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Fabiani M, Puopolo M, Filia A, Sacco C, Mateo-Urdiales A, Spila Alegiani S, Del Manso M, D’Ancona F, Vescio F, Bressi M, Petrone D, Spuri M, Rota MC, Massari M, Da Cas R, Morciano C, Stefanelli P, Bella A, Tallon M, Proietti V, Siddu A, Battilomo S, Palamara AT, Popoli P, Brusaferro S, Rezza G, Riccardo F, Menniti Ippolito F, Pezzotti P. Effectiveness of an mRNA vaccine booster dose against SARS-CoV-2 infection and severe COVID-19 in persons aged ≥60 years and other high-risk groups during predominant circulation of the delta variant in Italy, 19 July to 12 December 2021. Expert Rev Vaccines 2022; 21:975-982. [PMID: 35389748 PMCID: PMC9115794 DOI: 10.1080/14760584.2022.2064280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/06/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Consolidated information on the effectiveness of COVID-19 booster vaccination in Europe are scarce. RESEARCH DESIGN AND METHODS We assessed the effectiveness of a booster dose of an mRNA vaccine against any SARS-CoV-2 infection (symptomatic or asymptomatic) and severe COVID-19 (hospitalization or death) after over two months from administration among priority target groups (n = 18,524,568) during predominant circulation of the Delta variant in Italy (July-December 2021). RESULTS Vaccine effectiveness (VE) against SARS-CoV-2 infection and, to a lesser extent, against severe COVID-19, among people ≥60 years and other high-risk groups (i.e. healthcare workers, residents in long-term-care facilities, and persons with comorbidities or immunocompromised), peaked in the time-interval 3-13 weeks (VE against infection = 67.2%, 95% confidence interval (CI): 62.5-71.3; VE against severe disease = 89.5%, 95% CI: 86.1-92.0) and then declined, waning 26 weeks after full primary vaccination (VE against infection = 12.2%, 95% CI: -4.7-26.4; VE against severe disease = 65.3%, 95% CI: 50.3-75.8). After 3-10 weeks from the administration of a booster dose, VE against infection and severe disease increased to 76.1% (95% CI: 70.4-80.7) and 93.0% (95% CI: 90.2-95.0), respectively. CONCLUSIONS These results support the ongoing vaccination campaign in Italy, where the administration of a booster dose four months after completion of primary vaccination is recommended.
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Affiliation(s)
- Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Puopolo
- Department of Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fortunato D’Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fenicia Vescio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Bressi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Matteo Spuri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Massari
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Da Cas
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina Morciano
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Tallon
- Department of Informatics, Istituto Superiore di Sanità, Rome, Italy
| | - Valeria Proietti
- Directorate of Digitalisation, Health Information System and Statistics, Italian Ministry of Health, Rome, Italy
| | - Andrea Siddu
- General Directorate of Health Prevention, Italian Ministry of Health, Rome, Italy
| | - Serena Battilomo
- Directorate of Digitalisation, Health Information System and Statistics, Italian Ministry of Health, Rome, Italy
| | | | - Patrizia Popoli
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giovanni Rezza
- General Directorate of Health Prevention, Italian Ministry of Health, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Glatman-Freedman A, Feldman SF, Hershkovitz Y, Kaufman Z, Dichtiar R, Keinan-Boker L, Bromberg M. Vaccine Coverage Associated With Ending a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Wave: A Retrospective Longitudinal Analysis. Clin Infect Dis 2022; 76:e207-e215. [PMID: 35762838 PMCID: PMC9278214 DOI: 10.1093/cid/ciac524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Two SARS-CoV-2 waves in Israel ended while a substantial number of individuals remained unvaccinated or partially vaccinated. The indirect protective effect of the first BNT162b2 vaccination campaign in Israel was evaluated between 22 December 2020 and 18 May 2021. METHODS The daily percentage of new polymerase chain reaction (PCR)-confirmed SARS-CoV-2 cases among unvaccinated individuals was analyzed for trends. Major shifts were identified using piecewise linear regression analysis. At these shifts, the percentage of naturally vaccinated (past SARS-CoV-2 cases) and the percentage of actively vaccinated (by inoculation) individuals were weighted and summed to determine the percentage of natural and active vaccination (NAV). RESULTS A first decline among unvaccinated individuals occurred during a lockdown period, when the percentage of NAV was 8.16%. The major decline occurred after the end of the lockdown when the percentage of NAV reached 52.05%. SARS-CoV-2 cases ultimately declined among unvaccinated individuals when the percentage of NAV reached 63.55%. During the study period, the Alpha variant was prevalent and the use of nonpharmaceutical interventions, including social distancing, existed to varying degrees. CONCLUSIONS The vaccination campaign played a major role in the decline of SARS-CoV-2 infection among unvaccinated individuals, leading to the end of the first 2021 SARS-CoV-2 wave (Alpha variant) in Israel. Infection in unvaccinated individuals stopped when two-thirds of the population were naturally or actively vaccinated. Any change in characteristics of the virus or the population can lead to a new outbreak.
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Affiliation(s)
- Aharona Glatman-Freedman
- Corresponding author: Aharona Glatman-Freedman, The Israel Center for Disease Control, Tel Hashomer, Ramat Gan, Israel. E mail: aharona.freedman@ moh.gov.il
| | - Sarah F Feldman
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Tel Aviv, Israel
| | - Yael Hershkovitz
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Zalman Kaufman
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel,School of Public Health, Haifa University, Haifa, Israel
| | - Michal Bromberg
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel,Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Wada TT, Yokota K, Sakai S, Soma M, Kajiyama H, Tarumoto N, Maesaki S, Maeda T, Nagata M, Mimura T. Evaluation of anti-severe acute respiratory syndrome coronavirus 2 antibody levels in coronavirus disease breakthrough infection during immunosuppressive therapy in a patient with connective tissue disease-related interstitial lung disease. Mod Rheumatol Case Rep 2022; 7:288-292. [PMID: 35730997 PMCID: PMC9278182 DOI: 10.1093/mrcr/rxac052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/16/2022] [Accepted: 06/15/2022] [Indexed: 01/07/2023]
Abstract
Herein, we report the case of a 67-year-old man with severe coronavirus disease (COVID-19) pneumonia and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine breakthrough infection during immunosuppressive therapy for connective tissue disease-related interstitial lung disease (CTD-ILD). The patient received glucocorticoids combined with tacrolimus as maintenance therapy. His serum anti-SARS-CoV-2-immunoglobulin G (IgG) antibody levels were extremely low at the onset of COVID-19 pneumonia, even after the second dose of SARS-CoV-2 mRNA vaccine (BNT162b2). After treatment for COVID-19 pneumonia, the levels of anti-SARS-CoV-2-IgG antibodies increased. These results indicated a lack of the ability to produce neutralising antibodies from immune cells despite the booster vaccination. Therefore, we suggest that advanced-age patients with CTD-ILD receiving immunosuppressive therapy with polypharmacy require consistent personal protection, vaccination of close caregivers, increased awareness, and booster vaccination. Moreover, we recommend that tacrolimus should be withdrawn for a while after vaccination under controlled conditions.
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Affiliation(s)
- Takuma Tsuzuki Wada
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Kazuhiro Yokota
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Sakon Sakai
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Machika Soma
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Hiroshi Kajiyama
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Norihito Tarumoto
- Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, Japan
| | - Shigefumi Maesaki
- Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, Japan
| | - Takuya Maeda
- Department of Laboratory Medicine, Saitama Medical University, Saitama, Japan
| | - Makoto Nagata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Toshihide Mimura
- *Correspondence: Toshihide Mimura; ; Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama 350-0495, Japan
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Ogrič M, Žigon P, Podovšovnik E, Lakota K, Sodin-Semrl S, Rotar Ž, Čučnik S. Differences in SARS-CoV-2-Specific Antibody Responses After the First, Second, and Third Doses of BNT162b2 in Naïve and Previously Infected Individuals: A 1-Year Observational Study in Healthcare Professionals. Front Immunol 2022; 13:876533. [PMID: 35711413 PMCID: PMC9196038 DOI: 10.3389/fimmu.2022.876533] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Safe and effective vaccines against COVID-19 are critical for preventing the spread of SARS-CoV-2, but little is known about the humoral immune response more than 9 months after vaccination. We aimed to assess the humoral immune response after the first, second, and third (booster) doses of BNT162b2 vaccine in SARS-CoV-2 naïve and previously infected healthcare professionals (HCP) and the humoral immune response after infection in vaccinated HCP. Methods We measured anti-spike (anti-S) and anti-nucleocapsid antibodies at different time points up to 12 months in the sera of 300 HCP who had received two or three doses of BNT162b2 vaccine. Mixed-model analyses were used to assess anti-S antibody dynamics and to determine their predictors (age, sex, BMI, and previous infection). Results Naïve individuals had statistically lower anti-S antibody concentrations after the first dose (median 253 BAU/ml) than previously infected individuals (median 3648 BAU/ml). After the second dose, anti-S antibody concentrations increased in naïve individuals (median 3216 BAU/ml), whereas the second dose did not significantly increase concentrations in previously infected individuals (median 4503 BAU/ml). The third dose resulted in an additional increase in concentrations (median 4844 BAU/ml in naïve and median 5845 BAU/ml in previously infected individuals). Anti-S antibody concentrations steadily decreased after the second dose and after the third dose in naïve and previously infected individuals. In addition, we found that age had an effect on the humoral immune response. Younger individuals had higher anti-S antibody concentrations after the first and second doses. After infection with the new variant Omicron, a further increase in anti-S antibody concentrations to a median value of 4794 BAU/ml was observed in three times vaccinated HCP whose anti-S antibody concentrations were relatively high before infection (median 2141 BAU/ml). Our study also showed that individuals with systemic adverse events achieved higher anti-S antibody concentrations. Conclusion In this study, significant differences in humoral immune responses to BNT162b2 vaccine were observed between naïve and previously infected individuals, with age playing an important role, suggesting that a modified vaccination schedule should be practiced in previously infected individuals. In addition, we showed that the high anti-S antibodies were not protective against new variants of SARS-CoV-2.
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Affiliation(s)
- Manca Ogrič
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Polona Žigon
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,University of Primorska, Faculty of Mathematics, Natural Sciences and Information Technologies, Koper, Slovenia
| | | | - Katja Lakota
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,University of Primorska, Faculty of Mathematics, Natural Sciences and Information Technologies, Koper, Slovenia
| | - Snezna Sodin-Semrl
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,University of Primorska, Faculty of Mathematics, Natural Sciences and Information Technologies, Koper, Slovenia
| | - Žiga Rotar
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Saša Čučnik
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
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Patalon T, Saciuk Y, Peretz A, Perez G, Lurie Y, Maor Y, Gazit S. Waning effectiveness of the third dose of the BNT162b2 mRNA COVID-19 vaccine. Nat Commun 2022; 13:3203. [PMID: 35680872 PMCID: PMC9184525 DOI: 10.1038/s41467-022-30884-6] [Citation(s) in RCA: 86] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/24/2022] [Indexed: 12/19/2022] Open
Abstract
The duration of protection of the third (booster) dose of the BioNTech/Pfizer BNT162b2 mRNA Coronavirus Disease 2019 vaccine has been the subject of recent investigations, as global discussions around the necessity and effectiveness of a fourth dose are already underway. By conducting a retrospective study implementing a test-negative case-control design, analyzing 546,924 PCR tests performed throughout January 2022 by 389,265 persons who received at least two doses, we find that the effectiveness in each month-since-vaccination decreases significantly. Compared to those vaccinated five months prior to the outcome period, on August 2021, relative protection against infection waned from 53.4% a month after vaccination to 16.5% three months after vaccination. These results suggest that there is a significant waning of vaccine effectiveness against the Omicron variant of the third dose of the BNT162b2 vaccine within a few months after administration. Additional information could assist to comprehensively estimate the effectiveness of the three-dose-strategy. In this retrospective study, authors show that relative protection against SARS-CoV-2 infection wanes from 53.4% one month after vaccination to 16.5% three months after vaccination, suggesting that there is a significant waning of mRNA vaccine effectiveness against infection with the Omicron variant.
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Affiliation(s)
- Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel. .,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
| | - Yaki Saciuk
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel
| | - Asaf Peretz
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.,Internal Medicine COVID-19 Ward, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Yoav Lurie
- Liver unit, Shaare Zedek City Center Campus, Jerusalem, Israel
| | - Yasmin Maor
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Disease Unit, Edith Wolfson Medical Centre, Holon, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, 68125, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
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56
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Seo JD, Nam M, Lee TH, Ahn YS, Shin SH, Han HY, Moon HW. Comparison of Four Systems for SARS-CoV-2 Antibody at Three Time Points after SARS-CoV-2 Vaccination. Diagnostics (Basel) 2022; 12:diagnostics12061349. [PMID: 35741159 PMCID: PMC9222035 DOI: 10.3390/diagnostics12061349] [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: 05/18/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wanes over time after vaccination. Methods: We compared SARS-CoV-2 antibody levels in serial samples from 350 vaccinated individuals at 3 time points (3 weeks after the first or second dose and before the third dose) with 4 assays: GenScript cPASS SARS-CoV-2 neutralization antibody detection kits (cPASS), Siemens SARS-CoV-2 IgG (sCOVG), Abbott SARS-CoV-2 IgG II Quant (CoV-2 IgG II), and an Immuno-On™ COVID-19 IgG test (Immuno-On IgG). Antibody levels by time, concordance between assays, and values from other tests corresponding to the percent inhibition results in cPASS were assessed. Results: The median values at three time points were 49.31%, 90.87%, and 53.38% inhibition for cPASS, 5.39, 13.65, and 2.24 U/mL for sCOVG, 570.25, 1279.65, and 315.80 AU/mL for CoV-2 IgG II, and 223.22, 362.20, and 62.20 relative units (RU) for Immuno-On IgG. The concordance with cPASS at each time point ranged from 0.735 to 0.984, showing the highest concordance in the second sample and lowest concordance in the third in all comparative tests. The values corresponded to 30% inhibition, and the cutoffs of cPASS, were 2.02 U/mL, 258.6 AU/mL, and 74.2 RU for each test. Those for 50%, 70%, and 90% inhibition were 3.16, 5.66, and 8.26 U/mL for sCOVG, while they were 412.5, 596.9, and 1121.6 AU/mL for CoV-2 IgG II and 141.8, 248.92, and 327.14 RU for Immuno-On IgG. Conclusions: This study demonstrated the dynamic changes in antibody values at different time points using four test systems and is expected to provide useful baseline data for comparative studies and standardization efforts in the future.
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Affiliation(s)
- Jong Do Seo
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea; (J.D.S.); (T.H.L.); (Y.-S.A.); (S.-H.S.); (H.Y.H.)
| | - Minjeong Nam
- Department of Laboratory Medicine, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Tae Hwan Lee
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea; (J.D.S.); (T.H.L.); (Y.-S.A.); (S.-H.S.); (H.Y.H.)
| | - Yeon-Sun Ahn
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea; (J.D.S.); (T.H.L.); (Y.-S.A.); (S.-H.S.); (H.Y.H.)
| | - Seon-Hyeon Shin
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea; (J.D.S.); (T.H.L.); (Y.-S.A.); (S.-H.S.); (H.Y.H.)
| | - Hye Young Han
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea; (J.D.S.); (T.H.L.); (Y.-S.A.); (S.-H.S.); (H.Y.H.)
| | - Hee-Won Moon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea; (J.D.S.); (T.H.L.); (Y.-S.A.); (S.-H.S.); (H.Y.H.)
- Correspondence: author: ; Tel.: +82-2-2030-5583
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Panico A, Lobreglio G, Bagordo F, Zizza A, De Donno A, Rosato C, Lazzari R, Chicone M, Indino F, Recchia V, Alifano P, Grassi T. Antibody Response in Healthcare Workers before and after the Third Dose of Anti-SARS-CoV-2 Vaccine: A Pilot Study. Vaccines (Basel) 2022; 10:862. [PMID: 35746470 PMCID: PMC9229040 DOI: 10.3390/vaccines10060862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 12/12/2022] Open
Abstract
The SARS-CoV-2 pandemic led to the development of various vaccines. The BNT162b2 mRNA vaccine was the first approved due to its efficacy in eliciting a humoral immunity response after the second dose. However, a decrease in the antibody concentration was observed over time. Therefore, the administration of a third dose was scheduled, primarily for frail people and workers of essential public activities. The aim of this study was to assess the level of antibodies against the spike (S) RBD of SARS-CoV-2 in healthcare workers before and after the third dose of BNT162b2 vaccine, according to sex, age, and the time interval between vaccine doses and tests. All 37 (12 males, 25 females, 19 < 50 years old, 18 ≥ 50 years old) healthcare workers recruited showed a consistent antibody titer increase after the third dose. Data analysis showed that the antibody concentration before the third dose significantly decreased as the time interval up to the test increased, and a significantly higher level was shown in young than older people. Cluster analysis revealed that young females had a higher antibody level than older females before the third dose (p < 0.05). This study indicated the benefit of the third dose of BNT162b2 vaccine and its effect on leveling up the humoral immune response.
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Affiliation(s)
- Alessandra Panico
- Department of Biological and Environmental Science and Technology, University of Salento, 73100 Lecce, Italy; (A.P.); (A.D.D.); (P.A.); (T.G.)
| | - Giambattista Lobreglio
- Clinical Pathology and Microbiology Unit, Vito Fazzi General Hospital, 73100 Lecce, Italy; (G.L.); (C.R.); (R.L.); (M.C.); (F.I.)
| | - Francesco Bagordo
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Antonella Zizza
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy;
| | - Antonella De Donno
- Department of Biological and Environmental Science and Technology, University of Salento, 73100 Lecce, Italy; (A.P.); (A.D.D.); (P.A.); (T.G.)
| | - Chiara Rosato
- Clinical Pathology and Microbiology Unit, Vito Fazzi General Hospital, 73100 Lecce, Italy; (G.L.); (C.R.); (R.L.); (M.C.); (F.I.)
| | - Roberta Lazzari
- Clinical Pathology and Microbiology Unit, Vito Fazzi General Hospital, 73100 Lecce, Italy; (G.L.); (C.R.); (R.L.); (M.C.); (F.I.)
| | - Michele Chicone
- Clinical Pathology and Microbiology Unit, Vito Fazzi General Hospital, 73100 Lecce, Italy; (G.L.); (C.R.); (R.L.); (M.C.); (F.I.)
| | - Floriano Indino
- Clinical Pathology and Microbiology Unit, Vito Fazzi General Hospital, 73100 Lecce, Italy; (G.L.); (C.R.); (R.L.); (M.C.); (F.I.)
| | - Virginia Recchia
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy;
| | - Pietro Alifano
- Department of Biological and Environmental Science and Technology, University of Salento, 73100 Lecce, Italy; (A.P.); (A.D.D.); (P.A.); (T.G.)
| | - Tiziana Grassi
- Department of Biological and Environmental Science and Technology, University of Salento, 73100 Lecce, Italy; (A.P.); (A.D.D.); (P.A.); (T.G.)
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Wang K, Wang L, Li M, Xie B, He L, Wang M, Zhang R, Hou N, Zhang Y, Jia F. Real-Word Effectiveness of Global COVID-19 Vaccines Against SARS-CoV-2 Variants: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:820544. [PMID: 35665358 PMCID: PMC9160927 DOI: 10.3389/fmed.2022.820544] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/05/2022] [Indexed: 12/14/2022] Open
Abstract
Background Currently, promoted vaccinations against SARS-CoV-2 are being given out globally. However, the occurrence of numerous COVID-19 variants has hindered the goal of rapid mitigation of the COVID-19 pandemic by effective mass vaccinations. The real-word effectiveness of the current vaccines against COVID-19 variants has not been assessed by published reviews. Therefore, our study evaluated the overall effectiveness of current vaccines and the differences between the various vaccines and variants. Methods PubMed, Embase, Cochrane Library, medRxiv, bioRxiv, and arXiv were searched to screen the eligible studies. The Newcastle-Ottawa scale and the Egger test were applied to estimate the quality of the literature and any publication bias, respectively. The pooled incident rates of different variants after vaccination were estimated by single-arm analysis. Meanwhile, the pooled efficacies of various vaccines against variants were evaluated by two-arm analysis using odds ratios (ORs) and vaccine effectiveness (VE). Results A total of 6,118 studies were identified initially and 44 articles were included. We found that the overall incidence of variants post first/second vaccine were 0.07 and 0.03, respectively. The VE of the incidence of variants post first vaccine between the vaccine and the placebo or unvaccinated population was 40% and post second vaccine was 96%, respectively. The sub-single-arm analysis showed a low prevalence rate of COVID-19 variants after specific vaccination with the pooled incidence below 0.10 in most subgroups. Meanwhile, the sub-two-arm analysis indicated that most current vaccines had a good or moderate preventive effect on certain variants considering that the VE in these subgroups was between 66 and 95%, which was broadly in line with the results of the sub-single-arm analysis. Conclusion Our meta-analysis shows that the current vaccines that are used globally could prevent COVID-19 infection and restrict the spread of variants to a great extent. We would also support maximizing vaccine uptake with two doses, as the effectiveness of which was more marked compared with one dose. Although the mRNA vaccine was the most effective against variants according to our study, specific vaccines should be taken into account based on the local dominant prevalence of variants.
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Affiliation(s)
- Kai Wang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Lin Wang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Mingzhe Li
- Independent Researcher, Leeds, United Kingdom
| | - Bing Xie
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Lu He
- Hubei University of Medicine, Shiyan, China
| | - Meiyu Wang
- Department of Cardiology, The People's Hospital of Zhangdian District, Zibo, China
| | - Rumin Zhang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Nianzong Hou
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Yi Zhang
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Fusen Jia
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
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Parthymou A, Habeos EE, Habeos GI, Deligakis A, Livieratos E, Marangos M, Chartoumpekis DV. Factors associated with anti-SARS-CoV-2 antibody titres 3 months post-vaccination with the second dose of BNT162b2 vaccine: a longitudinal observational cohort study in western Greece. BMJ Open 2022; 12:e057084. [PMID: 35589363 PMCID: PMC9121112 DOI: 10.1136/bmjopen-2021-057084] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Vaccination against SARS-CoV-2 has been extensively deployed during COVID-19 pandemic. One efficient method to evaluate response to vaccination is the assessment of humoral immunity by measuring SARS-CoV-2 antibody titres. We investigated the association between anthropometric parameters (age, body mass index), smoking, diabetes, statin use, hypertension, levels of 25(OH)D and dehydroepiandrosterone sulfate (DHEAS), and SARS-CoV-2 antibody titres after vaccination. DESIGN In this longitudinal observational cohort study, 712 subjects were tested for SARS-CoV-2 antibodies 3 months after the second dose of BNT162b2 vaccine. Multiple linear regression analysis was performed to identify which factors are associated with the antibody titres. SETTING Healthcare units of western Greece (University Hospital of Patras and "St Andrews" State General Hospital of Patras). PARTICIPANTS All adults receiving their second dose of BNT162b2 vaccine at the participating healthcare units were eligible to participate in the study. Exclusion criteria were SARS-CoV-2 infection or positive SARS-CoV-2 antibody titre at baseline. Patients who did not provide all necessary information were excluded from our analyses. RESULTS We found age to be negatively associated with antibody titre (-0.005; 95% CI -0.009 to -0.001, p=0.0073), as was male gender (-0.11; 95% CI -0.1738 to -0.04617, p=0.0008). The interaction of age and gender was significant (-0.01090; 95% CI -0.01631 to -0.005490, p<0.0001), highlighting that the rate of decline in antibody titre with increasing age tends to be higher in men rather than in women. No linear trend was found between DHEAS levels and antibody titres when the lower quartile of DHEAS levels was used as reference. Tobacco use was associated with low antibody titre (-0.1097; 95% CI -0.174 to -0.046, p=0.0008) but overweight, obese or underweight subjects had similar antibody responses to normal-weight individuals. Although subjects with diabetes and hypertension had numerically lower antibody titres, this association was not statistically significant. Vitamin D levels showed no clear relationships with antibody titres. CONCLUSIONS Age, male gender and tobacco use are negatively associated with antibody titres after COVID-19 vaccination, but our data showed no clear correlation with vitamin D levels. TRIAL REGISTRATION NUMBER NCT04954651; Results.
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Affiliation(s)
- Anastasia Parthymou
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
| | - Evagelia E Habeos
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
| | - George I Habeos
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
| | | | - Ektoras Livieratos
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
| | - Markos Marangos
- Division of Endocrinology, Department of Internal Medicine, University of Patras, Patras, Greece
- Division of Infectious Diseases, Department of Internal Medicine, University of Patras, Patras, Greece
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Iwamoto M, Ukimura A, Ogawa T, Kawanishi F, Osaka N, Kubota M, Mori T, Sawamura R, Nishihara M, Suzuki T, Uchiyama K. Association between history of HBV vaccine response and anti-SARS-CoV-2 spike antibody response to the BioNTech/Pfizer's BNT162b2 mRNA SARS-CoV-2 vaccine among healthcare workers in Japan: A prospective observational study. PLoS One 2022; 17:e0268529. [PMID: 35576209 PMCID: PMC9109930 DOI: 10.1371/journal.pone.0268529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/02/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Inadequate vaccine response is a common concern among healthcare workers at the frontlines of the COVID-19 pandemic. We aimed to investigate if healthcare workers with history of weak immune response to HBV vaccination are more likely to have weak responses against the BioNTech/Pfizer's BNT162b2 mRNA SARS-CoV-2 vaccine. METHODS We prospectively tested 954 healthcare workers for the Anti-SARS-CoV-2 spike (S) protein antibody titers prior to the first and second BNT162b2 vaccination doses and after four weeks after the second dose using Roche's Elecsys® assay. We calculated the percentage of patients who seroconverted after the first and second doses. We estimated the relative risk of non-seroconversion after the first BNT162b2 vaccine (defined as anti-SARS-CoV-2-S titer <15 U/mL) among HBV vaccine non-responders (HBs-Ab titer <10 mIU/mL) and weak responders (≥10 and <100 mIU/mL) compared to normal responders (≥100 mIU/mL). RESULTS Among 954 healthcare workers recruited between March 9 and March 24, 2021 at Osaka Medical and Pharmaceutical University, weak and normal HBV vaccine responders had comparable S-protein titers after the first BNT162b2 dose (51.4 [95% confidence interval 25.2-137.0] versus 59.7 [29.8-138.0] U/mL, respectively). HBV vaccine non-responders were more likely than normal responders to not seroconvert after a single dose (age and sex-adjusted relative risk 1.85 95% confidence interval [1.10-3.13]) although nearly all participants seroconverted after the second dose. After limiting the analysis to 382 patients with baseline comorbidity data, the comorbidity-adjusted relative risk of non-seroconversion among HBV vaccine non-responders to normal responders was 1.32 (95% confidence interval [0.59-2.98]). DISCUSSION Long term follow-up studies are needed to understand if protective immunity against SARS-CoV-2 wanes faster among those with history of HBV vaccine non-response and when booster doses are warranted for these healthcare workers.
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Affiliation(s)
- Momoko Iwamoto
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Nakagyo Ward, Japan
| | - Akira Ukimura
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Taku Ogawa
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Fumiko Kawanishi
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Naofumi Osaka
- Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Mari Kubota
- Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Tatsuhiko Mori
- Health Administration Center Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Ritsuko Sawamura
- Health Administration Center Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Masami Nishihara
- Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Tomio Suzuki
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Kazuhisa Uchiyama
- Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
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61
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Jolobe OMP. Towards a deeper understanding of the dynamics of COVID-19-associated Guillain-Barre syndrome. QJM 2022; 115:342-343. [PMID: 34240216 PMCID: PMC8344536 DOI: 10.1093/qjmed/hcab186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Oscar M P Jolobe
- Flat 6 Souchay Court, 1 Clothorn Road, Manchester, 6BR M20
- Corresponding. Emial: Telephone: 44 161 900 6887
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Decarreaux D, Pouquet M, Souty C, Vilcu AM, Prévot-Monsacre P, Fourié T, Villarroel PMS, Priet S, Blanché H, Sebaoun JM, Deleuze JF, Turbelin C, Werner A, Kochert F, Grosgogeat B, Rabiega P, Laupie J, Abraham N, Guerrisi C, Noël H, van der Werf S, Carrat F, Hanslik T, Charrel R, de Lamballerie X, Blanchon T, Falchi A. Seroprevalence of SARS-CoV-2 IgG Antibodies and Factors Associated with SARS-CoV-2 IgG Neutralizing Activity among Primary Health Care Workers 6 Months after Vaccination Rollout in France. Viruses 2022; 14:v14050957. [PMID: 35632699 PMCID: PMC9148144 DOI: 10.3390/v14050957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/22/2022] [Accepted: 04/29/2022] [Indexed: 01/10/2023] Open
Abstract
We aimed to investigate the immunoglobulin G response and neutralizing activity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) among primary health care workers (PHCW) in France and assess the association between the neutralizing activity and several factors, including the coronavirus disease 2019 (COVID-19) vaccination scheme. A cross-sectional survey was conducted between 10 May 2021 and 31 August 2021. Participants underwent capillary blood sampling and completed a questionnaire. Sera were tested for the presence of antibodies against the nucleocapsid (N) protein and the S-1 portion of the spike (S) protein and neutralizing antibodies. In total, 1612 PHCW were included. The overall seroprevalences were: 23.6% (95% confidence interval (CI) 21.6–25.7%) for antibodies against the N protein, 94.7% (93.6–95.7%) for antibodies against the S protein, and 81.3% (79.4–83.2%) for neutralizing antibodies. Multivariate regression analyses showed that detection of neutralizing antibodies was significantly more likely in PHCW with previous SARS-CoV-2 infection than in those with no such history among the unvaccinated (odds ratio (OR) 16.57, 95% CI 5.96–59.36) and those vaccinated with one vaccine dose (OR 41.66, 95% CI 16.05–120.78). Among PHCW vaccinated with two vaccine doses, the detection of neutralizing antibodies was not significantly associated with previous SARS-CoV-2 infection (OR 1.31, 95% CI 0.86–2.07), but was more likely in those that received their second vaccine dose within the three months before study entry than in those vaccinated more than three months earlier (OR 5.28, 95% CI 3.51–8.23). This study highlights that previous SARS-CoV-2 infection and the time since vaccination should be considered when planning booster doses and the design of COVID-19 vaccine strategies.
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Affiliation(s)
- Dorine Decarreaux
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005 Marseille, France; (T.F.); (P.M.S.V.); (S.P.); (R.C.); (X.d.L.)
- Correspondence: (D.D.); (M.P.); (A.F.)
| | - Marie Pouquet
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
- Correspondence: (D.D.); (M.P.); (A.F.)
| | - Cecile Souty
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
| | - Ana-Maria Vilcu
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
| | - Pol Prévot-Monsacre
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
| | - Toscane Fourié
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005 Marseille, France; (T.F.); (P.M.S.V.); (S.P.); (R.C.); (X.d.L.)
| | - Paola Mariela Saba Villarroel
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005 Marseille, France; (T.F.); (P.M.S.V.); (S.P.); (R.C.); (X.d.L.)
| | - Stephane Priet
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005 Marseille, France; (T.F.); (P.M.S.V.); (S.P.); (R.C.); (X.d.L.)
| | - Hélène Blanché
- Fondation Jean Dausset-CEPH, 75000 Paris, France; (H.B.); (J.-M.S.); (J.-F.D.)
| | - Jean-Marc Sebaoun
- Fondation Jean Dausset-CEPH, 75000 Paris, France; (H.B.); (J.-M.S.); (J.-F.D.)
| | | | - Clément Turbelin
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
| | - Andréas Werner
- Association Française de Pédiatrie Ambulatoire (AFPA), 69000 Orléans, France; (A.W.); (F.K.)
| | - Fabienne Kochert
- Association Française de Pédiatrie Ambulatoire (AFPA), 69000 Orléans, France; (A.W.); (F.K.)
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69000 Lyon, France;
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69000 Lyon, France
- Réseau ReCOL, Association Dentaire Française, 75000 Paris, France;
- Service d’Odontologie, Hospices Civils de Lyon, 69007 Lyon, France
| | | | - Julien Laupie
- Réseau ReCOL, Association Dentaire Française, 75000 Paris, France;
| | - Nathalie Abraham
- IQVIA, Réseau de Pharmaciens, 75000 Paris, France; (P.R.); (N.A.)
| | - Caroline Guerrisi
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
| | - Harold Noël
- Infectious Diseases Division, Santé Publique France, 94410 Saint Maurice, France;
| | - Sylvie van der Werf
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Molecular Genetics of RNA Viruses Unit, 75015 Paris, France;
- Institut Pasteur, Université Paris Cité, National Reference Center for Respiratory Viruses, 75015 Paris, France
| | - Fabrice Carrat
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
- Département de Santé Publique, Hôpital Saint-Antoine, APHP, 75012 Paris, France
| | - Thomas Hanslik
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
- Faculty of Health Sciences Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, 78000 Versailles, France
- Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique—Hôpitaux de Paris (APHP), 92100 Boulogne Billancourt, France
| | - Remi Charrel
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005 Marseille, France; (T.F.); (P.M.S.V.); (S.P.); (R.C.); (X.d.L.)
| | - Xavier de Lamballerie
- Unité des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005 Marseille, France; (T.F.); (P.M.S.V.); (S.P.); (R.C.); (X.d.L.)
| | - Thierry Blanchon
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Sorbonne Université, 75012 Paris, France; (C.S.); (A.-M.V.); (P.P.-M.); (C.T.); (C.G.); (F.C.); (T.H.); (T.B.)
| | - Alessandra Falchi
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
- Correspondence: (D.D.); (M.P.); (A.F.)
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Nam SY, Jeon SW, Lee HS, Lim HJ, Lee DW, Yoo SS. Demographic and Clinical Factors Associated With Anti-SARS-CoV-2 Antibody Levels After 2 BNT162b2 mRNA Vaccine Doses. JAMA Netw Open 2022; 5:e2212996. [PMID: 35587345 PMCID: PMC9121186 DOI: 10.1001/jamanetworkopen.2022.12996] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/04/2022] [Indexed: 12/27/2022] Open
Abstract
Importance The factors associated with long-term serum levels of anti-SARS-CoV-2 antibodies after COVID-19 vaccination in healthy individuals have rarely been investigated. Objective To investigate factors associated with anti-SARS-CoV-2 antibody levels. Design, Setting, and Participants This prospective cohort study included health care workers at Kyungpook National University Chilgok Hospital (Daegu, Korea) with no history of SARS-CoV-2 infection who received 2 doses of the BNT162b2 mRNA COVID-19 vaccine (Pfizer/BioNTech; first dose, March 17-20, 2021; second dose, April 7-10, 2021). Serum samples were collected at 2, 4, and 6 months after the second injection. Interventions SARS-CoV-2 BNT162b2 mRNA vaccine. Main Outcomes and Measures Anti-SARS-CoV-2 specific antibodies were measured using enzyme-linked immunosorbent assay kits up to 6 months after the receipt of 2 doses of the BNT162b2 mRNA COVID-19 vaccine. The main outcome was factors associated with anti-SARS-CoV-2 antibody levels at 6 months. Results All 50 participants (mean [SD] age, 34.7 [9.4] years; 10 [20.0%] male; mean [SD] body mass index, 21.8 [5.4]) acquired anti-SARS-CoV-2 antibodies and maintained positive antibody (cutoff ≥30%) up to 6 months. The mean serum antibody level decreased with time (91.9%, 89.3%, and 81.5% at 2, 4, and 6 months, respectively). Serum antibody levels at 6 months were correlated with antibody levels at 2 months (R = 0.944; P < .001). The anti-SARS-CoV-2-specific antibody level was inversely correlated with weight, body mass index, body fat amount, and body weight to height ratio in Spearman correlation analysis. A 1-SD increase in body weight, weight to height ratio, and body mass index was associated with a 4%- to 5%-decrease in anti-SARS-CoV-2 antibodies in multiple linear regression analysis for women. In multivariate analysis for categorized variables, lower serum level of antibody (ie, <81.5%) was associated with weight (weight ≥55 kg: odds ratio, 9.01; 95% CI, 1.44-56.40). The probabilities of less than 70% and less than 80% antibody at 6 months were 0% and 11% in participants weighing less than 55 kg, respectively, but 16% and 42% in participants weighing 55 kg or greater. Conclusions and Relevance In this study, the inverse correlation of anti-SARS-CoV-2-specific antibody levels with weight was sustained up to 6 months after vaccination. A booster shot of BNT162b2 mRNA vaccination may be given later than 6 months after the second dose in young and middle-aged healthy persons with low body weight.
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Affiliation(s)
- Su Youn Nam
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Hyun Seok Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Hee Jeong Lim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Dong Wook Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Seung Soo Yoo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
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Gazit S, Shlezinger R, Perez G, Lotan R, Peretz A, Ben-Tov A, Herzel E, Alapi H, Cohen D, Muhsen K, Chodick G, Patalon T. The Incidence of SARS-CoV-2 Reinfection in Persons With Naturally Acquired Immunity With and Without Subsequent Receipt of a Single Dose of BNT162b2 Vaccine : A Retrospective Cohort Study. Ann Intern Med 2022; 175:674-681. [PMID: 35157493 PMCID: PMC8855786 DOI: 10.7326/m21-4130] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is insufficient evidence regarding the magnitude and durability of protection conferred by a combined effect of naturally acquired immunity after SARS-CoV-2 infection and vaccine-induced immunity. OBJECTIVE To compare the incidence rate of SARS-CoV-2 reinfection in previously infected persons to that of previously infected persons who subsequently received a single dose of BNT162b2 messenger RNA vaccine. DESIGN A retrospective cohort study emulating a randomized controlled target trial through a series of nested trials. SETTING Nationally centralized database of Maccabi Healthcare Services, Israel. PARTICIPANTS Persons with documented SARS-CoV-2 infection who did not receive subsequent SARS-CoV-2 vaccination were compared with persons with documented SARS-CoV-2 infection who received a single dose of the BNT162b2 vaccine at least 3 months after infection. INTERVENTION Forty-one randomized controlled trials were emulated, in which 107 413 Maccabi Healthcare Services' members aged 16 years and older were eligible for at least 1 trial. MEASUREMENTS SARS-CoV-2-related outcomes of infection, symptomatic disease, hospitalization, and death, between 2 March and 13 December 2021. RESULTS A statistically significant decreased risk (hazard ratio, 0.18 [95% CI, 0.15 to 0.20]) for reinfection was found among persons who were previously infected and then vaccinated versus those who were previously infected but remained unvaccinated. In addition, there was a decreased risk for symptomatic disease (hazard ratio, 0.24 [CI, 0.20 to 0.29]) among previously infected and vaccinated persons compared with those who were not vaccinated after infection. No COVID-19-related mortality cases were found. LIMITATION Hybrid protection against non-Delta variants could not be inferred. CONCLUSION Persons previously infected with SARS-CoV-2 gained additional protection against reinfection and COVID-19 from a subsequent single dose of the BNT162b2 vaccine. Nonetheless, even without a subsequent vaccination, reinfection appeared relatively rare. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center and Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (S.G., T.P.)
| | - Roei Shlezinger
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel (R.S.)
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Roni Lotan
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Asaf Peretz
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, and Internal Medicine COVID-19 Ward, Samson Assuta Ashdod University Hospital, Ashdod, Israel (A.P.)
| | - Amir Ben-Tov
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, and Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (A.B.)
| | - Esma Herzel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Hillel Alapi
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (G.P., R.L., E.H., H.A.)
| | - Dani Cohen
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (D.C., K.M.)
| | - Khitam Muhsen
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (D.C., K.M.)
| | - Gabriel Chodick
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, and Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel (G.C.)
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center and Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (S.G., T.P.)
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Peter JK, Wegner F, Gsponer S, Helfenstein F, Roloff T, Tarnutzer R, Grosheintz K, Back M, Schaubhut C, Wagner S, Seth-Smith HMB, Scotton P, Redondo M, Beckmann C, Stadler T, Salzmann A, Kurth H, Leuzinger K, Bassetti S, Bingisser R, Siegemund M, Weisser M, Battegay M, Sutter ST, Lebrand A, Hirsch HH, Fuchs S, Egli A. SARS-CoV-2 Vaccine Alpha and Delta Variant Breakthrough Infections Are Rare and Mild but Can Happen Relatively Early after Vaccination. Microorganisms 2022; 10:microorganisms10050857. [PMID: 35630302 PMCID: PMC9146960 DOI: 10.3390/microorganisms10050857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Background: Some COVID-19 vaccine recipients show breakthrough infection. It remains unknown, which factors contribute to risks and severe outcomes. Our aim was to identify risk factors for SCoV2 breakthrough infections in fully vaccinated individuals. (2) Methods: We conducted a retrospective case-control study from 28 December 2020 to 25 October 2021. Data of all patients with breakthrough infection was compared to data of all vaccine recipients in the Canton of Basel-City, Switzerland. Further, breakthrough infections by Alpha- and Delta-variants were compared. (3) Results: Only 0.39% (488/126,586) of all vaccine recipients suffered from a breakthrough infection during the observational period, whereof most cases were asymptomatic or mild (97.2%). Breakthrough infections after full vaccination occurred in the median after 78 days (IQR 47-123.5). Factors with lower odds for breakthrough infection were age (OR 0.987) and previous COVID-19 infection prior to vaccination (OR 0.296). Factors with higher odds for breakthrough infection included vaccination with Pfizer/BioNTech instead of Moderna (OR 1.459), chronic disease (OR 2.109), and healthcare workers (OR 1.404). (4) Conclusions: Breakthrough infections are rare and mild but can occur early after vaccination. This implies that booster vaccination might be initiated earlier, especially for risk groups. Due to new variants emerging repeatedly, continuous monitoring of breakthrough infections is crucial.
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Affiliation(s)
- Jelissa Katharina Peter
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Fanny Wegner
- Applied Microbiology Research, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland; (F.W.); (T.R.); (H.M.B.S.-S.)
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, 4031 Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, 1015 Lausanne, Switzerland;
| | - Severin Gsponer
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Fabrice Helfenstein
- Department of Clinical Research, University Hospital Basel, 4031 Basel, Switzerland;
| | - Tim Roloff
- Applied Microbiology Research, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland; (F.W.); (T.R.); (H.M.B.S.-S.)
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, 4031 Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, 1015 Lausanne, Switzerland;
| | - Rahel Tarnutzer
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Kerstin Grosheintz
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Moritz Back
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Carla Schaubhut
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Sabina Wagner
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Helena M. B. Seth-Smith
- Applied Microbiology Research, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland; (F.W.); (T.R.); (H.M.B.S.-S.)
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, 4031 Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, 1015 Lausanne, Switzerland;
| | - Patrick Scotton
- Corona Vaccination Centre for the Canton of Basel-City, 4058 Basel, Switzerland;
| | - Maurice Redondo
- Viollier AG, 4123 Allschwil, Switzerland; (M.R.); (C.B.); (A.S.); (H.K.); (H.H.H.)
| | - Christiane Beckmann
- Viollier AG, 4123 Allschwil, Switzerland; (M.R.); (C.B.); (A.S.); (H.K.); (H.H.H.)
| | - Tanja Stadler
- Department of Biosystems Science and Engineering, ETH Zurich, 4058 Basel, Switzerland;
| | - Andrea Salzmann
- Viollier AG, 4123 Allschwil, Switzerland; (M.R.); (C.B.); (A.S.); (H.K.); (H.H.H.)
| | - Henriette Kurth
- Viollier AG, 4123 Allschwil, Switzerland; (M.R.); (C.B.); (A.S.); (H.K.); (H.H.H.)
| | - Karoline Leuzinger
- Clinical Virology, University Hospital Basel, 4031 Basel, Switzerland;
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland
| | - Stefano Bassetti
- Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland;
| | - Roland Bingisser
- Emergency Medicine, University Hospital Basel, 4031 Basel, Switzerland;
| | - Martin Siegemund
- Intensive Care Medicine, University Hospital Basel, 4031 Basel, Switzerland;
| | - Maja Weisser
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (M.W.); (M.B.); (S.T.S.)
| | - Manuel Battegay
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (M.W.); (M.B.); (S.T.S.)
| | - Sarah Tschudin Sutter
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (M.W.); (M.B.); (S.T.S.)
| | - Aitana Lebrand
- SIB Swiss Institute of Bioinformatics, 1015 Lausanne, Switzerland;
| | - Hans H. Hirsch
- Viollier AG, 4123 Allschwil, Switzerland; (M.R.); (C.B.); (A.S.); (H.K.); (H.H.H.)
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland; (M.W.); (M.B.); (S.T.S.)
| | - Simon Fuchs
- Department of Health Basel-City, 4052 Basel, Switzerland; (J.K.P.); (S.G.); (R.T.); (K.G.); (M.B.); (C.S.); (S.W.); (S.F.)
| | - Adrian Egli
- Applied Microbiology Research, Department of Biomedicine, University of Basel, 4056 Basel, Switzerland; (F.W.); (T.R.); (H.M.B.S.-S.)
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, 4031 Basel, Switzerland
- Correspondence:
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Furlong E, Kotecha RS, Conyers R, O'Brien TA, Hansford JR, Super L, Downie P, Eisenstat DD, Haeusler G, McMullan B, Phillips MB, Padhye B, Dalla-Pozza L, Alvaro F, Fraser CJ, Nicholls W, Clark JE, O'Connor M, Saxon BR, Tapp H, Heath J, Hunter SE, Tsui K, Winstanley M, Lyver A, Best EJ, Wadia U, Yeoh D, Blyth CC, Gottardo NG. COVID-19 vaccination in children and adolescents aged 5 years and older undergoing treatment for cancer and non-malignant haematological conditions: Australian and New Zealand Children's Haematology/Oncology Group consensus statement. Med J Aust 2022; 216:312-319. [PMID: 35201615 PMCID: PMC9115069 DOI: 10.5694/mja2.51444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The Australian Technical Advisory Group on Immunisation and New Zealand Ministry of Health recommend all children aged ≥ 5 years receive either of the two mRNA COVID-19 vaccines: Comirnaty (Pfizer), available in both Australia and New Zealand, or Spikevax (Moderna), available in Australia only. Both vaccines are efficacious and safe in the general population, including children. Children and adolescents undergoing treatment for cancer and immunosuppressive therapy for non-malignant haematological conditions are particularly vulnerable, with an increased risk of severe or fatal COVID-19. There remains a paucity of data regarding the immune response to COVID-19 vaccines in immunosuppressed paediatric populations, with data suggestive of reduced immunogenicity of the vaccine in immunocompromised adults. RECOMMENDATIONS Considering the safety profile of mRNA COVID-19 vaccines and the increased risk of severe COVID-19 in immunocompromised children and adolescents, COVID-19 vaccination is strongly recommended for this at-risk population. We provide a number of recommendations regarding COVID-19 vaccination in this population where immunosuppressive, chemotherapeutic and/or targeted biological agents are used. These include the timing of vaccination in patients undergoing active treatment, management of specific situations where vaccination is contraindicated or recommended under special precautions, and additional vaccination recommendations for severely immunocompromised patients. Finally, we stress the importance of upcoming clinical trials to identify the safest and most efficacious vaccination regimen for this population. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT This consensus statement provides recommendations for COVID-19 vaccination in children and adolescents aged ≥ 5 years with cancer and immunocompromising non-malignant haematological conditions, based on evidence, national and international guidelines and expert opinion. ENDORSED BY The Australian and New Zealand Children's Haematology/Oncology Group.
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Affiliation(s)
- Eliska Furlong
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA
| | - Rishi S Kotecha
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA.,Curtin University, Perth, WA
| | - Rachel Conyers
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Tracey A O'Brien
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW.,University of New South Wales, Sydney, NSW
| | - Jordan R Hansford
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Leanne Super
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,Monash University, Melbourne, VIC
| | - Peter Downie
- Monash University, Melbourne, VIC.,Monash Children's Hospital, Melbourne, VIC.,Hudson Institute of Medical Research, Melbourne, VIC
| | - David D Eisenstat
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Gabrielle Haeusler
- Murdoch Children's Research Institute, Melbourne, VIC.,Paediatric Integrated Cancer Service, Melbourne, VIC.,National Centre for Infections in Cancer, Melbourne, VIC
| | - Brendan McMullan
- University of New South Wales, Sydney, NSW.,National Centre for Infections in Cancer, Melbourne, VIC.,Sydney Children's Hospital, Sydney, NSW
| | | | - Bhavna Padhye
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW
| | - Frank Alvaro
- John Hunter Children's Hospital, Newcastle, NSW.,University of Newcastle, Newcastle, NSW
| | | | - Wayne Nicholls
- Queensland Children's Hospital, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Julia E Clark
- Queensland Children's Hospital, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Matthew O'Connor
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - Benjamin R Saxon
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - Heather Tapp
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - John Heath
- Children's and Adolescent/Young Adult Cancer Centre, Royal Hobart Hospital, Hobart, TAS
| | - Sarah E Hunter
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Karen Tsui
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Mark Winstanley
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Amanda Lyver
- Children's Haematology Oncology Centre, Christchurch Hospital, Christchurch, NZ
| | - Emma J Best
- Starship Children's Hospital, Auckland, NZ.,Immunisation Advisory Centre, University of Auckland, Auckland, NZ.,University of Auckland, Auckland, NZ
| | - Ushma Wadia
- Perth Children's Hospital, Perth, WA.,Fiona Stanley Hospital, Perth, WA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
| | - Daniel Yeoh
- Perth Children's Hospital, Perth, WA.,National Centre for Infections in Cancer, Melbourne, VIC
| | - Christopher C Blyth
- Perth Children's Hospital, Perth, WA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
| | - Nicholas G Gottardo
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
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The Beneficial Effect of the COVID-19 Vaccine Booster Dose among Healthcare Workers in an Infectious Diseases Center. Vaccines (Basel) 2022; 10:vaccines10040552. [PMID: 35455301 PMCID: PMC9029317 DOI: 10.3390/vaccines10040552] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 12/20/2022] Open
Abstract
Introduction: Healthcare workers in Poland received a booster dose of the BNT162b2 mRNA vaccine (Pfizer-BioNTech, Manufacturer: Pfizer, Inc., and BioNTech; Moguncja, Germany) at the beginning of October 2021. Here, we report on the preliminary results of an ongoing clinical study into the antibody response to SARS-CoV-2 of healthcare workers previously exposed to the virus, with or without evidence of past infection, in the Hospital for Infectious Diseases in Warsaw before and after the vaccine booster dose. Methods: Blood samples were collected on the day the vaccine booster dose was administered and again 14 days later. The levels of SARS-CoV-2 IgG antibodies (against the n-protein, indicative of disease) and S-RBD (indicative of a response to vaccination) were measured. Results: One hundred and ten health care workers from the Hospital for Infectious Diseases were included in the study. The percentage of subjects with a positive test for anti-n-protein IgG antibodies at both time points remained unchanged (16, 14%), while a statistically significant increase in the percentage of subjects producing high levels of S-RBD antibodies (i.e., >433 BAU/mL) was observed (from 23, 21% to 109, 99%; p = 0.00001). Conclusions: The results of the study indicate that the booster dose of the vaccine significantly increases the percentage of people with high levels of S-RBD antibodies, regardless of previous contact with the virus, which may indicate greater protection against both the disease and a severe course of COVID-19.
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68
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Grainger R, Kim AHJ, Conway R, Yazdany J, Robinson PC. COVID-19 in people with rheumatic diseases: risks, outcomes, treatment considerations. Nat Rev Rheumatol 2022; 18:191-204. [PMID: 35217850 PMCID: PMC8874732 DOI: 10.1038/s41584-022-00755-x] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has brought challenges for people with rheumatic disease in addition to those faced by the general population, including concerns about higher risks of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and poor outcomes of COVID-19. The data that are now available suggest that rheumatic disease is associated with a small additional risk of SARS-CoV-2 infection, and that outcomes of COVID-19 are primarily influenced by comorbidities and particular disease states or treatments. Despite considerable advances in our knowledge of which therapeutic agents provide benefits in COVID-19, and of what constitutes effective vaccination strategies, the specific considerations that apply to people with rheumatic disease are yet to be definitively addressed. An overview of the most important COVID-19 studies to date that relate to people with rheumatic disease can contribute to our understanding of the clinical-care requirements of this population.
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Affiliation(s)
- Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Alfred H J Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Richard Conway
- Department of Rheumatology, St James's Hospital, Dublin, Ireland
| | - Jinoos Yazdany
- Division of Rheumatology, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA
| | - Philip C Robinson
- University of Queensland School of Clinical Medicine, Faculty of Medicine, Herston, Queensland, Australia.
- Royal Brisbane & Women's Hospital, Metro North Hospital & Health Service, Herston Road, Herston, Queensland, Australia.
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69
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Di Fusco M, Lin J, Vaghela S, Lingohr-Smith M, Nguyen JL, Scassellati Sforzolini T, Judy J, Cane A, Moran MM. COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies. Expert Rev Vaccines 2022; 21:435-451. [PMID: 35112973 PMCID: PMC8862165 DOI: 10.1080/14760584.2022.2035222] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/25/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION From July through October of 2021, several countries issued recommendations for increased COVID-19 vaccine protection for individuals with one or more immunocompromised (IC) conditions. It is critically important to understand the vaccine effectiveness (VE) of COVID-19 vaccines among IC populations as recommendations are updated over time in response to the evolving COVID-19 pandemic. AREAS COVERED A targeted literature review was conducted to identify real-world studies that assessed COVID-19 VE in IC populations between December 2020 and September 2021. A total of 10 studies from four countries were identified and summarized in this review. EXPERT OPINION VE of the widely available COVID-19 vaccines, including BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), Ad26.COV2.S (Janssen), and ChAdOx1 nCoV-19 (Oxford/AstraZeneca), ranged from 64% to 90% against SARS-CoV-2 infection, 73% to 84% against symptomatic illness, 70% to 100% against severe illness, and 63% to 100% against COVID-19-related hospitalization among the fully vaccinated IC populations included in the studies. COVID-19 VE for most outcomes in the IC populations included in these studies were lower than in the general populations. These findings provide preliminary evidence that the IC population requires greater protective measures to prevent COVID-19 infection and associated illness, hence should be prioritized while implementing recommendations of additional COVID-19 vaccine doses.
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Affiliation(s)
| | - Jay Lin
- Novosys Health, Green Brook, NJ, USA
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70
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Li J, Jiang N, Zeng QL, Zhang Y, He X, Chu Y, Jin W, Liu Y, Shi W, Yang M, He W, Han Q, Ma L, Xu Y, Guo Y, Zhang L, Ji F. The Epidemiological, Clinical Features and Outcomes of Imported Chinese COVID-19 Patients Following Inactivated Vaccines Injection. Infect Drug Resist 2022; 15:2115-2125. [PMID: 35498630 PMCID: PMC9042076 DOI: 10.2147/idr.s356460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination had been demonstrated as an effective way to reduce the risk of coronavirus disease 2019 (COVID-19), and only a few vaccines suffered from SARS-CoV-2 infection. However, limited data concerning the clinical features of these vaccines infected with SARS-CoV-2 can be identified. Methods We retrospectively collected and analyzed epidemiological and clinical characteristics data of the imported COVID-19 cases who received Chinese inactivated vaccines abroad. Data were extracted from electronic medical records from a designated hospital in the Shaanxi Province of China between March 22 and May 17, 2021. Results Totally, 46 confirmed SARS-CoV-2 infection patients were enrolled. The mean age was 40.5 years (range 20–61), 41 (89.1%) are male. Eighteen (39.1%) patients were from Pakistan. Fourteen (30.4%) patients had at least one comorbidity. Forty (87.0%) and 6 cases were fully vaccinated and partly vaccinated. The time interval between vaccination and infection was 88 days (IQR, 33–123), 31 (67.4%) and 15 (32.6%) were asymptomatic and symptomatic cases, respectively. Fever (3/46, 6.5%) was the most common symptom; however, none had a body temperature higher than 38.0°C, and no severe case was observed. Notably, the rate of SARS-CoV-2 shedding discontinuation at 7 days after hospitalization in asymptomatic cases was higher than symptomatic one (93.5% vs 40%, P < 0.0001). Conclusion Individuals who received Chinese inactivated vaccines abroad remain to have the probability of being infected with SARS-CoV-2, but all the vaccines infected with SARS-CoV-2 were asymptomatic or had mild symptoms with favorable clinical outcomes.
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Affiliation(s)
- Jianwu Li
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Na Jiang
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Qing-Lei Zeng
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Yue Zhang
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xinyuan He
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Yao Chu
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Wenni Jin
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Yi Liu
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Wan Shi
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Miao Yang
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Weihan He
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Qing Han
- Department of Integrated Traditional Chinese and Western Medicine, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Le Ma
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - You Xu
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
| | - Yaling Guo
- Isolation Ward for Covid-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
- Yaling Guo, Isolation ward for COVID-19, the Eighth Hospital of Xi’an City, Xi’an Jiaotong University, Xi’an, Shaanxi Province, 710061, People’s Republic of China, Tel/Fax +8629 85230200, Email
| | - Lei Zhang
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an, Shaanxi, People’s Republic of China
- Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Fanpu Ji
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi’an, Shaanxi, People’s Republic of China
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education of China, Xi’an, Shaanxi, People’s Republic of China
- Correspondence: Fanpu Ji, Department of Infectious Diseases, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China, Tel/Fax +862987678223, Email
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71
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Fano V, Crielesi A, Coviello E, Fabiani M, Salvatore Miglietta A, Colaiocco G, Moretti I, Pasqua C, Vivaldi F, De Angelis G, Cerimele M. Effectiveness of the Comirnaty and the Vaxzevria vaccines in preventing SARS-CoV-2 infection among residents in Lazio region (Italy). Vaccine 2022; 40:2540-2545. [PMID: 35341646 PMCID: PMC8938180 DOI: 10.1016/j.vaccine.2022.02.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 12/24/2022]
Abstract
We estimated the effectiveness of Comirnaty and Vaxzevria vaccines among 371,423 residents in Lazio Region (Italy) vaccinated since 27/12/2020, and followed until diagnosis of SARS-CoV-2 infection or 25/4/2021, whichever came first. By the end of follow-up most of the Comirnaty-cohort (60%) had received the second dose at recommended time of 21 days (98%), while the Vaxzevria-cohort had received only one dose. Adjusted hazard ratios of SARS-CoV-2 infection at weekly intervals since the first dose were estimated through a Cox regression model using 0–13 days as reference time-interval. An increase in effectiveness with increasing time since administration was observed for Comirnaty (five-weeks = 81%, 95 %CI 71–88%; three-months = 94%, 95 %CI 84–98%). One dose of Vaxzevria showed an effectiveness of 63% (95 %CI 25–82%) after 7 weeks, although further analyses are needed after complete vaccination with two doses. These results could support the ongoing vaccination campaign by reinforcing evidence-based communication aimed at reducing vaccine hesitancy.
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Affiliation(s)
| | | | | | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Irene Moretti
- Department of Economics and Law, Sapienza University, Rome, Italy
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Hatcher SM, Endres-Dighe SM, Angulo FJ, Srivastava A, Nguyen JL, Khan F, Martin C, Swerdlow DL, McLaughlin JM, Ubaka-Blackmore N, Brown LM. COVID-19 Vaccine Effectiveness: A Review of the First 6 Months of COVID-19 Vaccine Availability (1 January-30 June 2021). Vaccines (Basel) 2022; 10:393. [PMID: 35335025 PMCID: PMC8951318 DOI: 10.3390/vaccines10030393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
Observational studies are needed to demonstrate real-world vaccine effectiveness (VE) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outcomes. Our objective was to conduct a review of published SARS-CoV-2 VE articles, supplemented by preprints, during the first 6 months of COVID-19 vaccine availability. This review compares the effectiveness of completing the primary COVID-19 vaccination series against multiple SARS-CoV-2 disease presentations and disease severity outcomes in three population groups (general population, frontline workers, and older adults). Four hundred and seventy-one published articles and 47 preprints were identified. After title and abstract screening and full article review, 50 studies (28 published articles, 22 preprints) were included. VE results were reported for five COVID-19 vaccines and four combinations of COVID-19 vaccines. VE results for BNT162b2 were reported in 70.6% of all studies. Seventeen studies reported variant specific VE estimates; Alpha was the most common. This comprehensive review demonstrates that COVID-19 vaccination is an important tool for preventing COVID-19 morbidity and mortality among fully vaccinated persons aged 16 years and older and serves as an important baseline from which to follow future trends in COVID-19 evolution and effectiveness of new and updated vaccines.
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Affiliation(s)
- Sarah M. Hatcher
- RTI International, Research Triangle Park, NC 27709, USA; (S.M.H.); (S.M.E.-D.); (N.U.-B.); (L.M.B.)
| | - Stacy M. Endres-Dighe
- RTI International, Research Triangle Park, NC 27709, USA; (S.M.H.); (S.M.E.-D.); (N.U.-B.); (L.M.B.)
| | - Frederick J. Angulo
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - Amit Srivastava
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - Jennifer L. Nguyen
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - Farid Khan
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - Catherine Martin
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - David L. Swerdlow
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - John M. McLaughlin
- Pfizer, Inc., New York, NY 10017, USA; (A.S.); (J.L.N.); (F.K.); (C.M.); (D.L.S.); (J.M.M.)
| | - Nneka Ubaka-Blackmore
- RTI International, Research Triangle Park, NC 27709, USA; (S.M.H.); (S.M.E.-D.); (N.U.-B.); (L.M.B.)
| | - Linda Morris Brown
- RTI International, Research Triangle Park, NC 27709, USA; (S.M.H.); (S.M.E.-D.); (N.U.-B.); (L.M.B.)
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Roel E, Pistillo A, Recalde M, Fernández-Bertolín S, Aragón M, Soerjomataram I, Jenab M, Puente D, Prieto-Alhambra D, Burn E, Duarte-Salles T. Cancer and the risk of coronavirus disease 2019 diagnosis, hospitalisation and death: A population-based multistate cohort study including 4 618 377 adults in Catalonia, Spain. Int J Cancer 2022; 150:782-794. [PMID: 34655476 PMCID: PMC8652827 DOI: 10.1002/ijc.33846] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/31/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
The relationship between cancer and coronavirus disease 2019 (COVID-19) infection and severity remains poorly understood. We conducted a population-based cohort study between 1 March and 6 May 2020 describing the associations between cancer and risk of COVID-19 diagnosis, hospitalisation and COVID-19-related death. Data were obtained from the Information System for Research in Primary Care (SIDIAP) database, including primary care electronic health records from ~80% of the population in Catalonia, Spain. Cancer was defined as any primary invasive malignancy excluding non-melanoma skin cancer. We estimated adjusted hazard ratios (aHRs) for the risk of COVID-19 (outpatient) clinical diagnosis, hospitalisation (with or without a prior COVID-19 diagnosis) and COVID-19-related death using Cox proportional hazard regressions. Models were estimated for the overall cancer population and by years since cancer diagnosis (<1 year, 1-5 years and ≥5 years), sex, age and cancer type; and adjusted for age, sex, smoking status, deprivation and comorbidities. We included 4 618 377 adults, of which 260 667 (5.6%) had a history of cancer. A total of 98 951 individuals (5.5% with cancer) were diagnosed, and 6355 (16.4% with cancer) were directly hospitalised with COVID-19. Of those diagnosed, 6851 were subsequently hospitalised (10.7% with cancer), and 3227 died without being hospitalised (18.5% with cancer). Among those hospitalised, 1963 (22.5% with cancer) died. Cancer was associated with an increased risk of COVID-19 diagnosis (aHR: 1.08; 95% confidence interval [1.05-1.11]), direct COVID-19 hospitalisation (1.33 [1.24-1.43]) and death following hospitalisation (1.12 [1.01-1.25]). These associations were stronger for patients recently diagnosed with cancer, aged <70 years, and with haematological cancers. These patients should be prioritised in COVID-19 vaccination campaigns and continued non-pharmaceutical interventions.
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Affiliation(s)
- Elena Roel
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergio Fernández-Bertolín
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - María Aragón
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | - Mazda Jenab
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Diana Puente
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Edward Burn
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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74
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Del Cura-Bilbao A, López-Mendoza H, Chaure-Pardos A, Vergara-Ugarriza A, Guimbao-Bescós J. Effectiveness of 3 COVID-19 Vaccines in Preventing SARS-CoV-2 Infections, January–May 2021, Aragon, Spain. Emerg Infect Dis 2022; 28:591-598. [PMID: 35195514 PMCID: PMC8888243 DOI: 10.3201/eid2803.212027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is a worldwide challenge; widespread vaccination could be one strategy for control. We conducted a prospective, population-based cohort study of 964,258 residents of Aragon, Spain, during December 2020–May 2021. We used the Cox proportional-hazards model with vaccination status as the exposure condition to estimate the effectiveness of 3 coronavirus disease vaccines in preventing SARS-CoV-2 infection. Pfizer-BioNTech had 20.8% (95% CI 11.6%–29.0%) vaccine effectiveness (VE) against infection after 1 dose and 70.0% (95% CI 65.3%–74.1%) after 2 doses, Moderna had 52.8% (95% CI 30.7%–67.8%) VE after 1 dose and 70.3% (95% CI 52.2%–81.5%) after 2 doses, and Oxford-AstraZeneca had 40.3% (95% CI 31.8%–47.7%) VE after 1 dose. All estimates were lower than those from previous studies. Results imply that, although high vaccination coverage remains critical to protect people from disease, it will be difficult to effectively minimize transmission opportunities.
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75
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Marra AR, Kobayashi T, Suzuki H, Alsuhaibani M, Tofaneto BM, Bariani LM, Auler MDA, Salinas JL, Edmond MB, Doll M, Kutner JM, Pinho JRR, Rizzo LV, Miraglia JL, Schweizer ML. Short-term effectiveness of COVID-19 vaccines in immunocompromised patients: A systematic literature review and meta-analysis. J Infect 2022; 84:297-310. [PMID: 34982962 PMCID: PMC8720049 DOI: 10.1016/j.jinf.2021.12.035] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We aimed to assess the short-term effectiveness of COVID-19 vaccines among immunocompromised patients to prevent laboratory-confirmed symptomatic COVID-19 infection. METHODS Systematic review and meta-analysis. We calculated the pooled diagnostic odds ratio [DOR] (95% CI) for COVID-19 infection between immunocompromised patients and healthy people or those with stable chronic medical conditions. VE was estimated as 100% x (1-DOR). We also investigated the rates of developing anti-SARS-CoV-2 spike protein IgG between the 2 groups. RESULTS Twenty studies evaluating COVID-19 vaccine response, and four studies evaluating VE were included in the meta-analysis. The pooled DOR for symptomatic COVID-19 infection in immunocompromised patients was 0.296 (95% CI: 0.108-0.811) with an estimated VE of 70.4% (95% CI: 18.9%- 89.2%). When stratified by diagnosis, IgG antibody levels were much higher in the control group compared to immunocompromised patients with solid organ transplant (pOR 232.3; 95% Cl: 66.98-806.03), malignant diseases (pOR 42.0, 95% Cl: 11.68-151.03), and inflammatory rheumatic diseases (pOR 19.06; 95% Cl: 5.00-72.62). CONCLUSIONS We found COVID-19 mRNA vaccines were effective against symptomatic COVID-19 among the immunocompromised patients but had lower VE compared to the controls. Further research is needed to understand the discordance between antibody production and protection against symptomatic COVID-19 infection.
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Affiliation(s)
- Alexandre R Marra
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil; Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa, IA, USA.
| | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Hiroyuki Suzuki
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa, IA, USA
| | - Mohammed Alsuhaibani
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Pediatrics, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | | | | | | | | | - Michael B Edmond
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Michelle Doll
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | | | | | - Luiz Vicente Rizzo
- Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
| | - João Luiz Miraglia
- Saúde Populacional, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marin L Schweizer
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa, IA, USA
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76
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Shen C, Risk M, Schiopu E, Hayek SS, Xie T, Holevinski L, Akin C, Freed G, Zhao L. Efficacy of COVID-19 vaccines in patients taking immunosuppressants. Ann Rheum Dis 2022; 81:875-880. [PMID: 35197265 DOI: 10.1136/annrheumdis-2021-222045] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/09/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We intended to assess the effectiveness of all three US Food and Drug Administration approved COVID-19 vaccines at preventing SARS-CoV-2 infection and COVID-19 hospitalisation in a large cohort of individuals on immunosuppressants for a diverse range of conditions. METHODS We studied the effectiveness of BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna) and Ad26.COV2.S (Johnson & Johnson-Janssen) vaccines among individuals who take immunosuppressants (including disease-modifying antirheumatic drugs and glucocorticoids) by comparing vaccinated (n=97688) and unvaccinated (n=42094) individuals in the Michigan Medicine healthcare system from 1 January to 7 December 2021, using Cox proportional hazards modelling with time-varying covariates. RESULTS Among vaccinated and unvaccinated individuals, taking immunosuppressants increased the risk of SARS-CoV-2 infection (adjusted HR (aHR)=2.17, 95% CI 1.69 to 2.79 for fully vaccinated and aHR=1.40, 95% CI 1.07 to 1.83 for unvaccinated). Among individuals taking immunosuppressants, we found: (1) vaccination reduced the risk of SARS-CoV-2 infection (aHR=0.55, 95% CI 0.39 to 0.78); (2) the BNT162b2 and mRNA-1273 vaccines were highly effective at reducing the risk of SARS-CoV-2 infection (n=2046, aHR=0.59, 95% CI 0.38 to 0.91 for BNT162b2; n=2064, aHR=0.52, 95% CI 0.33 to 0.82 for mRNA-1273); (3) with a smaller sample size (n=173), Ad26.COV2.S vaccine protection did not reach statistical significance (aHR=0.34, 95% CI 0.09 to 1.30, p=0.17); and (4) receiving a booster dose reduced the risk of SARS-CoV-2 infection (aHR=0.42, 95% CI 0.24 to 0.76). CONCLUSIONS The mRNA-1273 and BNT162b2 vaccines are effective in individuals who take immunosuppressants. However, individuals who are vaccinated but on immunosuppressants are still at higher risk of SARS-CoV-2 infection and COVID-19 hospitalisation than the broader vaccinated population. Booster doses are effective and crucially important for individuals on immunosuppressants.
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Affiliation(s)
- Chen Shen
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Malcolm Risk
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Elena Schiopu
- Department of Rheumatology, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
| | - Salim S Hayek
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Tiankai Xie
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Lynn Holevinski
- Data Office for Clinical and Translational Research, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Cem Akin
- Division of Allergy, University of Michigan, Ann Arbor, Michigan, USA
| | - Gary Freed
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Lili Zhao
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
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Lin L, Zhao Y, Chen B, He D. Multiple COVID-19 Waves and Vaccination Effectiveness in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2282. [PMID: 35206474 PMCID: PMC8871705 DOI: 10.3390/ijerph19042282] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: The coronavirus 2019 (COVID-19) pandemic has caused multiple waves of cases and deaths in the United States (US). The wild strain, the Alpha variant (B.1.1.7) and the Delta variant (B.1.617.2) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were the principal culprits behind these waves. To mitigate the pandemic, the vaccination campaign was started in January 2021. While the vaccine efficacy is less than 1, breakthrough infections were reported. This work aims to examine the effects of the vaccination across 50 US states and the District of Columbia. (2) Methods: Based on the classic Susceptible-Exposed-Infectious-Recovered (SEIR) model, we add a delay class between infectious and death, a death class and a vaccinated class. We compare two special cases of our new model to simulate the effects of the vaccination. The first case expounds the vaccinated individuals with full protection or not, compared to the second case where all vaccinated individuals have the same level of protection. (3) Results: Through fitting the two approaches to reported COVID-19 deaths in all 50 US states and the District of Columbia, we found that these two approaches are equivalent. We calculate that the death toll could be 1.67-3.33 fold in most states if the vaccine was not available. The median and mean infection fatality ratio are estimated to be approximately 0.6 and 0.7%. (4) Conclusions: The two approaches we compared were equivalent in evaluating the effectiveness of the vaccination campaign in the US. In addition, the effect of the vaccination campaign was significant, with a large number of deaths averted.
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Affiliation(s)
| | | | | | - Daihai He
- Department of Applied Mathematics, The Hong Kong Polytechnic University, Hong Kong, China; (L.L.); (Y.Z.); (B.C.)
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78
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Different Clinical Outcomes of COVID-19 in Two Healthcare Workers Vaccinated with BNT162b2 Vaccine, Infected with the Same Viral Variant but with Different Predisposing Conditions for the Progression of the Disease. Vaccines (Basel) 2022; 10:vaccines10020298. [PMID: 35214756 PMCID: PMC8877805 DOI: 10.3390/vaccines10020298] [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: 01/01/2022] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023] Open
Abstract
Safe and effective vaccines are available to face the global threat of the COVID-19 pandemic. In this article, we report on the clinical cases of two healthcare workers vaccinated with two doses of BNT162b2 vaccine who were infected by the same viral clade but had different clinical outcomes.
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79
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Marra AR, Kobayashi T, Suzuki H, Alsuhaibani M, Schweizer ML, Diekema DJ, Tofaneto BM, Bariani LM, Auler MDA, Salinas JL, Edmond MB, Pinho JRR, Rizzo LV. The long-term effectiveness of coronavirus disease 2019 (COVID-19) vaccines: A systematic literature review and meta-analysis. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e22. [PMID: 36310810 PMCID: PMC9614898 DOI: 10.1017/ash.2021.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022]
Abstract
Background Although multiple studies revealed high vaccine effectiveness of coronavirus disease 2019 (COVID-19) vaccines within 3 months after the completion of vaccines, long-term vaccine effectiveness has not been well established, especially after the δ (delta) variant became prominent. We performed a systematic literature review and meta-analysis of long-term vaccine effectiveness. Methods We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from December 2019 to November 15, 2021, for studies evaluating the long-term vaccine effectiveness against laboratory-confirmed COVID-19 or COVID-19 hospitalization among individuals who received 2 doses of Pfizer/BioNTech, Moderna, or AstraZeneca vaccines, or 1 dose of the Janssen vaccine. Long-term was defined as >5 months after the last dose. We calculated the pooled diagnostic odds ratio (DOR) with 95% confidence interval for COVID-19 between vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated as 100% × (1 - DOR). Results In total, 16 studies including 17,939,172 individuals evaluated long-term vaccine effectiveness and were included in the meta-analysis. The pooled DOR for COVID-19 was 0.158 (95% CI: 0.157-0.160) with an estimated vaccine effectiveness of 84.2% (95% CI, 84.0- 84.3%). Estimated vaccine effectiveness against COVID-19 hospitalization was 88.7% (95% CI, 55.8%-97.1%). Vaccine effectiveness against COVID-19 during the δ variant period was 61.2% (95% CI, 59.0%-63.3%). Conclusions COVID-19 vaccines are effective in preventing COVID-19 and COVID-19 hospitalization across a long-term period for the circulating variants during the study period. More observational studies are needed to evaluate the vaccine effectiveness of third dose of a COVID-19 vaccine, the vaccine effectiveness of mixing COVID-19 vaccines, COVID-19 breakthrough infection, and vaccine effectiveness against newly emerging variants.
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Affiliation(s)
- Alexandre R. Marra
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Hiroyuki Suzuki
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Mohammed Alsuhaibani
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Department of Pediatrics, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Marin L. Schweizer
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Daniel J. Diekema
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | | | | | | | | | - Michael B. Edmond
- West Virginia University School of Medicine, Morgantown, West Virginia, United States
| | - João Renato Rebello Pinho
- Research and Development Sector, Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Luiz Vicente Rizzo
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Kudlay D, Svistunov A. COVID-19 Vaccines: An Overview of Different Platforms. Bioengineering (Basel) 2022; 9:bioengineering9020072. [PMID: 35200425 PMCID: PMC8869214 DOI: 10.3390/bioengineering9020072] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 12/29/2022] Open
Abstract
Vaccination is one of the key strategies to stop the COVID-19 pandemic. This review aims to evaluate the current state of vaccine development and to determine the issues that merit additional research. We conducted a literature review of the development of COVID-19 vaccines, their effectiveness, and their use in special patient groups. To date, 140 vaccines are in clinical development. Vector, RNA, subunit, and inactivated vaccines, as well as DNA vaccines, have been approved for human use. Vector vaccines have been well studied prior to the COVID-19 pandemic; however, their long-term efficacy and approaches to scaling up their production remain questionable. The main challenge for RNA vaccines is to improve their stability during production, storage, and transportation. For inactivated vaccines, the key issue is to improve their immunogenicity and effectiveness. To date, it has been shown that the immunogenicity of COVID-19 vaccines directly correlates with their clinical efficacy. In view of the constant mutation, the emerging new SARS-CoV-2 variants have been shown to be able to partially escape post-vaccination immune response; however, most vaccines remain sufficiently effective regardless of the variant of the virus. One of the promising strategies to improve the effectiveness of vaccination, which is being studied, is the use of different platforms within a single vaccination course. Despite significant progress in the development and study of COVID-19 vaccines, there are many issues that require further research.
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Affiliation(s)
- Dmitry Kudlay
- Department of Pharmacology, Institute of Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, Building 2, 119991 Moscow, Russia
- Correspondence: ; Tel.: +7-(499)-248-05-53
| | - Andrey Svistunov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, Building 2, 119991 Moscow, Russia;
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81
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Klompas M, Rhee C, Baker MA. Universal Use of N95 Respirators in Healthcare Settings When Community Coronavirus Disease 2019 Rates Are High. Clin Infect Dis 2022; 74:529-531. [PMID: 34113977 PMCID: PMC8384408 DOI: 10.1093/cid/ciab539] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Indexed: 12/23/2022] Open
Abstract
The Centers for Disease Control and Prevention recommends N95 respirators for all providers who see patients with possible or confirmed coronavirus disease 2019 (COVID-19). We suggest that N95 respirators may be just as important for the care of patients without suspected COVID-19 when community incidence rates are high. This is because severe acute respiratory syndrome coronavirus 2 is most contagious before symptom onset. Ironically, by the time patients are sick enough to be admitted to the hospital with COVID-19, they tend to be less contagious. The greatest threat of transmission in healthcare facilities may therefore be patients and healthcare workers with early occult infection. N95 respirators' superior fit and filtration provide superior exposure protection for healthcare providers seeing patients with early undiagnosed infection and superior source control to protect patients from healthcare workers with early undiagnosed infection. The probability of occult infection in patients and healthcare workers is greatest when community incidence rates are high. Universal use of N95 respirators may help decrease nosocomial transmission at such times.
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Affiliation(s)
- Michael Klompas
- Department of Population Medicine, Harvard Medical School
and Harvard Pilgrim Health Care Institute, Boston,
Massachusetts, USA
- Department of Medicine, Brigham and Women’s
Hospital, Boston, Massachusetts, USA
| | - Chanu Rhee
- Department of Population Medicine, Harvard Medical School
and Harvard Pilgrim Health Care Institute, Boston,
Massachusetts, USA
- Department of Medicine, Brigham and Women’s
Hospital, Boston, Massachusetts, USA
| | - Meghan A Baker
- Department of Population Medicine, Harvard Medical School
and Harvard Pilgrim Health Care Institute, Boston,
Massachusetts, USA
- Department of Medicine, Brigham and Women’s
Hospital, Boston, Massachusetts, USA
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82
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Fabiani M, Puopolo M, Morciano C, Spuri M, Spila Alegiani S, Filia A, D'Ancona F, Del Manso M, Riccardo F, Tallon M, Proietti V, Sacco C, Massari M, Da Cas R, Mateo-Urdiales A, Siddu A, Battilomo S, Bella A, Palamara AT, Popoli P, Brusaferro S, Rezza G, Menniti Ippolito F, Pezzotti P. Effectiveness of mRNA vaccines and waning of protection against SARS-CoV-2 infection and severe covid-19 during predominant circulation of the delta variant in Italy: retrospective cohort study. BMJ 2022; 376:e069052. [PMID: 35144968 PMCID: PMC8829820 DOI: 10.1136/bmj-2021-069052] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To estimate the effectiveness of mRNA vaccines against SARS-CoV-2 infection and severe covid-19 at different time after vaccination. DESIGN Retrospective cohort study. SETTING Italy, 27 December 2020 to 7 November 2021. PARTICIPANTS 33 250 344 people aged ≥16 years who received a first dose of BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine and did not have a previous diagnosis of SARS-CoV-2 infection. MAIN OUTCOME MEASURES SARS-CoV-2 infection and severe covid-19 (admission to hospital or death). Data were divided by weekly time intervals after vaccination. Incidence rate ratios at different time intervals were estimated by multilevel negative binomial models with robust variance estimator. Sex, age group, brand of vaccine, priority risk category, and regional weekly incidence in the general population were included as covariates. Geographic region was included as a random effect. Adjusted vaccine effectiveness was calculated as (1-IRR)×100, where IRR=incidence rate ratio, with the time interval 0-14 days after the first dose of vaccine as the reference. RESULTS During the epidemic phase when the delta variant was the predominant strain of the SARS-CoV-2 virus, vaccine effectiveness against SARS-CoV-2 infection significantly decreased (P<0.001) from 82% (95% confidence interval 80% to 84%) at 3-4 weeks after the second dose of vaccine to 33% (27% to 39%) at 27-30 weeks after the second dose. In the same time intervals, vaccine effectiveness against severe covid-19 also decreased (P<0.001), although to a lesser extent, from 96% (95% to 97%) to 80% (76% to 83%). High risk people (vaccine effectiveness -6%, -28% to 12%), those aged ≥80 years (11%, -15% to 31%), and those aged 60-79 years (2%, -11% to 14%) did not seem to be protected against infection at 27-30 weeks after the second dose of vaccine. CONCLUSIONS The results support the vaccination campaigns targeting high risk people, those aged ≥60 years, and healthcare workers to receive a booster dose of vaccine six months after the primary vaccination cycle. The results also suggest that timing the booster dose earlier than six months after the primary vaccination cycle and extending the offer of the booster dose to the wider eligible population might be warranted.
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Affiliation(s)
| | - Maria Puopolo
- Italian National Institute of Health (ISS), Rome, Italy
| | | | - Matteo Spuri
- Italian National Institute of Health (ISS), Rome, Italy
| | | | | | | | | | | | - Marco Tallon
- Italian National Institute of Health (ISS), Rome, Italy
| | | | - Chiara Sacco
- Italian National Institute of Health (ISS), Rome, Italy
| | - Marco Massari
- Italian National Institute of Health (ISS), Rome, Italy
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83
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Stille JK, Tjutrins J, Wang G, Venegas FA, Hennecker C, Rueda AM, Sharon I, Blaine N, Miron CE, Pinus S, Labarre A, Plescia J, Burai Patrascu M, Zhang X, Wahba AS, Vlaho D, Huot MJ, Schmeing TM, Mittermaier AK, Moitessier N. Design, synthesis and in vitro evaluation of novel SARS-CoV-2 3CL pro covalent inhibitors. Eur J Med Chem 2022; 229:114046. [PMID: 34995923 PMCID: PMC8665847 DOI: 10.1016/j.ejmech.2021.114046] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 12/20/2022]
Abstract
Severe diseases such as the ongoing COVID-19 pandemic, as well as the previous SARS and MERS outbreaks, are the result of coronavirus infections and have demonstrated the urgent need for antiviral drugs to combat these deadly viruses. Due to its essential role in viral replication and function, 3CLpro (main coronaviruses cysteine-protease) has been identified as a promising target for the development of antiviral drugs. Previously reported SARS-CoV 3CLpro non-covalent inhibitors were used as a starting point for the development of covalent inhibitors of SARS-CoV-2 3CLpro. We report herein our efforts in the design and synthesis of submicromolar covalent inhibitors when the enzymatic activity of the viral protease was used as a screening platform.
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Affiliation(s)
- Julia K Stille
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Jevgenijs Tjutrins
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Guanyu Wang
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Felipe A Venegas
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Christopher Hennecker
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Andrés M Rueda
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Itai Sharon
- Department of Biochemistry, McGill University, 3649 Promenade Sir William Osler Montreal, QC, Canada, H3G 0B1
| | - Nicole Blaine
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Caitlin E Miron
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Sharon Pinus
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Anne Labarre
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Jessica Plescia
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Mihai Burai Patrascu
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Xiaocong Zhang
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Alexander S Wahba
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Danielle Vlaho
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - Mitchell J Huot
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8
| | - T Martin Schmeing
- Department of Biochemistry, McGill University, 3649 Promenade Sir William Osler Montreal, QC, Canada, H3G 0B1
| | - Anthony K Mittermaier
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8.
| | - Nicolas Moitessier
- Department of Chemistry, McGill University, 801 Sherbrooke St W, Montreal, QC, Canada, H3A 0B8.
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84
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Galmiche S, Luong Nguyen LB, Tartour E, de Lamballerie X, Wittkop L, Loubet P, Launay O. Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review. Clin Microbiol Infect 2022; 28:163-177. [PMID: 35020589 PMCID: PMC8595936 DOI: 10.1016/j.cmi.2021.09.036] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Available data show that COVID-19 vaccines may be less effective in immunocompromised populations, who are at increased risk of severe COVID-19. OBJECTIVES We conducted a systematic review of literature to assess immunogenicity, efficacy and effectiveness of COVID-19 vaccines in immunocompromised populations. DATA SOURCES We searched Medline and Embase databases. STUDY ELIGIBILITY CRITERIA, PATIENTS, INTERVENTIONS We included studies of COVID-19 vaccines after complete vaccination in immunocompromised patients until 31 August 2021. Studies with <10 patients, safety data only and case series of breakthrough infections were excluded. METHODS Risk of bias was assessed via the tool developed by the National Institutes of Health on interventional and observational studies. Immunogenicity was assessed through non-response rate defined as no anti-SARS-CoV-2 spike protein antibodies, efficacy and effectiveness by the relative reduction in risk of SARS-CoV-2 infection or COVID-19. We collected factors associated with the risk of non-response. We presented collected data by immunosuppression type. RESULTS We screened 5917 results, included 162 studies. There were 157 on immunogenicity in 25 209 participants, including 7835 cancer or haematological malignancy patients (31.1%), 6302 patients on dialysis (25.0%), 5974 solid organ transplant recipients (23.7%) and 4680 immune-mediated disease patients (18.6%). Proportion of non-responders seemed higher among solid organ transplant recipients (range 18-100%) and patients with haematological malignancy (range 14-61%), and lower in patients with cancer (range 2-36%) and patients on dialysis (range 2-30%). Risk factors for non-response included older age, use of corticosteroids, immunosuppressive or anti-CD20 agent. Ten studies evaluated immunogenicity of an additional dose. Five studies evaluated vaccine efficacy or effectiveness: three on SARS-CoV-2 infection (range 71-81%), one on COVID-19-related hospitalization (62.9%), one had a too small sample size. CONCLUSIONS This systematic review highlights the risk of low immunogenicity of COVID-19 vaccines in immunocompromised populations, especially solid organ transplant recipients and patients with haematological malignancy. Despite lack of vaccine effectiveness data, enhanced vaccine regimens may be necessary.
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Affiliation(s)
- Simon Galmiche
- Assistance Publique - Hôpitaux de Paris (AP-HP), CIC Cochin Pasteur, Hôpital Cochin, Paris, France
| | - Liem Binh Luong Nguyen
- Assistance Publique - Hôpitaux de Paris (AP-HP), CIC Cochin Pasteur, Hôpital Cochin, Paris, France
| | - Eric Tartour
- AP-HP, Immunologie Biologique, Hôpital Européen Georges Pompidou, Paris, France
| | - Xavier de Lamballerie
- Aix Marseille Université, IRD 190, INSERM 1207, Unité des Virus Emergents, UVE, IHU Méditerranée Infection, Marseille, France
| | - Linda Wittkop
- Institut de Santé Publique d'Epidémiologie et de Développement, INSERM, Bordeaux Population Health Research Center, UMR 1219, Centre d'Investigation Clinique-Epidémiologie Clinique 1401, University of Bordeaux, Service d'Information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France
| | - Paul Loubet
- INSERM U1047, Department of Infectious and Tropical Diseases, CHU Nîmes, Université Montpellier, Nîmes, France
| | - Odile Launay
- Université de Paris, Faculté de Médecine Paris Descartes, AP-PH, Inserm, CIC Cochin Pasteur, Paris, France.
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85
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Patalon T, Gazit S, Pitzer VE, Prunas O, Warren JL, Weinberger DM. Odds of Testing Positive for SARS-CoV-2 Following Receipt of 3 vs 2 Doses of the BNT162b2 mRNA Vaccine. JAMA Intern Med 2022; 182:179-184. [PMID: 34846533 PMCID: PMC8634151 DOI: 10.1001/jamainternmed.2021.7382] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE With the evidence of waning immunity of the mRNA vaccine BNT162b2 (Pfizer-BioNTech), a nationwide third-dose (booster) vaccination campaign was initiated in Israel during August 2021; other countries have begun to administer a booster shot as well. OBJECTIVE To evaluate the initial short-term additional benefit of a 3-dose vs a 2-dose regimen against infection of SARS-CoV-2. DESIGN, SETTING, AND PARTICIPANTS This preliminary retrospective case-control study used 2 complementary approaches: a test-negative design and a matched case-control design. Participants were included from the national centralized database of Maccabi Healthcare Services, an Israeli healthcare maintenance organization covering 2.5 million members. Data were collected between March 1, 2020, and October 4, 2021, and analyses focused on the period from August 1, 2021, to October 4, 2021, because the booster dose was widely administered from August 1 onward. EXPOSURES Either 2 doses or 3 doses of the BNT162b2 vaccine. MAIN OUTCOMES AND MEASURES The reduction in the odds of a positive SARS-CoV-2 polymerase chain reaction (PCR) test at different time intervals following receipt of the booster dose (0-6, 7-13, 14-20, 21-27, and 28-65 days) compared with receiving only 2 doses. RESULTS The study population included 306 710 members of Maccabi Healthcare Services who were 40 years and older (55% female) and received either 2 or 3 doses of the BNT162b2 vaccine and did not have a positive PCR test result for SARS-CoV-2 prior to the start of the follow-up period. During this period, there were 500 232 PCR tests performed, 227 380 among those who received 2 doses and 272 852 among those who received 3 doses, with 14 989 (6.6%) and 4941 (1.8%) positive test results in each group, respectively. Comparing those who received a booster and those who received 2 doses, there was an estimated odds ratio of 0.14 (95% CI, 0.13-0.15) 28 to 65 days following receipt of the booster (86% reduction in the odds of testing positive for SARS-CoV-2). CONCLUSION AND RELEVANCE Previous studies have demonstrated that vaccine-derived protection against SARS-CoV-2 wanes over time. In this case-control analysis, we showed an association between receipt of the booster dose and a reduction in the odds of testing positive for SARS-CoV-2, potentially counteracting waning immunity in the short term. Further monitoring of data from this population is needed to determine the duration of immunity following the booster.
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Affiliation(s)
- Tal Patalon
- Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Virginia E Pitzer
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Ottavia Prunas
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Joshua L Warren
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut.,Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Daniel M Weinberger
- Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut
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86
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Stamatopoulou M, Tsamadias V, Theodosopoulos T, Demeridou S, Kaparos G, Memos N, Konstadoulakis M, Baka S. Rapid decay of anti-SARS-CoV-2 antibodies in infection-naïve healthcare workers four months after vaccination. Germs 2022; 11:625-629. [PMID: 35096682 DOI: 10.18683/germs.2021.1300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/22/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Maria Stamatopoulou
- RN, MSc, PhDc, Infection Control Department, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - Vasileios Tsamadias
- PhDc, Clinical Laboratory of Therapeutic Individualization, 2 Department of Obstetrics and Gynecology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - Theodosios Theodosopoulos
- MD, PhD, 2 Department of Surgery, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - Stiliani Demeridou
- MSc, Department of Biopathology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - George Kaparos
- PhD, Department of Biopathology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - Nikolaos Memos
- MD, PhD, 2 Department of Surgery, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - Manoussos Konstadoulakis
- MD, PhD, 2 Department of Surgery, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
| | - Stavroula Baka
- MD, PhD, Department of Biopathology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 76, Vas. Sofias Ave, 11528, Athens, Greece
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87
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Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, Peiffer-Smadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect 2022; 28:202-221. [PMID: 34715347 PMCID: PMC8548286 DOI: 10.1016/j.cmi.2021.10.005] [Citation(s) in RCA: 526] [Impact Index Per Article: 263.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 10/16/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Vaccines are critical cost-effective tools to control the coronavirus disease 2019 (COVID-19) pandemic. However, the emergence of variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may threaten the global impact of mass vaccination campaigns. AIMS The objective of this study was to provide an up-to-date comparative analysis of the characteristics, adverse events, efficacy, effectiveness and impact of the variants of concern for 19 COVID-19 vaccines. SOURCES References for this review were identified through searches of PubMed, Google Scholar, BioRxiv, MedRxiv, regulatory drug agencies and pharmaceutical companies' websites up to 22nd September 2021. CONTENT Overall, all COVID-19 vaccines had a high efficacy against the original strain and the variants of concern, and were well tolerated. BNT162b2, mRNA-1273 and Sputnik V after two doses had the highest efficacy (>90%) in preventing symptomatic cases in phase III trials. mRNA vaccines, AZD1222, and CoronaVac were effective in preventing symptomatic COVID-19 and severe infections against Alpha, Beta, Gamma or Delta variants. Regarding observational real-life data, full immunization with mRNA vaccines and AZD1222 seems to effectively prevent SARS-CoV-2 infection against the original strain and Alpha and Beta variants but with reduced effectiveness against the Delta strain. A decline in infection protection was observed at 6 months for BNT162b2 and AZD1222. Serious adverse event rates were rare for mRNA vaccines-anaphylaxis 2.5-4.7 cases per million doses, myocarditis 3.5 cases per million doses-and were similarly rare for all other vaccines. Prices for the different vaccines varied from $2.15 to $29.75 per dose. IMPLICATIONS All vaccines appear to be safe and effective tools to prevent severe COVID-19, hospitalization, and death against all variants of concern, but the quality of evidence greatly varies depending on the vaccines considered. Questions remain regarding a booster dose and waning immunity, the duration of immunity, and heterologous vaccination. The benefits of COVID-19 vaccination outweigh the risks, despite rare serious adverse effects.
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Affiliation(s)
- Thibault Fiolet
- Paris-Saclay University, UVSQ, INSERM, Gustave Roussy, 'Exposome and Heredity' team, CESP UMR1018, Villejuif, France.
| | - Yousra Kherabi
- Université de Paris, IAME, INSERM, Paris, France; Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Conor-James MacDonald
- Paris-Saclay University, UVSQ, INSERM, Gustave Roussy, 'Exposome and Heredity' team, CESP UMR1018, Villejuif, France
| | - Jade Ghosn
- Université de Paris, IAME, INSERM, Paris, France; Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Nathan Peiffer-Smadja
- Université de Paris, IAME, INSERM, Paris, France; Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France; National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
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88
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Cerqueira-Silva T, Oliveira VDA, Boaventura VS, Pescarini JM, Júnior JB, Machado TM, Flores-Ortiz R, Penna GO, Ichihara MY, de Barros JV, Barreto ML, Werneck GL, Barral-Netto M. Influence of age on the effectiveness and duration of protection of Vaxzevria and CoronaVac vaccines: A population-based study. LANCET REGIONAL HEALTH. AMERICAS 2022; 6:100154. [PMID: 34957437 PMCID: PMC8692070 DOI: 10.1016/j.lana.2021.100154] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Aging influences COVID-19 severity and response to vaccination, but previous vaccine effectiveness (VE) analyzes lack the power to evaluate its role in subgroups within the elderly age group. Here we analyzed the impact of age on viral vector and inactivated virus vaccines' effectiveness, the main platforms used in low- and middle-income countries. METHODS We report a retrospective longitudinal study of 75,919,840 Brazilian vaccinees from January 18 to July 24, 2021, evaluating documented infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19-related hospitalisation, ICU admission, and death. Negative binomial regression models adjusted for sociodemographic characteristics were used for VE estimation. FINDINGS The overall analyzes of full vaccination showed VE against hospitalisation, ICU admission, and death of 91·4% (95%CI:90·1-92·5), 91·1% (95%CI:88·9-92·9) and 92·3% (95%CI:90·5-93·7) for Vaxzevria and 71·2% (95%CI:70·0-72·4), 72·2% (95%CI:70·2-74·0) and 73·7% (95%CI:72·1-75·2) for CoronaVac, respectively. VE for all outcomes is progressively lower with age. In fully-Vaxzevria-vaccinated individuals aged <60 years, VE against death was 96.5% (95%CI:82.1-99.3) versus 68·5% (95%CI:40·0-83·4) in those ≥90 years. Among fully-CoronaVac-vaccinated individuals, VE against death was 84.8% (95%CI:77.1-89.9) in those <60 years compared to 63.5 (95%CI 58.7-67.7) for vaccinees aged 80-89 years and 48·6%; (95%CI:35·0-59·3) for individuals aged ≥90 years. Post-vaccination daily cumulative incidence curves for all outcomes showed increased risk from younger to elder decades of life. There was no increase in the incidence of hospitalisation for individuals <60 years vaccinated during the same period as those aged ≥90 years. INTERPRETATION Although both vaccines have been effective in protecting against infection, hospitalization and death; Vaxzevria and CoronaVac demonstrated high effectiveness against severe outcomes for individuals up to 79 years of age. Our results reinforce the idea that booster doses should be carefully considered in elders. FUNDING This study was partially supported by a donation from the "Fazer o bem faz bem" program.
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Affiliation(s)
- Thiago Cerqueira-Silva
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Vinicius de Araújo Oliveira
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | - Viviane S. Boaventura
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Julia M. Pescarini
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Juracy Bertoldo Júnior
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | | | - Renzo Flores-Ortiz
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | - Gerson O. Penna
- Escola Fiocruz de Governo, Núcleo de Medicina Tropical, Universidade de Brasília, Fiocruz Brasilia, Brasilia, DF, Brazil
| | - Maria Yury Ichihara
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | - Jacson Venâncio de Barros
- Departamento de Patologia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brazil
| | - Mauricio L. Barreto
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | | | - Manoel Barral-Netto
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
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Teerawattananon Y, Anothaisintawee T, Pheerapanyawaranun C, Botwright S, Akksilp K, Sirichumroonwit N, Budtarad N, Isaranuwatchai W. A systematic review of methodological approaches for evaluating real-world effectiveness of COVID-19 vaccines: Advising resource-constrained settings. PLoS One 2022; 17:e0261930. [PMID: 35015761 PMCID: PMC8752025 DOI: 10.1371/journal.pone.0261930] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/13/2021] [Indexed: 01/19/2023] Open
Abstract
Real-world effectiveness studies are important for monitoring performance of COVID-19 vaccination programmes and informing COVID-19 prevention and control policies. We aimed to synthesise methodological approaches used in COVID-19 vaccine effectiveness studies, in order to evaluate which approaches are most appropriate to implement in low- and middle-income countries (LMICs). For this rapid systematic review, we searched PubMed and Scopus for articles published from inception to July 7, 2021, without language restrictions. We included any type of peer-reviewed observational study measuring COVID-19 vaccine effectiveness, for any population. We excluded randomised control trials and modelling studies. All data used in the analysis were extracted from included papers. We used a standardised data extraction form, modified from STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Study quality was assessed using the REal Life EVidence AssessmeNt Tool (RELEVANT) tool. This study is registered with PROSPERO, CRD42021264658. Our search identified 3,327 studies, of which 42 were eligible for analysis. Most studies (97.5%) were conducted in high-income countries and the majority assessed mRNA vaccines (78% mRNA only, 17% mRNA and viral vector, 2.5% viral vector, 2.5% inactivated vaccine). Thirty-five of the studies (83%) used a cohort study design. Across studies, short follow-up time and limited assessment and mitigation of potential confounders, including previous SARS-CoV-2 infection and healthcare seeking behaviour, were major limitations. This review summarises methodological approaches for evaluating real-world effectiveness of COVID-19 vaccines and highlights the lack of such studies in LMICs, as well as the importance of context-specific vaccine effectiveness data. Further research in LMICs will refine guidance for conducting real-world COVID-19 vaccine effectiveness studies in resource-constrained settings.
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Affiliation(s)
- Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Thunyarat Anothaisintawee
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Siobhan Botwright
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
- * E-mail:
| | - Katika Akksilp
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Nuttakarn Budtarad
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
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Chen CY, Liu KT, Shih SR, Ye JJ, Chen YT, Pan HC, Hsu HJ, Sun CY, Lee CC, Wu CY, Lai CC, Wu IW. Neutralization Assessments Reveal High Cardiothoracic Ratio and Old Age as Independent Predictors of Low Neutralizing Antibody Titers in Hemodialysis Patients Receiving a Single Dose of COVID-19 Vaccine. J Pers Med 2022; 12:68. [PMID: 35055386 PMCID: PMC8781271 DOI: 10.3390/jpm12010068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Data are lacking regarding predictors of quantification of neutralizing antibodies (nAbs) based on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 50% neutralization titer (NT50) after a single dose of COVID-19 vaccine in hemodialysis (HD) patients. METHODS This prospective single-center study enrolled 200 HD patients and 82 healthy subjects to estimate antibodies against the SARS-CoV-2 viral spike protein 1 and receptor-binding domain after a first dose of a COVID-19 vaccine (ChAdOx1 or mRNA-1273), measured by enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict NT50 converted to international units. RESULTS After the first dose of ChAdOx1, multiple linear regression showed that age (p = 0.011) and cardiothoracic ratio (p = 0.002) were negatively associated with NT50. Older age (OR = 0.958, p = 0.052) and higher cardiothoracic ratio (OR < 0.001, p = 0.037) could predict negative humoral response (NT50 < 35.13 IU/mL). NT50 was lower in HD patients compared with healthy controls receiving ChAdOx1 (10.68 vs. 43.01 IU/m, p < 0.001) or mRNA-1273 (36.39 vs. 262.2 IU/mL, p < 0.001). ChAdOx1 elicited lower GMTs than mRNA-1273 in the HD cohort (10.68 vs. 36.39 IU/mL, p < 0.001) and in healthy controls (43.01 vs. 262.22 IU/mL, p < 0.001). CONCLUSION High cardiothoracic ratio and old age could independently predict a decline in nAb titers in an HD cohort vaccinated with a single dose of ChAdOx1.
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Affiliation(s)
- Chun-Yu Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Kuan-Ting Liu
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-T.L.); (S.-R.S.)
- Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Shin-Ru Shih
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-T.L.); (S.-R.S.)
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Jung-Jr Ye
- Department of Infectious Diseases, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Yih-Ting Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Heng-Chih Pan
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Heng-Jung Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chiao-Yin Sun
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chin-Chan Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chun-Ying Wu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - I-Wen Wu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
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Rifai A, Wahono CS, Pratama MZ, Handono K, Susianti H, Iskandar A, Diyah N, Santoningsih D, Samsu N, Gunawan A. Association Between the Effectiveness and Immunogenicity of Inactivated SARS-CoV2 Vaccine (CoronaVac) with the Presence of Hypertension among Health Care Workers. Clin Exp Hypertens 2022; 44:233-239. [PMID: 34994256 DOI: 10.1080/10641963.2021.2022687] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to observe the association between the presence of hypertension with Covid-19 vaccine effectiveness among healthcare workers who received CoronaVac vaccination. METHODS We conducted a prospective cohort study in Saiful Anwar General Hospital, Malang, Indonesia on 155 healthcare workers aged 18-59 years old who already received twice of the CoronaVac (Sinovac Life Science, Beijing, China) injection with 14-day intervals. Hypertension was diagnosed according to the 2020 International Society of Hypertension. Subjects were monitored for six months. The primary outcome was the rate of Covid-19 diagnosed by the pharyngeal swab for the real-time reverse transcription-polymerase chain reaction (RT-PCR) examination. The secondary endpoints were: (1) severity of Covid-19 among infected participants; (2) rate of hospitalizations; and (3) anti-SRBD antibody levels measured by ECLIA. RESULTS Among 155 participants, 18.7% of them were diagnosed with hypertension, and 31.0% had the desirable BP target according to the current guidelines. Subjects with hypertension, especially those with uncontrolled blood pressure, had a higher incidence of Covid-19 infection than subjects without hypertension. Subjects with symptomatic Covid-19 and hospitalized because of Covid-19 were higher in participants with hypertension. The anti-SRBD antibody levels were lower in the second month after CoronaVac vaccination in hypertensive subjects. In contrast, comparable anti-SRBD levels were seen from both groups at sixth months after vaccination. CONCLUSION Hypertension was associated with lower vaccine effectiveness in healthcare workers. Subjects with hypertension had a higher risk of being infected with Covid-19 despite getting a complete dose of vaccination and lower antibody production.
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Affiliation(s)
- Achmad Rifai
- Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Cesarius Singgih Wahono
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Mirza Zaka Pratama
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Kusworini Handono
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Hani Susianti
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Agustin Iskandar
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Nurima Diyah
- Department of Microbiology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Dewi Santoningsih
- Department of Microbiology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Nur Samsu
- Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Atma Gunawan
- Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
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Prunas O, Weinberger DM, Pitzer VE, Gazit S, Patalon T. Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.04.22268776. [PMID: 35018389 PMCID: PMC8750715 DOI: 10.1101/2022.01.04.22268776] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The short-term effectiveness of a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, though, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months. METHODS Leveraging the centralized computerized database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where two outcomes were evaluated separately: a documented SARS-CoV-2 infection (regardless of symptoms) and a symptomatic infection (COVID-19). Cases were defined as individuals aged 12 to 16 with a positive PCR test occurring between June 15 and December 8, 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously. RESULTS We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% and 90% effectiveness against SARS-CoV-2 infection and COVID-19, respectively. However, in line with previous findings for adults, waning of vaccine effectiveness was evident in adolescents as well. Long-term protection conferred by the vaccine was reduced to 75-78% against infection and symptomatic infection, respectively, 3 to 5 months after the second dose, and waned to 58% against infection and 65% against COVID-19 after 5 months. CONCLUSIONS Like adults, vaccine-induced protection against both SARS-CoV-2 infection and COVID-19 wanes with time, starting three months after inoculation and continuing for more than five months.
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Affiliation(s)
- Ottavia Prunas
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University; New Haven, CT USA.,Corresponding author
| | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University; New Haven, CT USA
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University; New Haven, CT USA
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Israel
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Azzi L, Dalla Gasperina D, Veronesi G, Shallak M, Ietto G, Iovino D, Baj A, Gianfagna F, Maurino V, Focosi D, Maggi F, Ferrario MM, Dentali F, Carcano G, Tagliabue A, Maffioli LS, Accolla RS, Forlani G. Mucosal immune response in BNT162b2 COVID-19 vaccine recipients. EBioMedicine 2022; 75:103788. [PMID: 34954658 PMCID: PMC8718969 DOI: 10.1016/j.ebiom.2021.103788] [Citation(s) in RCA: 134] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although the BNT162b2 COVID-19 vaccine is known to induce IgG neutralizing antibodies in serum protecting against COVID-19, it has not been studied in detail whether it could generate specific immunity at mucosal sites, which represent the primary route of entry of SARS-CoV-2. METHODS Samples of serum and saliva of 60 BNT162b2-vaccinated healthcare workers were collected at baseline, two weeks after the first dose and two weeks after the second dose. Anti-S1-protein IgG and IgA total antibodies titres and the presence of neutralizing antibodies against the Receptor Binding Domain in both serum and saliva were measured by quantitative and by competitive ELISA, respectively. FINDINGS Complete vaccination cycle generates a high serum IgG antibody titre as a single dose in previously infected seropositive individuals. Serum IgA concentration reaches a plateau after a single dose in seropositive individuals and two vaccine doses in seronegative subjects. After the second dose IgA level was higher in seronegative than in seropositive subjects. In saliva, IgG level is almost two orders of magnitude lower than in serum, reaching the highest values after the second dose. IgA concentration remains low and increases significantly only in seropositive individuals after the second dose. Neutralizing antibody titres were much higher in serum than in saliva. INTERPRETATION The mRNA BNT162b2 vaccination elicits a strong systemic immune response by drastically boosting neutralizing antibodies development in serum, but not in saliva, indicating that at least oral mucosal immunity is poorly activated by this vaccination protocol, thus failing in limiting virus acquisition upon its entry through this route. FUNDING This work was funded by the Department of Medicine and Surgery, University of Insubria, and partially supported by Fondazione Umberto Veronesi (COVID-19 Insieme per la ricerca di tutti, 2020).
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Affiliation(s)
- Lorenzo Azzi
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Daniela Dalla Gasperina
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giovanni Veronesi
- Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Mariam Shallak
- Laboratory of General Pathology and Immunology "Giovanna Tosi", Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giuseppe Ietto
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Domenico Iovino
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Andreina Baj
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Gianfagna
- Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Vittorio Maurino
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy
| | - Fabrizio Maggi
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Marco Mario Ferrario
- Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Dentali
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giulio Carcano
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Angelo Tagliabue
- Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Roberto Sergio Accolla
- Laboratory of General Pathology and Immunology "Giovanna Tosi", Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Greta Forlani
- Laboratory of General Pathology and Immunology "Giovanna Tosi", Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Alsaffar WA, Alwesaibi AA, Alhaddad MJ, Alsenan ZK, Alsheef HJ, Alramadan SH, Aljassas HA, Alsaghirat MA, Alzahrani HJ. The Effectiveness of COVID-19 Vaccines in Improving the Outcomes of Hospitalized COVID-19 Patients. Cureus 2022; 14:e21485. [PMID: 35103227 PMCID: PMC8783154 DOI: 10.7759/cureus.21485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 12/28/2022] Open
Abstract
Background With the rapid spread of coronavirus disease 2019 (COVID-19), most countries took extreme measures to control the disease. Equitable access to safe and effective vaccines is critical to ending the COVID-19 pandemic. The Ministry of Health program in Saudi Arabia aimed to cover 17.4 million adults (70% of the adult population of Saudi Arabia) by the third quarter of 2021. We investigated the impact of the COVID-19 vaccine on the clinical course and outcomes of the admitted confirmed COVID-19 patients, in comparison to non-vaccinated patients. Methodology A retrospective cross-sectional record review was conducted for all hospitalized confirmed COVID-19 patients at Dammam Medical Complex (Eastern Province, Saudi Arabia) from June to July 2021. Two groups were studied according to the vaccination status (i.e., vaccinated and non-vaccinated). Information regarding comorbidities, length of stay, high oxygen requirements, ICU admission, and mortality data were collected and analyzed using the Python programming language (version 3.7.6) with the use of SciPy library (1.4.1) and Statsmodels module (v0.11.1). Results The sample included a total of 260 admitted confirmed COVID-19 cases. The mortality was significantly lower in the vaccinated group versus the non-vaccinated group with an odds ratio (OR) of 0.378 (CI 0.154-0.928). In addition, the OR of ICU admission was 0.476 (CI 0.218-1.042) and OR of endotracheal intubation was 0.561 (CI 0.249-1.265), but these did not reach statistical significance. We also detected a statistically significant relationship between mortality - regardless of vaccination status - and age ≥ 65 years (P=0.000, OR=7.51; 95%CI 3.13 to 18.04), chronic kidney disease (P=0.010, OR=5.62; CI 1.52 to 20.79), and renal transplant (P=0.037, OR=10.17; CI 1.15 to 89.76). Of note, most of our vaccinated patients received only a single dose (85%). Conclusion There is a significant reduction in mortality cases as well as less complicated hospital courses among the vaccinated group, in spite of the fact that most of our admitted patients had only a single vaccine shot. Suboptimal response to the vaccines was observed in the elder, chronic kidney disease, and renal transplant patients, hence the poorer outcomes in comparison to other patients.
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Ben-Tov A, Lotan R, Gazit S, Chodick G, Perez G, Mizrahi-Reuveni M, Patalon T. Dynamics in COVID-19 symptoms during different waves of the pandemic among children infected with SARS-CoV-2 in the ambulatory setting. Eur J Pediatr 2022; 181:3309-3318. [PMID: 35778524 PMCID: PMC9395901 DOI: 10.1007/s00431-022-04531-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/22/2022] [Accepted: 06/12/2022] [Indexed: 12/04/2022]
Abstract
UNLABELLED The aim of this real-life, big data population-based study was to evaluate differences in symptomatic presentation of children infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) between the third and fourth waves of the pandemic in Israel, dominated by the Alpha and Delta variants, respectively. Our cohort included all children and adolescents, members of the second-largest Health Maintenance Organization in Israel that had positive real-time polymerase chain reaction (RT-PCR) test during the third and fourth waves of the pandemic (December 1, 2020, to April 30, 2021, and June 1, 2021, to October 10, 2021, respectively). A total of 32,485 and 44,130 children and adolescents in the third and fourth waves were included in the final analysis. The rate of children with symptomatic disease among patients with documented SARS-CoV-2 infection was higher in the fourth wave compared to the third wave (49.9% vs. 37.5%). The most commonly reported symptom and the only symptom that substantially differed between waves was fever, with 33% of SARS-CoV-2 infected children in the fourth wave vs. 13.6% in the third wave. Preschool children had the lowest prevalence of febrile illness compared to other age groups. CONCLUSION Children and adolescents infected during the fourth wave of the pandemic in Israel, a Delta-dominant period, had a significantly higher rate of symptomatic febrile illness than the Alpha-dominant period. This phenomenon occurred across all age groups. WHAT IS KNOWN • There are differences in COVID-19 severity among adults and children during different waves of the pandemic. • There is a paucity of data regarding symptomatic characteristics in children in large-scale cohorts aside from hospital settings. WHAT IS NEW • In a time period dominated by the Delta variant, there were substantially more children with symptomatic disease and febrile illness compared to a period dominated by the alpha variant. • Preschool children had the lowest rate of febrile illness among all age groups.
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Affiliation(s)
- Amir Ben-Tov
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
- Pediatric Gastroenterology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Lotan
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Galit Perez
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | | | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
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Bouillon K, Baricault B, Botton J, Jabagi MJ, Bertrand M, Semenzato L, Le Vu S, Drouin J, Dray-Spira R, Weill A, Zureik M. Effectiveness of BNT162b2, mRNA-1273, and ChAdOx1-S vaccines against severe covid-19 outcomes in a nationwide mass vaccination setting: cohort study. BMJ MEDICINE 2022; 1:e000104. [PMID: 36936561 PMCID: PMC9978755 DOI: 10.1136/bmjmed-2021-000104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/11/2022] [Indexed: 11/07/2022]
Abstract
Objective To estimate the effectiveness of the three covid-19 vaccines by Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Oxford-AstraZeneca (ChAdOx1-S) in people after receiving two doses. Design Cohort study. Setting Nationwide, population based data in France, from the French National Health Data System (Système National des Données de Santé), between 27 December 2020 and 30 April 2021. Participants Adults aged ≥50 years receiving a first dose of BNT162b2, mRNA-1273, or ChAdOx1-S were randomly selected (1:1) and matched on the date of vaccination with one unvaccinated control. Individuals were matched on year of birth, sex, region of residence, and residence in a nursing home (for individuals aged ≥75 years). All individuals were followed up until 20 August 2021. Main outcome measures Primary outcome measure was vaccine effectiveness estimated at least 14 days after the second dose against covid-19 related hospital admission using Cox proportional hazards models adjusted for baseline characteristics and comorbidities. Vaccine effectiveness against covid-19 related death in hospital was also investigated. Results 11 256 832 vaccinated individuals were included in the study (63.6% (n=7 161 658) with the BNT162b2 vaccine, 7.6% (n=856 599) with the mRNA-1273 vaccine, and 28.8% (n=3 238 575) with the ChAdOx1-S vaccine), along with 11 256 832 matched unvaccinated controls. During follow-up (up to 20 August 2021), 43 158 covid-19 related hospital admissions and 7957 covid-19 related deaths in hospital were registered. Compared with unvaccinated controls, vaccine effectiveness of two doses against covid-19 related hospital admission was 91% (95% confidence interval 91% to 92%), 95% (93% to 96%), and 91% (89% to 94%) for the BNT162b2, mRNA-1273, and ChAdOx1-S vaccines, respectively. Similar results were observed for vaccine effectiveness of two doses against covid-19 related deaths in hospital (BNT162b2, 91% (90% to 93%); mRNA-1273, 96% (92% to 98%); and ChAdOx1 nCoV-19, 88% (68% to 95%)). At 5-6 months after receiving the second dose of vaccine, effectiveness remained high at 94% (92% to 95%) for the BNT162b2 vaccine and 98% (93% to 100%) for the mRNA-1273 vaccine. Vaccine effectiveness of ChAdOx1-S estimated at 3-4 months was 90% (63% to 97%). All three vaccines remained effective at the time of circulation of the delta variant of SARS-CoV-2 between 1 July and 20 August 2021 (effectiveness between 89% and 95%). Conclusions These findings provide evidence indicating that two doses of ChAdOx1-S is as effective as two doses of mRNA vaccines in France against the alpha and delta variants of SARS-CoV-2. The effectiveness of ChAdOx1-S should be further examined with a longer follow-up and in the light of the circulation of new SARS-CoV-2 variants of concern.
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Affiliation(s)
- Kim Bouillon
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Bérangère Baricault
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Jérémie Botton
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
- Faculty of Pharmacy, Paris-Saclay University, Châtenay-Malabry, France
| | - Marie-Joëlle Jabagi
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Marion Bertrand
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Laura Semenzato
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Stéphane Le Vu
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Jérôme Drouin
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Rosemary Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, Saint-Denis, France
- CESP-Inserm, Anti-infective evasion and pharmacoepidemiology, Paris-Saclay University, UVSQ, Montigny le Bretonneux, France
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97
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Mathema B, Chen L, Chow KF, Zhao Y, Zody MC, Mediavilla JR, Cunningham MH, Composto K, Lee A, Oschwald DM, Germer S, Fennessey S, Patel K, Wilson D, Cassell A, Pascual L, Ip A, Corvelo A, Dar S, Kramer Y, Maniatis T, Perlin DS, Kreiswirth BN. Postvaccination SARS-COV-2 among Health Care Workers in New Jersey: A Genomic Epidemiological Study. Microbiol Spectr 2021; 9:e0188221. [PMID: 34787439 PMCID: PMC8597639 DOI: 10.1128/spectrum.01882-21] [Citation(s) in RCA: 3] [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: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 12/15/2022] Open
Abstract
Emergence of SARS-CoV-2 with high transmission and immune evasion potential, the so-called variants of concern (VOC), is a major concern. We describe the early genomic epidemiology of SARS-CoV-2 recovered from vaccinated health care professionals (HCP). Our postvaccination COVID-19 symptoms-based surveillance program among HCPs in a 17-hospital network identified all vaccinated HCPs who tested positive for COVID-19 after routine screening or after self-reporting. From 1 January 2021 to 30 April 2021, 23,687 HCPs received either mRNA-1273 or BNT162b2 mRNA vaccine. All available postvaccination SARS-CoV-2 samples and a random collection from nonvaccinated patients during the similar time frame were subjected to VOC screening and whole-genome sequencing (WGS). Sixty-two percent (23,697/37,500) of HCPs received at least one vaccine dose, with 60% (22,458) fully vaccinated. We detected 138 (0.58%, 138/23,697) COVID-19 cases, 105 among partially vaccinated and 33 (0.15%, 33/22,458) among fully vaccinated. Five partially vaccinated required hospitalization, four with supplemental oxygen. VOC screening from 16 fully vaccinated HCPs identified 6 (38%) harboring N501Y and 1 (6%) with E484K polymorphisms; percentage of concurrent nonvaccinated samples was 37% (523/1,404) and 20% (284/1,394), respectively. There was an upward trend from January to April for E484K/Q (3% to 26%) and N501Y (1% to 49%). WGS analysis from vaccinated and nonvaccinated individuals indicated highly congruent phylogenies. We did not detect an increased frequency of any receptor-binding domain (RBD)/N-terminal domain (NTD) polymorphism between groups (P > 0.05). Our results support robust protection by vaccination, particularly among recipients of both doses. Despite VOCs accounting for over 40% of SARS-CoV-2 from fully vaccinated individuals, the genomic diversity appears to proportionally represent VOCs among nonvaccinated populations. IMPORTANCE A number of highly effective vaccines have been developed and deployed to combat the COVID-19 pandemic. The emergence and epidemiological dominance of SARS-CoV-2 mutants with high transmission potential and immune evasion properties, the so-called variants of concern (VOC), continue to be a major concern. Whether these VOCs alter the efficacy of the administered vaccines is of great concern and a critical question to study. We describe the initial genomic epidemiology of SARS-CoV-2 recovered from partial/fully vaccinated health care professionals and probe specifically for VOC enrichment. Our findings support the high level of protection provided by full vaccination despite a steep increase in the prevalence of polymorphisms associated with increased transmission potential (N501Y) and immune evasion (E484K) in the nonvaccinated population. Thus, we do not find evidence of VOC enrichment among vaccinated groups. Overall, the genomic diversity of SARS-CoV-2 recovered postvaccination appears to proportionally represent the observed viral diversity within the community.
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Affiliation(s)
- Barun Mathema
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Liang Chen
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Kar Fai Chow
- Hackensack Meridian Health Biorepository, Hackensack, New Jersey, USA
| | - Yanan Zhao
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | | | - Jose R. Mediavilla
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Marcus H. Cunningham
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Kaelea Composto
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Annie Lee
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | | | | | | | - Kishan Patel
- Hackensack Meridian Health Biorepository, Hackensack, New Jersey, USA
| | - David Wilson
- Hackensack Meridian Health BI Analytics, Edison, New Jersey, USA
| | - Ann Cassell
- Hackensack Meridian Health BI Analytics, Edison, New Jersey, USA
| | - Lauren Pascual
- John Theurer Cancer Center, Outcomes Division, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Andrew Ip
- John Theurer Cancer Center, Outcomes Division, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | | | - Sophia Dar
- Hackensack Meridian Health Biorepository, Hackensack, New Jersey, USA
| | - Yael Kramer
- Hackensack Meridian Health Biorepository, Hackensack, New Jersey, USA
| | | | - David S. Perlin
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Barry N. Kreiswirth
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
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98
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O’Connor MA, Erasmus JH, Randall S, Archer J, Lewis TB, Brown B, Fredericks M, Groenier S, Iwayama N, Ahrens C, Garrison W, Wangari S, Guerriero KA, Fuller DH. A Single Dose SARS-CoV-2 Replicon RNA Vaccine Induces Cellular and Humoral Immune Responses in Simian Immunodeficiency Virus Infected and Uninfected Pigtail Macaques. Front Immunol 2021; 12:800723. [PMID: 34992610 PMCID: PMC8724308 DOI: 10.3389/fimmu.2021.800723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
The ongoing COVID-19 vaccine rollout is critical for reducing SARS-CoV-2 infections, hospitalizations, and deaths worldwide. Unfortunately, massive disparities exist in getting vaccines to vulnerable populations, including people living with HIV. Preliminary studies indicate that COVID-19 mRNA vaccines are safe and immunogenic in people living with HIV that are virally suppressed with potent antiretroviral therapy but may be less efficacious in immunocompromised individuals. This raises the concern that COVID-19 vaccines may be less effective in resource poor settings with limited access to antiretroviral therapy. Here, we evaluated the immunogenicity of a single dose COVID-19 replicon RNA vaccine expressing Spike protein (A.1) from SARS-CoV-2 (repRNA-CoV2S) in immunocompromised, SIV infected and immune competent, naïve pigtail macaques. Moderate vaccine-specific cellular Th1 T-cell responses and binding and neutralizing antibodies were induced by repRNA-CoV2S in SIV infected animals and naïve animals. Furthermore, vaccine immunogenicity was elicited even among the animals with the highest SIV viral burden or lowest peripheral CD4 counts prior to immunization. This study provides evidence that a SARS-CoV-2 repRNA vaccine could be employed to induce strong immunity against COVID-19 in HIV infected and other immunocompromised individuals.
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MESH Headings
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- COVID-19/immunology
- COVID-19/prevention & control
- COVID-19/virology
- COVID-19 Vaccines/administration & dosage
- COVID-19 Vaccines/genetics
- COVID-19 Vaccines/immunology
- Cells, Cultured
- Disease Models, Animal
- Host-Pathogen Interactions
- Immunity, Cellular/drug effects
- Immunity, Humoral/drug effects
- Immunocompromised Host
- Immunogenicity, Vaccine
- Macaca nemestrina
- Male
- Simian Acquired Immunodeficiency Syndrome/blood
- Simian Acquired Immunodeficiency Syndrome/immunology
- Simian Acquired Immunodeficiency Syndrome/virology
- Simian Immunodeficiency Virus/immunology
- Simian Immunodeficiency Virus/pathogenicity
- Spike Glycoprotein, Coronavirus/administration & dosage
- Spike Glycoprotein, Coronavirus/genetics
- Spike Glycoprotein, Coronavirus/immunology
- Th1 Cells/drug effects
- Th1 Cells/immunology
- Th1 Cells/virology
- Time Factors
- Vaccination
- Vaccine Efficacy
- mRNA Vaccines/administration & dosage
- mRNA Vaccines/genetics
- mRNA Vaccines/immunology
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Affiliation(s)
- Megan A. O’Connor
- Department of Microbiology, University of Washington, Seattle, WA, United States
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Jesse H. Erasmus
- Department of Microbiology, University of Washington, Seattle, WA, United States
- HDT Bio, Seattle, WA, United States
| | - Samantha Randall
- Department of Microbiology, University of Washington, Seattle, WA, United States
| | - Jacob Archer
- Department of Microbiology, University of Washington, Seattle, WA, United States
- HDT Bio, Seattle, WA, United States
| | - Thomas B. Lewis
- Department of Microbiology, University of Washington, Seattle, WA, United States
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Brieann Brown
- Department of Microbiology, University of Washington, Seattle, WA, United States
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Megan Fredericks
- Department of Microbiology, University of Washington, Seattle, WA, United States
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Skyler Groenier
- Department of Microbiology, University of Washington, Seattle, WA, United States
| | - Naoto Iwayama
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Chul Ahrens
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - William Garrison
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Solomon Wangari
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Kathryn A. Guerriero
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Deborah H. Fuller
- Department of Microbiology, University of Washington, Seattle, WA, United States
- Washington National Primate Research Center, University of Washington, Seattle, WA, United States
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99
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Cheng CJ, Lu CY, Chang YH, Sun Y, Chu HJ, Lee CY, Liu CH, Lin CH, Lu CJ, Li CY. Effectiveness of the WHO-Authorized COVID-19 Vaccines: A Rapid Review of Global Reports till 30 June 2021. Vaccines (Basel) 2021; 9:1489. [PMID: 34960235 PMCID: PMC8708265 DOI: 10.3390/vaccines9121489] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 01/06/2023] Open
Abstract
Large clinical trials have proven the efficacy of the COVID-19 vaccine, and the number of studies about the effectiveness rapidly grew in the first half of the year after mass vaccination was administrated globally. This rapid review aims to provide evidence syntheses as a means to complement the current evidence on the vaccine effectiveness (VE) against various outcomes in real-world settings. Databases (PubMed, EMBASE, and MedRxiv) were searched up to 30 June 2021, (PROSPERO ID: 266866). A total of 39 studies were included, covering over 15 million participants from 11 nations. Among the general population being fully vaccinated, the VE against symptomatic SARS-CoV-2 infection was estimated at 89-97%, 92% (95% CI, 78-97%), and 94% (95% CI, 86-97%) for BNT162b2, ChAdOx1, and mRNA-1273, respectively. As for the protective effects against B.1.617.2-related symptomatic infection, the VE was 88% (95% CI, 85.3-90.1%) by BNT162b2 and 67.0% (95% CI, 61.3-71.8%) by ChAdOx1 after full vaccination. This review revealed a consistently high effectiveness of certain vaccines among the general population in real-world settings. However, scarce data on the major variants of SARS-CoV-2 and the shortness of the study time may limit the conclusions to the mRNA vaccines and ChAdOx1.
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Affiliation(s)
- Chang-Jie Cheng
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
- Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chun-Yi Lu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, Taipei 100, Taiwan;
- College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
- Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Hai-Jui Chu
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
- Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chun-Yu Lee
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
- Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chang-Hsiu Liu
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
| | - Cheng-Huai Lin
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
| | - Chien-Jung Lu
- Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; (C.-J.C.); (H.-J.C.); (C.-Y.L.); (C.-H.L.); (C.-H.L.); (C.-J.L.)
- Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
- Department of Public Health, College of Public Health, China Medical University, Taichung 404, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
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100
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Levin EG, Lustig Y, Cohen C, Fluss R, Indenbaum V, Amit S, Doolman R, Asraf K, Mendelson E, Ziv A, Rubin C, Freedman L, Kreiss Y, Regev-Yochay G. Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months. N Engl J Med 2021; 385:e84. [PMID: 34614326 PMCID: PMC8522797 DOI: 10.1056/nejmoa2114583] [Citation(s) in RCA: 1173] [Impact Index Per Article: 391.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite high vaccine coverage and effectiveness, the incidence of symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been increasing in Israel. Whether the increasing incidence of infection is due to waning immunity after the receipt of two doses of the BNT162b2 vaccine is unclear. METHODS We conducted a 6-month longitudinal prospective study involving vaccinated health care workers who were tested monthly for the presence of anti-spike IgG and neutralizing antibodies. Linear mixed models were used to assess the dynamics of antibody levels and to determine predictors of antibody levels at 6 months. RESULTS The study included 4868 participants, with 3808 being included in the linear mixed-model analyses. The level of IgG antibodies decreased at a consistent rate, whereas the neutralizing antibody level decreased rapidly for the first 3 months with a relatively slow decrease thereafter. Although IgG antibody levels were highly correlated with neutralizing antibody titers (Spearman's rank correlation between 0.68 and 0.75), the regression relationship between the IgG and neutralizing antibody levels depended on the time since receipt of the second vaccine dose. Six months after receipt of the second dose, neutralizing antibody titers were substantially lower among men than among women (ratio of means, 0.64; 95% confidence interval [CI], 0.55 to 0.75), lower among persons 65 years of age or older than among those 18 to less than 45 years of age (ratio of means, 0.58; 95% CI, 0.48 to 0.70), and lower among participants with immunosuppression than among those without immunosuppression (ratio of means, 0.30; 95% CI, 0.20 to 0.46). CONCLUSIONS Six months after receipt of the second dose of the BNT162b2 vaccine, humoral response was substantially decreased, especially among men, among persons 65 years of age or older, and among persons with immunosuppression.
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Affiliation(s)
- Einav G Levin
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Yaniv Lustig
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Carmit Cohen
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Ronen Fluss
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Victoria Indenbaum
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Sharon Amit
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Ram Doolman
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Keren Asraf
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Ella Mendelson
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Arnona Ziv
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Carmit Rubin
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Laurence Freedman
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Yitshak Kreiss
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
| | - Gili Regev-Yochay
- From the Infection Prevention and Control Unit (E.G.L., C.C., G.R.-Y.), the Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research (R.F., A.Z., C.R., L.F.), the Automated Mega-Laboratory, Laboratory Division (R.D., K.A.), the Department of Clinical Microbiology (S.A.), and the Sheba Medical Center Management (Y.K.), Sheba Medical Center Tel Hashomer, and the Central Virology Laboratory, Public Health Services, Ministry of Health (Y.L., V.I., E.M.), Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (E.G.L., Y.L., E.M., Y.K., G.R.-Y.) - all in Israel
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