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Optimization of Vaccination Clinics to Improve Staffing Decisions for COVID-19: A Time-Motion Study. Vaccines (Basel) 2022; 10:vaccines10122045. [PMID: 36560455 PMCID: PMC9781296 DOI: 10.3390/vaccines10122045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
As the COVID-19 pandemic disturbed people's daily life for more than 2 years, many COVID-19 vaccines have been carried forward systematically to curb the transmission of the virus. However, high vaccination tasks bring great challenges to personnel allocation. We observed nine vaccination clinics in Huzhou and Shanghai and built a discrete-event simulation model to simulate the optimal staffing of vaccination clinics under 10 different scenarios. Based on the result of the simulations, we optimized the allocation of vaccination staff in different stages of epidemic development by province in China. The results showed that optimizing staffing could both boost service utilization and shorten the queuing time for vaccination recipients. Taking Jilin Province as an example, to increase the booster vaccination rate within 3 months, the number of vaccination staff members needed was 2028, with a continuous small-scale breakout and 2,416 under a stable epidemic situation. When there was a shortage of vaccination staff, the total number of vaccination clinic staff members needed could be significantly reduced by combining the preview and registration steps. This study provides theoretical support for the personnel arrangement of COVID-19 vaccinations of a booster dose by province and the assessment of current vaccination staff reserves.
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Valenzuela-Fernández A, Cabrera-Rodriguez R, Ciuffreda L, Perez-Yanes S, Estevez-Herrera J, González-Montelongo R, Alcoba-Florez J, Trujillo-González R, García-Martínez de Artola D, Gil-Campesino H, Díez-Gil O, Lorenzo-Salazar JM, Flores C, Garcia-Luis J. Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19. Front Bioeng Biotechnol 2022; 10:1052436. [PMID: 36507266 PMCID: PMC9732709 DOI: 10.3389/fbioe.2022.1052436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.
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Affiliation(s)
- Agustín Valenzuela-Fernández
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Romina Cabrera-Rodriguez
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Laura Ciuffreda
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Silvia Perez-Yanes
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Judith Estevez-Herrera
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Julia Alcoba-Florez
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Rodrigo Trujillo-González
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- Departamento de Análisis Matemático, Facultad de Ciencias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Helena Gil-Campesino
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Oscar Díez-Gil
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - José M. Lorenzo-Salazar
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
| | - Carlos Flores
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Jonay Garcia-Luis
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
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103
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Lee J, Khang D. Mucosal delivery of nanovaccine strategy against COVID-19 and its variants. Acta Pharm Sin B 2022; 13:S2211-3835(22)00489-0. [PMID: 36438851 PMCID: PMC9676163 DOI: 10.1016/j.apsb.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Despite the global administration of approved COVID-19 vaccines (e.g., ChAdOx1 nCoV-19®, mRNA-1273®, BNT162b2®), the number of infections and fatalities continue to rise at an alarming rate because of the new variants such as Omicron and its subvariants. Including COVID-19 vaccines that are licensed for human use, most of the vaccines that are currently in clinical trials are administered via parenteral route. However, it has been proven that the parenteral vaccines do not induce localized immunity in the upper respiratory mucosal surface, and administration of the currently approved vaccines does not necessarily lead to sterilizing immunity. This further supports the necessity of a mucosal vaccine that blocks the main entrance route of COVID-19: nasal and oral mucosal surfaces. Understanding the mechanism of immune regulation of M cells and dendritic cells and targeting them can be another promising approach for the successful stimulation of the mucosal immune system. This paper reviews the basic mechanisms of the mucosal immunity elicited by mucosal vaccines and summarizes the practical aspects and challenges of nanotechnology-based vaccine platform development, as well as ligand hybrid nanoparticles as potentially effective target delivery agents for mucosal vaccines.
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Affiliation(s)
- Junwoo Lee
- College of Medicine, Gachon University, Incheon 21999, South Korea
| | - Dongwoo Khang
- College of Medicine, Gachon University, Incheon 21999, South Korea
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, South Korea
- Gachon Advanced Institute for Health Science & Technology, Gachon University, Incheon 21999, South Korea
- Department of Physiology, College of Medicine, Gachon University, Incheon 21999, South Korea
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104
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Host Protective Immunity against Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) and the COVID-19 Vaccine-Induced Immunity against SARS-CoV-2 and Its Variants. Viruses 2022; 14:v14112541. [PMID: 36423150 PMCID: PMC9697230 DOI: 10.3390/v14112541] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
The world is now apparently at the last/recovery stage of the COVID-19 pandemic, starting from 29 December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With the progression of time, several mutations have taken place in the original SARS-CoV-2 Wuhan strain, which have generated variants of concern (VOC). Therefore, combatting COVID-19 has required the development of COVID-19 vaccines using several platforms. The immunity induced by those vaccines is vital to study in order to assure total protection against SARS-CoV-2 and its emerging variants. Indeed, understanding and identifying COVID-19 protection mechanisms or the host immune responses are of significance in terms of designing both new and repurposed drugs as well as the development of novel vaccines with few to no side effects. Detecting the immune mechanisms for host protection against SARS-CoV-2 and its variants is crucial for the development of novel COVID-19 vaccines as well as to monitor the effectiveness of the currently used vaccines worldwide. Immune memory in terms of the production of neutralizing antibodies (NAbs) during reinfection is also very crucial to formulate the vaccine administration schedule/vaccine doses. The response of antigen-specific antibodies and NAbs as well as T cell responses, along with the protective cytokine production and the innate immunity generated upon COVID-19 vaccination, are discussed in the current review in comparison to the features of naturally induced protective immunity.
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105
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Liu S, Stauft CB, Selvaraj P, Chandrasekaran P, D’Agnillo F, Chou CK, Wu WW, Lien CZ, Meseda CA, Pedro CL, Starost MF, Weir JP, Wang TT. Intranasal delivery of a rationally attenuated SARS-CoV-2 is immunogenic and protective in Syrian hamsters. Nat Commun 2022; 13:6792. [PMID: 36357440 PMCID: PMC9648440 DOI: 10.1038/s41467-022-34571-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
Few live attenuated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are in pre-clinical or clinical development. We seek to attenuate SARS-CoV-2 (isolate WA1/2020) by removing the polybasic insert within the spike protein and the open reading frames (ORFs) 6-8, and by introducing mutations that abolish non-structural protein 1 (Nsp1)-mediated toxicity. The derived virus (WA1-ΔPRRA-ΔORF6-8-Nsp1K164A/H165A) replicates to 100- to 1000-fold-lower titers than the ancestral virus and induces little lung pathology in both K18-human ACE2 (hACE2) transgenic mice and Syrian hamsters. Immunofluorescence and transcriptomic analyses of infected hamsters confirm that three-pronged genetic modifications attenuate the proinflammatory pathways more than the removal of the polybasic cleavage site alone. Finally, intranasal administration of just 100 PFU of the WA1-ΔPRRA-ΔORF6-8-Nsp1K164A/H165A elicits robust antibody responses in Syrian hamsters and protects against SARS-CoV-2-induced weight loss and pneumonia. As a proof-of-concept study, we demonstrate that live but sufficiently attenuated SARS-CoV-2 vaccines may be attainable by rational design.
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Affiliation(s)
- Shufeng Liu
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Charles B. Stauft
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Prabhuanand Selvaraj
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Prabha Chandrasekaran
- grid.94365.3d0000 0001 2297 5165Laboratory of Clinical Investigation, National Institutes of Aging, National Institutes of Health, Baltimore, USA
| | - Felice D’Agnillo
- grid.417587.80000 0001 2243 3366Laboratory of Biochemistry and Vascular Biology, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Chao-Kai Chou
- grid.417587.80000 0001 2243 3366Facility for Biotechnology Resources, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Wells W. Wu
- grid.417587.80000 0001 2243 3366Facility for Biotechnology Resources, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Christopher Z. Lien
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Clement A. Meseda
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Cyntia L. Pedro
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Matthew F. Starost
- grid.94365.3d0000 0001 2297 5165Division of Veterinary Resources, Diagnostic and Research Services Branch, National Institutes of Health, Rockville Pike, USA
| | - Jerry P. Weir
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
| | - Tony T. Wang
- grid.417587.80000 0001 2243 3366Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD USA
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106
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Li X, Yang X, Ning Z. Efficacy and safety of COVID-19 inactivated vaccine: A meta-analysis. Front Med (Lausanne) 2022; 9:1015184. [PMID: 36419789 PMCID: PMC9676443 DOI: 10.3389/fmed.2022.1015184] [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: 08/09/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
Background Inactivated vaccine is one of the primary technology types of Coronavirus Disease 2019 (COVID-19) vaccines, which has wide application in many countries, including mainland China. However, systematic evaluation of the efficacy and safety of COVID-19 inactivated vaccines remains limited. And trust in the vaccine is the key to solving vaccine hesitancy. Methods Various academic databases were searched comprehensively for randomized controlled trials (RCTs) related to COVID-19 inactivated vaccines. The deadline for retrieval was December 2021. Study screening and data extraction were according to inclusive and exclusive criteria. Statistical analyses were performed using RevMan software 5.3 version and STATA software 16.0 version. Results Eight studies with 79,334 subjects were included of which 48,123 had received two doses of COVID-19 inactivated vaccines, and 31,211 had received two doses of placebo. The results of the meta-analysis showed that: in terms of effectiveness evaluation, two doses of COVID-19 inactivated vaccines decreased the symptomatic infection [relative risk (RR) = 0.23, 95% confidence interval (CI) (0.18,0.30), P < 0.00001], asymptomatic infection [RR = 0.48, 95%CI (0.32, 0.74), P = 0.0008], total infection [RR = 0.32, 95%CI (0.24, 0.41), P < 0.00001] and hospitalization [RR = 0.06, 95%CI (0.01, 0.27), P = 0.0002] for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly. In terms of safety assessment, two doses of COVID-19 inactivated vaccines also caused more adverse events. After two inoculations, total adverse events and systemic adverse events increased significantly [total adverse events RR = 1.14, 95%CI (1.08, 1.21), P < 0.00001; systemic adverse events RR = 1.22, 95%CI (1.09, 1.35), P = 0.0002]. The most common adverse event was pain at the injection site. Almost all local adverse reactions consisted of these events. The incidence of pain at the injection site was related to adjuvants. Using aluminum hydroxide as an adjuvant increased local pain significantly [RR = 1.97, 95%CI (1.52, 2.55), P < 0.00001]. Two doses COVID-19 inactivated vaccines did not increase serious adverse events [RR = 0.71, 95%CI (0.57, 0.90), P = 0.004]. Conclusion Two doses of inactivated COVID-19 vaccines in people over 18 years of age effectively prevented SARS-CoV-2 infection and its associated hospitalizations. Short-term, mild to moderate adverse reactions had occurred, but serious adverse events were rare. No placebo or vaccine-related deaths had been reported. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: 42021291250.
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Affiliation(s)
- Xiaoming Li
- Department of General Practice, School of Graduate Studies, Guangxi Medical University, Nanning, China
| | - Xia Yang
- Department of General Practice, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China
| | - Zong Ning
- Department of General Practice, The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning, China
- *Correspondence: Zong Ning
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107
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Wang Q, Ning J, Chen Y, Li B, Shi L, He T, Zhang F, Chen X, Zhai A, Wu C. The BBIBP-CorV inactivated COVID-19 vaccine induces robust and persistent humoral responses to SARS-CoV-2 nucleocapsid, besides spike protein in healthy adults. Front Microbiol 2022; 13:1008420. [PMID: 36406456 PMCID: PMC9672472 DOI: 10.3389/fmicb.2022.1008420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2024] Open
Abstract
Vaccination is one of the best ways to control the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic. Among the various SARS-CoV-2 vaccines approved for use, the BBIBP-CorV inactivated vaccine has been widely used in 93 countries. In order to understand deeply the protective mechanism of inactivated vaccine, which retains all antigenic components of live virus, the analysis of humoral responses triggered by multiple proteins is necessary. In this research, antibody responses were generated with 6 selected recombinant proteins and 68 overlapping peptides that completely covered SARS-CoV-2 nucleocapsid (N) protein in 254 healthy volunteers vaccinated with BBIBP-CorV. As a result, antibody responses to the receptor binding domain (RBD), N, and non-structural protein 8 (NSP8) were induced following immunization by BBIBP-CorV. The antibody responses detected in donors after the 2nd dose vaccination can be maintained for about 6 months. Moreover, specific antibody levels can be restored after the boosting vaccination measured by ELISA. Furthermore, the level of SARS-CoV-2 specific IgG response is independent of age and gender. Moreover, N391-408 was identified as a dominant peptide after vaccination of BBIBP-CorV through peptide screening. Understanding the overview of humoral reactivity of the vaccine will contribute to further research on the protective mechanism of the SARS-CoV-2 inactivated vaccine and provide potential biomarkers for the related application of inactivated vaccine.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Aixia Zhai
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Chao Wu
- Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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108
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Ponnampalli S, Venkata Suryanarayana Birudukota N, Kamal A. COVID-19: Vaccines and therapeutics. Bioorg Med Chem Lett 2022; 75:128987. [PMID: 36113669 PMCID: PMC9472710 DOI: 10.1016/j.bmcl.2022.128987] [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: 06/15/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a communicable disease triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged as leading cause of death from a single infectious agent globally. Despite of rigorous protective measures, availability of multiple vaccines and with few approved therapeutics, the virus effect on the humankind throughout the world is perennial. COVID-19 has become the most urgent health concern with emergence of new challenging variants which outnumbered all other health issues and ensued in overwhelming number of reported deaths. In this unprecedented period of COVID-19 pandemic, scientists work round the clock for rapid development of efficient vaccines for prevention of infection and effective therapeutics for treatment. Here, we report the status of COVID-19 and highlight the ongoing research and development of vaccines and therapeutic strategies. It is necessary to know the present situation and available options to fight against the COVID-19 pandemic.
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Affiliation(s)
- Swapna Ponnampalli
- Department of Chemistry, CVR College of Engineering, Hyderabad 501510, India
| | | | - Ahmed Kamal
- Department of Pharmacy, Birla Institute of Technology & Science, Pilani, Hyderabad Campus, Hyderabad 500078, India; School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi 110062, India.
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109
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Contractor A, Shivaprakash S, Tiwari A, Setia MS, Gianchandani T. Effectiveness of Covid-19 vaccines (CovishieldTM and Covaxin ®) in healthcare workers in Mumbai, India: A retrospective cohort analysis. PLoS One 2022; 17:e0276759. [PMID: 36301977 PMCID: PMC9612509 DOI: 10.1371/journal.pone.0276759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND India started its vaccination programme for Coronavirus-19 infection (COVID-19) on 16 January 2021 with CovishieldTM (Oxford/Astra Zeneca vaccine manufactured by Serum Institute of India) and Covaxin ® (Bharat Biotech, India). We designed the present study to study the effectiveness of vaccines for COVID-19 in prevention of breakthrough infections and severe symptomatic cases among health care workers in a real-life scenario in Mumbai, India. Furthermore, we also wanted to study the factors associated with this effectiveness. METHODS This is cohort analysis of secondary data of 2762 individuals working in a tertiary health care setting in Mumbai, India (16 January 2021 to 16 October 2021). Vaccination records of all groups of health care staff (including the date of vaccination, type of vaccine taken, and date of positivity for COVID-19) were maintained at the hospital. The staff were tested for COVID-19 at least once a week and when symptomatic. The observation time for everyone was divided into unvaccinated, partially vaccinated (14 days after the first dose); and fully vaccinated (14 days after the second dose). If the individual was found to be positive, the day of positivity was considered the 'day of the event' for that individual. We combined unvaccinated/partially vaccinated into one group and completely vaccinated in the other group. We estimated hazard ratios (HR) and their 95% confidence intervals. The vaccine effectiveness (VE) was assessed as (1-HR)*100. RESULTS The mean age (SD) of the study participants was 32.3 (8.3) years; majority of these individuals had taken Covishield TM (99.0%) and only 0.9% (n = 27) had taken Covaxin ®. The incidence rate in the overall population was 0.067/100 person-days (PD). The incidence rate was significantly higher in the unvaccinated/partially vaccinated group compared with the fully vaccinated group (0.0989 / 100 PD vs 0.0403/100 PD; p < 0.001). The adjusted HR (aHR) in the fully vaccinated group compared with the unvaccinated/partially vaccinated group in the complete cohort was 0.30 (95% CI: 0.23, 0.39). Thus, the vaccine effectiveness (VE) for full vaccination was 70% (95% CI: 61%, 77%). It remained the same in the Covishield TM only cohort. The VE in completely vaccinated and with a history of previous infection was 88% (95% CI: 80%, 93%). Only 11 health care workers required hospitalization over the entire observation period; the incidence rate in our cohort was 0.0016 / 100 PD. None of the HCWs reported any severe adverse events after vaccination. CONCLUSIONS In this real-world scenario, we did find that complete vaccination reduced the rate of infection, particularly severe infection in health care personnel even during the severe delta wave in the country. Even among those infected, the hospitalisation rates were very low, and none died. We did not record any major side effects of vaccination in these personnel. Previous infection with COVID-19 and complete vaccination had a significantly higher effectiveness in prevention of infection.
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Affiliation(s)
- Aashish Contractor
- Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
| | | | - Anjali Tiwari
- Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Maninder Singh Setia
- Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
- * E-mail:
| | - Tarang Gianchandani
- Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
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Tulimilli SV, Dallavalasa S, Basavaraju CG, Kumar Rao V, Chikkahonnaiah P, Madhunapantula SV, Veeranna RP. Variants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Vaccine Effectiveness. Vaccines (Basel) 2022; 10:vaccines10101751. [PMID: 36298616 PMCID: PMC9607623 DOI: 10.3390/vaccines10101751] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/07/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
The incidence and death toll due to SARS-CoV-2 infection varied time-to-time; and depended on several factors, including severity (viral load), immune status, age, gender, vaccination status, and presence of comorbidities. The RNA genome of SARS-CoV-2 has mutated and produced several variants, which were classified by the SARS-CoV-2 Interagency Group (SIG) into four major categories. The first category; “Variant Being Monitored (VBM)”, consists of Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2), Epsilon (B.1.427, B.1.429), Eta (B.1.525), Iota (B.1.526), Kappa (B.1.617.1), Mu (B.1.621), and Zeta (P.2); the second category; “Variants of Concern” consists of Omicron (B.1.1.529). The third and fourth categories include “Variants of Interest (VOI)”, and “Variants of High Consequence (VOHC)”, respectively, and contain no variants classified currently under these categories. The surge in VBM and VOC poses a significant threat to public health globally as they exhibit altered virulence, transmissibility, diagnostic or therapeutic escape, and the ability to evade the host immune response. Studies have shown that certain mutations increase the infectivity and pathogenicity of the virus as demonstrated in the case of SARS-CoV-2, the Omicron variant. It is reported that the Omicron variant has >60 mutations with at least 30 mutations in the Spike protein (“S” protein) and 15 mutations in the receptor-binding domain (RBD), resulting in rapid attachment to target cells and immune evasion. The spread of VBM and VOCs has affected the actual protective efficacy of the first-generation vaccines (ChAdOx1, Ad26.COV2.S, NVX-CoV2373, BNT162b2). Currently, the data on the effectiveness of existing vaccines against newer variants of SARS-CoV-2 are very scanty; hence additional studies are immediately warranted. To this end, recent studies have initiated investigations to elucidate the structural features of crucial proteins of SARS-CoV-2 variants and their involvement in pathogenesis. In addition, intense research is in progress to develop better preventive and therapeutic strategies to halt the spread of COVID-19 caused by variants. This review summarizes the structure and life cycle of SARS-CoV-2, provides background information on several variants of SARS-CoV-2 and mutations associated with these variants, and reviews recent studies on the safety and efficacy of major vaccines/vaccine candidates approved against SARS-CoV-2, and its variants.
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Affiliation(s)
- SubbaRao V. Tulimilli
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
| | - Siva Dallavalasa
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
| | - Chaithanya G. Basavaraju
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
| | - Vinay Kumar Rao
- Department of Medical Genetics, JSS Medical College & Hospital, JSS Academy of Higher Education & Research (JSS AHER), Mysore 570015, Karnataka, India
| | - Prashanth Chikkahonnaiah
- Department of Pulmonary Medicine, Mysore Medical College and Research Institute, Mysuru 570001, Karnataka, India
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Center), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
- Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
| | - Ravindra P. Veeranna
- Department of Biochemistry, Council of Scientific and Industrial Research (CSIR)-Central Food Technological Research Institute (CFTRI), Mysuru 570020, Karnataka, India
- Correspondence:
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Chi WY, Li YD, Huang HC, Chan TEH, Chow SY, Su JH, Ferrall L, Hung CF, Wu TC. COVID-19 vaccine update: vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection. J Biomed Sci 2022; 29:82. [PMID: 36243868 PMCID: PMC9569411 DOI: 10.1186/s12929-022-00853-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/01/2022] [Indexed: 12/23/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) has been the most severe public health challenge in this century. Two years after its emergence, the rapid development and deployment of effective COVID-19 vaccines have successfully controlled this pandemic and greatly reduced the risk of severe illness and death associated with COVID-19. However, due to its ability to rapidly evolve, the SARS-CoV-2 virus may never be eradicated, and there are many important new topics to work on if we need to live with this virus for a long time. To this end, we hope to provide essential knowledge for researchers who work on the improvement of future COVID-19 vaccines. In this review, we provided an up-to-date summary for current COVID-19 vaccines, discussed the biological basis and clinical impact of SARS-CoV-2 variants and subvariants, and analyzed the effectiveness of various vaccine booster regimens against different SARS-CoV-2 strains. Additionally, we reviewed potential mechanisms of vaccine-induced severe adverse events, summarized current studies regarding immune correlates of protection, and finally, discussed the development of next-generation vaccines.
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Affiliation(s)
- Wei-Yu Chi
- Physiology, Biophysics and Systems Biology Graduate Program, Weill Cornell Medicine, New York, NY, USA
| | - Yen-Der Li
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Hsin-Che Huang
- Tri-Institutional PhD Program in Chemical Biology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Timothy En Haw Chan
- International Max Planck Research School for Immunobiology, Epigenetics and Metabolism (IMPRS-IEM), Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
- Department of Urology, Medical Center, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Sih-Yao Chow
- Downstream Process Science, EirGenix Inc., Zhubei, Hsinchu, Taiwan R.O.C
| | - Jun-Han Su
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Louise Ferrall
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA
| | - T-C Wu
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA.
- Department of Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
- The Johns Hopkins Medical Institutions, CRB II Room 309, 1550 Orleans St, MD, 21231, Baltimore, USA.
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Palatnik-de-Sousa I, Wallace ZS, Cavalcante SC, Ribeiro MPF, Silva JABM, Cavalcante RC, Scheuermann RH, Palatnik-de-Sousa CB. A novel vaccine based on SARS-CoV-2 CD4 + and CD8 + T cell conserved epitopes from variants Alpha to Omicron. Sci Rep 2022; 12:16731. [PMID: 36202985 PMCID: PMC9537284 DOI: 10.1038/s41598-022-21207-2] [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: 05/08/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
COVID-19 caused, as of September, 1rst, 2022, 599,825,400 confirmed cases, including 6,469,458 deaths. Currently used vaccines reduced severity and mortality but not virus transmission or reinfection by different strains. They are based on the Spike protein of the Wuhan reference virus, which although highly antigenic suffered many mutations in SARS-CoV-2 variants, escaping vaccine-generated immune responses. Multiepitope vaccines based on 100% conserved epitopes of multiple proteins of all SARS-CoV-2 variants, rather than a single highly mutating antigen, could offer more long-lasting protection. In this study, a multiepitope multivariant vaccine was designed using immunoinformatics and in silico approaches. It is composed of highly promiscuous and strong HLA binding CD4+ and CD8+ T cell epitopes of the S, M, N, E, ORF1ab, ORF 6 and ORF8 proteins. Based on the analysis of one genome per WHO clade, the epitopes were 100% conserved among the Wuhan-Hu1, Alpha, Beta, Gamma, Delta, Omicron, Mµ, Zeta, Lambda and R1 variants. An extended epitope-conservancy analysis performed using GISAID metadata of 3,630,666 SARS-CoV-2 genomes of these variants and the additional genomes of the Epsilon, Lota, Theta, Eta, Kappa and GH490 R clades, confirmed the high conservancy of the epitopes. All but one of the CD4 peptides showed a level of conservation greater than 97% among all genomes. All but one of the CD8 epitopes showed a level of conservation greater than 96% among all genomes, with the vast majority greater than 99%. A multiepitope and multivariant recombinant vaccine was designed and it was stable, mildly hydrophobic and non-toxic. The vaccine has good molecular docking with TLR4 and promoted, without adjuvant, strong B and Th1 memory immune responses and secretion of high levels of IL-2, IFN-γ, lower levels of IL-12, TGF-β and IL-10, and no IL-6. Experimental in vivo studies should validate the vaccine’s further use as preventive tool with cross-protective properties.
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Affiliation(s)
- Iam Palatnik-de-Sousa
- Department of Electrical Engeneering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Zachary S Wallace
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA, USA.,Department of Computer Science and Engineering, University of California, San Diego, CA, USA
| | - Stephany Christiny Cavalcante
- Department of General Microbiology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Paula Fonseca Ribeiro
- Department of General Microbiology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - João Antônio Barbosa Martins Silva
- Department of General Microbiology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Ciro Cavalcante
- Department of Pharmacy, Campus Professor Antônio Garcia Filho, Federal University of Sergipe, Lagarto, Sergipe, Brazil
| | - Richard H Scheuermann
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA, USA.,Department of Pathology, University of California, San Diego, CA, USA.,Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, CA, USA.,Global Virus Network, Baltimore, MD, USA
| | - Clarisa Beatriz Palatnik-de-Sousa
- Department of General Microbiology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. .,Institute for Immunological Investigation (III), INCT, National Council for Scientific and Technological Development (CNPq), São Paulo, Brazil.
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Muacevic A, Adler JR. A Hitchhiker's Guide to Worldwide COVID-19 Vaccinations: A Detailed Review of Monovalent and Bivalent Vaccine Schedules, COVID-19 Vaccine Side Effects, and Effectiveness Against Omicron and Delta Variants. Cureus 2022; 14:e29837. [PMID: 36204257 PMCID: PMC9527088 DOI: 10.7759/cureus.29837] [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] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
For the primary prevention of coronavirus disease 2019 (COVID-19), there are currently four different vaccines available in the USA. These are Pfizer (messenger RNA [mRNA]), Moderna (mRNA), Novavax (recombinant protein), and Jansen/Johnson & Johnson (adenoviral vector). All individuals should get vaccinated, and the Centers for Disease Control and Prevention (CDC) has provided comprehensive guidelines on recommended doses, their frequency by age group, and vaccine types, all discussed in detail in this article. Vaccines are a critical and cost-effective tool for preventing the disease. Prior to receiving a vaccine, patients should get adequate counseling regarding any potential adverse effects post vaccination. Appropriate safety precautions must be taken for those more likely to experience adverse consequences. Healthcare professionals should be aware of the symptoms, indicators, and treatment of any adverse event post-vaccination. We have provided a comprehensive review of the different characteristics of COVID-19 vaccines available in the United States, including their effectiveness against various variants, adverse effects, and precautions necessary for healthcare professionals and the general population. This article also briefly covers COVID-19 vaccines available worldwide, specifically their mode of action and effectiveness.
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114
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Sagiraju HKR, Elavarasi A, Gupta N, Garg RK, Paul SS, Vig S, Sirohiya P, Ratre B, Garg R, Pandit A, Singh R, Kumar B, Meena VP, Wig N, Mittal S, Pahuja S, Madan K, Das N, Dwivedi T, Gupta R, Wundavalli L, Singh AR, Singh S, Mishra A, Pandey M, Matharoo KS, Kumar S, Mohan A, Guleria R, Bhatnagar S. The Effectiveness of SARS-CoV-2 Vaccination in Preventing Severe Illness and Death - Real-world Data from a Cohort of Patients Hospitalized with COVID-19. Indian J Community Med 2022; 47:510-516. [PMID: 36742977 PMCID: PMC9891054 DOI: 10.4103/ijcm.ijcm_1388_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/24/2021] [Indexed: 02/07/2023] Open
Abstract
Background While long-term studies on the correlates of protection, vaccine effectiveness, and enhanced surveillance are awaited for SARS-CoV-2 vaccine, studies on breakthrough infections help understand the nature and course of this illness among vaccinated individuals and guide in public health preparedness. This study aims to compare the differences in the hospitalization outcomes SARS-CoV-2 infection of fully vaccinated individuals with with those of unvaccinated and partially vaccinated individuals. Materials and Methods Single institution observational cohort study. This study compared the differences in clinical, biochemical parameters and the hospitalization outcomes of 53 fully vaccinated individuals with those of unvaccinated (1464) and partially vaccinated (231) individuals, among a cohort of 2,080 individuals hospitalized with SARS-CoV-2 infection. Descriptive statistics and propensity-score weighted multivariate logistic regression analysis adjusting for clinical and laboratory parameters were used to compare the differences and to identify factors associated with outcomes. Results Completing the course of vaccination protected individuals from developing severe COVID-19 as evidenced by lower proportions of those with hypoxia, abnormal levels of inflammatory markers, requiring ventilatory support, and death compared to unvaccinated and partially vaccinated individuals. There were no differences in these outcomes among patients who received either vaccine type approved in India. Conclusions Efforts should be made to improve the vaccination rates as a timely measure to prepare for the upcoming waves of this highly transmissible pandemic. Vaccination rates of the communities may also guide in the planning of the health needs and appropriate use of medical resources.
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Affiliation(s)
- Hari Krishna Raju Sagiraju
- Department of Preventive Oncology, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Arunmozhimaran Elavarasi
- Department of Neurology, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Kumar Garg
- Department of Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Saurav Sekhar Paul
- Department of Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Vig
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Sirohiya
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Brajesh Ratre
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Garg
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Anuja Pandit
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Ram Singh
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Balbir Kumar
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Ved Prakash Meena
- Department of Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Naveet Wig
- Department of Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Mittal
- Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Sourabh Pahuja
- Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Nupur Das
- Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Tanima Dwivedi
- Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Gupta
- Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - LaxmiTej Wundavalli
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Angel Rajan Singh
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Sheetal Singh
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Abhinav Mishra
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Pandey
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Karanvir Singh Matharoo
- Department of Onco-Anesthesia and Palliative Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Sunil Kumar
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
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Park T, Hwang H, Moon S, Kang SG, Song S, Kim YH, Kim H, Ko EJ, Yoon SD, Kang SM, Hwang HS. Vaccines against SARS-CoV-2 variants and future pandemics. Expert Rev Vaccines 2022; 21:1363-1376. [PMID: 35924678 PMCID: PMC9979704 DOI: 10.1080/14760584.2022.2110075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/02/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Vaccination continues to be the most effective method for controlling COVID-19 infectious diseases. Nonetheless, SARS-CoV-2 variants continue to evolve and emerge, resulting in significant public concerns worldwide, even after more than 2 years since the COVID-19 pandemic. It is important to better understand how different COVID-19 vaccine platforms work, why SARS-CoV-2 variants continue to emerge, and what options for improving COVID-19 vaccines can be considered to fight against SARS-CoV-2 variants and future pandemics. AREA COVERED Here, we reviewed the innate immune sensors in the recognition of SARS-CoV-2 virus, innate and adaptive immunity including neutralizing antibodies by different COVID-19 vaccines. Efficacy comparison of the several COVID-19 vaccine platforms approved for use in humans, concerns about SARS-CoV-2 variants and breakthrough infections, and the options for developing future COIVD-19 vaccines were also covered. EXPERT OPINION Owing to the continuous emergence of novel pathogens and the reemergence of variants, safer and more effective new vaccines are needed. This review also aims to provide the knowledge basis for the development of next-generation COVID-19 and pan-coronavirus vaccines to provide cross-protection against new SARS-CoV-2 variants and future coronavirus pandemics.
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Affiliation(s)
- Taeyoung Park
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Hyogyeong Hwang
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Suhyeong Moon
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Sang Gu Kang
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Seunghyup Song
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Young Hun Kim
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Hanbi Kim
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
| | - Eun-Ju Ko
- College of Veterinary Medicine and Interdisciplinary Graduate Program in Advanced Convergence Technology and Science, Jeju National University, Jeju, South Korea
| | - Soon-Do Yoon
- Department of Chemical and Biomolecular Engineering, Chonnam National University, Yeosu, South Korea
| | - Sang-Moo Kang
- Center for Inflammation, Immunity & Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Hye Suk Hwang
- Department of Biology, College of Life Science and Industry, Sunchon National University (SCNU), Suncheon, South Korea
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Thakar M, Bhattacharya S. Central retinal artery occlusion after vaccination with whole virion inactivated SARSCoV- 2 vaccine Covaxin. Indian J Ophthalmol 2022; 70:3716-3718. [PMID: 36190081 PMCID: PMC9789834 DOI: 10.4103/ijo.ijo_1148_22] [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] [Indexed: 11/05/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccinations have been associated with a higher risk of thromboembolic events. There have been no reports of central retinal artery occlusion (CRAO) after vaccination with the indigenously developed Covaxin, and worldwide, there has been only one such isolated case after administration of the AstraZeneca vaccine. We report a case of a 44-year-old healthy man who presented with sudden painless vision loss in his left eye 10 days after receiving Covaxin. His best-corrected visual acuity was minimal perception of light, with a relative afferent pupillary defect. Fundus examination revealed arterial attenuation and macular cherry red spot, suggesting an acute CRAO. Optical coherence tomography showed macular swelling and disorganization of the inner layers due to ischemic sequelae. Blood work was normal and cardiovascular examination was unremarkable. The patient was kept on follow-up. To our knowledge, this is the first case of an isolated CRAO after Covaxin administration, but further studies are needed to evaluate this potential association.
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Affiliation(s)
- Meenakshi Thakar
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Shruti Bhattacharya
- Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, Delhi, India,Correspondence to: Dr. Shruti Bhattacharya, Retina Clinic, Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi - 110002, India. E-mail:
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Miteva D, Peshevska-Sekulovska M, Snegarova V, Batselova H, Alexandrova R, Velikova T. Mucosal COVID-19 vaccines: Risks, benefits and control of the pandemic. World J Virol 2022; 11:221-236. [PMID: 36188733 PMCID: PMC9523321 DOI: 10.5501/wjv.v11.i5.221] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/14/2022] [Accepted: 08/11/2022] [Indexed: 02/05/2023] Open
Abstract
Based on mucosal immunization to promote both mucosal and systemic immune responses, next-generation coronavirus disease 2019 (COVID-19) vaccines would be administered intranasally or orally. The goal of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines is to provide adequate immune protection and avoid severe disease and death. Mucosal vaccine candidates for COVID-19 including vector vaccines, recombinant subunit vaccines and live attenuated vaccines are under development. Furthermore, subunit protein vac-cines and virus-vectored vaccines have made substantial progress in preclinical and clinical settings, resulting in SARS-CoV-2 intranasal vaccines based on the previously successfully used nasal vaccines. Additional to their ability to trigger stable, protective immune responses at the sites of pathogenic infection, the development of ‘specific’ mucosal vaccines targeting coronavirus antigens could be an excellent option for preventing future pandemics. However, their efficacy and safety should be confirmed.
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Affiliation(s)
- Dimitrina Miteva
- Department of Genetics, Sofia University “St. Kliment Ohridski,” Faculty of Biology, Sofia 1164, Bulgaria
| | - Monika Peshevska-Sekulovska
- Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
| | - Violeta Snegarova
- Clinic of Internal Diseases, Naval Hospital - Varna, Military Medical Academy, Medical Faculty, Medical University, Varna 9000, Bulgaria
| | - Hristiana Batselova
- Department of Epidemiology and Disaster Medicine, Medical University, Plovdiv, University Hospital “St George”, Plovdiv 6000, Bulgaria
| | - Radostina Alexandrova
- Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia 1000, Bulgaria
| | - Tsvetelina Velikova
- Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
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Arankalle V, Kulkarni-Munje A, Kulkarni R, Palkar S, Patil R, Oswal J, Lalwani S, Mishra AC. Immunogenicity of two COVID-19 vaccines used in India: An observational cohort study in health care workers from a tertiary care hospital. Front Immunol 2022; 13:928501. [PMID: 36211366 PMCID: PMC9540493 DOI: 10.3389/fimmu.2022.928501] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19 pandemic witnessed rapid development and use of several vaccines. In India, a country-wide immunization was initiated in January 2021. COVISHIELD, the chimpanzee adenoviral-vectored vaccine with full-length SARS-COV-2 spike insert and COVAXIN, the whole virus-inactivated vaccines were used. To assess and compare immune response of health-care-workers to COVISHIELD (n=187) and COVAXIN (n=21), blood samples were collected pre-vaccination, 1month post-1/post-2 doses and 6months post-dose-2 and tested for IgG-anti-SARS-CoV-2 (ELISA) and neutralizing (Nab,PRNT50) antibodies. Spike-protein-specific T cells were quantitated by IFN-γ-ELISPOT. In pre-vaccination-antibody-negative COVISHIELD recipients (pre-negatives, n=120), %Nab seroconversion (median, IQR Nab titers) increased from 55.1% (16, 2.5-36.3) post-dose-1 to 95.6% (64.5, 4.5-154.2, p<0.001) post-dose-2 that were independent of age/gender/BMI. Nab response was higher among pre-positives with hybrid immunity at all-time points (p<0.01-0.0001) and independent of age/gender/BMI/Comorbidities. Post-dose-2-seroconversion (50%, p<0.001) and Nab titers (6.75, 2.5-24.8, p<0.001) in COVAXIN-recipients were lower than COVISHIELD. COVAXIN elicited a superior IFN-γ-T cell response as measured by ELISPOT (100%; 1226, 811-1532 spot forming units, SFU/million PBMCs v/s 57.8%; 21.7,1.6-169.2; p<0.001). At 6months, 28.3% (15/53) COVISHIELD and 3/3COVAXIN recipients were Nab-negative. T cell response remained unchanged. During immunization, COVID-19 cases were detected among COVISHIELD (n=4) and COVAXIN (n=2) recipients. At 6months, 9cases were recorded in COVISHIELD-recipients. This first-time, systematic, real-world assessment and long-term follow up revealed generation of higher neutralizing antibody titers by COVISHIELD and stronger T-cell response by COVAXIN. Diminished Nab titers at 6months emphasize early booster. Immunogenicity/efficacy of vaccines will change with the progression of the pandemic needing careful evaluations in the field-settings.
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Affiliation(s)
- Vidya Arankalle
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
- *Correspondence: Vidya Arankalle, ;
| | - Archana Kulkarni-Munje
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
| | - Ruta Kulkarni
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
| | - Sonali Palkar
- Department of Pediatrics, Bharati Vidyapeeth Medical College, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
| | - Rahul Patil
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
| | - Jitendra Oswal
- Department of Pediatrics, Bharati Vidyapeeth Medical College, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Vidyapeeth Medical College, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
- Bharati Vidyapeeth Medical College, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
| | - Akhilesh Chandra Mishra
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India
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Al-Momani H, Aldajah K, Alda'ajah E, ALjafar Y, Abushawer Z. Effectiveness of Pfizer/BioNTech and Sinopharm COVID-19 vaccines in reducing hospital admissions in prince Hamza hospital, Jordan. Front Public Health 2022; 10:1008521. [PMID: 36211700 PMCID: PMC9532618 DOI: 10.3389/fpubh.2022.1008521] [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: 07/31/2022] [Accepted: 09/05/2022] [Indexed: 01/27/2023] Open
Abstract
Background There is a need to establish the effectiveness of the coronavirus disease 2019 (COVID-19) vaccines in reducing COVID-19-related hopitalization of patients in Jordan. As the vaccination program accelerates, it is important to determine whether the vaccines' effectiveness (VE) has successfully reduced the number of acute cases admitted to hospital. Methods To determine the efficacy of Pfizer-BioNTech and Sinopharm COVID-19 vaccines among Jordanian patients admitted to Prince Hamza hospital, a single center case-control study was performed. The study analyzed the hospitalization rates of vaccinated (n = 536) and unvaccinated (n = 585) individuals across the 2-month period from February 6 to April 6, 2022. The cases were patients who tested positive for SARS-CoV-2 ("case-patients"), whilst the control group were hospital patients who did not test positive for SARS-CoV-2 ("control-patients"). Results This study found that among 1,121 total participants (561 cases and 560 control), the overall vaccine effectiveness (VE) among the participants was 84% (95% Cl 79-88%). VE was higher in females (88%, 95% Cl 84-93%) than in males (77%, 95% Cl 67-84%) (p < 0.001), and it was highest in those between the ages of 18 and 28-years-old (95%, 95% CI 86-98%). For patients with pre-existing conditions, including chronic heart disease, chronic lung disease, and diabetes, VE was higher compared to patients with no comorbidities, though the difference was not statistically significant. Finally, in comparing all vaccinated participants, VE was higher for those who received the Pfizer vaccine (VE = 92%, 95% CI 88-94%) (OR 0.08, 95% CI 0.06-0.12) than for those who received the Sinopharm vaccine (VE = 67%, 95% CI 52-78%) (OR 0.33, 95% CI 0.22-0.48); (p = 0.011). Conclusion Overall, Pfizer and Sinopharm vaccines were found to be effective in limiting hospitalizations for acute cases of coronavirus among Jordanian adult's patient's cohort between February 6 and April 6, 2022, especially among patients with comorbidities.
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Affiliation(s)
- Hafez Al-Momani
- Basic Medical Science Department, School of Medicine, Hashemite University, Zarqa, Jordan,*Correspondence: Hafez Al-Momani
| | - Khawla Aldajah
- Infection Control Unit, Prince Hamza Hospital, Amman, Jordan
| | | | - Yousef ALjafar
- Infection Control Unit, Prince Hamza Hospital, Amman, Jordan
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Patnaik AP, Rout NK, Ahmed S, Dash KA, Praharaj AK, Patro ARK. Correlation of Breakthrough Infection During the Omicron Wave With Seropositivity of Vaccinated Patients Undergoing Hemodialysis. Cureus 2022; 14:e29296. [PMID: 36277581 PMCID: PMC9578564 DOI: 10.7759/cureus.29296] [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] [Accepted: 09/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Patients with chronic kidney disease and undergoing hemodialysis are at greater risk of developing COVID-19. In spite of vaccine efficacy, SARS-CoV-2 breakthrough infection has been reported in several studies. This study was carried out to assess if seroconversion could predict SARS-CoV-2 breakthrough infection in a cohort of vaccinated patients undergoing hemodialysis. Methodology Patients undergoing maintenance hemodialysis for at least three months and who had received two doses of BBV152 or AZD1222 vaccine were included in the study. Their baseline IgG antibodies to SARS-CoV-2 were measured and followed up for a median of three months during the third wave of COVID-19 in India with SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) to detect breakthrough infections. Results Of 80 patients enrolled, seroconversion was seen in 81% of the cases, and SARS-CoV-2 breakthrough cases have been detected in 16% (13/80; 95% CI 8.95-26.18) patients undergoing hemodialysis. Of the 13 patients, seven patients required hospitalization and others had a mild outcome. There was no correlation of baseline seropositivity with breakthrough infections or hospitalization. Conclusions A majority of patients who underwent hemodialysis are seropositive post-vaccination. The breakthrough infection did not correlate with baseline seroconversion. Thus, there would be other predictors of breakthrough COVID-19 infections that need to be recognized in this susceptible population.
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Kumar NP, Banurekha VV, Kumar CPG, Nancy A, Padmapriyadarsini C, Shankar S, Hanna LE, Murhekar M, Devi KRU, Babu S. Inactivated COVID-19 vaccines: durability of Covaxin/BBV152 induced immunity against variants of concern. J Travel Med 2022; 29:6651027. [PMID: 35900009 PMCID: PMC9384591 DOI: 10.1093/jtm/taac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Covaxin/BBV152 is one of the most widely used vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and one of the few vaccines used extensively in low- and middle-income countries (LMIC). METHODS We investigated the effect of Covaxin on the SARS-CoV-2 specific IgG and IgA and neutralizing antibody (NAb) levels at baseline (M0) and at Months 1 (M1), 2 (M2), 3 (M3), 4 (M4), 6 (M6) and 12 (M12) following vaccination in healthcare workers. In addition, we also examined the NAb levels against variant lineages of B.1.617.2 (Delta, India), B.1.617.2.1 (Delta Plus, India), B.1.351 (Beta, SA), B.1.1.7 (Alpha, UK) and B.1.1.529 (Omicron). RESULTS Covaxin induces enhanced SARS-CoV-2 binding antibodies of IgG and IgA responses against both spike (S) and nucleocapsid (N) antigens at M1, M2, M3, M4, M6 and M12 in comparison with M0. Our data also reveal that NAb levels against the ancestral strain (Wuhan, wild type) are elevated and sustained at M1, M2, M3, M4, M6 and M12 in comparison with M0 and against variant lineages of B.1.617.2 (Delta, India), B.1.617.2.1 (Delta Plus, India), B.1.351 (Beta, SA) and B.1.1.7 (Alpha, UK) are elevated at M3, M6 and M12 in comparison with M0. However, NAb levels against B.1.1.529 (Omicron) was consistently below the limit of detection except at M12. CONCLUSION Thus, Covaxin induces an enhanced humoral immune response, with persistence till at least 12 months post-vaccination against most SARS-CoV-2 variants.
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Affiliation(s)
- Nathella Pavan Kumar
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - V V Banurekha
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - C P Girish Kumar
- Laboratory Division, ICMR-National Institute of Epidemiology, Chennai 600077, India
| | - Arul Nancy
- International Centre for Excellence in Research, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | | | - Sakila Shankar
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Luke Elizabeth Hanna
- Department of Virology and Biotechnology, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Manoj Murhekar
- Epidemiology and Biostatistics Division, ICMR-National Institute of Epidemiology, Chennai 600077, India
| | - K R Uma Devi
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Subash Babu
- International Centre for Excellence in Research, ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
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Babu MV, Debnath DJ, Tripathi M, Samatha Y, Shankar S, Kattimani V, Manikam DV, Kumar P. The Post-Vaccination Quantitative Total Immunoglobulin Levels against SARS-CoV-2 in Healthcare Workers: A Multi-Centric Cohort Study in India. Vaccines (Basel) 2022; 10:vaccines10091535. [PMID: 36146613 PMCID: PMC9500680 DOI: 10.3390/vaccines10091535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Abstract
Healthcare workers (HCWs) in India received the AZD1222 and BBV152 vaccines from January 2021 onwards. The objective of this study was to compare the immune response (seropositivity rate and geometric mean titer (GMT), and 95% confidence interval (CI)] against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in HCWs who received these vaccines, after the first and second doses. Therefore, the total immunoglobulin (Ig) levels specific to SARS-CoV-2 were measured using quantitative enzyme-linked immunosorbent assay (ELISA). The study population of 133 HCWs consisted of two groups in which the immune response was measured for the AZD1222 and BBV152 vaccines. Data collection was performed from 6 February to 20 August 2021. Four weeks after the first and second dose, the odds ratio of seroconversion for AZD1222 and BBV152 vaccine was 10.3 times (95% CI: 4.5–23.7) and 15.9 times (95% CI: 6.3–39.9), respectively. The GMT was 6392.93 and 6398.82 U/mL for AZD1222 and 1480.47 and 990.38 U/mL for BBV152 after the first and second doses, respectively. Both vaccines elicited an immune response, but the seroconversion rate and GMT after each dose were significantly higher for AZD1222 than those for the BBV152 vaccine in this study.
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Affiliation(s)
- Mangayarkarasi V. Babu
- All India Institute of Medical Sciences, Mangalagiri 522503, Andhra Pradesh, India
- Correspondence: ; Tel.: +91-9840410566
| | | | - Mukesh Tripathi
- All India Institute of Medical Sciences, Mangalagiri 522503, Andhra Pradesh, India
| | | | - Sumita Shankar
- Guntur Institute of Medical Sciences, Guntur 522004, Andhra Pradesh, India
| | | | | | - Pradeep Kumar
- All India Institute of Medical Sciences, Mangalagiri 522503, Andhra Pradesh, India
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Pramanik R, Dey S, Malakar S, Mirjalili S, Sarkar R. TOPSIS aided ensemble of CNN models for screening COVID-19 in chest X-ray images. Sci Rep 2022; 12:15409. [PMID: 36104401 PMCID: PMC9471038 DOI: 10.1038/s41598-022-18463-7] [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: 08/15/2021] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
The novel coronavirus (COVID-19), has undoubtedly imprinted our lives with its deadly impact. Early testing with isolation of the individual is the best possible way to curb the spread of this deadly virus. Computer aided diagnosis (CAD) provides an alternative and cheap option for screening of the said virus. In this paper, we propose a convolution neural network (CNN)-based CAD method for COVID-19 and pneumonia detection from chest X-ray images. We consider three input types for three identical base classifiers. To capture maximum possible complementary features, we consider the original RGB image, Red channel image and the original image stacked with Robert's edge information. After that we develop an ensemble strategy based on the technique for order preference by similarity to an ideal solution (TOPSIS) to aggregate the outcomes of base classifiers. The overall framework, called TOPCONet, is very light in comparison with standard CNN models in terms of the number of trainable parameters required. TOPCONet achieves state-of-the-art results when evaluated on the three publicly available datasets: (1) IEEE COVID-19 dataset + Kaggle Pneumonia Dataset, (2) Kaggle Radiography dataset and (3) COVIDx.
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Li Z, Liu S, Li F, Li Y, Li Y, Peng P, Li S, He L, Liu T. Efficacy, immunogenicity and safety of COVID-19 vaccines in older adults: a systematic review and meta-analysis. Front Immunol 2022; 13:965971. [PMID: 36177017 PMCID: PMC9513208 DOI: 10.3389/fimmu.2022.965971] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/24/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundOlder adults are more susceptible to severe health outcomes for coronavirus disease 2019 (COVID-19). Universal vaccination has become a trend, but there are still doubts and research gaps regarding the COVID-19 vaccination in the elderly. This study aimed to investigate the efficacy, immunogenicity, and safety of COVID-19 vaccines in older people aged ≥ 55 years and their influencing factors.MethodsRandomized controlled trials from inception to April 9, 2022, were systematically searched in PubMed, EMBASE, the Cochrane Library, and Web of Science. We estimated summary relative risk (RR), rates, or standardized mean difference (SMD) with 95% confidence interval (CI) using random-effects meta-analysis. This study was registered with PROSPERO (CRD42022314456).ResultsOf the 32 eligible studies, 9, 21, and 25 were analyzed for efficacy, immunogenicity, and safety, respectively. In older adults, vaccination was efficacious against COVID-19 (79.49%, 95% CI: 60.55−89.34), with excellent seroconversion rate (92.64%, 95% CI: 86.77−96.91) and geometric mean titer (GMT) (SMD 3.56, 95% CI: 2.80−4.31) of neutralizing antibodies, and provided a significant protection rate against severe disease (87.01%, 50.80−96.57). Subgroup and meta-regression analyses consistently found vaccine types and the number of doses to be primary influencing factors for efficacy and immunogenicity. Specifically, mRNA vaccines showed the best efficacy (90.72%, 95% CI: 86.82−93.46), consistent with its highest seroconversion rate (98.52%, 95% CI: 93.45−99.98) and GMT (SMD 6.20, 95% CI: 2.02−10.39). Compared to the control groups, vaccination significantly increased the incidence of total adverse events (AEs) (RR 1.59, 95% CI: 1.38−1.83), including most local and systemic AEs, such as pain, fever, chill, etc. For inactivated and DNA vaccines, the incidence of any AEs was similar between vaccination and control groups (p > 0.1), while mRNA vaccines had the highest risk of most AEs (RR range from 1.74 to 7.22).ConclusionCOVID-19 vaccines showed acceptable efficacy, immunogenicity and safety in older people, especially providing a high protection rate against severe disease. The mRNA vaccine was the most efficacious, but it is worth surveillance for some AEs it caused. Increased booster coverage in older adults is warranted, and additional studies are urgently required for longer follow-up periods and variant strains.
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Affiliation(s)
- Zejun Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shouhuan Liu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fengming Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yifeng Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Yilin Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Pu Peng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sai Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Li He
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu, ; Li He,
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu, ; Li He,
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Dotiwala F, Upadhyay AK. A comprehensive review of BBV152 vaccine development, effectiveness, safety, challenges, and prospects. Front Immunol 2022; 13:940715. [PMID: 36177016 PMCID: PMC9513542 DOI: 10.3389/fimmu.2022.940715] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The world has responded to the COVID-19 pandemic with unprecedented speed and vigor in the mass vaccination campaigns, targeted to reduce COVID-19 severity and mortality, reduce the pressure on the healthcare system, re-open society, and reduction in disease mortality and morbidity. Here we review the preclinical and clinical development of BBV152, a whole virus inactivated vaccine and an important tool in the fight to control this pandemic. BBV152, formulated with a TLR7/8 agonist adjuvant generates a Th1-biased immune response that induces high neutralization efficacy against different SARS-CoV-2 variants of concern and robust long-term memory B- and T-cell responses. With seroconversion rates as high as 98.3% in vaccinated individuals, BBV152 shows 77.8% and 93.4% protection from symptomatic COVID-19 disease and severe symptomatic COVID-19 disease respectively. Studies in pediatric populations show superior immunogenicity (geometric mean titer ratio of 1.76 compared to an adult) with a seroconversion rate of >95%. The reactogenicity and safety profiles were comparable across all pediatric age groups between 2-18 yrs. as in adults. Like most approved vaccines, the BBV152 booster given 6 months after full vaccination, reverses a waning immunity, restores the neutralization efficacy, and shows synergy in a heterologous prime-boost study with about 3-fold or 300% increase in neutralization titers against multiple SARS-CoV-2 variants of concern. Based on the interim Phase III data, BBV152 received full authorization for adults and emergency use authorization for children from ages 6 to 18 years in India. It is also licensed for emergency use in 14 countries globally. Over 313 million vaccine doses have already been administered in India alone by April 18th, 2022.
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Shao W, Chen X, Zheng C, Liu H, Wang G, Zhang B, Li Z, Zhang W. Effectiveness of COVID-19 Vaccines against SARS-CoV-2 Variants of Concern in Real-world: a Literature Review and Meta-analysis. Emerg Microbes Infect 2022; 11:2383-2392. [PMID: 36069511 PMCID: PMC9542696 DOI: 10.1080/22221751.2022.2122582] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Knowing vaccine effectiveness (VE) against variants of concern (VOCs) in the real-world setting is essential for public health decision-making. A systematic landscape of the VE against a series of clinical outcomes caused by the VOCs in the real-world setting is needed. We systematically searched for studies that evaluated VE against VOCs in the real-world setting and collected individual data. We identified 113 studies meeting the eligibility criteria. We found full vaccination provided strong protection against each clinical outcome with summary VE ranging from 86.8% to 96.0% Alpha, moderate protection against infection caused by Beta, Gamma and Delta with summary VE ranging from 70.9% to 72.8%, strong protection against severe disease caused by Delta with summary VE ranging from 84.9% to 90.3%, limited protection with summary VE of 23.5% (95% CI, 17.0–29.5) against infection and moderate protection with summary VE ranging from 56.5% to 82.4% against severe diseases caused by Omicron. Booster vaccination can provide a substantial improvement in protection against Delta and Omicron, but not as much as the Delta. The meta-regression analysis showed that the VE against the Omicron wanned over time, and the VE against hospitalization declined relatively slowly, compared to against infection. Those findings supported the need for public health measures, increasing booster vaccination coverage in response to current and new infectious waves driven by variants and developing broadly protective vaccines to confront virus evolution.
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Affiliation(s)
- Weihao Shao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Xiaorui Chen
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Caifang Zheng
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Haoshuang Liu
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Gaili Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Bowen Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Zhiyuan Li
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
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Mariatulqabtiah AR, Buttigieg KR. COVID-19 vaccinations for children. THE LANCET INFECTIOUS DISEASES 2022; 22:1255-1256. [PMID: 35760075 PMCID: PMC9232194 DOI: 10.1016/s1473-3099(22)00414-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022]
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Mohamed Y, El-Maradny YA, Saleh AK, Nayl AA, El-Gendi H, El-Fakharany EM. A comprehensive insight into current control of COVID-19: Immunogenicity, vaccination, and treatment. Biomed Pharmacother 2022; 153:113499. [PMID: 36076589 PMCID: PMC9343749 DOI: 10.1016/j.biopha.2022.113499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 02/07/2023] Open
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Ahmad A, Fawaz MAM, Aisha A. A comparative overview of SARS-CoV-2 and its variants of concern. LE INFEZIONI IN MEDICINA 2022; 30:328-343. [PMID: 36148164 PMCID: PMC9448317 DOI: 10.53854/liim-3003-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/05/2022] [Indexed: 06/16/2023]
Abstract
In December 2019, the severe acute respiratory syndrome 2 (SARS-CoV-2) coronavirus outbreak began in Wuhan, China, and quickly spread to practically every corner of the globe, killing millions of people. SARS-CoV-2 produced numerous variants, five of which have been identified as variants of concern (VOC) by the World Health Organization (WHO) (Alpha, Beta, Gamma, Delta, and Omicron). We conducted a comparative epidemiological analysis of SARS-CoV-2 and its VOC in this paper. We compared the effects of various spike (S) protein mutations in SARS-CoV-2 and its VOC on transmissibility, illness severity, hospitalization risk, fatality rate, immunological evasion, and vaccine efficacy in this review. We also looked into the clinical characteristics of patients infected with SARS-CoV-2 and its VOC.
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Affiliation(s)
- Aqeel Ahmad
- Department of Medical Biochemistry, College of Medicine, Shaqra University, Shaqra, Saudi Arabia
| | - Mohammed Ali Mullah Fawaz
- Department of Microbiology, Aware Medical Education and Research Institute (Aware Group), Shantivanam, Hyderabad, India
| | - Arafeen Aisha
- Department of Pathology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
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Ahmed TI, Rishi S, Irshad S, Aggarwal J, Happa K, Mansoor S. Inactivated vaccine Covaxin/BBV152: A systematic review. Front Immunol 2022; 13:863162. [PMID: 36016940 PMCID: PMC9395719 DOI: 10.3389/fimmu.2022.863162] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
We systematically reviewed and summarized studies focusing on Bharat Biotech’s Whole Virion Inactivated Corona Virus Antigen BBV152 (Covaxin), which is India’s indigenous response to fighting the SARS-CoV-2 pandemic. Studies were searched for data on the efficacy, immunogenicity, and safety profile of BBV152. All relevant studies published up to March 22, 2022, were screened from major databases, and 25 studies were eventually inducted into the systematic review. The studies focused on the virus antigen (6 μg) adjuvanted with aluminium hydroxide gel and/or Imidazo quinolin gallamide (IMDG), aTLR7/8 agonist. Pre-clinical, phase I, and II clinical trials showed appreciable immunogenicity. Both neutralizing and binding antibody titers were significant and T cell responses were Th1-biased. Phase III trials on the 6 μg +Algel-IMDG formulation showed a 93.4% efficacy against severe COVID-19. Data from the trials revealed an acceptable safety profile with mostly mild-moderate local and systemic adverse events. No serious adverse events or fatalities were seen, and most studies reported milder and lesser adverse events with Covaxin when compared with other vaccines, especially Oxford-Astra Zeneca’s AZD1222 (Covishield). The immunogenicity performance of Covaxin, which provided significant protection only after the second dose, was mediocre and it was consistently surpassed by Covishield. One study reported adjusted effectiveness against symptomatic infection to be just 50% at 2 weeks after the second dose. Nonetheless, appreciable results were seen in previously infected individuals administered both doses. There was some evidence of coverage against the Alpha, Beta, and Delta variants. However, neither Covaxin nor Covishield showed sufficient protection against the Omicron variant. Two studies reported super-additive results on mixing Covaxin with Covishield. Further exploration of heterologous prime-boost vaccination with a combination of an inactivated vaccine and an adenoviral vector-based vaccine for tackling future variants may be beneficial.
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Affiliation(s)
- Tousief Irshad Ahmed
- Department of Clinical Biochemistry, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, JK, India
| | - Saqib Rishi
- Department of Microbiology, Government Medical College, Srinagar, JK, India
| | - Summaiya Irshad
- Department of Ophthalmology, Government Medical College, Jammu, JK, India
| | - Jyoti Aggarwal
- Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Ambala, HR, India
| | - Karan Happa
- Department of General Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, JK, India
| | - Sheikh Mansoor
- Advanced Centre for Human Genetics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, JK, India
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Kaur U, K L A, Chauhan M, Joshi A, Das A, Kansal S, Jaisawal V, Patwardhan K, Chakrabarti SS. A Prospective Observational Study on BBV152 Coronavirus Vaccine Use in Adolescents and Comparison with Adults: Interim Results of the First Real-World Safety Analysis. Drug Saf 2022; 45:1099-1109. [PMID: 36030299 PMCID: PMC9419918 DOI: 10.1007/s40264-022-01226-8] [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] [Accepted: 08/07/2022] [Indexed: 11/29/2022]
Abstract
Introduction The BBV152 coronavirus disease 2019 (COVID-19) vaccine (COVAXIN) has recently been approved for adolescents. Objective We provide the first real-world safety data of COVAXIN use in adolescents and compare with adults. Methods A prospective observational study was initiated in January 2022. Enrolled adolescents and adults were contacted by telephone after 14 days of receiving the BBV152 vaccine. The primary outcome was vaccine safety assessed as rate of adverse events following immunization (AEFIs). Severity grading of AEFIs was done using the Food and Drug Administration (FDA) scale. Interim results are presented. Results A total of 698 adolescents and 326 adults were enrolled. AEFIs after the first dose developed in 243 out of 670 adolescents (36.3%), with 21% reporting only local AEFIs and 15.2% reporting systemic AEFIs. Among 340 adolescents who had received the second dose of vaccine, 129 (37.9%) developed AEFIs, with only local involvement in 20.3% and systemic involvement in 17.6%. Injection site pain and fever were the common AEFIs. The majority of AEFIs were mild-moderate. Nearly 0.9% of adolescents receiving the first dose reported severe AEFIs. Atypical AEFIs were observed in 0.6–0.9% of adolescents. The majority of the AEFIs resolved in 1–2 days. AEFIs were persistent in > 2% of adolescents at day 14 after the second dose, and also in 3.7% of adults overall at follow-up. No difference was observed in AEFI incidence and patterns between adolescents and adults. Regression analysis showed females and those with a history of allergy to be, respectively, at 1.6 times and 3 times increased risk of AEFIs among adolescents. Conclusions COVAXIN carries an overall favorable short-term safety profile in adolescents. The observed AEFI rates in adolescents are much lower than that reported with mRNA vaccines, but head–head comparisons in the same population are required to generate relative vaccine safety data. Female adolescents and those with a history of allergy need watchfulness for severe and persistent AEFIs. With some AEFIs persisting at 14 days, a longer follow-up is recommended to strengthen the safety data of COVAXIN. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-022-01226-8.
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Affiliation(s)
- Upinder Kaur
- Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Anju K L
- Department of Kaumarbhritya/Balroga (Ayurveda-Paediatrics), Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India
| | - Mayank Chauhan
- Department of Kriya Sharir (Ayurveda-Physiology), Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India
| | - Aditi Joshi
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Agniva Das
- Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Sangeeta Kansal
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
| | - Vaibhav Jaisawal
- Department of Kaumarbhritya/Balroga (Ayurveda-Paediatrics), Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India.
| | - Kishor Patwardhan
- Department of Kriya Sharir (Ayurveda-Physiology), Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India.
| | - Sankha Shubhra Chakrabarti
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India.
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132
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He X, Su J, Ma Y, Zhang W, Tang S. A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines. Front Immunol 2022; 13:945930. [PMID: 36090988 PMCID: PMC9459021 DOI: 10.3389/fimmu.2022.945930] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
It is urgently needed to update the comprehensive analysis about the efficacy or effectiveness of COVID-19 vaccines especially during the COVID-19 pandemic caused by SARS-CoV-2 Delta and Omicron variants. In general, the current COVID-19 vaccines showed a cumulative efficacy of 66.4%, 79.7%, and 93.6% to prevent SARS-CoV-2 infection, symptomatic COVID-19, and severe COVID-19, respectively, but could not prevent the asymptomatic infection of SARS-CoV-2. Furthermore, the current COVID-19 vaccines could effectively prevent COVID-19 caused by the Delta variant although the incidence of breakthrough infection of the SARS-CoV-2 Delta variant increased when the intervals post full vaccination extended, suggesting the waning effectiveness of COVID-19 vaccines. In addition, one-dose booster immunization showed an effectiveness of 74.5% to prevent COVID-19 caused by the Delta variant. However, current COVID-19 vaccines could not prevent the infection of Omicron sub-lineage BA.1.1.529 and had about 50% effectiveness to prevent COVID-19 caused by Omicron sub-lineage BA.1.1.529. Furthermore, the effectiveness was 87.6% and 90.1% to prevent severe COVID-19 and COVID-19-related death caused by Omicron sub-lineage BA.2, respectively, while one-dose booster immunization could enhance the effectiveness of COVID-19 vaccines to prevent the infection and COVID-19 caused by Omicron sub-lineage BA.1.1.529 and sub-lineage BA.2. Two-dose booster immunization showed an increased effectiveness of 81.8% against severe COVID-19 caused by the Omicron sub-lineage BA.1.1.529 variant compared with one-dose booster immunization. The effectiveness of the booster immunization with RNA-based vaccine BNT162b2 or mRNA-1273 was over 75% against severe COVID-19 more than 17 weeks after booster immunization whereas the heterogenous booster immunization showed better effectiveness than homologous booster immunization. In summary, the current COVID-19 vaccines could effectively protect COVID-19 caused by Delta and Omicron variants but was less effective against Omicron variant infection. One-dose booster immunization could enhance protection capability, and two-dose booster immunization could provide additional protection against severe COVID-19.
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Affiliation(s)
- Xiaofeng He
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Institute of Evidence-Based Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Jiao Su
- Department of biochemistry, Changzhi Medical College, Changzhi, China
| | - Yu’nan Ma
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenping Zhang
- Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Shixing Tang,
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Navarro AP, Pilkington V, Pepperrell T, Mirchandani M, Levi J, Hill A. Efficacy of Approved versus Unapproved Vaccines for SARS-CoV-2 Infection in Randomised Blinded Clinical Trials. Open Forum Infect Dis 2022; 9:ofac408. [PMID: 36092832 PMCID: PMC9452066 DOI: 10.1093/ofid/ofac408] [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] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background Five severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are approved in North America and/or Europe: Pfizer/BioNTech, Moderna, Janssen, Oxford-AstraZeneca, and Novavax. Other vaccines have been developed, including Sinopharm, SinoVac, QazVac, Covaxin, Soberana, Zifivax, Medicago, Clover, and Cansino, but they are not approved in high-income countries. This meta-analysis compared the efficacy of US Food and Drug Administration (FDA)/European Medicines Agency (EMA)-approved and -unapproved vaccines in randomized clinical trials (RCTs). Methods A systematic review of trial registries identified RCTs of SARS-CoV-2 vaccines. Risk of bias was assessed using the Cochrane tool (RoB 2). In the meta-analysis, relative risks of symptomatic infection and severe disease were compared for each vaccine versus placebo, using Cochrane-Mantel Haenszel Tests (random effects method). Results Twenty-two RCTs were identified and 1 was excluded for high-risk of bias. Ten RCTs evaluated 5 approved vaccines and 11 RCTs evaluated 9 unapproved vaccines. In the meta-analysis, prevention of symptomatic infection was 84% (95% confidence interval [CI], 68%–92%) for approved vaccines versus 72% (95% CI, 66%–77%) for unapproved vaccines, with no significant difference between vaccine types (P = .12). Prevention of severe SARS-CoV-2 infection was 94% (95% CI, 75%–98%) for approved vaccines versus 86% (95% CI, 76%–92%) for unapproved vaccines (P = .33). The risk of serious adverse events was similar between vaccine types (P = .12). Conclusions This meta-analysis of 21 RCTs in 390 459 participants showed no significant difference in efficacy between the FDA/EMA-approved and -unapproved vaccines for symptomatic or severe infection. Differences in study design, endpoint definitions, variants, and infection prevalence may have influenced results. New patent-free vaccines could lower costs of worldwide SARS-CoV-2 vaccination campaigns significantly.
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Affiliation(s)
| | - Victoria Pilkington
- Oxford University Clinical Academic Graduate School, University of Oxford , United Kingdom
| | - Toby Pepperrell
- University of Edinburgh, School of Medicine and Veterinary Medicine , Edinburgh , UK
| | | | - Jacob Levi
- Royal Free University Hospital NHS Trust , London , UK
| | - Andrew Hill
- Department of Pharmacology and Therapeutics, University of Liverpool , Liverpool, L69 3GF , UK
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Chavda VP, Chen Y, Dave J, Chen ZS, Chauhan SC, Yallapu MM, Uversky VN, Bezbaruah R, Patel S, Apostolopoulos V. COVID-19 and vaccination: myths vs science. Expert Rev Vaccines 2022; 21:1603-1620. [PMID: 35980281 DOI: 10.1080/14760584.2022.2114900] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Several vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed since the inception of the coronavirus disease 2019 (COVID-19) in December 2019, at unprecedented speed. However, these rapidly developed vaccines raised many questions related to the efficacy and safety of vaccines in different communities across the globe. Various hypotheses regarding COVID-19 and its vaccines were generated, and many of them have also been answered with scientific evidence. Still, there are many myths/misinformation related to COVID-19 and its vaccines, which create hesitancy for COVID-19 vaccination, and must be addressed critically to achieve success in the battle against the pandemic. AREA COVERED The development of anti-SARS-CoV-2 vaccines against COVID-19, their safety and efficacy, and myths/misinformation relating to COVID-19 and vaccines are presented. EXPERT OPINION In this pandemic we have seen a global collaborative effort of researchers, governments, and industry, supported by billions of dollars in funding, have allowed the development of vaccines far more quickly than in the past. Vaccines go through rigorous testing, analysis, and evaluations in clinical settings prior to their approval, even if they are approved for emergency use. Despite the myths, vaccination represents an important strategy to get back to normality.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L.M. College of Pharmacy, Ahmedabad
| | - Yangmin Chen
- Peter J. Tobin College of Business, St. John's University, Queens, NY 11439, USA
| | - Jayant Dave
- Department of Pharmaceutical Quality Assurance, L.M. College of Pharmacy, Ahmedabad
| | - Zhe-Sheng Chen
- College of Pharmacy and Health Sciences, St. John's University, Queens, NY 11439, USA
| | - Subhash C Chauhan
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA.,South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA
| | - Murali M Yallapu
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA.,South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA
| | - Vladimir N Uversky
- Department of Molecular Medicine and Byrd Alzheimer's Research Institure, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Rajashri Bezbaruah
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh -786004, Assam, India
| | - Sandip Patel
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Immunology and Translational Research Group, Victoria University, Melbourne, VIC, 3030, Australia.,Immunology Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, VIC, 3021, Australia
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135
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Alesci A, Gitto M, Kotańska M, Lo Cascio P, Miller A, Nicosia N, Fumia A, Pergolizzi S. Immunogenicity, effectiveness, safety and psychological impact of COVID-19 mRNA vaccines. Hum Immunol 2022; 83:755-767. [PMID: 35963787 PMCID: PMC9359511 DOI: 10.1016/j.humimm.2022.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 07/10/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022]
Abstract
In December 2019, a new single-stranded RNA coronavirus, SARS-CoV-2, appeared in China and quickly spread around the world leading to a pandemic. Infection with SARS-CoV-2 generates symptoms ranging from asymptomatic to severe, occasionally requiring hospitalization in intensive care units, and, in more severe cases, leading to death. Scientists and researchers around the world have made a real race against time to develop various vaccines to slow down and stop the spread of the virus. In addition to conventional viral vector vaccines, new generation mRNA vaccines, BNT152b2 (Comirnaty) and mRNA-1273 (Spikevax), have been developed respectively by Pfizer/BioNTech and Moderna. These vaccines act on immune cells to induce an immune response with the production of specific antibodies against Spike protein of SARS-CoV-2, and to stimulate the differentiation of T and B memory cells. The objective of this review is to provide a detailed picture of the validity of these new vaccines and the safety of vaccination. Not only was the immunogenic effect of mRNA vaccines evaluated, but also the psychosocial impact they had on the population. The data collected show that this type of vaccine can also be an excellent candidate for future treatment and eradication of possible new pathologies with viral and non-viral etiology.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy.
| | - Marco Gitto
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; Phoniatric Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, 20157 Milan, Italy.
| | - Magdalena Kotańska
- Department of Pharmacological Screening, Jagiellonian University, Medical College, PL 30-688 Cracow, Poland.
| | - Patrizia Lo Cascio
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy.
| | - Anthea Miller
- Department of Veterinary Sciences, University of Messina, Polo Universitario dell'Annunziata, 98168 Messina, Italy.
| | - Noemi Nicosia
- Department of Pharmacological Screening, Jagiellonian University, Medical College, PL 30-688 Cracow, Poland; Division of Neuroscience, Vita Salute San Raffaele University, 20132, Milan, Italy.
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, Padiglione C, A. O. U. Policlinico "G. Martino", 98147 Messina, Italy.
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy.
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136
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Kaur U, Bala S, Joshi A, Reddy NTS, Japur C, Chauhan M, Pedapanga N, Kumar S, Mukherjee A, Mishra V, Talda D, Singh R, Gupta RK, Yadav AK, Rana PJ, Srivastava J, Bhat K. S, Singh A, G. NKP, Pandey M, Patwardhan K, Kansal S, Chakrabarti SS. Persistent Health Issues, Adverse Events, and Effectiveness of Vaccines during the Second Wave of COVID-19: A Cohort Study from a Tertiary Hospital in North India. Vaccines (Basel) 2022; 10:vaccines10071153. [PMID: 35891317 PMCID: PMC9319407 DOI: 10.3390/vaccines10071153] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/16/2022] [Accepted: 07/17/2022] [Indexed: 02/06/2023] Open
Abstract
Background There is paucity of real-world data on COVID-19 vaccine effectiveness from cohort designs. Variable vaccine performance has been observed in test-negative case-control designs. There is also scarce real-world data of health issues in individuals receiving vaccines after prior COVID-19, and of adverse events of significant concern (AESCs) in the vaccinated. Methods: A cohort study was conducted from July 2021 to December 2021 in a tertiary hospital of North India. The primary outcome was vaccine effectiveness against COVID-19 during the second wave in India. Secondary outcomes were AESCs, and persistent health issues in those receiving COVID-19 vaccines. Regression analyses were performed to determine risk factors of COVID-19 outcomes and persistent health issues. Results: Of the 2760 health care workers included, 2544 had received COVID-19 vaccines, with COVISHIELD (rChAdOx1-nCoV-19 vaccine) received by 2476 (97.3%) and COVAXIN (inactivated SARS-CoV-2 vaccine) by 64 (2.5%). A total of 2691 HCWs were included in the vaccine effectiveness analysis, and 973 COVID-19 events were reported during the period of analysis. Maximum effectiveness of two doses of vaccine in preventing COVID-19 occurrence was 17% across three different strategies of analysis adopted for robustness of data. One-dose recipients were at 1.27-times increased risk of COVID-19. Prior SARS-CoV-2 infection was a strong independent protective factor against COVID-19 (aOR 0.66). Full vaccination reduced moderate–severe COVID-19 by 57%. Those with lung disease were at 2.54-times increased risk of moderate–severe COVID-19, independent of vaccination status. AESCs were observed in 33/2544 (1.3%) vaccinees, including one case each of myocarditis and severe hypersensitivity. Individuals with hypothyroidism were at 5-times higher risk and those receiving a vaccine after recovery from COVID-19 were at 3-times higher risk of persistent health issues. Conclusions: COVID-19 vaccination reduced COVID-19 severity but offered marginal protection against occurrence. The possible relationship of asthma and hypothyroidism with COVID-19 outcomes necessitates focused research. With independent protection of SARS-CoV-2 infection, and high-risk of persistent health issues in individuals receiving vaccine after recovery from SARS-CoV-2 infection, the recommendation of vaccinating those with prior SARS-CoV-2 infection needs reconsideration.
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Affiliation(s)
- Upinder Kaur
- Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Sapna Bala
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (S.B.); (R.S.); (R.K.G.); (A.S.)
| | - Aditi Joshi
- Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (A.J.); (N.T.S.R.); (C.J.); (S.K.); (A.M.)
| | - Noti Taruni Srija Reddy
- Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (A.J.); (N.T.S.R.); (C.J.); (S.K.); (A.M.)
| | - Chetan Japur
- Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (A.J.); (N.T.S.R.); (C.J.); (S.K.); (A.M.)
| | - Mayank Chauhan
- Department of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Nikitha Pedapanga
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Shubham Kumar
- Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (A.J.); (N.T.S.R.); (C.J.); (S.K.); (A.M.)
| | - Anurup Mukherjee
- Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (A.J.); (N.T.S.R.); (C.J.); (S.K.); (A.M.)
| | - Vaibhav Mishra
- Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Dolly Talda
- Department of Obstetrics & Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Rohit Singh
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (S.B.); (R.S.); (R.K.G.); (A.S.)
| | - Rohit Kumar Gupta
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (S.B.); (R.S.); (R.K.G.); (A.S.)
| | - Ashish Kumar Yadav
- Center for Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Poonam Jyoti Rana
- College of Nursing, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (P.J.R.); (J.S.)
| | - Jyoti Srivastava
- College of Nursing, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (P.J.R.); (J.S.)
| | - Shobha Bhat K.
- Department of Agad Tantra, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Anup Singh
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (S.B.); (R.S.); (R.K.G.); (A.S.)
| | - Naveen Kumar P. G.
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Manoj Pandey
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
| | - Kishor Patwardhan
- Department of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
- Correspondence: (K.P.); (S.K.); (S.S.C.); Tel.: +91-9918-000-344 (K.P.); +91-9415-223-697 (S.K.);+91-9935-615-563 (S.S.C.)
| | - Sangeeta Kansal
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India;
- Correspondence: (K.P.); (S.K.); (S.S.C.); Tel.: +91-9918-000-344 (K.P.); +91-9415-223-697 (S.K.);+91-9935-615-563 (S.S.C.)
| | - Sankha Shubhra Chakrabarti
- Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; (S.B.); (R.S.); (R.K.G.); (A.S.)
- Correspondence: (K.P.); (S.K.); (S.S.C.); Tel.: +91-9918-000-344 (K.P.); +91-9415-223-697 (S.K.);+91-9935-615-563 (S.S.C.)
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137
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Gracheva AV, Korchevaya ER, Ammour YI, Smirnova DI, Sokolova OS, Glukhov GS, Moiseenko AV, Zubarev IV, Samoilikov RV, Leneva IA, Svitich OA, Zverev VV, Faizuloev EB. Immunogenic properties of SARS-CoV-2 inactivated by ultraviolet light. Arch Virol 2022; 167:2181-2191. [PMID: 35857146 PMCID: PMC9296761 DOI: 10.1007/s00705-022-05530-7] [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: 03/22/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022]
Abstract
Vaccination against COVID-19 is the most effective method of controlling the spread of SARS-CoV-2 and reducing mortality from this disease. The development of vaccines with high protective activity against a wide range of SARS-CoV-2 antigenic variants remains relevant. In this regard, evaluation of the effectiveness of physical methods of virus inactivation, such as ultraviolet irradiation (UV) of the virus stock, remains relevant. This study demonstrates that the UV treatment of SARS-CoV-2 completely inactivates its infectivity while preserving its morphology, antigenic properties, and ability to induce the production of virus-neutralizing antibodies in mice through immunization. Thus, the UV inactivation of SARS-CoV-2 makes it possible to obtain viral material similar in its antigenic and immunogenic properties to the native antigen, which can be used both for the development of diagnostic test systems and for the development of an inactivated vaccine against COVID-19.
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Affiliation(s)
- A V Gracheva
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
| | - E R Korchevaya
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
| | - Yu I Ammour
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
| | - D I Smirnova
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
| | - O S Sokolova
- Faculty of Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
| | - G S Glukhov
- Faculty of Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
| | - A V Moiseenko
- Faculty of Biology, Lomonosov Moscow State University, Moscow, 119234, Russia.,N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, Moscow, 119991, Russia
| | - I V Zubarev
- Faculty of Medicine, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - R V Samoilikov
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
| | - I A Leneva
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia
| | - O A Svitich
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia.,F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - V V Zverev
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia.,F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Evgeny B Faizuloev
- I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, 105064, Russia.
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138
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Effectiveness of BBV152/Covaxin and AZD1222/Covishield vaccines against severe COVID-19 and B.1.617.2/Delta variant in India, 2021: A multi-centric hospital-based case-control study. Int J Infect Dis 2022; 122:693-702. [PMID: 35843496 PMCID: PMC9288262 DOI: 10.1016/j.ijid.2022.07.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND India introduced BBV152/Covaxin and AZD1222/Covishield vaccines from January 2021. We estimated effectiveness of these vaccines against severe Coronavirus disease 2019 (COVID-19) among individuals aged ≥45 years. METHODS We did a multi-centric, hospital-based, case-control study between May and July 2021. Cases were severe COVID-19 patients and controls were COVID-19 negative individuals from 11 hospitals. Vaccine effectiveness (VE) was estimated for full (2 doses ≥14days) and partial (1 dose ≥21 days) vaccination; duration between two vaccine doses and against the Delta variant. We used a random effects logistic regression model to calculate adjusted odds ratios (aOR) with 95% CI after adjusting for relevant known confounders. RESULTS We enrolled 1,143 cases and 2,541 controls. The VE of full vaccination was 85% (95% CI: 79%-89%) with AZD1222/Covishield and 71% (95% CI: 57%-81%) with BBV152/Covaxin. The VE was highest for an interval of 6-8 weeks between two doses of AZD1222/Covishield (94%, 95% CI: 86%-97%) and BBV152/Covaxin (93%, 95% CI: 34%-99%). The VE estimates were similar against the Delta strain and sub-lineages. CONCLUSION BBV152/Covaxin and AZD1222/Covishield were effective against severe COVID-19 among the Indian population during the period of dominance of highly transmissible Delta variant in second wave of pandemic. An escalation of two-dose coverage with COVID-19 vaccines is critical to reduce severe COVID-19 and further mitigate the pandemic in the country.
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139
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Vadrevu KM, Ganneru B, Reddy S, Jogdand H, Raju D, Sapkal G, Yadav P, Reddy P, Verma S, Singh C, Redkar SV, Gillurkar CS, Kushwaha JS, Mohapatra S, Bhate A, Rai SK, Ella R, Abraham P, Prasad S, Ella K. Persistence of immunity and impact of third dose of inactivated COVID-19 vaccine against emerging variants. Sci Rep 2022; 12:12038. [PMID: 35835822 PMCID: PMC9281359 DOI: 10.1038/s41598-022-16097-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/04/2022] [Indexed: 12/30/2022] Open
Abstract
This is a comprehensive report on immunogenicity of COVAXIN® booster dose against ancestral and Variants of Concern (VOCs) up to 12 months. It is well known that neutralizing antibodies induced by COVID-19 vaccines wane within 6 months of vaccination leading to questions on the effectiveness of two-dose vaccination against breakthrough infections. Therefore, we assessed the persistence of immunogenicity up to 6 months after a two or three-dose with BBV152 and the safety of a booster dose in an ongoing phase 2, double-blind, randomized controlled trial (ClinicalTrials.gov: NCT04471519). We report persistence of humoral and cell mediated immunity up to 12 months of vaccination, despite decline in the magnitude of antibody titers. Administration of a third dose of BBV152 increased neutralization titers against both homologous (D614G) and heterologous strains (Alpha, Beta, Delta, Delta Plus and Omicron) with a slight increase in B cell memory responses. Thus, seronversion rate remain high in boosted recipients compared to non-booster, even after 6 months, post third dose against variants. No serious adverse events observed, except pain at the injection site, itching and redness. Hence, these results indicate that a booster dose of BBV152 is safe and necessary to ensure persistent immunity to minimize breakthrough infections of COVID-19, due to newly emerging variants. Trial registration: Registered with the Clinical Trials Registry (India) No. CTRI/2021/04/032942, dated 19/04/2021 and on Clinicaltrials.gov: NCT04471519.
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Affiliation(s)
| | - Brunda Ganneru
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Siddharth Reddy
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Harsh Jogdand
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Dugyala Raju
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Gajanan Sapkal
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Pragya Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | | | - Savita Verma
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | | | | | | | | | | | | | | | - Raches Ella
- Independent Clinical Development Consultant, Cambridge, USA
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Sai Prasad
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
| | - Krishna Ella
- Bharat Biotech International Limited, Genome Valley, Hyderabad, 500 078, India
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140
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Sutton N, San Francisco Ramos A, Beales E, Smith D, Ikram S, Galiza E, Hsia Y, Heath PT. Comparing Reactogenicity of COVID-19 vaccines: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1301-1318. [PMID: 35796029 DOI: 10.1080/14760584.2022.2098719] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES A number of vaccines have now been developed against COVID-19. Differences in reactogenicity and safety profiles according to the vaccine technologies employed are becoming apparent from clinical trials. METHODS Five databases (Medline, EMBASE, Science Citation Index, Cochrane Central Register of Controlled Trials, London School of Hygiene and Tropical Medicine COVID-19 vaccine tracker) were searched for relevant randomised controlled trials between 1 January 2020 and 12 January 2022 according to predetermined criteria with no language limitations. RESULTS Forty-two datasets were identified, with 20 vaccines using four different technologies (viral vector, inactivated, mRNA and protein sub-unit). Adults and adolescents over 12 years were included. Control groups used saline placebos, adjuvants, and comparator vaccines. The most consistently reported solicited adverse events were fever, fatigue, headache, pain at injection site, redness, and swelling. Both doses of mRNA vaccines, the second dose of protein subunit and the first dose of adenovirus vectored vaccines were the most reactogenic, while the inactivated vaccines were the least reactogenic. CONCLUSIONS The different COVID-19 vaccines currently available appear to have distinct reactogenicity profiles, dependent on the vaccine technology employed. Awareness of these differences may allow targeted recommendations for specific populations. Greater standardization of methods for adverse event reporting will aid future research in this field.
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Affiliation(s)
- Natalina Sutton
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Alberto San Francisco Ramos
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Emily Beales
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - David Smith
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Sabina Ikram
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Eva Galiza
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Yingfen Hsia
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE.,Queen's University Belfast, School of Pharmacy 97 Lisburn Rd Belfast BT9 7BL Northern Ireland
| | - Paul T Heath
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
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141
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Immunity after COVID-19 Recovery and Vaccination: Similarities and Differences. Vaccines (Basel) 2022; 10:vaccines10071068. [PMID: 35891232 PMCID: PMC9322013 DOI: 10.3390/vaccines10071068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with a robust immune response. The development of systemic inflammation leads to a hyperinflammatory state due to cytokine release syndrome during severe COVID-19. The emergence of many new SARS-CoV-2 variants across the world deteriorates the protective antiviral immunity induced after infection or vaccination. The innate immune response to SARS-CoV-2 is crucial for determining the fate of COVID-19 symptomatology. T cell-mediated immunity is the main factor of the antiviral immune response; moreover, SARS-CoV-2 infection initiates a rapid B-cell response. In this paper, we present the current state of knowledge on immunity after COVID-19 infection and vaccination. We discuss the mechanisms of immune response to various types of vaccines (nucleoside-modified, adenovirus-vectored, inactivated virus vaccines and recombinant protein adjuvanted formulations). This includes specific aspects of vaccination in selected patient populations with altered immune activity (the elderly, children, pregnant women, solid organ transplant recipients, patients with systemic rheumatic diseases or malignancies). We also present diagnostic and research tools available to study the anti-SARS-CoV-2 cellular and humoral immune responses.
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142
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Xu K, Fan C, Han Y, Dai L, Gao GF. Immunogenicity, efficacy and safety of COVID-19 vaccines: an update of data published by 31 December 2021. Int Immunol 2022; 34:595-607. [PMID: 35778913 PMCID: PMC9278184 DOI: 10.1093/intimm/dxac031] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused a disaster for public health in the last 2 years, without any sign of an ending. Various vaccines were developed rapidly as soon as the outbreak occurred. Clinical trials demonstrated the reactogenicity, immunogenicity and protection efficacy in humans, and some of the vaccines have been approved for clinical use. However, waves of infections such as the recently circulating Omicron variant still occur. Newly emerging variants, especially the variants of concern, and waning humoral responses pose serious challenges to the control of the COVID-19 pandemic. Previously, we summarized the humoral and cellular immunity, safety profiles and protection efficacy of COVID-19 vaccines with clinical data published by 21 May 2021. In this review, we summarize and update the published clinical data of COVID-19 vaccines and candidates up to 31 December 2021.
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Affiliation(s)
- Kun Xu
- Research Network of Immunity and Health (RNIH), Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China,Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Tropical Medicine and Laboratory Medicine, The First Affiliated Hospital, Hainan Medical University, Hainan, China
| | - Chunxiang Fan
- National Immunization Programme, Chinese Center for Diseases Control and Prevention, Beijing, China
| | - Yuxuan Han
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Lianpan Dai
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Tropical Medicine and Laboratory Medicine, The First Affiliated Hospital, Hainan Medical University, Hainan, China,Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China,CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
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143
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Guleria R, Agarwal S. Covid-19: What the pandemic has taught us and the way forward. THE NATIONAL MEDICAL JOURNAL OF INDIA 2022; 35:193-196. [PMID: 36715040 DOI: 10.25259/nmji_1064_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Randeep Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine All India Institute of Medical Scierces Ansari Nagar New Delhi India
| | - Shubham Agarwal
- Department of Pulmonary, Critical Care and Sleep Medicine All India Institute of Medical Scierces Ansari Nagar New Delhi India
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144
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Copaescu AM, Rosa Duque JS, Phillips EJ. What have we learned about the allergenicity and adverse reactions associated with the severe acute respiratory syndrome coronavirus 2 vaccines: One year later. Ann Allergy Asthma Immunol 2022; 129:40-51. [PMID: 35390476 PMCID: PMC8979618 DOI: 10.1016/j.anai.2022.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the most rapid response and scale-up in vaccine and therapeutic development in history. We highlight the history of these amazing achievements with a focus on the description of the classification and mechanisms of allergic reactions and adverse events relevant to the allergist and immunologist that have been associated with the SARS-CoV-2 vaccines. Finally, we offer a detailed management approach in the context of a possible allergic reaction. DATA SOURCES Using defined search strategy, we identified peer-reviewed articles within PubMed that were published between January 1, 2019, and December 4, 2021. STUDY SELECTIONS All recent articles on COVID-19 published in English were reviewed with focus on the immunogenicity and allergenicity of the current existing COVID-19 vaccines. RESULTS Following a detailed literature review, we discuss the evolution and development of the new vaccines for SARS-CoV-2. Furthermore, we provide evidence regarding the significance and mechanisms of allergic reactions associated with the vaccines and offer a management approach for those with an increased risk of presenting an allergic or other relevant vaccine reaction. CONCLUSION The international rollout of COVID-19 vaccination started with reports of immediate allergic reactions. Although we still need to understand the mechanisms of these reactions, we can be reassured that patients with underlying allergic disease will not need to avoid SARS-CoV-2 vaccination. In addition, the vast majority of those with a first-dose reaction will tolerate subsequent doses.
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Affiliation(s)
- Ana M Copaescu
- Division of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada; The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada; Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Jaime S Rosa Duque
- Li Ka Shing Faculty of Medicine, Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Elizabeth Jane Phillips
- Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia.
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145
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Vikkurthi R, Ansari A, Pai AR, Jha SN, Sachan S, Pandit S, Nikam B, Kalia A, Jit BP, Parray HA, Singh S, Kshetrapal P, Wadhwa N, Shrivastava T, Coshic P, Kumar S, Sharma P, Sharma N, Taneja J, Pandey AK, Sharma A, Thiruvengadam R, Grifoni A, Weiskopf D, Sette A, Bhatnagar S, Gupta N. Inactivated whole-virion vaccine BBV152/Covaxin elicits robust cellular immune memory to SARS-CoV-2 and variants of concern. Nat Microbiol 2022; 7:974-985. [PMID: 35681012 DOI: 10.1038/s41564-022-01161-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 05/24/2022] [Indexed: 12/25/2022]
Abstract
BBV152 is a whole-virion inactivated vaccine based on the Asp614Gly variant. BBV152 is the first alum-imidazoquinolin-adjuvanted vaccine authorized for use in large populations. Here we characterized the magnitude, quality and persistence of cellular and humoral memory responses up to 6 months post vaccination. We report that the magnitude of vaccine-induced spike and nucleoprotein antibodies was comparable with that produced after infection. Receptor binding domain-specific antibodies declined against variants in the order of Alpha (B.1.1.7; 3-fold), Delta (B.1.617.2; 7-fold) and Beta (B.1.351; 10-fold). However, pseudovirus neutralizing antibodies declined up to 2-fold against the Delta followed by the Beta variant (1.7-fold). Vaccine-induced memory B cells were also affected by the Delta and Beta variants. The SARS-CoV-2-specific multicytokine-expressing CD4+ T cells were found in ~85% of vaccinated individuals. Only a ~1.3-fold reduction in efficacy was observed in CD4+ T cells against the Beta variant. We found that antigen-specific CD4+ T cells were present in the central memory compartment and persisted for at least up to 6 months post vaccination. Vaccine-induced CD8+ T cells were detected in ~50% of individuals. Importantly, the vaccine was capable of inducing follicular T helper cells that exhibited B-cell help potential. These findings show that inactivated vaccine BBV152 induces robust immune memory to SARS-CoV-2 and variants of concern that persists for at least 6 months after vaccination.
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Affiliation(s)
- Rajesh Vikkurthi
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Asgar Ansari
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Anupama R Pai
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Someshwar Nath Jha
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Shilpa Sachan
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Suvechchha Pandit
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Bhushan Nikam
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Anurag Kalia
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India
| | - Bimal Prasad Jit
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | | | - Savita Singh
- Translational Health Science and Technology Institute, Faridabad, India
| | | | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | | | - Poonam Coshic
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Suresh Kumar
- Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Pragya Sharma
- Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Nandini Sharma
- Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Juhi Taneja
- ESIC Medical College and Hospital, Faridabad, India
| | | | - Ashok Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | | | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, USA.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, USA
| | | | - Nimesh Gupta
- Vaccine Immunology Laboratory, National Institute of Immunology, New Delhi, India.
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146
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A machine learning-based approach to determine infection status in recipients of BBV152 (Covaxin) whole-virion inactivated SARS-CoV-2 vaccine for serological surveys. Comput Biol Med 2022; 146:105419. [PMID: 35483225 PMCID: PMC9040372 DOI: 10.1016/j.compbiomed.2022.105419] [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: 12/24/2021] [Revised: 02/19/2022] [Accepted: 02/19/2022] [Indexed: 12/16/2022]
Abstract
Data science has been an invaluable part of the COVID-19 pandemic response with multiple applications, ranging from tracking viral evolution to understanding the vaccine effectiveness. Asymptomatic breakthrough infections have been a major problem in assessing vaccine effectiveness in populations globally. Serological discrimination of vaccine response from infection has so far been limited to Spike protein vaccines since whole virion vaccines generate antibodies against all the viral proteins. Here, we show how a statistical and machine learning (ML) based approach can be used to discriminate between SARS-CoV-2 infection and immune response to an inactivated whole virion vaccine (BBV152, Covaxin). For this, we assessed serial data on antibodies against Spike and Nucleocapsid antigens, along with age, sex, number of doses taken, and days since last dose, for 1823 Covaxin recipients. An ensemble ML model, incorporating a consensus clustering approach alongside the support vector machine model, was built on 1063 samples where reliable qualifying data existed, and then applied to the entire dataset. Of 1448 self-reported negative subjects, our ensemble ML model classified 724 to be infected. For method validation, we determined the relative ability of a random subset of samples to neutralize Delta versus wild-type strain using a surrogate neutralization assay. We worked on the premise that antibodies generated by a whole virion vaccine would neutralize wild type more efficiently than delta strain. In 100 of 156 samples, where ML prediction differed from self-reported uninfected status, neutralization against Delta strain was more effective, indicating infection. We found 71.8% subjects predicted to be infected during the surge, which is concordant with the percentage of sequences classified as Delta (75.6%-80.2%) over the same period. Our approach will help in real-world vaccine effectiveness assessments where whole virion vaccines are commonly used.
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147
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Turley JL, Lavelle EC. Resolving adjuvant mode of action to enhance vaccine efficacy. Curr Opin Immunol 2022; 77:102229. [PMID: 35779364 DOI: 10.1016/j.coi.2022.102229] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/15/2022] [Accepted: 05/25/2022] [Indexed: 12/11/2022]
Abstract
Adjuvants are a miscellaneous range of molecules and materials that can enhance the magnitude, functionality, breadth and durability of immune responses. Despite the multiplicity of compounds with adjuvant properties, less than a dozen are in clinical use in vaccines against infectious diseases. While many factors have contributed to their slow development, among the major challenges are the high safety and efficacy standards set by current adjuvants in human vaccines and our limited understanding of how adjuvants mediate their effects. This review outlines why it is so difficult to elucidate their mechanism of action, highlights areas that require in-depth research and discusses recent advancements that are revitalising adjuvant development. It is hoped that a fuller understanding of adjuvant sensing, signalling and function will facilitate the design of vaccines that promote sustained protective immunity against challenging bacterial and viral pathogens.
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Affiliation(s)
- Joanna L Turley
- Adjuvant Research Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2 D02R590, Ireland.
| | - Ed C Lavelle
- Adjuvant Research Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2 D02R590, Ireland.
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148
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Semwal R, Kumar A, Chauhan A, Semwal RB, Joshi NC, Joshi SK, Semwal DK. Infection Pattern, Treatment Protocols and Post-COVID-19 Complications–A Survey on 706 COVID-19 Recovered Participants. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022. [DOI: 10.14218/erhm.2021.00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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149
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Bellamkonda N, Lambe UP, Sawant S, Nandi SS, Chakraborty C, Shukla D. Immune Response to SARS-CoV-2 Vaccines. Biomedicines 2022; 10:1464. [PMID: 35884770 PMCID: PMC9312515 DOI: 10.3390/biomedicines10071464] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 12/21/2022] Open
Abstract
COVID-19 vaccines have been developed to confer immunity against the SARS-CoV-2 infection. Prior to the pandemic of COVID-19 which started in March 2020, there was a well-established understanding about the structure and pathogenesis of previously known Coronaviruses from the SARS and MERS outbreaks. In addition to this, vaccines for various Coronaviruses were available for veterinary use. This knowledge supported the creation of various vaccine platforms for SARS-CoV-2. Before COVID-19 there are no reports of a vaccine being developed in under a year and no vaccine for preventing coronavirus infection in humans had ever been developed. Approximately nine different technologies are being researched and developed at various levels in order to design an effective COVID-19 vaccine. As the spike protein of SARS-CoV-2 is responsible for generating substantial adaptive immune response, mostly all the vaccine candidates have been targeting the whole spike protein or epitopes of spike protein as a vaccine candidate. In this review, we have compiled the immune response to SARS-CoV-2 infection and followed by the mechanism of action of various vaccine platforms such as mRNA vaccines, Adenoviral vectored vaccine, inactivated virus vaccines and subunit vaccines in the market. In the end we have also summarized the various adjuvants used in the COVID-19 vaccine formulation.
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Affiliation(s)
- Navya Bellamkonda
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | | | - Sonali Sawant
- ICMR-NIV, Mumbai Unit, A. D. Road, Parel, Mumbai 400012, India; (U.P.L.); (S.S.)
| | - Shyam Sundar Nandi
- ICMR-NIV, Mumbai Unit, A. D. Road, Parel, Mumbai 400012, India; (U.P.L.); (S.S.)
| | | | - Deepak Shukla
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL 60612, USA
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150
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Poh XY, Lee IR, Lim C, Teo J, Rao S, Chia PY, Ong SWX, Lee TH, Lin RJH, Ng LFP, Ren EC, Lin RTP, Wang LF, Renia L, Lye DC, Young BE. Evaluation of the safety and immunogenicity of different COVID-19 vaccine combinations in healthy individuals: study protocol for a randomized, subject-blinded, controlled phase 3 trial [PRIBIVAC]. Trials 2022; 23:498. [PMID: 35710572 PMCID: PMC9201789 DOI: 10.1186/s13063-022-06345-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/23/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Over 2021, COVID-19 vaccination programs worldwide focused on raising population immunity through the primary COVID-19 vaccine series. In Singapore, two mRNA vaccines (BNT162b2 and mRNA-1273) and the inactivated vaccine CoronaVac are currently authorized under the National Vaccination Programme for use as the primary vaccination series. More than 90% of the Singapore population has received at least one dose of a COVID-19 vaccine as of December 2021. With the demonstration that vaccine effectiveness wanes in the months after vaccination, and the emergence of Omicron which evades host immunity from prior infection and/or vaccination, attention in many countries has shifted to how best to maintain immunity through booster vaccinations. METHODS The objectives of this phase 3, randomized, subject-blinded, controlled clinical trial are to assess the safety and immunogenicity of heterologous boost COVID-19 vaccine regimens (intervention groups 1-4) compared with a homologous boost regimen (control arm) in up to 600 adult volunteers. As non-mRNA vaccine candidates may enter the study at different time points depending on vaccine availability and local regulatory approval, participants will be randomized at equal probability to the available intervention arms at the time of randomization. Eligible participants will have received two doses of a homologous mRNA vaccine series with BNT162b2 or mRNA-1273 at least 6 months prior to enrolment. Participants will be excluded if they have a history of confirmed SARS or SARS-CoV-2 infection, are immunocompromised, or are pregnant. Participants will be monitored for adverse events and serious adverse events by physical examinations, laboratory tests and self-reporting. Blood samples will be collected at serial time points [pre-vaccination/screening (day - 14 to day 0), day 7, day 28, day 180, day 360 post-vaccination] for assessment of antibody and cellular immune parameters. Primary endpoint is the level of anti-SARS-CoV-2 spike immunoglobulins at day 28 post-booster and will be measured against wildtype SARS-CoV-2 and variants of concern. Comprehensive immune profiling of the humoral and cellular immune response to vaccination will be performed. DISCUSSION This study will provide necessary data to understand the quantity, quality, and persistence of the immune response to a homologous and heterologous third booster dose of COVID-19 vaccines. This is an important step in developing COVID-19 vaccination programs beyond the primary series. TRIAL REGISTRATION ClinicalTrials.gov NCT05142319 . Registered on 2 Dec 2021.
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Affiliation(s)
- Xuan Ying Poh
- National Centre for Infectious Diseases, Singapore, Singapore
| | - I Russel Lee
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Clarissa Lim
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Jefanie Teo
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Suma Rao
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
| | - Po Ying Chia
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Sean W X Ong
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
| | - Tau Hong Lee
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
| | - Ray J H Lin
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
| | - Lisa F P Ng
- A*STAR Infectious Diseases Lab, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Chee Ren
- Singapore Immunology Network, A*STAR, Singapore, Singapore
| | | | - Lin-Fa Wang
- Duke-NUS Medical School, Singapore, Singapore
| | - Laurent Renia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- A*STAR Infectious Diseases Lab, Singapore, Singapore
| | - David Chien Lye
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Barnaby E Young
- National Centre for Infectious Diseases, Singapore, Singapore.
- Tan Tock Seng Hospital, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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