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Hookham L, Lee HC, Patel DA, Coelho M, Giglio N, Le Doare K, Pannaraj PS. Vaccinating Children against SARS-CoV-2: A Literature Review and Survey of International Experts to Assess Safety, Efficacy and Perceptions of Vaccine Use in Children. Vaccines (Basel) 2022; 11:78. [PMID: 36679923 PMCID: PMC9862079 DOI: 10.3390/vaccines11010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction: The balance of risks and benefits of COVID-19 vaccination in children is more complex than in adults with limited paediatric data resulting in no global consensus on whether all healthy children should be vaccinated. We sought to assess the safety, efficacy, and effectiveness of childhood vaccination against SARS-CoV-2, as well as better understanding perceptions of vaccination in parents and vaccine experts. Methods: We performed a literature review for COVID-19 vaccine safety, efficacy, effectiveness, and perceptions. We searched international safety databases for safety data and developed an electronic survey to elicit country-specific COVID-19 immunisation data, including vaccine regulations, policies, rates, and public attitudes solicited from vaccine experts. Results: Nine studies were included in the final safety analysis. Local reactions were frequently reported across all studies and vaccine types. Adverse events reported to surveillance systems tended to be non-serious, and commonly included injection site reactions and dizziness. Twenty-three studies reported immunogenicity, efficacy, and effectiveness data. There were nine randomised control trials of six different vaccine types, which showed seroconversion of neutralising antibodies in vaccinated children ranging from 88% to 100%. The vaccine efficacy for Pfizer and Moderna vaccines ranged from 88% to 100%. There were 118 survey responses representing 55 different countries. Reported vaccination rates ranged from <1% to 98%. Most respondents described “mixed opinions” regarding paediatric vaccination policies in their country. By region, a more positive public attitude towards vaccination correlated with higher vaccination rates. Discussion: In this mixed-methods review, we have found evidence that vaccination against COVID-19 in children is safe, efficacious, and effective. Overall, the combined evidence from both the literature review and survey highlights the need for further data on both the safety and effectiveness of COVID-19 vaccinations in children.
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Affiliation(s)
- Lauren Hookham
- Institute for Infection and Immunity, St. George’s University of London, London SW17 0RE, UK
| | - Hillary C. Lee
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Divya A. Patel
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Mariana Coelho
- Independent Researcher, Buenos Aires Ciudad 1425, Argentina
| | - Norberto Giglio
- Children’s Hospital Ricardo Gutiérrez, Buenos Aires Ciudad 1425, Argentina
| | - Kirsty Le Doare
- Institute for Infection and Immunity, St. George’s University of London, London SW17 0RE, UK
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152
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Piché‐Renaud P, Morris SK, Top KA. A narrative review of vaccine pharmacovigilance during mass vaccination campaigns: Focus on myocarditis and pericarditis after COVID-19 mRNA vaccination. Br J Clin Pharmacol 2022; 89:967-981. [PMID: 36480113 PMCID: PMC9878271 DOI: 10.1111/bcp.15625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
Vaccines have had a tremendous impact on reducing the burden of infectious diseases; however, they have the potential to cause adverse events following immunization (AEFIs). Prelicensure clinical trials are limited in their ability to detect rare AEFIs that may occur in less than one per thousand individuals. While postmarketing surveillance systems have shown COVID-19 mRNA vaccines to be safe, they led to the identification of rare cases of myocarditis and pericarditis after COVID-19 vaccination that were not initially detected in clinical trials. In this narrative review, we highlight concepts of vaccine pharmacovigilance during mass vaccination campaigns and compare the approaches used in the context of myocarditis and pericarditis following COVID-19 vaccination to historical examples. We describe mechanisms of passive and active surveillance, their strengths and limitations, and how they interacted to identify and characterize the safety signal of myocarditis and pericarditis after COVID-19 mRNA vaccination. Articles were synthesized from a PubMed search using relevant keywords for articles published on vaccine surveillance systems and myocarditis and pericarditis after COVID-19 vaccination, as well as the authors' collections of relevant publications and grey literature reports. The global experience around the identification and monitoring of myocarditis and pericarditis after COVID-19 mRNA vaccination has provided important lessons for vaccine safety surveillance and highlighted its importance in maintaining public trust in mass vaccination programmes in a pandemic context.
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Affiliation(s)
| | - Shaun K. Morris
- Division of Infectious DiseasesThe Hospital for Sick ChildrenTorontoOntarioCanada,Centre for Global Child HealthThe Hospital for Sick ChildrenTorontoOntarioCanada,Department of Pediatrics, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada,Clinical Public Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Karina A. Top
- Department of PediatricsDalhousie University and Canadian Center for Vaccinology, IWK Health CentreHalifaxNova ScotiaCanada
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153
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Abstract
Multiple vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been evaluated in clinical trials. However, trials addressing the immune response in the pediatric population are scarce. The inactivated vaccine CoronaVac has been shown to be safe and immunogenic in a phase 1/2 clinical trial in a pediatric cohort in China. Here, we report interim safety and immunogenicity results of a phase 3 clinical trial for CoronaVac in healthy children and adolescents in Chile. Participants 3 to 17 years old received two doses of CoronaVac in a 4-week interval until 31 December 2021. Local and systemic adverse reactions were registered for volunteers who received one or two doses of CoronaVac. Whole-blood samples were collected from a subgroup of 148 participants for humoral and cellular immunity analyses. The main adverse reaction reported after the first and second doses was pain at the injection site. Four weeks after the second dose, an increase in neutralizing antibody titer was observed in subjects relative to their baseline visit. Similar results were found for activation of specific CD4+ T cells. Neutralizing antibodies were identified against the Delta and Omicron variants. However, these titers were lower than those for the D614G strain. Importantly, comparable CD4+ T cell responses were detected against these variants of concern. Therefore, CoronaVac is safe and immunogenic in subjects 3 to 17 years old, inducing neutralizing antibody secretion and activating CD4+ T cells against SARS-CoV-2 and its variants. (This study has been registered at ClinicalTrials.gov under no. NCT04992260.) IMPORTANCE This work evaluated the immune response induced by two doses of CoronaVac separated by 4 weeks in healthy children and adolescents in Chile. To date, few studies have described the effects of CoronaVac in the pediatric population. Therefore, it is essential to generate knowledge regarding the protection of vaccines in this population. Along these lines, we reported the anti-S humoral response and cellular immune response to several SARS-CoV-2 proteins that have been published and recently studied. Here, we show that a vaccination schedule consisting of two doses separated by 4 weeks induces the secretion of neutralizing antibodies against SARS-CoV-2. Furthermore, CoronaVac induces the activation of CD4+ T cells upon stimulation with peptides from the proteome of SARS-CoV-2. These results indicate that, even though the neutralizing antibody response induced by vaccination decreases against the Delta and Omicron variants, the cellular response against these variants is comparable to the response against the ancestral strain D614G, even being significantly higher against Omicron.
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154
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Florentino PTV, Cerqueira-Silva T, Barral-Netto M, Paixão ES. Effectiveness of covid-19 vaccines in adolescents and children. BMJ 2022; 379:o3018. [PMID: 36593577 DOI: 10.1136/bmj.o3018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Pilar T V Florentino
- Gonçalo Moniz Insitute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil
- Biomedical Science Institute, University of São Paulo, São Paulo, Brazil
| | | | | | - Enny S Paixão
- London School of Hygiene and Tropical Medicine, London, UK
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155
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Iglesias García G, Díaz Rodríguez Á, Díaz Fernández B, Cuello Estrada C, García Ferreiro T, Crespo García N, Seco-Calvo J. An Evaluation of Serological Tests to Determine Postvaccinal Immunity to SARS-CoV-2 by mRNA Vaccines. J Clin Med 2022; 11:jcm11247534. [PMID: 36556149 PMCID: PMC9781667 DOI: 10.3390/jcm11247534] [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: 10/25/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The duration of the protective efficacy of vaccines against SARS-CoV-2 is unknown. Thus, an evaluation of the clinical performance of available tests is required. OBJECTIVES To evaluate the clinical performance of LFIA immunoassay compared to ELIA and CLIA immunoassays available in Europe for the detection of IgG antibodies generated by mRNA vaccines against SARS-CoV-2. METHODS Two automated immunoassays (the EUROIMMUN anti-SARS-CoV-2 IgG S1 ELISA and the LIAISON de Diasorin anti-SARS-CoV-2 IgG S1/S2 test) and a lateral flow immunoassay (the Livzon LFIA anti-SARS-CoV-2 IgG S test) were tested. We analyzed 300 samples distributed in three groups: 100 subjects aged over 18 years and under 45 years, 100 subjects aged between 45 and 65 years, and 100 subjects aged over 65 years. The samples were collected before vaccination; at 21 days; and then at 1, 2, 3, and 6 months after vaccination. The sensitivity, specificity, positive predictive value, negative predictive value, positive probability quotient, negative probability quotient, and concordance (kappa index) were calculated for each serological test. RESULTS The maximum sensitivity values for IgG were 98.7%, 98.1%, and 97.8% for the EUROIMMUN ELISA, Abbott CLIA, and Livzon LFIA tests, respectively, and the maximum specificity values for IgG were 99.4%, 99.9%%, and 98.4% for the ELISA, CLIA, and LFIA tests, respectively, at the third month after vaccination, representing a decrease in the antibody levels after the sixth month. The best agreement was observed between the ELISA and CLIA tests at 100% (k = 1.00). The agreement between the ELIA, CLIA, and LFIA tests was 99% (k = 0.964) at the second and third month after vaccination. Seroconversion was faster and more durable in the younger age groups. CONCLUSION Our study examined the equivalent and homogeneous clinical performance for IgG of three immunoassays after vaccination and found LFIA to be the most cost-effective, reliable, and accurate for routine use in population seroconversion and seroprevalence studies.
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Affiliation(s)
| | - Ángel Díaz Rodríguez
- Institute of Biomedicine (IBIOMED), Campus of Vegazana, University of Leon, 24071 Leon, Spain
- Bembibre Health Center, University of Leon, Carbajal Street 1, 24300 Bembibre, Spain
- Correspondence:
| | | | | | - Tania García Ferreiro
- Bembibre Health Center, University of Leon, Carbajal Street 1, 24300 Bembibre, Spain
| | - Noelia Crespo García
- Bembibre Health Center, University of Leon, Carbajal Street 1, 24300 Bembibre, Spain
| | - Jesús Seco-Calvo
- Physiotherapy Department, Institute of Biomedicine (IBIOMED), Campus of Vegazana, University of Leon, 24071 Leon, Spain
- Psychology Department, Faculty of Medicine, Basque Country University, 48900 Leioa, Spain
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156
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Cinicola BL, Piano Mortari E, Zicari AM, Agrati C, Bordoni V, Albano C, Fedele G, Schiavoni I, Leone P, Fiore S, Capponi M, Conti MG, Petrarca L, Stefanelli P, Spalice A, Midulla F, Palamara AT, Quinti I, Locatelli F, Carsetti R. The BNT162b2 vaccine induces humoral and cellular immune memory to SARS-CoV-2 Wuhan strain and the Omicron variant in children 5 to 11 years of age. Front Immunol 2022; 13:1094727. [PMID: 36591287 PMCID: PMC9797965 DOI: 10.3389/fimmu.2022.1094727] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
SARS-CoV-2 mRNA vaccines prevent severe COVID-19 by generating immune memory, comprising specific antibodies and memory B and T cells. Although children are at low risk of severe COVID-19, the spreading of highly transmissible variants has led to increasing in COVID-19 cases and hospitalizations also in the youngest, but vaccine coverage remains low. Immunogenicity to mRNA vaccines has not been extensively studied in children 5 to 11 years old. In particular, cellular immunity to the wild-type strain (Wuhan) and the cross-reactive response to the Omicron variant of concern has not been investigated. We assessed the humoral and cellular immune response to the SARS-CoV-2 BNT162b2 vaccine in 27 healthy children. We demonstrated that vaccination induced a potent humoral and cellular immune response in all vaccinees. By using spike-specific memory B cells as a measurable imprint of a previous infection, we found that 50% of the children had signs of a past, undiagnosed infection before vaccination. Children with pre-existent immune memory generated significantly increased levels of specific antibodies, and memory T and B cells, directed against not only the wild type virus but also the omicron variant.
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Affiliation(s)
- Bianca Laura Cinicola
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy,Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - E Piano Mortari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy,B cell unit, Immunology Research Area, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Anna Maria Zicari
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Chiara Agrati
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Veronica Bordoni
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Christian Albano
- B cell unit, Immunology Research Area, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Giorgio Fedele
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Ilaria Schiavoni
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Pasqualina Leone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Capponi
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Spalice
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Isabella Quinti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy,Catholic University of the Sacred Hearth, Rome, Italy
| | - Rita Carsetti
- B cell unit, Immunology Research Area, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy,*Correspondence: Rita Carsetti,
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157
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Alwafi H, Naser AY, Aldhahir AM, Alhazmi A, Alosaimi AN, Mandili RA, Majeed Z, Salawati E, Ekram R, Samannodi M, Assaggaf H, Almatrafi M, Alqahtani JS, Alsanosi SM, Minshawi F. COVID-19 vaccination side effects among the child age group: a large cross-sectional online based survey in Saudi Arabia. BMC Infect Dis 2022; 22:911. [PMID: 36474174 PMCID: PMC9724422 DOI: 10.1186/s12879-022-07905-2] [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: 08/11/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Multiple vaccines have been tested in clinical trials for their efficacy and safety. In Saudi Arabia, Pfizer-BioNTech or Moderna were approved for children, however, previous studies to report their safety profile are limited. This research aims to understand the side effect of children's vaccination against SARS-CoV-2 infection in Saudi Arabia. METHODS This was an observational retrospective cross-sectional study was conducted using an online survey in Saudi Arabia from March to May 2022. The inclusion criteria were parents aged 18 years and above who live in Saudi Arabia and have vaccinated their children. The self-reported questionnaire was adopted from published studies to investigate the study objectives Descriptive statistics were used to describe patients' demographic characteristics, continuous data were reported as mean ± S.D., categorical data were reported as percentages (frequencies), and logistic regression was used to identify predictors of persistent post-COVID-19 symptoms. RESULTS This study had a total of 4,069 participants. Only 41.9% of the participants reported that their child(ren) had been infected with the coronavirus. 2.00 was the median number of children (IQR: 1.00-4.00). More than half of the study participants (64.2%) reported that a family member had been infected with the coronavirus. Both parents received COVID-19 vaccination, according to most participants (88.7%). Most participants (70.5%) stated that all children who met the vaccination criteria had received the vaccine. Most participants (83.5%) said their child or children had two doses of their vaccine, and about half (50.4%) of those who received the vaccine reported experiencing side effects. In addition, the majority (78.9%) reported that the side effects appeared within one day of receiving the vaccine, and nearly two-thirds (65.7%) reported that the side effects lasted between one and three. A total of 11,831 side effects cases were documented. Pain at the injection site, hyperthermia, and fatigue were the most reported side effects, accounting for 15.3%, 14.1%, and 13.2%, respectively. CONCLUSION It appears that the side effects of the COVID-19 vaccine for children are minor, tolerable, and like those described previously in clinical trials. Our data should encourage the public about the safety of receiving the COVID-19 vaccine for children.
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Affiliation(s)
- Hassan Alwafi
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia ,grid.413517.50000 0004 1796 5802Al-Noor Specialist Hospital, Mecca, Saudi Arabia
| | - Abdallah Y. Naser
- grid.460941.e0000 0004 0367 5513Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Abdulelah M. Aldhahir
- grid.411831.e0000 0004 0398 1027Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Alhazmi
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Areen Naif Alosaimi
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Rasha Abdulaziz Mandili
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Zaid Majeed
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Emad Salawati
- grid.412125.10000 0001 0619 1117Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rakan Ekram
- grid.412832.e0000 0000 9137 6644School of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mohammed Samannodi
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Hamza Assaggaf
- grid.412832.e0000 0000 9137 6644Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mohammed Almatrafi
- grid.412832.e0000 0000 9137 6644Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Jaber S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammām, Saudi Arabia
| | - Safaa Mohammed Alsanosi
- grid.412832.e0000 0000 9137 6644Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Faisal Minshawi
- grid.412832.e0000 0000 9137 6644Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
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Bratic JS, Gans HA, Chen SF, Banaei N, Johnston EM, Sear K, Samreth S, Nadimpalli SS. Pediatric solid organ transplant recipients demonstrate robust cell-mediated and humoral responses to three doses of mRNA SARS-CoV-2 vaccine. Am J Transplant 2022; 22:3047-3052. [PMID: 36083190 PMCID: PMC9539089 DOI: 10.1111/ajt.17195] [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: 02/07/2022] [Revised: 08/17/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023]
Abstract
Pediatric solid organ transplant recipients (pSOTR) often demonstrate suboptimal vaccine responses and are not included in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine efficacy trials. This population has shown variable humoral immunity following SARS-CoV-2 vaccination, and no studies have assessed cell-mediated responses after SARS-CoV-2 vaccination in pSOTR. SARS-CoV-2-specific interferon-gamma release assay (IGRA), immunoglobulin G (IgG), and receptor-binding domain (RBD)-angiotensin-converting enzyme 2 (ACE2) blocking antibody (Ab) were measured in pSOTR aged 5-17 years after 2-3 doses of SARS-CoV-2 mRNA vaccine. In all, 33 subjects were included, with 25 tested after the second dose of mRNA vaccine (V2) and 21 tested after the third dose of mRNA vaccine (V3). Of the 19 subjects who had IgG testing after V3, 100.0% (19/19) had a positive IgG response. Of the 17 subjects who had IGRA testing after V3, 94.1% (16/17) had a positive IGRA response. RBD-ACE2 blocking antibody increased significantly from V2 to V3 (p = .007). Subjects <1 year from transplant demonstrated a significantly larger increase in RBD-ACE2 blocking Ab from V2 to V3 than did those >1 year from transplant (p = .05). SARS-CoV-2 vaccination induces humoral and cell-mediated responses in the majority of pSOTR, with improved quantitative humoral response after three doses.
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Affiliation(s)
- Julia S. Bratic
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Hayley A. Gans
- Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Sharon F. Chen
- Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Niaz Banaei
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Erica M. Johnston
- Stanford Maternal and Child Health Research Institute, Stanford, California, USA
| | - Katherine Sear
- Division of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Sarah Samreth
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Sruti S. Nadimpalli
- Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, California, USA,Correspondence Sruti S. Nadimpalli, Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, CA, USA.
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159
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Rudan I, Millington T, Antal K, Grange Z, Fenton L, Sullivan C, Buelo A, Wood R, Woolford L, Swann OV, Murray JL, Cullen LA, Moore E, Haider F, Almaghrabi F, McMenamin J, Agrawal U, Shah SA, Kerr S, Simpson CR, Katikireddi SV, Ritchie SLD, Robertson C, Sheikh SA. BNT162b2 COVID-19 vaccination uptake, safety, effectiveness and waning in children and young people aged 12-17 years in Scotland. THE LANCET REGIONAL HEALTH. EUROPE 2022; 23:100513. [PMID: 36189425 PMCID: PMC9514975 DOI: 10.1016/j.lanepe.2022.100513] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background The two-dose BNT162b2 (Pfizer-BioNTech) vaccine has demonstrated high efficacy against COVID-19 disease in clinical trials of children and young people (CYP). Consequently, we investigated the uptake, safety, effectiveness and waning of the protective effect of the BNT162b2 against symptomatic COVID-19 in CYP aged 12-17 years in Scotland. Methods The analysis of the vaccine uptake was based on information from the Turas Vaccination Management Tool, inclusive of Mar 1, 2022. Vaccine safety was evaluated using national data on hospital admissions and General Practice (GP) consultations, through a self-controlled case series (SCCS) design, investigating 17 health outcomes of interest. Vaccine effectiveness (VE) against symptomatic COVID-19 disease for Delta and Omicron variants was estimated using a test-negative design (TND) and S-gene status in a prospective cohort study using the Scotland-wide Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. The waning of the VE following each dose of BNT162b2 was assessed using a matching process followed by conditional logistic regression. Findings Between Aug 6, 2021 and Mar 1, 2022, 75.9% of the 112,609 CYP aged 16-17 years received the first and 49.0% the second COVID-19 vaccine dose. Among 237,681 CYP aged 12-15 years, the uptake was 64.5% and 37.2%, respectively. For 12-17-year-olds, BNT162b2 showed an excellent safety record, with no increase in hospital stays following vaccination for any of the 17 investigated health outcomes. In the 16-17-year-old group, VE against symptomatic COVID-19 during the Delta period was 64.2% (95% confidence interval [CI] 59.2-68.5) at 2-5 weeks after the first dose and 95.6% (77.0-99.1) at 2-5 weeks after the second dose. The respective VEs against symptomatic COVID-19 in the Omicron period were 22.8% (95% CI -6.4-44.0) and 65.5% (95% CI 56.0-73.0). In children aged 12-15 years, VE against symptomatic COVID-19 during the Delta period was 65.4% (95% CI 61.5-68.8) at 2-5 weeks after the first dose, with no observed cases at 2-5 weeks after the second dose. The corresponding VE against symptomatic COVID-19 during the Omicron period were 30.2% (95% CI 18.4-40.3) and 81.2% (95% CI 77.7-84.2). The waning of the protective effect against the symptomatic disease began after five weeks post-first and post-second dose. Interpretation During the study period, uptake of BNT162b2 in Scotland has covered more than two-thirds of CYP aged 12-17 years with the first dose and about 40% with the second dose. We found no increased likelihood of admission to hospital with a range of health outcomes in the period after vaccination. Vaccination with both doses was associated with a substantial reduction in the risk of COVID-19 symptomatic disease during both the Delta and Omicron periods, but this protection began to wane after five weeks. Funding UK Research and Innovation (Medical Research Council); Research and Innovation Industrial Strategy Challenge Fund; Chief Scientist's Office of the Scottish Government; Health Data Research UK; National Core Studies - Data and Connectivity.
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Affiliation(s)
- Igor Rudan
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | | | - Rachael Wood
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Public Health Scotland, Glasgow, UK
| | - Lana Woolford
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Olivia V. Swann
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Royal Hospital for Sick Children, Paediatric Infectious Diseases, Edinburgh, UK
| | | | | | | | - Fasih Haider
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | | | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | | | - Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Colin R. Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | | | | | - Chris Robertson
- Public Health Scotland, Glasgow, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
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Fong Y, McDermott AB, Benkeser D, Roels S, Stieh DJ, Vandebosch A, Le Gars M, Van Roey GA, Houchens CR, Martins K, Jayashankar L, Castellino F, Amoa-Awua O, Basappa M, Flach B, Lin BC, Moore C, Naisan M, Naqvi M, Narpala S, O'Connell S, Mueller A, Serebryannyy L, Castro M, Wang J, Petropoulos CJ, Luedtke A, Hyrien O, Lu Y, Yu C, Borate B, van der Laan LWP, Hejazi NS, Kenny A, Carone M, Wolfe DN, Sadoff J, Gray GE, Grinsztejn B, Goepfert PA, Little SJ, Paiva de Sousa L, Maboa R, Randhawa AK, Andrasik MP, Hendriks J, Truyers C, Struyf F, Schuitemaker H, Douoguih M, Kublin JG, Corey L, Neuzil KM, Carpp LN, Follmann D, Gilbert PB, Koup RA, Donis RO. Immune correlates analysis of the ENSEMBLE single Ad26.COV2.S dose vaccine efficacy clinical trial. Nat Microbiol 2022; 7:1996-2010. [PMID: 36357712 PMCID: PMC10166187 DOI: 10.1038/s41564-022-01262-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/04/2022] [Indexed: 11/12/2022]
Abstract
Measuring immune correlates of disease acquisition and protection in the context of a clinical trial is a prerequisite for improved vaccine design. We analysed binding and neutralizing antibody measurements 4 weeks post vaccination as correlates of risk of moderate to severe-critical COVID-19 through 83 d post vaccination in the phase 3, double-blind placebo-controlled phase of ENSEMBLE, an international randomized efficacy trial of a single dose of Ad26.COV2.S. We also evaluated correlates of protection in the trial cohort. Of the three antibody immune markers we measured, we found most support for 50% inhibitory dilution (ID50) neutralizing antibody titre as a correlate of risk and of protection. The outcome hazard ratio was 0.49 (95% confidence interval 0.29, 0.81; P = 0.006) per 10-fold increase in ID50; vaccine efficacy was 60% (43%, 72%) at non-quantifiable ID50 (<2.7 IU50 ml-1) and increased to 89% (78%, 96%) at ID50 = 96.3 IU50 ml-1. Comparison of the vaccine efficacy by ID50 titre curves for ENSEMBLE-US, the COVE trial of the mRNA-1273 vaccine and the COV002-UK trial of the AZD1222 vaccine supported the ID50 titre as a correlate of protection across trials and vaccine types.
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Affiliation(s)
- Youyi Fong
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Adrian B McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - David Benkeser
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sanne Roels
- Janssen R&D, a division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Daniel J Stieh
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - An Vandebosch
- Janssen R&D, a division of Janssen Pharmaceutica NV, Beerse, Belgium
| | | | | | | | - Karen Martins
- Biomedical Advanced Research and Development Authority, Washington, DC, USA
| | | | - Flora Castellino
- Biomedical Advanced Research and Development Authority, Washington, DC, USA
| | - Obrimpong Amoa-Awua
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Manjula Basappa
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Britta Flach
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Bob C Lin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Christopher Moore
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mursal Naisan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Muhammed Naqvi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandeep Narpala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sarah O'Connell
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Allen Mueller
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Leo Serebryannyy
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mike Castro
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Alex Luedtke
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Ollivier Hyrien
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Yiwen Lu
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Chenchen Yu
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Bhavesh Borate
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lars W P van der Laan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Nima S Hejazi
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Division of Biostatistics, School of Public Health, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Avi Kenny
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Daniel N Wolfe
- Biomedical Advanced Research and Development Authority, Washington, DC, USA
| | - Jerald Sadoff
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Glenda E Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Beatriz Grinsztejn
- Evandro Chagas National Institute of Infectious Diseases-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paul A Goepfert
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Susan J Little
- Division of Infectious Diseases, University of California San Diego, La Jolla, CA, USA
| | - Leonardo Paiva de Sousa
- Evandro Chagas National Institute of Infectious Diseases-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rebone Maboa
- Ndlovu Elandsdoorn Site, Dennilton, Limpopo, South Africa
| | - April K Randhawa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Michele P Andrasik
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Jenny Hendriks
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Carla Truyers
- Janssen R&D, a division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Frank Struyf
- Janssen R&D, a division of Janssen Pharmaceutica NV, Beerse, Belgium
| | | | | | - James G Kublin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Kathleen M Neuzil
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lindsay N Carpp
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Dean Follmann
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter B Gilbert
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA.
| | - Richard A Koup
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ruben O Donis
- Biomedical Advanced Research and Development Authority, Washington, DC, USA
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161
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Benites-Zapata VA, Herrera-Añazco P, Benites-Meza JK, Bonilla-Aguilar K, Urrunaga-Pastor D, Bendezu-Quispe G, Uyen-Cateriano A, Rodriguez-Morales AJ, Hernandez AV. Prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19: A comparative analysis in Colombia and Peru. Vaccine X 2022; 12:100198. [PMID: 35935750 PMCID: PMC9344873 DOI: 10.1016/j.jvacx.2022.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 04/07/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
About 9 out of 10 parents in Colombia and Peru intend to vaccinate their children and adolescents against COVID-19. Colombia: being vaccinated, 35 to 54 years old, maintaining physical distance, using masks, having economic insecurity, anxiety, and comorbidities increased the intention of vaccinating children and adolescents. Peru: being vaccinated, female, maintaining physical distancing, using a mask, having economic insecurity, comorbidities, and have had COVID-19 increased the intention to vaccinate children and adolescents. Peru: living in a town, village or rural area was associated with reducing the intention to vaccinate children and adolescents.
We aimed to estimate the prevalence and factors associated with parents’ non-intention to vaccinate their children and adolescents against COVID-19 in Colombia and Peru. We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc). We Included adult (18 and over) Facebook users residing in LAC who responded to the survey between May 20, and November 5, 2021. We Included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95 %CI. We analyzed a sample of 44,678 adults from Colombia and 24,302 from Peru. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.41 % (n = 3,274) for Colombia and 6.64 % (n = 1,464) for Peru. In Colombia, age above 35 years old, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, and being vaccinated were associated with a higher probability of vaccinating children and adolescents against COVID-19. In Peru, female gender, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, having had COVID-19, and being vaccinated were associated with a higher probability of vaccinating children against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. About 9 out of 10 parents in Colombia and Peru intend to vaccinate their children and adolescents against COVID-19. This intention is associated with some factors which are similar between the two countries, as well as other factors and variations among the different regions of each country.
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162
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Takanohashi A, Alameh MG, Woidill S, Hacker J, Davis B, Helman G, Gavazzi F, Adang L, D'Aiello R, Winters P, Cordova D, Khandaker T, Ni H, Tam Y, Lin P, Weissman D, Shults J, Vanderver A. SARS-CoV-2 mRNA-based vaccines in the Aicardi Goutières Syndrome. Mol Genet Metab 2022; 137:320-327. [PMID: 36334423 PMCID: PMC9550281 DOI: 10.1016/j.ymgme.2022.10.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 12/14/2022]
Abstract
Aicardi Goutières Syndrome (AGS) is an autoinflammatory disorder resulting in sustained interferon activation through defects in nucleic acid modification and sensing pathways. Thus, mRNA-based vaccination used against SARS-CoV-2, raise disease-specific safety concerns. To assess interferon signaling, we tested mRNA SARS-CoV-2 vaccines in AGS whole blood samples. Interferon activation is measured through quantitation of interferon signaling gene (ISG) expression and is increased in AGS patients. There was no increase in ISG scores from baseline following treatment with the nucleoside modified mRNA formulation compared to an increase with unmodified. A patient-family survey reported that the vaccines were well tolerated. These findings suggest that COVID vaccination using nucleoside-modified forms of mRNA vaccines are unlikely to directly stimulate ISG expression in response to mRNA internalization in AGS tissues. With continued community spread, we recommend vaccination using nucleoside-modified mRNA vaccines in this rare disease group in individuals for whom vaccines were previously well tolerated.
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Affiliation(s)
- Asako Takanohashi
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Mohamad-Gabriel Alameh
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Sarah Woidill
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Julia Hacker
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Benjamin Davis
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Guy Helman
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Francesco Gavazzi
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Laura Adang
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Russell D'Aiello
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Patrick Winters
- Aicardi-Goutières Syndrome Advocacy Association, Crested Butte, USA
| | - Devon Cordova
- Aicardi-Goutières Syndrome Advocacy Association, Crested Butte, USA
| | | | - Houping Ni
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Ying Tam
- Acuitas Therapeutics, Vancouver, Canada
| | - Paulo Lin
- Acuitas Therapeutics, Vancouver, Canada
| | - Drew Weissman
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Justine Shults
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia, USA; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Adeline Vanderver
- Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
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163
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Schwartz BN, Harahsheh AS, Krishnan A, Martin GR. Cardiac Effects of COVID-19 Infection, MIS-C, and the Vaccine in Infants and Children: What Is Known and Future Implications. Am J Perinatol 2022; 39:S1-S6. [PMID: 36307093 DOI: 10.1055/s-0042-1757238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The cardiac effects of novel coronavirus disease 2019 (COVID-19) infection on the pediatric heart has become an area of particular interest as elevated cardiac enzymes and abnormalities on echocardiogram and electrocardiogram were seen in a portion of children affected by the virus. In this article, we review the cardiac manifestations of acute COVID-19 infection, multisystem inflammatory syndrome in children, and postvaccine myocarditis. The limited research on the effects of COVID-19 on neonates and infants is also reported. KEY POINTS: · Cardiac involvement from MIS-C is much higher than the risk of COVID-19 vaccine-induced myocarditis.. · Neonates and infants have overall been less affected by COVID-19 than adults and older children.. · At this point in time, there is limited research on the cardiac effects of COVID-19 in neonates..
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Affiliation(s)
- Bryanna N Schwartz
- Division of Cardiology, Children's National Hospital, Washington, District of Columbia.,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Ashraf S Harahsheh
- Division of Cardiology, Children's National Hospital, Washington, District of Columbia.,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Anita Krishnan
- Division of Cardiology, Children's National Hospital, Washington, District of Columbia.,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Gerard R Martin
- Division of Cardiology, Children's National Hospital, Washington, District of Columbia.,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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164
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Morozov NG, Dror AA, Daoud A, Eisenbach N, Kaykov E, Barhoum M, Sheleg T, Sela E, Edelstein M. Reasons underlying the intention to vaccinate children aged 5-11 against COVID-19: A cross-sectional study of parents in Israel, November 2021. Hum Vaccin Immunother 2022; 18:2112879. [PMID: 36037533 DOI: 10.1080/21645515.2022.2112879] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vaccination is a key tool to mitigate impacts of the COVID-19 pandemic. In Israel, COVID-19 vaccines became available to adults in December 2020 and to 5-11-year-old children in November 2021. Ahead of the vaccine roll-out in children, we aimed to determine whether surveyed parents intended to vaccinate their children and describe reasons for their intentions. We collected information on parental socio-demographic characteristics, COVID-19 vaccine history, intention to vaccinate their children against COVID-19, and reasons for parental decisions using an anonymous online survey. We identified associations between parental characteristics and plans to vaccinate children using a logistic regression model and described reasons for intentions to vaccinate or not. Parental non-vaccination and having experienced major vaccination side effects were strongly associated with non-intention to vaccinate their children (OR 0.09 and 0.18 respectively, p < .001). Parents who were younger, lived in the socio-economically deprived periphery, and belonged to the Arab population had lower intentions to vaccinate their children. Reasons for non-intention to vaccinate included concerns about vaccine safety and efficacy (53%, 95%CI 50-56) and the belief that COVID-19 is a mild disease (73%, 95%CI 73-79), while a frequent motive for vaccination was the return to normal social and educational life (89%, 95%CI 87-91). Understanding rationales for COVID-19 vaccine rejection or acceptance, as well as parental demographic data, can pave the way for intentional educational campaigns to encourage not only vaccination against COVID-19, but also regular childhood vaccine programming.
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Affiliation(s)
| | - Amiel A Dror
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Amani Daoud
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Netanel Eisenbach
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Edward Kaykov
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Masad Barhoum
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Tsvi Sheleg
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Eyal Sela
- Galilee Medical Center, Nahariyah, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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165
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Ripabelli G, Sammarco ML, D'Amico A, De Dona R, Iafigliola M, Parente A, Samprati N, Santagata A, Adesso C, Natale A, Di Palma MA, Cannizzaro F, Romano R, Licianci A, Tamburro M. Safety of mRNA BNT162b2 COVID-19 (Pfizer-BioNtech) vaccine in children aged 5-11 years: Results from an active pharmacovigilance study in central Italy. Hum Vaccin Immunother 2022; 18:2126668. [PMID: 36315849 PMCID: PMC9746364 DOI: 10.1080/21645515.2022.2126668] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This survey investigated on adverse events after vaccination with mRNA BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine in children aged 5-11 years in central Italy through active surveillance reporting. During December 2021-January 2022, parents of children who undergone vaccination were interviewed using a structured questionnaire. 197 out of 208 contacted parents participated (94.7% response rate), of whom 166 (84.3%) had one child. Of the 229 children, the mean age was 8.9 years, 50.7% were female. 193 (84.3%) had at least one adverse event after the first dose (mean age 9.1 years; 54.4% female), and 146 (73.4%) of 199 after the second (mean age 8.9 years; 54.8% female), which was not administered to 30 children due to previous COVID-19 history. Local symptoms after the first and second dose occurred in 183 (94.8%) and 141 (96.6%) recipients (p = .435), respectively, while systemic reactions in 62 (32.1%) and 34 (23.3%) (p = .074). Mild events were reported by 81.7% and 69.8% children after the first and second dose, followed by moderate (3.9% and 10.6%) and severe (1.3% and 0.5%). After each dose, injection site reactions (79.5% and 68.8%) were the most frequent, followed by headache (13.1%) and lymphadenopathy (8.5%) after the first and second dose, respectively. The adverse events were reported to pediatricians only for 5.7% and 3.9% of children and treated for 17.6% and 15.8%. This is the first report about safety profile through active surveillance of mRNA BNT162b2 among children in Italy, revealing temporary and mild-to-moderate symptoms with no serious events after each vaccine dose.
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Affiliation(s)
- Giancarlo Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Michela Lucia Sammarco
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Antonio D'Amico
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Roberta De Dona
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Mariagrazia Iafigliola
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Albino Parente
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Nicandro Samprati
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Arturo Santagata
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Carmen Adesso
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Anna Natale
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Michela Anna Di Palma
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Fabio Cannizzaro
- School of Specialization in Hygiene and Preventive Medicine, University of Molise, Campobasso, Italy
| | - Roberto Romano
- Antonio Cardarelli Hospital, Azienda Sanitaria Regionale del Molise, Campobasso, Italy
| | - Antonietta Licianci
- Antonio Cardarelli Hospital, Azienda Sanitaria Regionale del Molise, Campobasso, Italy
| | - Manuela Tamburro
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
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166
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Higashimoto Y, Kozawa K, Miura H, Kawamura Y, Ihira M, Hiramatsu H, Suzuki R, Haga K, Takai-Todaka R, Sawada A, Katayama K, Yoshikawa T. Correlation between anti-S IgG and neutralizing antibody titers against three live SARS-CoV-2 variants in BNT162b2 vaccine recipients. Hum Vaccin Immunother 2022; 18:2105611. [PMID: 36094467 DOI: 10.1080/21645515.2022.2105611] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We analyzed serially collected serum samples from healthy adults who underwent BNT162b2 vaccination to elucidate the association between spike (S)-IgG antibody titers determined by ELISA using the WHO international standard (NIBSC code 20/136) and neutralizing antibody titers against three live SARS-CoV-2 variants. This study included 53 health care workers who received two doses of the BNT162b2 vaccine. S-IgG and nucleocapsid (N)-IgG antibody titers were measured by ELISA. Neutralizing (NT) antibody responses against three variants (Wuhan D614 G: KUH003, Alpha, and Delta) were evaluated before and after the first and second vaccination. N-IgG were not detected in any serum samples. S-IgG antibody titers remarkably increased after two BNT162b2 vaccine doses in all participants. S-IgG antibody titers were strongly correlated with NT titers against three variants of live viruses: KUH003 (r = 0.86), Alpha (r = 0.72), and Delta (r = 0.84). Serum samples from participants after one dose of BNT162b2 neutralized Alpha efficiently (median titer, 113.0), but median NT titers against KUH003 and Delta variants were lower, 57.0 and 28.0, respectively (p < .01). Two doses of the BNT162b2 vaccine elicited a strong immune response in this study. The second dose was required for induction of a strong booster effect. Serum collected from BNT162b2 vaccine recipients contained significantly lower neutralizing activity against Delta than that of against KUH003 (p < .0001) and Alpha (p < .0001). If a new variant emerges, live virus-based NT titers should be examined in serum obtained from vaccine recipients to evaluate vaccine efficacy for protection against infection.
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Affiliation(s)
- Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Hiroyuki Hiramatsu
- Department of Clinical Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Ryota Suzuki
- Department of Clinical Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Kei Haga
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Reiko Takai-Todaka
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Akihito Sawada
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Kazuhiko Katayama
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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167
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Fergie J, Moran MM, Cane A, Pather S, Türeci Ӧ, Srivastava A. COVID-19 Epidemiology, Immunity, and Vaccine Development in Children: A Review. Vaccines (Basel) 2022; 10:vaccines10122039. [PMID: 36560448 PMCID: PMC9781884 DOI: 10.3390/vaccines10122039] [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: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
Although pediatric populations experienced lower COVID-19 severity and mortality than adults, the epidemiology of this disease continues to evolve. COVID-19 clinical manifestations in pediatrics commonly include fever and cough, but may differ from adults and by variant. Serious complications, including MIS-C, rarely occur. Although early data showed a decreased likelihood of COVID-19 transmission from children versus adults, outbreaks and viral shedding studies support pediatric transmission potential. Children may mount more robust initial immune responses to SARS-CoV-2 versus adults. COVID-19 vaccines with available pediatric data include BNT162b2, mRNA-1273, CoronaVac, and BBIBP-CorV. Depending on age group and jurisdiction, BNT162b2 and mRNA-1273 have received full approval or emergency/conditional authorization in the United States and European Union from 6 months of age. Clinical trials have shown BNT162b2 and mRNA-1273 safety and high efficacy in pediatric populations, with demonstrably noninferior immune responses versus young adults. Real-world studies further support BNT162b2 safety and effectiveness against the Delta variant. mRNA vaccination benefits are considered to outweigh risks, including myocarditis; however, pediatric vaccination rates remain relatively low. Given a growing body of clinical trial and real-world data showing vaccine safety and effectiveness, pediatric vaccination should be prioritized as an important strategy to control the pandemic.
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Affiliation(s)
- Jaime Fergie
- Driscoll Children’s Hospital, Corpus Christi, TX 78411, USA
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168
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Ma Y, Liu N, Zhong G, Wang D, Cao L, Bai S, Zhu P, Zhang A, Wang X. Parent Acceptance toward Inactivated COVID-19 Vaccination in Children with Acute Lymphoblastic Leukemia: The Power of Oncologist and Alliance. Vaccines (Basel) 2022; 10:vaccines10122016. [PMID: 36560428 PMCID: PMC9785446 DOI: 10.3390/vaccines10122016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives: The current study aims to survey the willingness of parents to vaccinate their children, who are childhood acute lymphoblastic leukemia survivors (CALLS), and identify factors associated with vaccine acceptance. Methods: Parents of CALLS on/off treatment, with the general condition of being amendable to vaccination, were recruited for interviews with attending oncologists about COVID-19 vaccination acceptance from July to November 2021 in China. After controlling for socioeconomic factors, the Association of Oncologists’ recommendations and parent−oncologist alliance with acceptance status were investigated. For validation, propensity score-matched (PSM) analysis was used. Results: A total of 424 families were included in the study, with CALLS mean remission age of 5.99 ± 3.40 years. Among them, 91 (21.4%) agreed, 168 (39.6%) hesitated, and 165 (38.9%) parents disagreed with the vaccination. The most common reason that kept parents from vaccinating their children was lack of recommendations from professional personnel (84/165, 50.9%), and massive amounts of internet information (78/175, 44.6%) was the main nonhealthcare resource against vaccination. Logistic regression analysis showed that only the recommendation from the oncologist was associated with parents’ vaccine acceptance (OR = 3.17, 95% CI = 1.93−5.20), as demonstrated by PSM comparison (42 in recommendation group vs. 18 in nonrecommendation group among 114 pairs, p < 0.001). An exploratory analysis revealed that parents with a better patient−oncologist alliance had a significantly higher level of acceptance (65.6% in alliance group vs. 15.6% in nonalliance group among 32 pairs, p < 0.001). Conclusions: Due to a lack of professional recommendation resources and the potential for serious consequences, parents were generally reluctant to vaccinate their CALLS. The recommendation of oncologists, which was influenced by the parent−oncologist alliance, significantly increased acceptance. This study emphasizes the critical role of oncologists in vaccinating cancer survivors and can be used to promote COVID-19 vaccines among vulnerable populations.
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Affiliation(s)
- Yifei Ma
- Department of Orthopedics and Spine Surgery, The Second Affiliated Hospital of Shantou University Medical College, 69 Dongsha North Road, Shantou 515000, China
- Department of Bone and Soft Tissue Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515041, China
| | - Nianqi Liu
- Faculty of Psychology, Institute of Educational Science, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Guanqing Zhong
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Dao Wang
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Lu Cao
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Shenrui Bai
- Department of Hematological Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Pengfei Zhu
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Ao Zhang
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Xinjia Wang
- Department of Orthopedics and Spine Surgery, The Second Affiliated Hospital of Shantou University Medical College, 69 Dongsha North Road, Shantou 515000, China
- Department of Bone and Soft Tissue Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515041, China
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169
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Bartsch YC, St Denis KJ, Kaplonek P, Kang J, Lam EC, Burns MD, Farkas EJ, Davis JP, Boribong BP, Edlow AG, Fasano A, Shreffler WG, Zavadska D, Johnson M, Goldblatt D, Balazs AB, Yonker LM, Alter G. SARS-CoV-2 mRNA vaccination elicits robust antibody responses in children. Sci Transl Med 2022; 14:eabn9237. [PMID: 35881018 PMCID: PMC9348753 DOI: 10.1126/scitranslmed.abn9237] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 07/01/2022] [Indexed: 01/11/2023]
Abstract
Although children have been largely spared from coronavirus disease 2019 (COVID-19), the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) with increased transmissibility, combined with fluctuating mask mandates and school reopenings, has led to increased infections and disease among children. Thus, there is an urgent need to roll out COVID-19 vaccines to children of all ages. However, whether children respond equivalently to adults to mRNA vaccines and whether dosing will elicit optimal immunity remain unclear. Here, we aimed to deeply profile the vaccine-induced humoral immune response in 6- to 11-year-old children receiving either a pediatric (50 μg) or adult (100 μg) dose of the mRNA-1273 vaccine and to compare these responses to vaccinated adults, infected children, and children who experienced multisystem inflammatory syndrome in children (MIS-C). Children elicited an IgG-dominant vaccine-induced immune response, surpassing adults at a matched 100-μg dose but more variable immunity at a 50-μg dose. Irrespective of titer, children generated antibodies with enhanced Fc receptor binding capacity. Moreover, like adults, children generated cross-VOC humoral immunity, marked by a decline of omicron-specific receptor binding domain, but robustly preserved omicron spike protein binding. Fc receptor binding capabilities were also preserved in a dose-dependent manner. These data indicate that both the 50- and 100-μg doses of mRNA vaccination in children elicit robust cross-VOC antibody responses and that 100-μg doses in children result in highly preserved omicron-specific functional humoral immunity.
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Affiliation(s)
- Yannic C Bartsch
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Kerri J St Denis
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Paulina Kaplonek
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Jaewon Kang
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Evan C Lam
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Madeleine D Burns
- Massachusetts General Hospital Department of Pediatrics, Mucosal Immunology and Biology Research Center, Boston, MA 02114, USA
| | - Eva J Farkas
- Massachusetts General Hospital Department of Pediatrics, Mucosal Immunology and Biology Research Center, Boston, MA 02114, USA
| | - Jameson P Davis
- Massachusetts General Hospital Department of Pediatrics, Mucosal Immunology and Biology Research Center, Boston, MA 02114, USA
| | - Brittany P Boribong
- Massachusetts General Hospital Department of Pediatrics, Mucosal Immunology and Biology Research Center, Boston, MA 02114, USA
| | - Andrea G Edlow
- Massachusetts General Hospital Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Vincent Center for Reproductive Biology, Boston, MA 02114, USA
| | - Alessio Fasano
- Massachusetts General Hospital Department of Pediatrics, Mucosal Immunology and Biology Research Center, Boston, MA 02114, USA
| | - Wayne G Shreffler
- Massachusetts General Hospital Food Allergy Center, Division of Pediatric Allergy and Immunology, Boston, MA 02114, USA
| | - Dace Zavadska
- Children's Clinical University Hospital, Riga, LV-1004, Latvia
| | - Marina Johnson
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London, London WC1N 1EH, UK
| | - David Goldblatt
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London, London WC1N 1EH, UK
| | | | - Lael M Yonker
- Massachusetts General Hospital Department of Pediatrics, Mucosal Immunology and Biology Research Center, Boston, MA 02114, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
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170
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Joseph G, Klein E, Lustig Y, Weiss-Ottolenghi Y, Asraf K, Indenbaum V, Amit S, Kriger O, Gilboa M, Levy Y, Pessach IM, Kreiss Y, Regev-Yochay G, Stein M. Real-World Immunogenicity and Reactogenicity of Two Doses of Pfizer-BioNTech COVID-19 Vaccination in Children Aged 5-11 Years. Vaccines (Basel) 2022; 10:1954. [PMID: 36423049 PMCID: PMC9693260 DOI: 10.3390/vaccines10111954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 07/30/2023] Open
Abstract
There are limited data concerning the immunogenicity and reactogenicity of COVID-19 vaccines in children. A total of 110 children, 5-11 years old were vaccinated with two doses (with a 3-week interval between doses) of the Pfizer-BioNTech COVID-19 vaccine and were followed for 21, 90, and 180 days after vaccination for immunogenicity, adverse events, and breakthrough infections. Ninety days after the first vaccine dose, the GeoMean (CI 95%) of IgG ascended to 1291.0 BAU (929.6-1790.2) for uninfected children and 1670.0 BAU (1131.0-2466.0) for Infected children. One hundred and eighty days after receiving the first dose of the vaccine, the titers decreased to 535.5 BAU (288.4-993.6) for the uninfected children, while only a small decline was detected among infected children-1479.0 (878.2-2490.0). The neutralizing antibodies titer almost did not change over time in the uninfected children, and even elevated for the infected children. Of the 110 vaccinated children, 75.5% were infected, with only mild COVID-19 infection symptoms. Child vaccination was found to be safe, with mild, mostly local, and of short duration, reported AEs. No serious adverse events (SAEs) were reported after vaccination. The durability of two doses of vaccine in children is longer, thus a booster may not be needed as early as in adults.
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Affiliation(s)
- Gili Joseph
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Elisheva Klein
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Yaniv Lustig
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Yael Weiss-Ottolenghi
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Keren Asraf
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Victoria Indenbaum
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Sharon Amit
- Clinical Microbiology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Or Kriger
- Clinical Microbiology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Mayan Gilboa
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Yuval Levy
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Itai M. Pessach
- Pediatric Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Yitshak Kreiss
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Gili Regev-Yochay
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Michal Stein
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Pediatric Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
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171
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Jiang Q, Cao Y, Ruan JW, Hu P. A comparative immune response to COVID-19 vaccination between children and adults. Influenza Other Respir Viruses 2022; 17:e13070. [PMID: 36394189 PMCID: PMC9835434 DOI: 10.1111/irv.13070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Qi Jiang
- Department of PediatricsThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yue Cao
- Department of PediatricsThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Jin Wei Ruan
- Department of PediatricsThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Peng Hu
- Department of PediatricsThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
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172
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Chemaitelly H, AlMukdad S, Ayoub HH, Altarawneh HN, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Al-Romaihi HE, Butt AA, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Covid-19 Vaccine Protection among Children and Adolescents in Qatar. N Engl J Med 2022; 387:1865-1876. [PMID: 36322837 PMCID: PMC9644642 DOI: 10.1056/nejmoa2210058] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The BNT162b2 vaccine against coronavirus disease 2019 (Covid-19) has been authorized for use in children 5 to 11 years of age and adolescents 12 to 17 years of age but in different antigen doses. METHODS We assessed the real-world effectiveness of the BNT162b2 vaccine against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and adolescents in Qatar. To compare the incidence of SARS-CoV-2 infection in the national cohort of vaccinated participants with the incidence in the national cohort of unvaccinated participants, we conducted three matched, retrospective, target-trial, cohort studies - one assessing data obtained from children 5 to 11 years of age after the B.1.1.529 (omicron) variant became prevalent and two assessing data from adolescents 12 to 17 years of age before the emergence of the omicron variant (pre-omicron study) and after the omicron variant became prevalent. Associations were estimated with the use of Cox proportional-hazards regression models. RESULTS Among children, the overall effectiveness of the 10-μg primary vaccine series against infection with the omicron variant was 25.7% (95% confidence interval [CI], 10.0 to 38.6). Effectiveness was highest (49.6%; 95% CI, 28.5 to 64.5) right after receipt of the second dose but waned rapidly thereafter and was negligible after 3 months. Effectiveness was 46.3% (95% CI, 21.5 to 63.3) among children 5 to 7 years of age and 16.6% (95% CI, -4.2 to 33.2) among those 8 to 11 years of age. Among adolescents, the overall effectiveness of the 30-μg primary vaccine series against infection with the omicron variant was 30.6% (95% CI, 26.9 to 34.1), but many adolescents had been vaccinated months earlier. Effectiveness waned over time since receipt of the second dose. Effectiveness was 35.6% (95% CI, 31.2 to 39.6) among adolescents 12 to 14 years of age and 20.9% (95% CI, 13.8 to 27.4) among those 15 to 17 years of age. In the pre-omicron study, the overall effectiveness of the 30-μg primary vaccine series against SARS-CoV-2 infection among adolescents was 87.6% (95% CI, 84.0 to 90.4) and waned relatively slowly after receipt of the second dose. CONCLUSIONS Vaccination in children was associated with modest, rapidly waning protection against omicron infection. Vaccination in adolescents was associated with stronger, more durable protection, perhaps because of the larger antigen dose. (Funded by Weill Cornell Medicine-Qatar and others.).
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Affiliation(s)
- Hiam Chemaitelly
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Sawsan AlMukdad
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Houssein H Ayoub
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Heba N Altarawneh
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Peter Coyle
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Patrick Tang
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hadi M Yassine
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hebah A Al-Khatib
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Maria K Smatti
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohammad R Hasan
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Zaina Al-Kanaani
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Einas Al-Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Andrew Jeremijenko
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Anvar H Kaleeckal
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Ali N Latif
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Riyazuddin M Shaik
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hanan F Abdul-Rahim
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Gheyath K Nasrallah
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohamed G Al-Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hamad E Al-Romaihi
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Adeel A Butt
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohamed H Al-Thani
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Abdullatif Al-Khal
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Roberto Bertollini
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Laith J Abu-Raddad
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
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173
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Humoral and cellular response to the COVID-19 vaccine in immunocompromised children. Pediatr Res 2022:10.1038/s41390-022-02374-4. [PMID: 36376507 PMCID: PMC9662120 DOI: 10.1038/s41390-022-02374-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND A suboptimal response to the 2-dose COVID-19 vaccine series in the immunocompromised population prompted recommendations for a 3rd primary dose. We aimed to determine the humoral and cellular immune response to the 3rd COVID-19 vaccine in immunocompromised children. METHODS Prospective cohort study of immunocompromised participants, 5-21 years old, who received 2 prior doses of an mRNA COVID-19 vaccine. Humoral and CD4/CD8 T-cell responses were measured to SARS-CoV-2 spike antigens prior to receiving the 3rd vaccine dose and 3-4 weeks after the 3rd dose was given. RESULTS Of the 37 participants, approximately half were solid organ transplant recipients. The majority (86.5%) had a detectable humoral response after the 2nd and 3rd vaccine doses, with a significant increase in antibody levels after the 3rd dose. Positive T-cell responses increased from being present in 86.5% to 100% of the cohort after the 3rd dose. CONCLUSIONS Most immunocompromised children mount a humoral and cellular immune response to the 2-dose COVID-19 vaccine series, which is significantly augmented after receiving the 3rd vaccine dose. This supports the utility of the 3rd vaccine dose and the rationale for ongoing emphasis for vaccination against COVID-19 in this population. IMPACT Most immunocompromised children mount a humoral and cellular immune response to the 2-dose COVID-19 vaccine series, which is significantly augmented after receiving the 3rd vaccine dose. This is the first prospective cohort study to analyze both the humoral and T-cell immune response to the 3rd COVID-19 primary vaccine dose in children who are immunocompromised. The results of this study support the utility of the 3rd vaccine dose and the rationale for ongoing emphasis for vaccination against COVID-19 in the immunosuppressed pediatric population.
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174
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Paul S, Mishra CM. Do we need to vaccinate every child against COVID-19: What evidence suggests-A systematic review of opinions. Front Public Health 2022; 10:1002992. [PMID: 36424958 PMCID: PMC9679503 DOI: 10.3389/fpubh.2022.1002992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022] Open
Abstract
It is still debatable whether all children should receive the COVID-19 vaccine. The comparatively mild cases and low risk of COVID-19 in children compared to adults, as well as the lack of clarity on the relative effects of the disease and vaccine, indicate that the risk-benefit ratio of vaccination in children is more nuanced. To consider and highlight the complexity of policy decisions regarding COVID-19 vaccination in children, we outlined the points regarding for and against vaccination of children against COVID-19 in this systemic review. Using Medical Search Headings (MeSH) terms and keywords, we searched PubMed, PubMed Central, Scopus, and Google Scholar. The primary search term was COVID-19 vaccination (all synonyms), factors (all synonyms), and among children (all synonyms). A total of 367 articles were searched. Finally, 64 articles met the inclusion criteria and were included in the review. The major theme/tone of 28 (43.75%) articles was in favor of children's COVID vaccination, and they were highlighting the positive factors, whereas the major theme/tone of 20 (31.25%) articles was against it. Approximately 16 (25.0%) articles were in a neutral position. Major factors highlighted by articles in favor of childhood COVID vaccination were as follows: the increasing rate of disease burden (29 articles), prevention of interruption of academic activities of children or school reopening (24 articles), and a role in defense against COVID infection (21 articles). Major factors against childhood vaccination were as follows: mild infection among children (27 articles), ethical concerns and legal problems regarding the consent of minors (17 articles), and vaccine hesitancy among parents for childhood vaccination (11 articles). Whereas, factors of uncertainty were the role in the reduction of community transmission (19 articles), protection against MIS-C (10 articles), and defense against long COVID (7 articles). Considering all the factors of COVID-19 disease progression among children, a cautious approach will be essential before proceeding with COVID-19 vaccination in children.
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Affiliation(s)
| | - Chandra Mauli Mishra
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
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175
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Sabu JM, Zahid I, Jacob N, Alele FO, Malau-Aduli BS. Effectiveness of the BNT162b2 (Pfizer-BioNTech) Vaccine in Children and Adolescents: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1880. [PMID: 36366387 PMCID: PMC9698079 DOI: 10.3390/vaccines10111880] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 10/15/2023] Open
Abstract
Efforts to control the COVID-19 pandemic have expanded to the vaccination of children and adolescents. This systematic review assesses the utility of the BNT162b2 (Pfizer-BioNTech) vaccine in children and adolescents aged 5-18 years, considering its effectiveness against COVID infection, hospital and intensive care admission and duration of effectiveness after vaccination. Six databases were searched following the PRISMA guidelines. Pooled estimates and 95% confidence intervals (CIs) were calculated using meta-analysis. Fifteen studies were included in the systematic review, while 12 studies were included in the meta-analysis. Evidence suggests that the two-dose vaccination regime provided high effectiveness of 92% (95% CI, 86-96) against COVID infection. Vaccination also conferred high protection against hospitalisation (91%) and intensive care admission (85%). The vaccine was highly protective against the Delta variant of the virus, but showed a lower protection against the Omicron variant. Most adverse effects were transient and mild, commonly including pain at the injection site, fatigue and headache. Current findings are suggestive of waning immunity over time; however, further research is needed to investigate the relevance of booster doses in this age group. In summary, the Pfizer-BioNTech BNT162b2 vaccine demonstrated high levels of protection against COVID-19 infection and its complications while maintaining an adequate safety profile in children and adolescents.
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Affiliation(s)
- Jewel Maria Sabu
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Izza Zahid
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Namitha Jacob
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Faith O. Alele
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Bunmi S. Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
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176
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Anderson EJ, Creech CB, Berthaud V, Piramzadian A, Johnson KA, Zervos M, Garner F, Griffin C, Palanpurwala K, Turner M, Gerber J, Bennett RL, Ali K, Ampajwala M, Berman G, Nayak J, Chronis C, Rizzardi B, Muller WJ, Smith CA, Fuchs G, Hsia D, Tomassini JE, DeLucia D, Reuter C, Kuter B, Zhao X, Deng W, Zhou H, Ramirez Schrempp D, Hautzinger K, Girard B, Slobod K, McPhee R, Pajon R, Aunins A, Das R, Miller JM, Schnyder Ghamloush S. Evaluation of mRNA-1273 Vaccine in Children 6 Months to 5 Years of Age. N Engl J Med 2022; 387:1673-1687. [PMID: 36260859 PMCID: PMC9634866 DOI: 10.1056/nejmoa2209367] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The safety, reactogenicity, immunogenicity, and efficacy of the mRNA-1273 coronavirus disease 2019 (Covid-19) vaccine in young children are unknown. METHODS Part 1 of this ongoing phase 2-3 trial was open label for dose selection; part 2 was an observer-blinded, placebo-controlled evaluation of the selected dose. In part 2, we randomly assigned young children (6 months to 5 years of age) in a 3:1 ratio to receive two 25-μg injections of mRNA-1273 or placebo, administered 28 days apart. The primary objectives were to evaluate the safety and reactogenicity of the vaccine and to determine whether the immune response in these children was noninferior to that in young adults (18 to 25 years of age) in a related phase 3 trial. Secondary objectives were to determine the incidences of Covid-19 and severe acute respiratory syndrome coronavirus 2 infection after administration of mRNA-1273 or placebo. RESULTS On the basis of safety and immunogenicity results in part 1 of the trial, the 25-μg dose was evaluated in part 2. In part 2, 3040 children 2 to 5 years of age and 1762 children 6 to 23 months of age were randomly assigned to receive two 25-μg injections of mRNA-1273; 1008 children 2 to 5 years of age and 593 children 6 to 23 months of age were randomly assigned to receive placebo. The median duration of follow-up after the second injection was 71 days in the 2-to-5-year-old cohort and 68 days in the 6-to-23-month-old cohort. Adverse events were mainly low-grade and transient, and no new safety concerns were identified. At day 57, neutralizing antibody geometric mean concentrations were 1410 (95% confidence interval [CI], 1272 to 1563) among 2-to-5-year-olds and 1781 (95% CI, 1616 to 1962) among 6-to-23-month-olds, as compared with 1391 (95% CI, 1263 to 1531) among young adults, who had received 100-μg injections of mRNA-1273, findings that met the noninferiority criteria for immune responses for both age cohorts. The estimated vaccine efficacy against Covid-19 was 36.8% (95% CI, 12.5 to 54.0) among 2-to-5-year-olds and 50.6% (95% CI, 21.4 to 68.6) among 6-to-23-month-olds, at a time when B.1.1.529 (omicron) was the predominant circulating variant. CONCLUSIONS Two 25-μg doses of the mRNA-1273 vaccine were found to be safe in children 6 months to 5 years of age and elicited immune responses that were noninferior to those in young adults. (Funded by the Biomedical Advanced Research and Development Authority and National Institute of Allergy and Infectious Diseases; KidCOVE ClinicalTrials.gov number, NCT04796896.).
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Affiliation(s)
- Evan J Anderson
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - C Buddy Creech
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Vladimir Berthaud
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Arin Piramzadian
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Kimball A Johnson
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Marcus Zervos
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Fredric Garner
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Carl Griffin
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Khozema Palanpurwala
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Mark Turner
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Jeffrey Gerber
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Richard L Bennett
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Kashif Ali
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Madhavi Ampajwala
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Gary Berman
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Jennifer Nayak
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Carey Chronis
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Barbara Rizzardi
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - William J Muller
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Christopher A Smith
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - George Fuchs
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Daniel Hsia
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Joanne E Tomassini
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Dianne DeLucia
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Caroline Reuter
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Barbara Kuter
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Xiaoping Zhao
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Weiping Deng
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Honghong Zhou
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Daniela Ramirez Schrempp
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Kelly Hautzinger
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Bethany Girard
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Karen Slobod
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Roderick McPhee
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Rolando Pajon
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Anne Aunins
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Rituparna Das
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Jacqueline M Miller
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Sabine Schnyder Ghamloush
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
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Lee E. Management of patients with allergic diseases in the era of COVID-19. Clin Exp Pediatr 2022; 65:529-535. [PMID: 36229025 PMCID: PMC9650355 DOI: 10.3345/cep.2022.00759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/11/2022] [Indexed: 11/27/2022] Open
Abstract
In the early days of the coronavirus disease 2019 (COVID-19) pandemic, allergic diseases, especially asthma, were considered to be risk factors for severe COVID-19 infection, hospitalization, and death. These concerns stemmed from the idea that individuals with allergic diseases are generally more susceptible to respiratory virus infections, which are major causes of exacerbation of allergic diseases. However, epidemiologic data with mechanistic studies showed that the associations between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and clinical outcomes of allergic diseases are complex and affected by diverse factors such as allergic disease severity, phenotypes, and control status with current medications. In addition, children generally have less severe clinical outcomes of COVID-19 than those of adults, which complicates the association between allergic diseases and COVID-19-related outcomes among them. The present review summarizes the potential association between allergic diseases and COVID-19-related outcomes and discusses the factors requiring consideration. The findings viewed herein will aid the management of allergic diseases in patients with SARS-CoV-2 infection and the establishment of medical polices for managing patients with allergic diseases.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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Garnett L, Tse C, Funk D, Dust K, Tran KN, Hedley A, Poliquin G, Bullard J, Strong JE. Differential Infectivity of Original and Delta Variants of SARS-CoV-2 in Children Compared to Adults. Microbiol Spectr 2022; 10:e0039522. [PMID: 35972128 PMCID: PMC9602606 DOI: 10.1128/spectrum.00395-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
Although children of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, they have not been implicated as major drivers of transmission thus far. However, it is still unknown if this finding holds true with new variants of concern (VOC), such as Delta (B.1.617.2). This study aimed to examine differences in both viral RNA (as measured by cycle threshold [CT]) and viable-virus levels from children infected with Delta and those infected with original variants (OV). Furthermore, we aimed to compare the pediatric population infection trends to those in adults. We obtained 690 SARS-CoV-2 RT-PCR positive nasopharyngeal swabs from across Manitoba, Canada, which were further screened for mutations characteristic of VOC. Aliquots of sample were then provided for TCID50 (50% tissue culture infective dose) assays to determine infectious titers. Using a variety of statistical analyses we compared CT and infectivity of VOC in different age demographics. Comparing 122 Delta- to 175 OV-positive nasopharyngeal swab samples from children, we found that those infected with Delta are 2.7 times more likely to produce viable SARS-CoV-2 with higher titers (in TCID50 per milliliter), regardless of viral RNA levels. Moreover, comparing the pediatric samples to 130 OV- and 263 Delta-positive samples from adults, we found only that the Delta pediatric culture-positive samples had titers (TCID50 per milliliter) similar to those of culture-positive adult samples. IMPORTANCE These important findings show that children may play a larger role in viral transmission of Delta than for previously circulating SARS-CoV-2 variants. Additionally, they may suggest a mechanism for why Delta has evolved to be the predominant circulating variant.
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Affiliation(s)
- Lauren Garnett
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carmen Tse
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Duane Funk
- Departments of Anaesthesiology and Medicine, Section of Critical Care, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kerry Dust
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
| | - Kaylie N. Tran
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Adam Hedley
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
| | - Guillaume Poliquin
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jared Bullard
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James E. Strong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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Yang B, Huang X, Gao H, Leung NH, Tsang TK, Cowling BJ. Immunogenicity, efficacy, and safety of SARS-CoV-2 vaccine dose fractionation: a systematic review and meta-analysis. BMC Med 2022; 20:409. [PMID: 36284331 PMCID: PMC9595080 DOI: 10.1186/s12916-022-02600-0] [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: 07/06/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dose fractionation of a coronavirus disease 2019 (COVID-19) vaccine could effectively accelerate global vaccine coverage, while supporting evidence of efficacy, immunogenicity, and safety are unavailable, especially with emerging variants. METHODS We systematically reviewed clinical trials that reported dose-finding results and estimated the dose-response relationship of neutralizing antibodies (nAbs) of COVID-19 vaccines using a generalized additive model. We predicted the vaccine efficacy against both ancestral and variants, using previously reported correlates of protection and cross-reactivity. We also reviewed and compared seroconversion to nAbs, T cell responses, and safety profiles between fractional and standard dose groups. RESULTS We found that dose fractionation of mRNA and protein subunit vaccines could induce SARS-CoV-2-specific nAbs and T cells that confer a reasonable level of protection (i.e., vaccine efficacy > 50%) against ancestral strains and variants up to Omicron. Safety profiles of fractional doses were non-inferior to the standard dose. CONCLUSIONS Dose fractionation of mRNA and protein subunit vaccines may be safe and effective, which would also vary depending on the characteristics of emerging variants and updated vaccine formulations.
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Affiliation(s)
- Bingyi Yang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Huizhi Gao
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Nancy H Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tim K Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. .,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China.
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180
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Safety after BBIBP-CorV (Sinopharm) COVID-19 Vaccine in Adolescents Aged 10-17 Years in Thailand. Vaccines (Basel) 2022; 10:vaccines10101765. [PMID: 36298630 PMCID: PMC9612063 DOI: 10.3390/vaccines10101765] [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: 09/28/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022] Open
Abstract
Coronavirus disease 2019 affected child health and impacted learning because of the resulting onsite school closures. This prospective cohort study included children aged 10-17 who received two 4 µg doses of BBIBP-CorV administered intramuscularly 21-28 days apart. To assess vaccine safety, 36,808 participants were then followed with paper- and web-based online questionnaire surveys that captured local and systemic reactogenicities following vaccine administration on days 1, 7, and 30. Among participants, 76% (27,880) reported reactogenicity within the first 24 h and 7 days following the first dose. Half (51.41%) of participants experienced pain at the injection site; the majority of cases were mild in severity. Injection site tenderness (37.93%) was another common local reaction. Fatigue (37.89%), myalgia (33.56%), and headache (26.76%) were the most common systemic reactions. On days 2-7 after the first dose, 25.85% of participants experienced adverse reactions. Following the second dose, reactogenicity was 7.6% and 1.09% within 24 h and between days 2-7. The majority of reactions were of mild to moderate severity. We report that two doses of the BBIBP-CorV caused mild to moderate side effects in adolescents in Thailand. The findings confirm the vaccine's safety profile in this age group.
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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: 65] [Impact Index Per Article: 32.5] [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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182
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Toepfner N, von Meißner WCG, Strumann C, Drinka D, Stuppe D, Jorczyk M, Moor J, Püschel J, Liss M, von Poblotzki E, Berner R, Moor MB, Chao CM. Comparative Safety of the BNT162b2 Messenger RNA COVID-19 Vaccine vs Other Approved Vaccines in Children Younger Than 5 Years. JAMA Netw Open 2022; 5:e2237140. [PMID: 36255723 PMCID: PMC9579908 DOI: 10.1001/jamanetworkopen.2022.37140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE SARS-CoV-2 vaccines are authorized for use in most age groups. The safety of SARS-CoV-2 vaccines is unknown in children younger than 5 years. OBJECTIVE To retrospectively evaluate the safety of the BNT162b2 vaccine used off-label in children younger than 5 years compared with the safety of non-SARS-CoV-2 vaccines in the same sample. DESIGN, SETTING, AND PARTICIPANTS This investigator-initiated retrospective cohort study included parents or caregivers who registered children for SARS-CoV-2 vaccination in outpatient care facilities in Germany. The study was performed as an authenticated online survey. A total of 19 000 email addresses were contacted from vaccination registration databases between April 14 and May 9, 2022. Inclusion criteria were child age younger than 5 years at the first BNT162b2 vaccination and use of a correct authentication code to prove invitation. EXPOSURES Off-label BNT162b2 vaccination and on-label non-SARS-CoV-2 vaccinations. MAIN OUTCOMES AND MEASURES Reported short-term safety data of 1 to 3 doses of 3 to 10 μg BNT162b2 in children from birth to younger than 60 months are presented. Coprimary outcomes were the frequencies of 11 categories of symptoms after vaccination with bivariate analyses and regression models adjusting for age, sex, weight, and height. RESULTS The study included 7806 children (median age, 3 years [IQR, 2-4 years]; 3824 [49.0%] female) who were followed up of for a mean (SD) of 91.4 (38.8) days since first BNT162b2 vaccination (survey response rate, 41.1%). A 10-μg dosage was more frequently associated with local injection-site symptoms compared with lower dosages. In the active-comparator analysis, the probability of any symptoms (odds ratio [OR], 1.62; 95% CI, 1.43-1.84), local symptoms (OR, 1.68; 95% CI, 1.38-2.05), musculoskeletal symptoms (OR, 2.55; 95% CI, 1.32-4.94), dermatologic symptoms (OR, 2.18; 95% CI, 10.7-4.45), or otolaryngologic symptoms (OR, 6.37; 95% CI, 1.50-27.09) were modestly elevated after BNT162b2 compared with non-SARS-CoV-2 vaccines, whereas the probabilities of general symptoms (OR, 0.77; 95% CI, 0.63-0.95) and fever (OR, 0.42; 95% CI, 0.32-0.55) were lower after BNT162b2. Symptoms requiring hospitalization (n = 10) were reported only at BNT162b2 dosages above 3 μg. CONCLUSIONS AND RELEVANCE In this cohort study, the symptoms reported after BNT162b2 administration were comparable overall to those for on-label non-SARS-CoV-2 vaccines in this cohort of children younger than 5 years. The present data may be used together with prospective licensure studies of BNT162b2 efficacy and safety and could help guide expert recommendations about BNT162b2 vaccinations in this age group.
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Affiliation(s)
- Nicole Toepfner
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Christoph Strumann
- Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | - Denisa Drinka
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - David Stuppe
- Department of Pediatrics, University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Maximilian Jorczyk
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jeanne Moor
- Department of General Internal Medicine, Inselspital University Hospital Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | - Melanie Liss
- Praxis für Kinder- und Jugendmedizin, Düsseldorf, Germany
| | | | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Matthias B. Moor
- Department of Nephrology and Hypertension, Inselspital University Hospital Bern, Bern, Switzerland
| | - Cho-Ming Chao
- Department of Pediatrics, University Medical Center Rostock, University of Rostock, Rostock, Germany
- Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, member of the German Center for Lung Research, Justus Liebig University Giessen, Giessen, Germany
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183
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Mallapaty S. COVID jabs for kids: they're safe and they work - so why is uptake so patchy? Nature 2022; 610:246-248. [PMID: 36220929 DOI: 10.1038/d41586-022-03203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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184
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Britto C, Alter G. The next frontier in vaccine design: blending immune correlates of protection into rational vaccine design. Curr Opin Immunol 2022; 78:102234. [PMID: 35973352 PMCID: PMC9612370 DOI: 10.1016/j.coi.2022.102234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/27/2022] [Accepted: 07/13/2022] [Indexed: 02/02/2023]
Abstract
Despite the extraordinary speed and success in SARS-Cov-2 vaccine development, the emergence of variants of concern perplexed the vaccine development community. Neutralizing antibodies waned antibodies waned and were evaded by viral variants, despite the preservation of protection against severe disease and death across vaccinated populations. Similar to other vaccine design efforts, the lack of mechanistic correlates of immunity against Coronavirus Disease 2019, raised questions related to the need for vaccine redesign and boosting. Hence, our limited understanding of mechanistic correlates of immunity - across pathogens - remains a major obstacle in vaccine development. The identification and incorporation of mechanistic correlates of immunity are key to the accelerated design of highly impactful globally relevant vaccines. Systems-biology tools can be applied strategically to define a complete understanding of mechanistic correlates of immunity. Embedding immunological dissection and target immune profile identification, beyond canonical antibody binding and neutralization, may accelerate the design and success of durable protective vaccines.
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Affiliation(s)
- Carl Britto
- Department of Pediatrics, Boston Children's Hospital, USA; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.
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185
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Mancuso R, Agostini S, Citterio LA, Chiarini D, Santangelo MA, Clerici M. Systemic and Mucosal Humoral Immune Response Induced by Three Doses of the BNT162b2 SARS-CoV-2 mRNA Vaccines. Vaccines (Basel) 2022; 10:vaccines10101649. [PMID: 36298514 PMCID: PMC9610882 DOI: 10.3390/vaccines10101649] [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: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
BNT162b2 (BioNTech/Pfizer) was the first SARS-CoV-2 mRNA vaccine approved by the European Medicines Agency. We monitored the long-term humoral responses of healthcare workers (HCWs) who received three vaccine doses. A total of 59 healthcare workers were studied: 47 were never SARS-CoV-2-infected (naïve-HCWs), and 12 (infected-HCWs) recovered from COVID-19 before the first vaccine. Serum and saliva were collected at baseline (before the first dose), just before the second dose, 1, 3, 6, and 9 months after the second dose, and 10 days after the third vaccine. SARS-CoV-2-specific IgG and IgA were evaluated in serum and saliva, respectively, and the presence of neutralizing antibodies (NAb) was analyzed in serum. SARS-CoV-2-specific IgG peaked one month after the second vaccine in naïve-HCWs but right before this timepoint in infected-HCWs. IgG titers significantly decreased during follow-up and at month 9 were still detectable in 50% of naïve-HCWs and 90% of infected-HCWs. NAb were significantly decreased 6 months after the second vaccine in naïve-HCWs and 9 months after this dose in infected-HCWs. Salivary SARS-CoV-2-specific IgA titers were significantly higher in infected-HCWs and were undetectable 9 months after the second vaccine in 43% of the naïve-HCWs alone. The third vaccine greatly increased humoral IgG and mucosal IgA in both groups. Two BNT162b2 doses induced strong systemic and humoral immune responses; to note, these responses weakened over time, although they are more prolonged in individuals who had recovered from COVID-19. The third vaccine dose quickly boosts systemic and mucosal humoral responses.
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Affiliation(s)
- Roberta Mancuso
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Simone Agostini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
- Correspondence: ; Tel.: +39-0240308375
| | | | - Debora Chiarini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | | | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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186
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Muacevic A, Adler JR. Uncommon Side Effects of COVID-19 Vaccination in the Pediatric Population. Cureus 2022; 14:e30276. [PMID: 36258808 PMCID: PMC9573128 DOI: 10.7759/cureus.30276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The rapid development of vaccines followed the Coronavirus disease 2019 (COVID-19) pandemic. There is still significant vaccine hesitancy, especially among parents. Large-scale pediatric population-based studies or reviews about vaccine side effects are limited. Data sources and methods The Centers for Disease Control and Prevention (CDC) recommends recipients or their providers notify possible adverse events to the Vaccine Adverse Event Reporting System (VAERS). We evaluated Delaware state data from the VAERS system for the pediatric age group. Results A total of 111 reports were reviewed, with summaries of the reported key side effects discussed, including seizures, myocarditis, stroke, multisystem inflammatory syndrome in children (MIS-C), chest pain, hematuria, menstrual disorder, appendicitis, behavioral and otological side effects, etc. Conclusions We noted the approximate prevalence of reported adverse events to be <0.2%. Further studies with larger sample sizes or those focused on each key side effect are needed to evaluate these side effects in detail. An open discussion about the possible side effects and reinforcing the individual, family, and community benefits are key to promoting COVID-19 vaccine acceptance.
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187
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Duhen R, Beymer M, Jensen SM, Abbina S, Abraham S, Jain N, Thomas A, Geall AJ, Hu HM, Fox BA, Weinberg AD. OX40 agonist stimulation increases and sustains humoral and cell-mediated responses to SARS-CoV-2 protein and saRNA vaccines. Front Immunol 2022; 13:896310. [PMID: 36238275 PMCID: PMC9551348 DOI: 10.3389/fimmu.2022.896310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/08/2022] [Indexed: 12/01/2022] Open
Abstract
To prevent SARS-CoV-2 infections and generate long-lasting immunity, vaccines need to generate strong viral-specific B and T cell responses. Previous results from our lab and others have shown that immunizations in the presence of an OX40 agonist antibody lead to higher antibody titers and increased numbers of long-lived antigen-specific CD4 and CD8 T cells. Using a similar strategy, we explored the effect of OX40 co-stimulation in a prime and boost vaccination scheme using an adjuvanted SARS-CoV-2 spike protein vaccine in C57BL/6 mice. Our results show that OX40 engagement during vaccination significantly increases long-lived antibody responses to the spike protein. In addition, after immunization spike protein-specific proliferation was greatly increased for both CD4 and CD8 T cells, with enhanced, spike-specific secretion of IFN-γ and IL-2. Booster (3rd injection) immunizations combined with an OX40 agonist (7 months post-prime) further increased vaccine-specific antibody and T cell responses. Initial experiments assessing a self-amplifying mRNA (saRNA) vaccine encoding the spike protein antigen show a robust antigen-specific CD8 T cell response. The saRNA spike-specific CD8 T cells express high levels of GrzmB, IFN-γ and TNF-α which was not observed with protein immunization and this response was further increased by the OX40 agonist. Similar to protein immunizations the OX40 agonist also increased vaccine-specific CD4 T cell responses. In summary, this study compares and contrasts the effects and benefits of both protein and saRNA vaccination and the extent to which an OX40 agonist enhances and sustains the immune response against the SARS-CoV-2 spike protein.
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Affiliation(s)
- Rebekka Duhen
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, United States
- *Correspondence: Rebekka Duhen,
| | - Michael Beymer
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, United States
| | - Shawn M. Jensen
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, United States
| | | | | | - Nikita Jain
- Precision NanoSystems Inc, Vancouver, BC, Canada
| | | | | | - Hong-Ming Hu
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, United States
| | - Bernard A. Fox
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, United States
| | - Andrew D. Weinberg
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, United States
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188
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Wu HHL, Shenoy M, Kalra PA, Chinnadurai R. Intrinsic Kidney Pathology in Children and Adolescents Following COVID-19 Vaccination: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1467. [PMID: 36291403 PMCID: PMC9600377 DOI: 10.3390/children9101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Global COVID-19 vaccination programs for children and adolescents have been developed with international clinical trial data confirming COVID-19 mRNA vaccine safety and efficacy for the pediatric population. The impact of COVID-19 vaccination in the kidneys is thought to be explained by a complex immune-mediated relationship between the two, although the pathophysiological mechanisms of how COVID-19 vaccination potentially induces kidney pathology are not presently well known. Whilst intrinsic kidney pathologies following COVID-19 vaccination have been reported in adults, such cases are only being recently reported with greater frequency in children and adolescents. Conforming to the PRISMA checklist, we conducted a systematic review of the current literature to provide an overview on the range of intrinsic kidney pathologies that have been reported following COVID-19 vaccination in children and adolescents. All English language research articles published on or before 30 June 2022 reporting new-onset or relapsed intrinsic kidney pathology in children or adolescents (≤18 years) following COVID-19 vaccination were selected for qualitative analysis. Out of 18 cases from the 13 published articles selected, there were 10 cases of IgA nephropathy (1 case of rapidly progressive glomerulonephritis requiring acute hemodialysis), 5 cases of minimal change disease (MCD), 1 case of concurrent MCD/tubulointerstitial nephritis (TIN) and 2 cases of TIN. There is no indication currently to avoid vaccination, unless specific circumstances exist, as the benefits of COVID-19 vaccination far outweigh its risks. Concluding the findings from our systematic review based on preliminary evidence, potential adverse effects to the kidney from COVID-19 vaccination affects a small number of children and adolescents among the many who have been vaccinated. There remains good reason at present to support vaccination of children and adolescents with a greater morbidity status, such as those living with preexisting chronic kidney disease. Close observation of all children and adolescents receiving COVID-19 vaccination is recommended, particularly in those with preceding intrinsic kidney pathology to identify risks of relapsed disease.
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Affiliation(s)
- Henry H. L. Wu
- Renal Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, St. Leonards, Sydney, NSW 2065, Australia
| | - Mohan Shenoy
- Department of Pediatric Nephrology, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PG, UK
| | - Philip A. Kalra
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PG, UK
- Department of Renal Medicine, Salford Royal Hospital, Northern Care Alliance Foundation Trust, Salford M6 8HD, UK
| | - Rajkumar Chinnadurai
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PG, UK
- Department of Renal Medicine, Salford Royal Hospital, Northern Care Alliance Foundation Trust, Salford M6 8HD, UK
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189
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Tharmaratnam T, D'Urzo A, Cazzola M. Medical knowledge about COVID-19 is travelling at the speed of mistrust: why this is relevant to primary care. Fam Pract 2022; 39:988-991. [PMID: 35079783 PMCID: PMC9383313 DOI: 10.1093/fampra/cmac001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Anthony D'Urzo
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mario Cazzola
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
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190
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Shoji K, Funaki T, Yamada M, Mikami M, Miyake K, Ueno S, Tao C, Myojin S, Aiba H, Matsui T, Ogimi C, Kato H, Miyairi I. Safety of and antibody response to the BNT162b2 COVID-19 vaccine in adolescents and young adults with underlying disease. J Infect Chemother 2022; 29:61-66. [PMID: 36152928 PMCID: PMC9490955 DOI: 10.1016/j.jiac.2022.09.013] [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: 06/25/2022] [Revised: 08/19/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Data are limited regarding the safety of and antibody response to the BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger ribonucleic acid vaccine in adolescents and young adults with underlying disease. METHODS This prospective observational study enrolled patients age 12-25 years with chronic underlying disease who received 2 doses of BNT162b2. A 18-item questionnaire was used to assess adverse events within 7 days post-vaccination, and data regarding severe adverse events were collected from electronic medical records. An antibody titer for the receptor-binding domain of the spike protein in SARS-CoV-2 was used to assess antibody response after the second vaccine dose. RESULTS Study participants were 429 patients (241 [56.2%] age 12-15 years; 188 [43.8%] age 16-25 years). The most common underlying diseases were genetic or chromosomal abnormalities and/or congenital anomalies, followed by endocrine or metabolic diseases; 32% of participants were immunocompromised. Severe adverse events were observed after the second dose in 1 (0.4%) patient age 12-15 years and in 2 (1.1%) patients age 16-25 years; all patients recovered. Seropositivity after the second vaccine dose was 99.0%. The geometric mean antibody titer was higher in patients age 12-15 years versus 16-25 years (1603.3 [1321.8-1944.7] U/mL vs. 949.4 [744.2-1211.0] U/mL). Compared with immunocompetent patients, immunocompromised patients had a lower antibody titer (2106.8 [1917.5-2314.7] U/mL vs. 467.9 [324.4-674.8] U/mL). CONCLUSIONS Vaccination with BNT162b2 was acceptably safe and immunogenic for adolescents and young adults with underlying disease.
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Affiliation(s)
- Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
| | - Takanori Funaki
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Masaki Yamada
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Department for Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Masashi Mikami
- Biostatistics Unit, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kozue Miyake
- Department of Clinical Research Promotion, National Center for Child Health and Development, Tokyo, Japan
| | - Saki Ueno
- Department of Clinical Research Promotion, National Center for Child Health and Development, Tokyo, Japan
| | - Chiaki Tao
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Shota Myojin
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroyuki Aiba
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiro Matsui
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikara Ogimi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hitoshi Kato
- Former Executive Director, National Center for Child Health and Development, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
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191
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Caniza MA, Homsi MR, Bate J, Adrizain R, Ahmed T, Alexander S, Bhattacharyya A, Copado‐Gutierrez JL, Gutierrez I, Lim YY, Morrissey L, Naidu G, Paintsil V, Radhakrishnan N, Mukkada S, Phillips R, Alexander KA, Pritchard‐Jones K. Answers to common questions about COVID-19 vaccines in children with cancer. Pediatr Blood Cancer 2022; 69:e29985. [PMID: 36114651 PMCID: PMC9538403 DOI: 10.1002/pbc.29985] [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: 04/17/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND The SARS-CoV-2 outbreak in 2020 evolved into a global pandemic, and COVID-19 vaccines became rapidly available, including for pediatric patients. However, questions emerged that challenged vaccine acceptance and use. We aimed to answer these questions and give recommendations applicable for use in pediatric patients with cancer by healthcare professionals and the public. METHODS A 12-member global COVID-19 Vaccine in Pediatric Oncology Working Group made up of physicians and nurses from all world regions met weekly from March to July 2021. We used a modified Delphi method to select the top questions. The Working Group, in four-member subgroups, answered assigned questions by providing brief recommendations, followed by a discussion of the rationale for each answer. All Working Group members voted on each recommendation using a scale of 1 to 10, 10 being complete agreement. A "pass" recommendation corresponded to an agreement ≥7.5. RESULTS We selected 15 questions from 173 suggested questions. Based on existing published information, we generated answers for each question as recommendations. The overall average agreement for the 24 recommendations was 9.5 (95% CI 9.4-9.6). CONCLUSION Top COVID-19 vaccine-related questions could be answered using available information. Reports on COVID-19 vaccination and related topics have been published at record speed, aided by available technology and the priority imposed by the pandemic; however, all efforts were made to incorporate emerging information throughout our project. Recommendations will be periodically updated on a dedicated website.
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Affiliation(s)
- Miguela A. Caniza
- Departments of Global Pediatric Medicine, St. Jude Children's Research HospitalMemphisTennesseeUSA,Departments of Infectious DiseasesSt. Jude Children's Research HospitalMemphisTennesseeUSA,Department of or PediatricsUniversity of Tennessee Health Science CenterMemphisTennesseeUSA
| | - Maysam R. Homsi
- Departments of Global Pediatric Medicine, St. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Jessica Bate
- Department of Paediatric OncologySouthampton Children's HospitalSouthamptonUK
| | - Riyadi Adrizain
- Department of Child HealthFaculty of Medicine Universitas Padjadjaran Dr. Hasan Sadikin General HospitalBandungIndonesia
| | - Tarek Ahmed
- Department of Pediatric OncologyChildren's Cancer Hospital EgyptCairoEgypt
| | - Sarah Alexander
- Division of Haematology/Oncology, Hospital for Sick Children, Department of PediatricsUniversity of TorontoTorontoCanada
| | | | | | - Ivan Gutierrez
- Department of Pediatric Infectious DiseasesResearch Group Colsubsidio InvestigaClinical Infantil ColsubsidioBogotáColombia,Division of Pediatric Infectious DiseasesClinica Infantil Santa María del LagoBogotáColombia
| | - Yan Yin Lim
- Division of NursingKK Women's and Children's HospitalSingaporeSingapore
| | - Lisa Morrissey
- Department of NursingBoston Children's HospitalBostonMassachusettsUSA
| | - Gita Naidu
- Department of Pediatric OncologyChris Hani Baragwanath Academic HospitalUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Vivian Paintsil
- Department of Child HealthSchool of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Nita Radhakrishnan
- Department of Pediatric Hematology OncologyPost Graduate Institute of Child HealthNoidaIndia
| | - Sheena Mukkada
- Departments of Global Pediatric Medicine, St. Jude Children's Research HospitalMemphisTennesseeUSA,Departments of Infectious DiseasesSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Robert Phillips
- Regional Department of Hematology and OncologyLeeds Children's HospitalLeedsUK,Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Kenneth A. Alexander
- Department of PediatricsDivision of Infectious DiseasesNemours Children's Hospital‐FloridaOrlandoFloridaUSA
| | - Kathy Pritchard‐Jones
- Developmental Biology and Cancer Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
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192
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Gupta SL, Mantus G, Manning KE, Ellis M, Patel M, Ciric CR, Lu A, Turner JS, O’Halloran JA, Presti RM, Joshi DJ, Ellebedy AH, Anderson EJ, Rostad CA, Suthar MS, Wrammert J. Loss of Pfizer (BNT162b2) Vaccine-Induced Antibody Responses against the SARS-CoV-2 Omicron Variant in Adolescents and Adults. J Virol 2022; 96:e0058222. [PMID: 35976000 PMCID: PMC9472620 DOI: 10.1128/jvi.00582-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/12/2022] [Indexed: 12/19/2022] Open
Abstract
Emerging variants, especially the recent Omicron variant, and gaps in vaccine coverage threaten mRNA vaccine mediated protection against SARS-CoV-2. While children have been relatively spared by the ongoing pandemic, increasing case numbers and hospitalizations are now evident among children. Thus, it is essential to better understand the magnitude and breadth of vaccine-induced immunity in children against circulating viral variant of concerns (VOCs). Here, we compared the magnitude and breadth of humoral immune responses in adolescents and adults 1 month after the two-dose Pfizer (BNT162b2) vaccination. We found that adolescents (aged 11 to 16) demonstrated more robust binding antibody and neutralization responses against the wild-type SARS-CoV-2 virus spike protein contained in the vaccine compared to adults (aged 27 to 55). The quality of the antibody responses against VOCs in adolescents were very similar to adults, with modest changes in binding and neutralization of Beta, Gamma, and Delta variants. In comparison, a significant reduction of binding titers and a striking lack of neutralization was observed against the newly emerging Omicron variant for both adolescents and adults. Overall, our data show that a two-dose BNT162b2 vaccine series may be insufficient to protect against the Omicron variant. IMPORTANCE While plasma binding and neutralizing antibody responses have been reported for cohorts of infected and vaccinated adults, much less is known about the vaccine-induced antibody responses to variants including Omicron in children. This illustrates the need to characterize vaccine efficacy in key vulnerable populations. A third (booster) dose of BNTb162b was approved for children 12 to 15 years of age by the Food and Drug Administration (FDA) on January 1, 2022, and pediatric clinical trials are under way to evaluate the safety, immunogenicity, and effectiveness of a third dose in younger children. Similarly, variant-specific booster doses and pan-coronavirus vaccines are areas of active research. Our data show adolescents mounted stronger humoral immune responses after vaccination than adults. It also highlights the need for future studies of antibody durability in adolescents and children as well as the need for future studies of booster vaccination and their efficacy against the Omicron variant.
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Affiliation(s)
- Sneh Lata Gupta
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Grace Mantus
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kelly E. Manning
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Madison Ellis
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Mit Patel
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Caroline Rose Ciric
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Austin Lu
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jackson S. Turner
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jane A. O’Halloran
- Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rachel M. Presti
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Devyani Jaideep Joshi
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Ali H. Ellebedy
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Evan J. Anderson
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christina A. Rostad
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Mehul S. Suthar
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Microbiology and Immunology, Emory University, Atlanta, Georgia, USA
- National Primate Research Center, Atlanta, Georgia, USA
| | - Jens Wrammert
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA
- Centers for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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193
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Khemiri H, Ayouni K, Triki H, Haddad-Boubaker S. SARS-CoV-2 infection in pediatric population before and during the Delta (B.1.617.2) and Omicron (B.1.1.529) variants era. Virol J 2022; 19:144. [PMID: 36076271 PMCID: PMC9452867 DOI: 10.1186/s12985-022-01873-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/27/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19, the coronavirus disease that emerged in December 2019, caused drastic damage worldwide. At the beginning of the pandemic, available data suggested that the infection occurs more frequently in adults than in infants. In this review, we aim to provide an overview of SARS-CoV-2 infection in children before and after B.1.617.2 Delta and B.1.1.529 Omicron variants emergence in terms of prevalence, transmission dynamics, clinical manifestations, complications and risk factors. METHODS Our method is based on the literature search on PubMed, Science Direct and Google Scholar. From January 2020 to July 2022, a total of 229 references, relevant for the purpose of this review, were considered. RESULTS The incidence of SARS-CoV-2 infection in infants was underestimated. Up to the first half of May, most of the infected children presented asymptomatic or mild manifestations. The prevalence of COVID-19 varied from country to another: the highest was reported in the United States (22.5%). COVID-19 can progress and become more severe, especially with the presence of underlying health conditions. It can also progress into Kawasaki or Multisystem Inflammatory Syndrome (MIS) manifestations, as a consequence of exacerbating immune response. With the emergence of the B.1.617.2 Delta and B.1.1.529 Omicron variants, it seems that these variants affect a large proportion of the younger population with the appearance of clinical manifestations similar to those presented by adults with important hospitalization rates. CONCLUSION The pediatric population constitutes a vulnerable group that requires particular attention, especially with the emergence of more virulent variants. The increase of symptomatic SARS-CoV-2 infection and hospitalization rate among children highlights the need to extend vaccination to the pediatric population.
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Affiliation(s)
- Haifa Khemiri
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, 13 place Pasteur, BP74 1002 le Belvédère, Tunis, Tunisia
- LR 20 IPT 02 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Kaouther Ayouni
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, 13 place Pasteur, BP74 1002 le Belvédère, Tunis, Tunisia
- LR 20 IPT 02 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, 13 place Pasteur, BP74 1002 le Belvédère, Tunis, Tunisia
| | - Sondes Haddad-Boubaker
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, 13 place Pasteur, BP74 1002 le Belvédère, Tunis, Tunisia.
- LR 20 IPT 02 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
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194
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Changes in Parents' COVID-19 Vaccine Hesitancy for Children Aged 3-17 Years before and after the Rollout of the National Childhood COVID-19 Vaccination Program in China: Repeated Cross-Sectional Surveys. Vaccines (Basel) 2022; 10:vaccines10091478. [PMID: 36146556 PMCID: PMC9502861 DOI: 10.3390/vaccines10091478] [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: 07/26/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
China started to implement COVID-19 vaccination programs for children in July 2021. This study investigated the changes in parents’ COVID-19 vaccine hesitancy for children before and after the vaccination program rollout. Repeated cross-sectional online surveys among full-time adult factory workers were conducted in Shenzhen, China. This analysis was based on 844 (first round) and 1213 parents (second round) who had at least one child aged 3−17 years. The prevalence of vaccine hesitancy for children aged 3−11 years dropped from 25.9% (first round) to 17.4% (second round), while such a prevalence for children aged 12−17 years dropped from 26.0% (first round) to 3.5% (second round) (p < 0.001). Positive attitudes, a perceived subjective norm, and perceived behavioral control related to children’s COVID-19 vaccination were associated with lower vaccine hesitancy in both rounds. In the second round and among parents with children aged 3−11 years, negative attitudes and exposure to information on SARS-CoV-2 infection after receiving a primary vaccine series were associated with higher vaccine hesitancy, while exposure to experiences shared by vaccine recipients and infectiousness of variants of concern were associated with lower vaccine hesitancy. Regular monitoring of vaccine hesitancy and its associated factors among parents should be conducted to guide health promotion.
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195
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Vicetti Miguel CP, Dasgupta-Tsinikas S, Lamb GS, Olarte L, Santos RP. Race, Ethnicity, and Health Disparities in US Children With COVID-19: A Review of the Evidence and Recommendations for the Future. J Pediatric Infect Dis Soc 2022; 11:S132-S140. [PMID: 36063366 PMCID: PMC9494369 DOI: 10.1093/jpids/piac099] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an important cause of morbidity in children in the United States (U.S.). Moreover, the U.S. has witnessed significant disparities affecting American Indian/Alaska Native, Black, and Hispanic/Latino children, stemming from systemic racism and social-structural inequalities and not differences in innate biological susceptibility. We review what is known on COVID-19 and health disparities in disease burden, access to care, pharmaceutical interventions, and clinical research in children, with a focus on the U.S. context. In addition, we propose strategies to communicate scientific data in ways that do not promote racism and biological susceptibility themes, and to address pediatric disparities in clinical infectious diseases research.
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Affiliation(s)
- Claudia P Vicetti Miguel
- Corresponding author: Claudia P. Vicetti Miguel, MD, Children’s Corporate Center, Suite C450, 999 N 92nd St, Wauwatosa, WI 53226,
| | | | - Gabriella S Lamb
- Department of Pediatrics, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA
| | - Liset Olarte
- Division of Pediatric Infectious Diseases, Children's Mercy Kansas City, University of Missouri-Kansas City, MO
| | - Roberto P Santos
- Division of Infectious Diseases, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS
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196
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Hoste L, Soriano-Arandes A, Buddingh EP, Whittaker E, Belot A, Ulloa-Gutierrez R, Olbrich P, Haerynck F. Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination in Children with a History of Multisystem Inflammatory Syndrome in Children: An International Survey. J Pediatr 2022; 248:114-118. [PMID: 35598642 PMCID: PMC9119291 DOI: 10.1016/j.jpeds.2022.05.028] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 12/16/2022]
Abstract
The optimal severe acute respiratory syndrome coronavirus 2 vaccine strategy for patients with a history of multisystem inflammatory syndrome in children (MIS-C) is unclear. We performed an international survey (32 countries) and found substantial variations in vaccine policies. Respondents did not report relapses of MIS-C or other severe inflammatory side effects after severe acute respiratory syndrome coronavirus 2 vaccination in 273 patients with a history of MIS-C.
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Affiliation(s)
- Levi Hoste
- Primary Immune Deficiency Research Laboratory, Department of Internal Diseases and Pediatrics, Centre for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent, Belgium,Department of Internal Medicine and Pediatrics, Division of Pediatric Pulmonology, Infectious Diseases and Inborn Errors of Immunity, Ghent University Hospital, Ghent, Belgium
| | | | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | | | - Elizabeth Whittaker
- Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, United Kingdom,Section of Paediatric Infectious Diseases, Imperial College, London, United Kingdom
| | - Alexandre Belot
- Pediatric Nephrology Rheumatology and Dermatology, CHU Lyon, Lyon, France
| | - Rolando Ulloa-Gutierrez
- Servicio de Infectología Pediátrica, Hospital Nacional de Niños “Dr Carlos Sáenz Herrera”, Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (C.C.S.S.), San José, Costa Rica
| | - Peter Olbrich
- Pediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, IBiS/Universidad de Sevilla/CSIC, Red de Investigación Traslacional en Infectología Pediátrica RITIP, Sevilla, Spain,Departamento de Farmacología, Pediatría y Radiología, Facultad de Medicina, Universidad de Sevilla, Spain
| | - Filomeen Haerynck
- Primary Immune Deficiency Research Laboratory, Department of Internal Diseases and Pediatrics, Centre for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Division of Pediatric Pulmonology, Infectious Diseases and Inborn Errors of Immunity, Ghent University Hospital, Ghent, Belgium.
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197
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Gilbert PB, Huang Y, deCamp AC, Karuna S, Zhang Y, Magaret CA, Giorgi EE, Korber B, Edlefsen PT, Rossenkhan R, Juraska M, Rudnicki E, Kochar N, Huang Y, Carpp LN, Barouch DH, Mkhize NN, Hermanus T, Kgagudi P, Bekker V, Kaldine H, Mapengo RE, Eaton A, Domin E, West C, Feng W, Tang H, Seaton KE, Heptinstall J, Brackett C, Chiong K, Tomaras GD, Andrew P, Mayer BT, Reeves DB, Sobieszczyk ME, Garrett N, Sanchez J, Gay C, Makhema J, Williamson C, Mullins JI, Hural J, Cohen MS, Corey L, Montefiori DC, Morris L. Neutralization titer biomarker for antibody-mediated prevention of HIV-1 acquisition. Nat Med 2022; 28:1924-1932. [PMID: 35995954 PMCID: PMC9499869 DOI: 10.1038/s41591-022-01953-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 07/14/2022] [Indexed: 01/28/2023]
Abstract
The Antibody Mediated Prevention trials showed that the broadly neutralizing antibody (bnAb) VRC01 prevented acquisition of human immunodeficiency virus-1 (HIV-1) sensitive to VRC01. Using AMP trial data, here we show that the predicted serum neutralization 80% inhibitory dilution titer (PT80) biomarker-which quantifies the neutralization potency of antibodies in an individual's serum against an HIV-1 isolate-can be used to predict HIV-1 prevention efficacy. Similar to the results of nonhuman primate studies, an average PT80 of 200 (meaning a bnAb concentration 200-fold higher than that required to reduce infection by 80% in vitro) against a population of probable exposing viruses was estimated to be required for 90% prevention efficacy against acquisition of these viruses. Based on this result, we suggest that the goal of sustained PT80 <200 against 90% of circulating viruses can be achieved by promising bnAb regimens engineered for long half-lives. We propose the PT80 biomarker as a surrogate endpoint for evaluatinon of bnAb regimens, and as a tool for benchmarking candidate bnAb-inducing vaccines.
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Affiliation(s)
- Peter B. Gilbert
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA ,grid.34477.330000000122986657Department of Biostatistics, University of Washington, Seattle, WA USA
| | - Yunda Huang
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA ,grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA
| | - Allan C. deCamp
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Shelly Karuna
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Yuanyuan Zhang
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Craig A. Magaret
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Elena E. Giorgi
- grid.148313.c0000 0004 0428 3079Los Alamos National Laboratory, Los Alamos, NM USA ,grid.270240.30000 0001 2180 1622Present Address: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Bette Korber
- grid.148313.c0000 0004 0428 3079Los Alamos National Laboratory, Los Alamos, NM USA
| | - Paul T. Edlefsen
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Raabya Rossenkhan
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Michal Juraska
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Erika Rudnicki
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Nidhi Kochar
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Ying Huang
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Lindsay N. Carpp
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Dan H. Barouch
- grid.239395.70000 0000 9011 8547Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA USA ,grid.32224.350000 0004 0386 9924Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA USA
| | - Nonhlanhla N. Mkhize
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tandile Hermanus
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Prudence Kgagudi
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Valerie Bekker
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ,grid.26009.3d0000 0004 1936 7961Present Address: Duke Center for Human Systems Immunology, Duke University Departments of Surgery, Immunology, Molecular Genetics and Microbiology, Durham, NC USA
| | - Haajira Kaldine
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rutendo E. Mapengo
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amanda Eaton
- grid.189509.c0000000100241216Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Elize Domin
- grid.189509.c0000000100241216Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Carley West
- grid.189509.c0000000100241216Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Wenhong Feng
- grid.189509.c0000000100241216Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Haili Tang
- grid.189509.c0000000100241216Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Kelly E. Seaton
- grid.26009.3d0000 0004 1936 7961Duke University Departments of Surgery, Immunology, Molecular Genetics and Micobiology, Duke Center for Human Systems Immunology, Durham, NC USA
| | - Jack Heptinstall
- grid.26009.3d0000 0004 1936 7961Duke University Departments of Surgery, Immunology, Molecular Genetics and Micobiology, Duke Center for Human Systems Immunology, Durham, NC USA
| | - Caroline Brackett
- grid.26009.3d0000 0004 1936 7961Duke University Departments of Surgery, Immunology, Molecular Genetics and Micobiology, Duke Center for Human Systems Immunology, Durham, NC USA
| | - Kelvin Chiong
- grid.26009.3d0000 0004 1936 7961Duke University Departments of Surgery, Immunology, Molecular Genetics and Micobiology, Duke Center for Human Systems Immunology, Durham, NC USA
| | - Georgia D. Tomaras
- grid.26009.3d0000 0004 1936 7961Duke University Departments of Surgery, Immunology, Molecular Genetics and Micobiology, Duke Center for Human Systems Immunology, Durham, NC USA
| | - Philip Andrew
- grid.245835.d0000 0001 0300 5112Family Health International, Durham, NC USA
| | - Bryan T. Mayer
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Daniel B. Reeves
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Magdalena E. Sobieszczyk
- grid.21729.3f0000000419368729Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY USA
| | - Nigel Garrett
- grid.16463.360000 0001 0723 4123Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa ,grid.16463.360000 0001 0723 4123Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Jorge Sanchez
- grid.10800.390000 0001 2107 4576Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cynthia Gay
- grid.10698.360000000122483208Division of Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Joseph Makhema
- Botswana-Harvard AIDS Initiative Partnership for HIV Research and Education, Gaborone, Botswana ,grid.239395.70000 0000 9011 8547Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA USA
| | - Carolyn Williamson
- grid.7836.a0000 0004 1937 1151Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - James I. Mullins
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Microbiology, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Medicine, University of Washington, Seattle, WA USA
| | - John Hural
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA
| | - Myron S. Cohen
- grid.10698.360000000122483208Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Lawrence Corey
- grid.270240.30000 0001 2180 1622Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA USA ,grid.34477.330000000122986657Department of Medicine, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Department of Laboratory Medicine, University of Washington, Seattle, WA USA
| | - David C. Montefiori
- grid.189509.c0000000100241216Department of Surgery, Duke University Medical Center, Durham, NC USA
| | - Lynn Morris
- grid.416657.70000 0004 0630 4574National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ,grid.16463.360000 0001 0723 4123Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
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198
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Vaccinating children: the pros and cons. Infect Dis Now 2022; 52:S9-S11. [DOI: 10.1016/j.idnow.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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199
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González S, Olszevicki S, Gaiano A, Baino ANV, Regairaz L, Salazar M, Pesci S, Marín L, Martínez VVG, Varela T, Ceriani L, Garcia E, Kreplak N, Navarro A, Estenssoro E, Marsico F. Effectiveness of BBIBP-CorV, BNT162b2 and mRNA-1273 vaccines against hospitalisations among children and adolescents during the Omicron outbreak in Argentina: A retrospective cohort study. LANCET REGIONAL HEALTH. AMERICAS 2022; 13:100316. [PMID: 35872665 PMCID: PMC9288143 DOI: 10.1016/j.lana.2022.100316] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Although paediatric clinical presentations of COVID-19 are usually less severe than in adults, serious illness and death have occurred. Many countries started the vaccination rollout of children in 2021; still, information about effectiveness in the real-world setting is scarce. The aim of our study was to evaluate vaccine effectiveness (VE) against COVID-19-associated-hospitalisations in the 3–17-year population during the Omicron outbreak. Methods We conducted a retrospective cohort study including individuals aged 3–17 registered in the online vaccination system of the Buenos Aires Province, Argentina. mRNA-1273 and BNT162b2 were administered to 12–17-year subjects; and BBIBP-CorV to 3–11-year subjects. Vaccinated group had received a two-dose scheme by 12/1/2021. Unvaccinated group did not receive any COVID-19 vaccine between 12/14/2021 and 3/9/2022, which was the entire monitoring period. Vaccine effectiveness (VE) against COVID-19-associated hospitalisations was calculated as (1-OR)x100. Findings By 12/1/2021, 1,536,435 individuals aged 3–17 who had received zero or two doses of SARS-CoV-2 vaccines were included in this study. Of the latter, 1,440,389 were vaccinated and 96,046 not vaccinated. VE were 78.0%[68.7–84.2], 76.4%[62.9–84.5] and 80.0%[64.3–88.0] for the entire cohort, 3–11-year (BBIBP-CorV) subgroup and 12–17 (mRNA vaccines) subgroup, respectively. VE for the entire population was 82.7% during the period of Delta and Omicron overlapping circulation and decreased to 67.7% when Omicron was the only variant present. Interpretation This report provides evidence of high vaccine protection against associated hospitalisations in the paediatric population during the Omicron outbreak but suggests a decrease of protection when Omicron became predominant. Application of a booster dose in children aged 3–11-year warrants further consideration. Funding None.
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Affiliation(s)
- Soledad González
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Santiago Olszevicki
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Alejandra Gaiano
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Ana Nina Varela Baino
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Lorena Regairaz
- Immunology Unit, Children's Hospital Sor Maria Ludovica, La Plata, Buenos Aires, Argentina
| | - Martín Salazar
- Faculty of Medical Sciences - National University of La Plata, Argentina
| | - Santiago Pesci
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Lupe Marín
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | | | - Teresa Varela
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Leticia Ceriani
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Enio Garcia
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Nicolás Kreplak
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Alexia Navarro
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Elisa Estenssoro
- Ministry of Health of the Province of Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Franco Marsico
- Calculus Institute, University of Buenos Aires, Buenos Aires, Argentina
- Corresponding author.
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200
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Howell KD, Kelly MM, DeMuri GP, McBride JA, Katz B, Edmonson MB, Sklansky DJ, Shadman KA, Ehlenbach ML, Butteris SM, Warner G, Zhao Q, Coller RJ. COVID-19 Vaccination Intentions for Children With Medical Complexity. Hosp Pediatr 2022; 12:e295-e302. [PMID: 36039687 PMCID: PMC10039457 DOI: 10.1542/hpeds.2022-006544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The chronic conditions and functional limitations experienced by children with medical complexity (CMC) place them at disproportionate risk for COVID-19 transmission and poor outcomes. To promote robust vaccination uptake, specific constructs associated with vaccine hesitancy must be understood. Our objective was to describe demographic, clinical, and vaccine perception variables associated with CMC parents' intention to vaccinate their child against COVID-19. METHODS We conducted a cross-sectional survey (June-August 2021) for primary caregivers of CMC between ages 5 to 17 at an academic medical center in the Midwest. Multivariable logistic regression examined associations between vaccination intent and selected covariates. RESULTS Among 1330 families, 65.8% indicated vaccination intent. In multivariable models, demographics had minimal associations with vaccination intent; however, parents of younger children (<12 years) had significantly lower adjusted odds of vaccination intent (adjusted odds ratio [95% confidence interval]: 0.26 [0.17-0.3]) compared to parents of older children (≥12 years). CMC with higher severity of illness, ie, those with ≥1 hospitalization in the previous year (versus none) or >1 complex chronic condition (vs 1), had higher adjusted odds of vaccination intent (1.82 [1.14-2.92] and 1.77 [1.16-2.71], respectively). Vaccine perceptions associated with vaccine intention included "My doctor told me to get my child a COVID-19 vaccine" (2.82 [1.74-4.55]); and "I'm concerned about my child's side effects from the vaccine" (0.18 [0.12-0.26]). CONCLUSIONS One-third of CMC families expressed vaccine hesitation; however, constructs strongly associated with vaccination intent are potentially modifiable. Pediatrician endorsement of COVID-19 vaccination and careful counseling on side effects might be promising strategies to encourage uptake.
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Affiliation(s)
- Kristina Devi Howell
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Michelle M. Kelly
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Gregory P. DeMuri
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Joseph A. McBride
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - M. Bruce Edmonson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Daniel J. Sklansky
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kristin A. Shadman
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mary L. Ehlenbach
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sabrina M. Butteris
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Gemma Warner
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ryan J. Coller
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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