBH), by using the Chi-square test/Fisher exact test. Results: Among the 1164 study participants, 51.4% were male, and 80.4% were medical professionals. The half of study participants (52.1%) agreed to take the COVID-19 vaccine BD or had already taken it, while the rest of them refused (34.7%) or hesitated (24.2%) to take it. These attitudes of the participants were significantly associated (p < 0.001) with psychological divers about the COVID-19 vaccine BD. Conclusion: This study revealed that Pakistani HCPs hesitant to take the COVID-19 vaccine BD had concerns about the safety, efficacy, and risk/benefits ratio of the vaccine’s BD. To eliminate the hesitancy, regarding BD in HCPs, certain educational strategies should be implemented by health authorities to address the concerns of HCPs.
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99
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Agrawal U, Bedston S, McCowan C, Oke J, Patterson L, Robertson C, Akbari A, Azcoaga-Lorenzo A, Bradley DT, Fagbamigbe AF, Grange Z, Hall ECR, Joy M, Katikireddi SV, Kerr S, Ritchie L, Murphy S, Owen RK, Rudan I, Shah SA, Simpson CR, Torabi F, Tsang RSM, de Lusignan S, Lyons RA, O'Reilly D, Sheikh A. Severe COVID-19 outcomes after full vaccination of primary schedule and initial boosters: pooled analysis of national prospective cohort studies of 30 million individuals in England, Northern Ireland, Scotland, and Wales. Lancet 2022; 400:1305-1320. [PMID: 36244382 PMCID: PMC9560746 DOI: 10.1016/s0140-6736(22)01656-7] [Citation(s) in RCA: 126] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Current UK vaccination policy is to offer future COVID-19 booster doses to individuals at high risk of serious illness from COVID-19, but it is still uncertain which groups of the population could benefit most. In response to an urgent request from the UK Joint Committee on Vaccination and Immunisation, we aimed to identify risk factors for severe COVID-19 outcomes (ie, COVID-19-related hospitalisation or death) in individuals who had completed their primary COVID-19 vaccination schedule and had received the first booster vaccine. METHODS We constructed prospective cohorts across all four UK nations through linkages of primary care, RT-PCR testing, vaccination, hospitalisation, and mortality data on 30 million people. We included individuals who received primary vaccine doses of BNT162b2 (tozinameran; Pfizer-BioNTech) or ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccines in our initial analyses. We then restricted analyses to those given a BNT162b2 or mRNA-1273 (elasomeran; Moderna) booster and had a severe COVID-19 outcome between Dec 20, 2021, and Feb 28, 2022 (when the omicron (B.1.1.529) variant was dominant). We fitted time-dependent Poisson regression models and calculated adjusted rate ratios (aRRs) and 95% CIs for the associations between risk factors and COVID-19-related hospitalisation or death. We adjusted for a range of potential covariates, including age, sex, comorbidities, and previous SARS-CoV-2 infection. Stratified analyses were conducted by vaccine type. We then did pooled analyses across UK nations using fixed-effect meta-analyses. FINDINGS Between Dec 8, 2020, and Feb 28, 2022, 16 208 600 individuals completed their primary vaccine schedule and 13 836 390 individuals received a booster dose. Between Dec 20, 2021, and Feb 28, 2022, 59 510 (0·4%) of the primary vaccine group and 26 100 (0·2%) of those who received their booster had severe COVID-19 outcomes. The risk of severe COVID-19 outcomes reduced after receiving the booster (rate change: 8·8 events per 1000 person-years to 7·6 events per 1000 person-years). Older adults (≥80 years vs 18-49 years; aRR 3·60 [95% CI 3·45-3·75]), those with comorbidities (≥5 comorbidities vs none; 9·51 [9·07-9·97]), being male (male vs female; 1·23 [1·20-1·26]), and those with certain underlying health conditions-in particular, individuals receiving immunosuppressants (yes vs no; 5·80 [5·53-6·09])-and those with chronic kidney disease (stage 5 vs no; 3·71 [2·90-4·74]) remained at high risk despite the initial booster. Individuals with a history of COVID-19 infection were at reduced risk (infected ≥9 months before booster dose vs no previous infection; aRR 0·41 [95% CI 0·29-0·58]). INTERPRETATION Older people, those with multimorbidity, and those with specific underlying health conditions remain at increased risk of COVID-19 hospitalisation and death after the initial vaccine booster and should, therefore, be prioritised for additional boosters, including novel optimised versions, and the increasing array of COVID-19 therapeutics. FUNDING National Core Studies-Immunity, UK Research and Innovation (Medical Research Council), Health Data Research UK, the Scottish Government, and the University of Edinburgh.
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Affiliation(s)
- Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Stuart Bedston
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lynsey Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK; Public Health Scotland, Glasgow, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | | | - Declan T Bradley
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Public Health Agency, Belfast, UK
| | | | | | | | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Steven Kerr
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Lewis Ritchie
- Academic Primary Care, University of Aberdeen School of Medicine and Dentistry, Aberdeen, UK
| | - Siobhán Murphy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Igor Rudan
- Centre of Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK; Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Colin R Simpson
- Usher Institute, University of Edinburgh, Edinburgh, UK; Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Fatemeh Torabi
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Ruby S M Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK.
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100
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Chi WY, Li YD, Huang HC, Chan TEH, Chow SY, Su JH, Ferrall L, Hung CF, Wu TC. COVID-19 vaccine update: vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection. J Biomed Sci 2022; 29:82. [PMID: 36243868 PMCID: PMC9569411 DOI: 10.1186/s12929-022-00853-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/01/2022] [Indexed: 12/23/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) has been the most severe public health challenge in this century. Two years after its emergence, the rapid development and deployment of effective COVID-19 vaccines have successfully controlled this pandemic and greatly reduced the risk of severe illness and death associated with COVID-19. However, due to its ability to rapidly evolve, the SARS-CoV-2 virus may never be eradicated, and there are many important new topics to work on if we need to live with this virus for a long time. To this end, we hope to provide essential knowledge for researchers who work on the improvement of future COVID-19 vaccines. In this review, we provided an up-to-date summary for current COVID-19 vaccines, discussed the biological basis and clinical impact of SARS-CoV-2 variants and subvariants, and analyzed the effectiveness of various vaccine booster regimens against different SARS-CoV-2 strains. Additionally, we reviewed potential mechanisms of vaccine-induced severe adverse events, summarized current studies regarding immune correlates of protection, and finally, discussed the development of next-generation vaccines.
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Affiliation(s)
- Wei-Yu Chi
- Physiology, Biophysics and Systems Biology Graduate Program, Weill Cornell Medicine, New York, NY, USA
| | - Yen-Der Li
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Hsin-Che Huang
- Tri-Institutional PhD Program in Chemical Biology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Timothy En Haw Chan
- International Max Planck Research School for Immunobiology, Epigenetics and Metabolism (IMPRS-IEM), Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
- Department of Urology, Medical Center, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Sih-Yao Chow
- Downstream Process Science, EirGenix Inc., Zhubei, Hsinchu, Taiwan R.O.C
| | - Jun-Han Su
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Louise Ferrall
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA
| | - T-C Wu
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA.
- Department of Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
- The Johns Hopkins Medical Institutions, CRB II Room 309, 1550 Orleans St, MD, 21231, Baltimore, USA.
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