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de Albuquerque TR, Macedo LFR, de Oliveira EG, Neto MLR, de Menezes IRA. Vaccination for COVID-19 in children: Denialism or misinformation? J Pediatr Nurs 2022; 64:141-142. [PMID: 35144851 PMCID: PMC8820958 DOI: 10.1016/j.pedn.2022.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/13/2022]
Abstract
In the current pandemic scenario, vaccines for children have been scientifically approved; however, there is a challenge faced globally: parents' hesitation about vaccinating their children for COVID-19, which can hamper adherence to vaccine campaigns. This issue is due to the lack of information or access to fake news that affects the parents' power of judgment. The experience of the vaccine process with Pfizer's immunizer in several countries successfully reduced the number of hospitalized and prevented hundreds of child deaths from COVID-19. All health professionals must encourage the vaccination of children from the age of 5, sharing reliable scientific data, thus reducing the spread of fake news.
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Affiliation(s)
| | | | | | | | - Irwin Rose Alencar de Menezes
- Laboratory of Pharmacology and Molecular Chemistry, Department of Biological Chemistry, Regional University of Cariri, Crato, Brazil
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302
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Paediatric vaccination against COVID-19 beyond adolescence. Another reality. VACUNAS (ENGLISH EDITION) 2022. [PMCID: PMC9296685 DOI: 10.1016/j.vacune.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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303
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Curtis JR, Johnson SR, Anthony DD, Arasaratnam RJ, Baden LR, Bass AR, Calabrese C, Gravallese EM, Harpaz R, Kroger A, Sadun RE, Turner AS, Williams EA, Mikuls TR. American College of Rheumatology Guidance for COVID-19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 4. Arthritis Rheumatol 2022; 74:e21-e36. [PMID: 35474640 PMCID: PMC9082483 DOI: 10.1002/art.42109] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To provide guidance to rheumatology providers on the use of COVID-19 vaccines for patients with rheumatic and musculoskeletal diseases (RMDs). METHODS A task force was assembled that included 9 rheumatologists/immunologists, 2 infectious disease specialists, and 2 public health physicians. After agreeing on scoping questions, an evidence report was created that summarized the published literature and publicly available data regarding COVID-19 vaccine efficacy and safety, as well as literature for other vaccines in RMD patients. Task force members rated their agreement with draft consensus statements on a 9-point numerical scoring system, using a modified Delphi process and the RAND/University of California Los Angeles Appropriateness Method, with refinement and iteration over 2 sessions. Consensus was determined based on the distribution of ratings. RESULTS Despite a paucity of direct evidence, statements were developed by the task force and agreed upon with consensus to provide guidance for use of the COVID-19 vaccines, including supplemental/booster dosing, in RMD patients and to offer recommendations regarding the use and timing of immunomodulatory therapies around the time of vaccination. CONCLUSION These guidance statements are intended to provide direction to rheumatology health care providers on how to best use COVID-19 vaccines and to facilitate implementation of vaccination strategies for RMD patients.
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Affiliation(s)
| | - Sindhu R Johnson
- Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Donald D Anthony
- Louis Stokes Cleveland VA Medical Center, MetroHealth Medical Center, and Case Western Reserve University, Cleveland, Ohio
| | - Reuben J Arasaratnam
- VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas
| | | | - Anne R Bass
- Hospital for Special Surgery and Weill Cornell Medicine, New York, New York
| | | | | | | | | | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
| | | | - Ted R Mikuls
- University of Nebraska Medical Center and VA Nebraska-Western, Iowa Health Care System, Omaha
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304
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Tobin NH, Yang OO. COVID-19 vaccine dosage in children, adolescents, and young adults – is less more? Open Forum Infect Dis 2022; 9:ofac222. [PMID: 35821728 PMCID: PMC9272428 DOI: 10.1093/ofid/ofac222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/28/2022] [Indexed: 12/03/2022] Open
Abstract
The lower efficacy of the COVID-19 mRNA vaccines in 5-11 year old children was unexpected. Neutralizing antibody titers elicited by the vaccines in children, adolescents, and young adults suggest that the lower efficacy is not due to the lower dosage. Confirming the efficacy of these vaccines in children, determining if mRNA vaccination strategies are less effective in younger children, as well as optimizing the dosage, dosing intervals, and number of doses needed in children, adolescents, and young adults are critical to improve vaccination strategies for these populations going forward.
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Affiliation(s)
- Nicole H. Tobin
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095 USA
| | - Otto O. Yang
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095 USA
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095 USA
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305
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Noor A, Backer M, Krilov LR. Children Lagging with COVID-19 Vaccination. Pediatr Ann 2022; 51:e180-e185. [PMID: 35575538 DOI: 10.3928/19382359-20220314-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Children account for a growing share of coronavirus disease 2019 (COVID-19) infections in the United States. Since the widespread availability of COVID-19 vaccine in adults, there has been an upward trend of cases in children, accounting for approximately 20% of the weekly new cases. The majority (38.3%) reported in high school students age 14 to 17 years. Children are also at risk of a postinflammatory condition, known as multisystem inflammatory syndrome in children, after COVID-19. In addition, infected children could transmit the virus to vulnerable adults, contributing to ongoing pandemic. We believe that children need to be vaccinated against COVID-19 and review the available evidence. [Pediatr Ann. 2022;51(5):e180-e185.].
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306
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Almalki OS, Alfayez OM, Al Yami MS, Asiri YA, Almohammed OA. Parents' Hesitancy to Vaccinate Their 5-11-Year-Old Children Against COVID-19 in Saudi Arabia: Predictors From the Health Belief Model. Front Public Health 2022; 10:842862. [PMID: 35433579 PMCID: PMC9005777 DOI: 10.3389/fpubh.2022.842862] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/09/2022] [Indexed: 11/21/2022] Open
Abstract
Data exploring parents' hesitancy to vaccinate their 5–11-year-old children against COVID-19, and associated factors, is limited. This study aims to investigate parents' beliefs and intentions to vaccinate their 5–11-year-old children using the Health Belief Model in Saudi Arabia. A national, cross-sectional, questionnaire-based study was conducted in November, 2021. The self-administered online questionnaire was distributed to a random sample of parents. Adult parents with at least one 5–11-year-old child were included. The main outcome was parents' intention to vaccinate their 5–11-year-old children. Variability in parents' intention was assessed by demographics, COVID-19-related factors, children's health status, and constructs from the Health Belief Model. Univariate and multivariable logistic regression were used to investigate each factor and adjust for the intervariable effect on parental intention to vaccinate their children. Of the 4,135 participants, 61.9% were hesitant to vaccinate their 5–11-year-old children. Parents aged 31 to 40 years (OR = 1.23; 95% CI, 1.02–1.49) and females (OR = 1.52; 95% CI, 1.25–1.84) had higher odds of being hesitant to vaccinate their children than parents from other groups. Parents who perceived low benefit from the vaccine (OR = 16.3; 95% CI, 12.1–21.9) or who had safety or efficacy concerns (OR = 3.76; 95% CI, 3.10–4.58) were among the most hesitant to vaccinate their children. In conclusion, vaccine hesitancy is prevalent among parents of 5–11-year-old children in Saudi Arabia and those who had beliefs of minimal benefits or lack of safety from the COVID-19 vaccine were more hesitant. Government efforts must be directed toward increasing parents' vaccine awareness and tackling the constructs of the Health Belief Model through a well-designed vaccination campaign.
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Affiliation(s)
- Ohoud S Almalki
- Department of Pharmacy Practice, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Osamah M Alfayez
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Majed S Al Yami
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yousif A Asiri
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Omar A Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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307
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Sherman AC, Rouphael N, Baden LR. Coronavirus Disease 2019 Vaccine Trials (and Tribulations): How to Improve the Process of Clinical Trials in a Pandemic. Clin Infect Dis 2022; 75:S5-S10. [PMID: 35436331 PMCID: PMC9047247 DOI: 10.1093/cid/ciac301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Indexed: 01/19/2023] Open
Abstract
Vaccine clinical trials have been essential to developing effective severe acute respiratory syndrome coronavirus 2 vaccines. The challenges of supply chain disruptions, infection control, study designs, and participant factors that affect trial procedures are reviewed, with specific solutions to streamline the clinical trial process.
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Affiliation(s)
- Amy C. Sherman
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States,Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, United States,Corresponding Author: Amy C. Sherman, MD, Brigham and Women’s Hospital, 15 Francis Street, PBB-A-4, Boston, MA 02115, USA,
| | - Nadine Rouphael
- Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Lindsey R. Baden
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States,Alternate Corresponding Author: Lindsey R. Baden, MD, Brigham and Women’s Hospital, 15 Francis Street, PBB-A-4, Boston, MA 02115, USA,
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308
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Araujo da Silva AR, de Carvalho BRR, Esteves MDM, Teixeira CH, Souza CV. The Role of COVID-19 Vaccinal Status in Admitted Children during OMICRON Variant Circulation in Rio de Janeiro, City-Preliminary Report. Vaccines (Basel) 2022; 10:vaccines10040619. [PMID: 35455368 PMCID: PMC9025062 DOI: 10.3390/vaccines10040619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 12/16/2022] Open
Abstract
Objective: To evaluate COVID-19 vaccination status in admitted children in 2020−2021 and during the OMICRON variant circulation (2022), a period when children older than 12 years of age had received two doses of COVID-19 vaccines. Design: An observational retrospective study. Patients with confirmed COVID-19 were compared in two different periods: 2020−2021 when adolescents aged 12−18 years had not received the complete COVID-19 vaccine, and 2022 when children older than 12 years had received the complete Pfizer-BioNTech vaccine scheme. Setting: Two pediatric hospitals in Rio de Janeiro city. Patients: Children aged < 18 years with confirmed COVID-19. Intervention: None. Main outcome: Vaccination status for COVID-19 on admission. Results: In total, 300 patients were admitted with confirmed COVID-19 (240 in 2020−2021 and 60 in 2022). The distribution of patients according to the age-groups was: 0−2 years (33.3% in 2020−2021 and 53.4% in 2022), 2−5 years (21.7% in 2020−2021 and 10% in 2022), 5−11 years (29.2% in 2020−2021 and 28.3% in 2022), and 12−18 years (15.8% in 2020−2021 and 8.3% in 2022) (p = 0.076). The median length of stay was six days in 2020−2021 and six days in 2022 (p = 0.423). We verified six deaths in the first analysis period and one death in the second one (p = 0.894). Of the 60 children admitted in 2022, 58 (96.7%) did not receive the complete COVID-19 vaccine scheme available. Conclusions: We verified in a “real-world condition” the ability of the Pfizer-BioNTech vaccine to prevent hospitalization in children over 12 years of age.
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Affiliation(s)
- André Ricardo Araujo da Silva
- Materno-Infantil Department, Faculty of Medicine, Fluminense Federal University, Niterói 24033-900, Brazil; (B.R.R.d.C.); (M.d.M.E.)
- Correspondence:
| | | | - Monica del Monaco Esteves
- Materno-Infantil Department, Faculty of Medicine, Fluminense Federal University, Niterói 24033-900, Brazil; (B.R.R.d.C.); (M.d.M.E.)
| | | | - Cristina Vieira Souza
- Infection Control Committee, Prontobaby Group, Rio de Janeiro 20540-100, Brazil; (C.H.T.); (C.V.S.)
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309
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Du Y, Chen L, Shi Y. Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Adolescents, Children, and Infants: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:829176. [PMID: 35493393 PMCID: PMC9046659 DOI: 10.3389/fpubh.2022.829176] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/24/2022] [Indexed: 01/14/2023] Open
Abstract
BackgroundAs the epidemic progresses, universal vaccination against COVID-19 has been the trend, but there are still some doubts about the efficacy and safety of COVID-19 vaccines in adolescents, children, and even infants.PurposeTo evaluate the safety, immunogenicity, and efficacy of COVID-19 vaccines in the population aged 0–17 years.MethodA comprehensive search for relevant randomized controlled trials (RCTs) was conducted in PubMed, Embase, and the Cochrane Library from inception to November 9, 2021. All data were pooled by RevMan 5.3 statistical software, with risk ratio (RR) and its 95% confidence interval as the effect measure. This study protocol was registered on PROSPERO (CRD42021290205).ResultsThere was a total of six randomized controlled trials included in this systematic review and meta-analysis, enrolling participants in the age range of 3–17 years, and containing three types of COVID-19 vaccines. Compared with mRNA vaccines and adenovirus vector vaccines, inactivated vaccines have a more satisfactory safety profile, both after initial (RR 1.40, 95% CI 1.04–1.90, P = 0.03) and booster (RR 1.84, 95% CI 1.20–2.81, P = 0.005) vaccination. The risk of adverse reactions was significantly increased after the first and second doses, but there was no significant difference between the first two doses (RR 1.00, 95%CI 0.99–1.02, P = 0.60). Nevertheless, the two-dose regimen is obviously superior to the single-dose schedule for immunogenicity and efficacy. After booster vaccination, both neutralizing antibodies (RR 144.80, 95%CI 44.97–466.24, P < 0.00001) and RBD-binding antibodies (RR 101.50, 95%CI 6.44–1,600.76, P = 0.001) reach optimal levels, but the cellular immune response seemed not to be further enhanced. In addition, compared with younger children, older children and adolescents were at significantly increased risk of adverse reactions after vaccination, with either mRNA or inactivated vaccines, accompanied by a stronger immune response.ConclusionThe available evidence suggests that the safety, immunogenicity and efficacy of COVID-19 vaccines are acceptable in people aged 3–17 years. However, there is an urgent need for additional multicenter, large-sample studies, especially in younger children under 3 years of age and even in infants, with long-term follow-up data.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290205, identifier: CRD42021290205.
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Affiliation(s)
- Yuxuan Du
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Long Chen
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yuan Shi
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
- *Correspondence: Yuan Shi
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310
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COVID-19 Vaccine Hesitancy among Arab Americans. Vaccines (Basel) 2022; 10:vaccines10040610. [PMID: 35455359 PMCID: PMC9030465 DOI: 10.3390/vaccines10040610] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total of 73% reported willingness to receive a booster, and 72% plan to give their children the vaccine. On multivariate analysis, respondents were more likely to be vaccine-hesitant if they were hesitant about receiving any vaccine in general. They were less likely to be vaccine-hesitant if they were immigrants, over the age of 40, up to date on their general vaccination and if they believed that COVID-19 vaccines are safe and effective in preventing an infection. The belief that all vaccines are effective at preventing diseases was also associated with lower hesitancy. (4) Conclusions: This sample of AAs have higher vaccination rates and are more willing to vaccinate their children against COVID-19 when compared to the rest of the population. However, a reemergence of hesitancy might be arising towards the boosters.
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311
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The Importance of Vaccination in the Context of the COVID-19 Pandemic: A Brief Update Regarding the Use of Vaccines. Vaccines (Basel) 2022; 10:vaccines10040591. [PMID: 35455340 PMCID: PMC9027942 DOI: 10.3390/vaccines10040591] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has led the world to undertake the largest vaccination campaign in human history. In record time, unprecedented scientific and governmental efforts have resulted in the acquisition of immunizers utilizing different technologies (nucleotide acids, viral vectors, inactivated and protein-based vaccines). Currently, 33 vaccines have already been approved by regulatory agencies in different countries, and more than 10 billion doses have been administered worldwide. Despite the undeniable impact of vaccination on the control of the pandemic, the recurrent emergence of new variants of interest has raised new challenges. The recent viral mutations precede new outbreaks that rapidly spread at global proportions. In addition, reducing protective efficacy rates have been observed among the main authorized vaccines. Besides these issues, several other crucial issues for the appropriate combatting of the pandemic remain uncertain or under investigation. Particularly noteworthy issues include the use of vaccine-boosting strategies to increase protection; concerns related to the long-term safety of vaccines, child immunization reliability and uncommon adverse events; the persistence of the virus in society; and the transition from a pandemic to an endemic state. In this review, we describe the updated scenario regarding SARS-CoV-2 variants and COVID-19 vaccines. In addition, we outline current discussions covering COVID-19 vaccine safety and efficacy, and the future pandemic perspectives.
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312
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Fong Y, McDermott AB, Benkeser D, Roels S, Stieh DJ, Vandebosch A, Gars ML, 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, de Sousa LP, 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 a Single Ad26.COV2.S Dose in the ENSEMBLE COVID-19 Vaccine Efficacy Clinical Trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.04.06.22272763. [PMID: 35441174 PMCID: PMC9016647 DOI: 10.1101/2022.04.06.22272763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Anti-spike IgG binding antibody, anti-receptor binding domain IgG antibody, and pseudovirus neutralizing antibody measurements four weeks post-vaccination were assessed as correlates of risk of moderate to severe-critical COVID-19 outcomes through 83 days post-vaccination and as correlates of protection following a single dose of Ad26.COV2.S COVID-19 vaccine in the placebo-controlled phase of ENSEMBLE, an international, randomized efficacy trial. Each marker had evidence as a correlate of risk and of protection, with strongest evidence for 50% inhibitory dilution (ID50) neutralizing antibody titer. 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 nonquantifiable ID50 (< 2.7 IU50/ml) and rose to 89% (78, 96%) at ID50 = 96.3 IU50/ml. Comparison of the vaccine efficacy by ID50 titer curves for ENSEMBLE-US, the COVE trial of the mRNA-1273 vaccine, and the COV002-UK trial of the AZD1222 vaccine supported consistency of the ID50 titer 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
| | | | - 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, RJ, 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, RJ, Brazil
| | - Rebone Maboa
- Ndlovu Elandsdoorn Site, Limpopo, Dennilton, 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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313
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Butt AA, Dargham SR, Loka S, Shaik RM, Chemaitelly H, Tang P, Hasan MR, Coyle PV, Yassine HM, Al-Khatib HA, Smatti MK, Kaleeckal AH, Latif AN, Zaqout A, Almaslamani MA, Al Khal A, Bertollini R, Abou-Samra AB, Abu-Raddad LJ. COVID-19 Disease Severity in Children Infected with the Omicron Variant. Clin Infect Dis 2022; 75:e361-e367. [PMID: 35404391 PMCID: PMC9047187 DOI: 10.1093/cid/ciac275] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Indexed: 12/21/2022] Open
Abstract
Background There are limited data assessing COVID-19 disease severity in children/adolescents infected with the Omicron variant. Methods We identified children and adolescents <18 years with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. Primary outcome was disease severity, determined by hospital admission, admission to ICU, or mechanical ventilation within 14 days of diagnosis, or death within 28 days. Results Among 1,735 cases with Delta variant infection between June 1 and November 6, 2021 and 32 635 cases with Omicron variant infection between January 1 and January 15, 2022 who did not have prior infection and were not vaccinated, we identified 985 propensity-score matched pairs. Among Delta infected, 84.2% had mild, 15.7% had moderate, and 0.1% had severe/critical disease. Among Omicron infected, 97.8% had mild, 2.2% had moderate, and none had severe/critical disease (P < .001). Omicron variant infection (vs. Delta) was associated with significantly lower odds of moderate or severe/critical disease (adjusted odds ratio, 0.12; 95% CI 0.07-0.18). Those aged 6–11, and 12-<18 years had lower odds of developing moderate or severe/critical disease compared with those younger than six years (aOR, 95% CI 0.47; 0.33-0.66 for 6-11 year old; aOR 0.45, 95% CI 0.21-0.94 for 12-<18 years old). Conclusions Omicron variant infection in children/adolescents is associated with less severe disease than Delta variant infection as measured by hospitalization rates and need for ICU care or mechanical ventilation. Those 6 to <18 years also have less severe disease than those <6 years old.
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Affiliation(s)
- Adeel A Butt
- Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, New York, NY and Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, New York, NY and Doha, Qatar
| | - Soha R Dargham
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | | | | | - Hiam Chemaitelly
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY and Doha, Qatar.,Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | | | | | | | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Laith J Abu-Raddad
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY and Doha, Qatar.,Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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314
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Abstract
Purpose of Review Due to the rapidly changing landscape of COVID-19, the purpose of this review is to provide a concise and updated summary of pediatric COVID-19 diagnosis and management. Recent Findings The relative proportion of pediatric cases have significantly increased following the emergence of the Omicron variant (from < 2% in the early pandemic to 25% from 1/27 to 2/3/22). While children present with milder symptoms than adults, severe disease can still occur, particularly in children with comorbidities. There is a relative paucity of pediatric data in the management of COVID-19 and the majority of recommendations remain based on adult data. Summary Fever and cough remain the most common clinical presentations, although atypical presentations such as “COVID toes,” anosmia, and croup may be present. Children are at risk for post-infectious complications such as MIS-C and long COVID. Nucleic acid amplification tests through respiratory PCR remain the mainstay of diagnosis. The mainstay of management remains supportive care and prevention through vaccination is highly recommended. In patients at increased risk of progression, interventions such as monoclonal antibody therapy, PO Paxlovid, or IV remdesivir × 3 days should be considered. In patients with severe disease, the use of remdesivir, dexamethasone, and immunomodulatory agents (tocilizumab, baricitinib) is recommended. Children can be at risk for thrombosis from COVID-19 and anticoagulation is recommended in children with markedly elevated D-dimer levels or superimposed clinical risk factors for hospital associated venous thromboembolism.
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315
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Buonsenso D, Valentini P, Macchi M, Folino F, Pensabene C, Patria MF, Agostoni C, Castaldi S, Lecce M, Giannì ML, Marchisio P, Milani GP. Caregivers' Attitudes Toward COVID-19 Vaccination in Children and Adolescents With a History of SARS-CoV-2 Infection. Front Pediatr 2022; 10:867968. [PMID: 35463893 PMCID: PMC9021633 DOI: 10.3389/fped.2022.867968] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022] Open
Abstract
Background Limited data are available on the attitudes of caregivers toward COVID-19 vaccination in children and adolescents with a history of SARS-CoV-2 infection or Long Covid symptoms. The aim of this study was to investigate the vaccine hesitancy among caregivers of children and adolescents with a documented history of SARS-CoV-2 infection and to explore the possible associations between COVID-19 manifestations and the acceptance of the vaccine. Methods Caregivers of children or adolescents with a microbiologically confirmed diagnosis of SARS-CoV-2 infection evaluated in two University Hospitals were interviewed. Results We were able to contact 132 caregivers and 9 declined to participate. 68 caregivers (56%) were in favor of COVID-19 vaccination for their child. In the multiple logistic regression, child's age (OR 1.17, 95%CI 1.06-1.28) and hospitalization due to COVID-19 (OR 3.25, 95%CI 1.06-9.95) were positively associated with being in favor of COVID-19 vaccination. On the contrary, the occurrence of child's Long Covid was associated with a higher likelihood of being against the vaccination (OR 0.28, 95%CI 0.10-0.80). Conclusions This preliminary study shows that only about half of the interviewed parents of children and adolescents with a previous SARS-CoV-2 infection are willing to vaccinate them to prevent a repeated COVID-19 infection. These findings might help healthcare workers to provide tailored information to caregivers of children with a previous SARS-CoV-2 infection.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
- Center for Global Health Research and Studies, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
- Center for Global Health Research and Studies, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marina Macchi
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Francesco Folino
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Carola Pensabene
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | | | - Carlo Agostoni
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maurizio Lecce
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Lorella Giannì
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gregorio P. Milani
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
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316
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Furlong E, Kotecha RS, Conyers R, O'Brien TA, Hansford JR, Super L, Downie P, Eisenstat DD, Haeusler G, McMullan B, Phillips MB, Padhye B, Dalla-Pozza L, Alvaro F, Fraser CJ, Nicholls W, Clark JE, O'Connor M, Saxon BR, Tapp H, Heath J, Hunter SE, Tsui K, Winstanley M, Lyver A, Best EJ, Wadia U, Yeoh D, Blyth CC, Gottardo NG. COVID-19 vaccination in children and adolescents aged 5 years and older undergoing treatment for cancer and non-malignant haematological conditions: Australian and New Zealand Children's Haematology/Oncology Group consensus statement. Med J Aust 2022; 216:312-319. [PMID: 35201615 PMCID: PMC9115069 DOI: 10.5694/mja2.51444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The Australian Technical Advisory Group on Immunisation and New Zealand Ministry of Health recommend all children aged ≥ 5 years receive either of the two mRNA COVID-19 vaccines: Comirnaty (Pfizer), available in both Australia and New Zealand, or Spikevax (Moderna), available in Australia only. Both vaccines are efficacious and safe in the general population, including children. Children and adolescents undergoing treatment for cancer and immunosuppressive therapy for non-malignant haematological conditions are particularly vulnerable, with an increased risk of severe or fatal COVID-19. There remains a paucity of data regarding the immune response to COVID-19 vaccines in immunosuppressed paediatric populations, with data suggestive of reduced immunogenicity of the vaccine in immunocompromised adults. RECOMMENDATIONS Considering the safety profile of mRNA COVID-19 vaccines and the increased risk of severe COVID-19 in immunocompromised children and adolescents, COVID-19 vaccination is strongly recommended for this at-risk population. We provide a number of recommendations regarding COVID-19 vaccination in this population where immunosuppressive, chemotherapeutic and/or targeted biological agents are used. These include the timing of vaccination in patients undergoing active treatment, management of specific situations where vaccination is contraindicated or recommended under special precautions, and additional vaccination recommendations for severely immunocompromised patients. Finally, we stress the importance of upcoming clinical trials to identify the safest and most efficacious vaccination regimen for this population. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT This consensus statement provides recommendations for COVID-19 vaccination in children and adolescents aged ≥ 5 years with cancer and immunocompromising non-malignant haematological conditions, based on evidence, national and international guidelines and expert opinion. ENDORSED BY The Australian and New Zealand Children's Haematology/Oncology Group.
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Affiliation(s)
- Eliska Furlong
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA
| | - Rishi S Kotecha
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA.,Curtin University, Perth, WA
| | - Rachel Conyers
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Tracey A O'Brien
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW.,University of New South Wales, Sydney, NSW
| | - Jordan R Hansford
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Leanne Super
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,Monash University, Melbourne, VIC
| | - Peter Downie
- Monash University, Melbourne, VIC.,Monash Children's Hospital, Melbourne, VIC.,Hudson Institute of Medical Research, Melbourne, VIC
| | - David D Eisenstat
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Gabrielle Haeusler
- Murdoch Children's Research Institute, Melbourne, VIC.,Paediatric Integrated Cancer Service, Melbourne, VIC.,National Centre for Infections in Cancer, Melbourne, VIC
| | - Brendan McMullan
- University of New South Wales, Sydney, NSW.,National Centre for Infections in Cancer, Melbourne, VIC.,Sydney Children's Hospital, Sydney, NSW
| | | | - Bhavna Padhye
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW
| | - Frank Alvaro
- John Hunter Children's Hospital, Newcastle, NSW.,University of Newcastle, Newcastle, NSW
| | | | - Wayne Nicholls
- Queensland Children's Hospital, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Julia E Clark
- Queensland Children's Hospital, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Matthew O'Connor
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - Benjamin R Saxon
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - Heather Tapp
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - John Heath
- Children's and Adolescent/Young Adult Cancer Centre, Royal Hobart Hospital, Hobart, TAS
| | - Sarah E Hunter
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Karen Tsui
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Mark Winstanley
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Amanda Lyver
- Children's Haematology Oncology Centre, Christchurch Hospital, Christchurch, NZ
| | - Emma J Best
- Starship Children's Hospital, Auckland, NZ.,Immunisation Advisory Centre, University of Auckland, Auckland, NZ.,University of Auckland, Auckland, NZ
| | - Ushma Wadia
- Perth Children's Hospital, Perth, WA.,Fiona Stanley Hospital, Perth, WA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
| | - Daniel Yeoh
- Perth Children's Hospital, Perth, WA.,National Centre for Infections in Cancer, Melbourne, VIC
| | - Christopher C Blyth
- Perth Children's Hospital, Perth, WA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
| | - Nicholas G Gottardo
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
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317
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Guimarães RM. Children vaccination as a population strategy to increase COVID-19 vaccine coverage in Brazil. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100240. [PMID: 35373175 PMCID: PMC8956957 DOI: 10.1016/j.lana.2022.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Raphael Mendonça Guimarães
- Fundação Oswaldo Cruz (FIOCRUZ), National School of Public Health, Department of Social Sciences | Fiocruz COVID-19 Observatory. Rio de Janeiro, RJ, Brazil
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318
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Fernandez M, Matta G, Paiva E. COVID-19, vaccine hesitancy and child vaccination: Challenges from Brazil. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100246. [PMID: 35399648 PMCID: PMC8974801 DOI: 10.1016/j.lana.2022.100246] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Michelle Fernandez
- Prédio IPOL\IREL, Institute of Political Science, University of Brasilia, UnB Área 1, Campus Darcy Ribeiro, Asa Norte, Brasília, DF CEP 70904-970, Brazil
| | - Gustavo Matta
- National School of Public Health Sérgio Arouca, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Ester Paiva
- National School of Public Health Sérgio Arouca, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
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319
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Brüssow H. COVID-19 and children: medical impact and collateral damage. Microb Biotechnol 2022; 15:1035-1049. [PMID: 35182108 PMCID: PMC8966019 DOI: 10.1111/1751-7915.14018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 12/23/2022] Open
Abstract
Children mostly experience mild SARS-CoV-2 infections, but the extent of paediatric COVID-19 disease differs between geographical regions and the distinct pandemic waves. Not all infections in children are mild, some children even show a strong inflammatory reaction resulting in a multisystem inflammatory syndrome. The assessments of paediatric vaccination depend on the efficacy of protection conferred by vaccination, the risk of adverse reactions and whether children contribute to herd immunity against COVID-19. Children were also the target of consequential public health actions such as school closure which caused substantial harm to children (educational deficits, sociopsychological problems) and working parents. It is, therefore, important to understand the transmission dynamics of SARS-CoV-2 infections by children to assess the efficacy of school closures and paediatric vaccination. The societal restrictions to contain the COVID-19 pandemic had additional negative effects on children's health, such as missed routine vaccinations, nutritional deprivation and lesser mother-child medical care in developing countries causing increased child mortality as a collateral damage. In this complex epidemiological context, it is important to have an evidence-based approach to public health approaches. The present review summaries pertinent published data on the role of children in the pandemic, whether they are drivers or followers of the infection chains and whether they are (after elderlies) major sufferers or mere bystanders of the COVID-19 pandemic.
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Affiliation(s)
- Harald Brüssow
- Department of BiosystemsLaboratory of Gene TechnologyKU LeuvenLeuvenBelgium
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320
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The unjustified and politicized battle against vaccination of children and adolescents in Brazil. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100206. [PMID: 35224530 PMCID: PMC8857864 DOI: 10.1016/j.lana.2022.100206] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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321
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Cazzato G, Romita P, Foti C, Lobreglio D, Trilli I, Colagrande A, Ingravallo G, Resta L. Development of Flat Warts on the Cheeks after BioNTech-Pfizer BNT162b2 Vaccine: Is There a Correlation? Vaccines (Basel) 2022; 10:vaccines10040532. [PMID: 35455281 PMCID: PMC9032489 DOI: 10.3390/vaccines10040532] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
The SARS-CoV-2 pandemic has affected health systems across the globe, making the use of vaccines more urgent and topical than ever. Since the first months after the introduction of vaccinations, several reactions, both local and systemic, have been reported although they were mostly very mild and only rarely harbingers of more serious complications. We present a case of multiple flat warts onset over the cheeks in a patient after the second dose of mRNA BioNTech-Pfizer BNT162b2 vaccine, and we discuss the possible temporal association between the two events, also considering the patient's antibody status.
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
- Correspondence: ; Tel.: +39-34-0520-3641
| | - Paolo Romita
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (P.R.); (C.F.); (D.L.)
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (P.R.); (C.F.); (D.L.)
| | - Debora Lobreglio
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (P.R.); (C.F.); (D.L.)
| | - Irma Trilli
- Odontomastotologic Clinic, University of Chieti “G. d’Annunzio”, 66100 Chieti, Italy;
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Emergency and Organ Tranplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (G.I.); (L.R.)
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322
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Feingold B, Berman P, Moninger A, Huston A, Stinner B, West SC, Rose‐Felker K, Zinn MD, Miller SA, Michaels MG. Responsiveness to second and third dose of mRNA COVID-19 vaccination in adolescent and young adult heart transplant recipients. Pediatr Transplant 2022; 26:e14272. [PMID: 35340096 PMCID: PMC9115437 DOI: 10.1111/petr.14272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Third-dose mRNA COVID-19 vaccine is currently recommended in the United States for SOT recipients based in part on data showing diminished immune response, including Ab production, after a two-dose regimen. Data on vaccine response in adolescent and young adult SOT recipients are limited, including no data reported on third-dose responsiveness. METHODS Results of serologic testing in a convenience sample of 28 vaccinated adolescent and young adult HT recipients at a single institution were collected from the medical record and summarized. RESULTS At a median of 98.5 days (IQR 59-150) after second dose, 17 (61%) had an Ab response. Among 12 who had serology before and after third-dose vaccination, four of seven who were negative prior to third dose became positive at a median of 34 days (IQR 31-39.5) following third dose. No myocarditis, acute rejection, graft dysfunction, graft loss, or deaths were observed. CONCLUSIONS These findings support recommendations for the routine administration of three doses of mRNA vaccines in adolescent and young adult HT recipients and show a potential subpopulation in whom the fourth dose should be contemplated.
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Affiliation(s)
- Brian Feingold
- Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Clinical and Translational ScienceUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Pamela Berman
- Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Allison Moninger
- Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Allison Huston
- Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Brenda Stinner
- Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Shawn C. West
- Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Kirsten Rose‐Felker
- Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Matthew D. Zinn
- Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Susan A. Miller
- Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
| | - Marian G. Michaels
- Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA,Hillman Center for Pediatric TransplantationUPMC Children’s Hospital of PittsburghPittsburghPennsylvaniaUSA
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Rodriguez-Morales AJ, León-Figueroa DA, Romaní L, McHugh TD, Leblebicioglu H. Vaccination of children against COVID-19: the experience in Latin America. Ann Clin Microbiol Antimicrob 2022; 21:14. [PMID: 35337354 PMCID: PMC8949833 DOI: 10.1186/s12941-022-00505-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 12/18/2022] Open
Affiliation(s)
- Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia. .,Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. .,School of Medicine, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia.
| | - Darwin A León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru.,Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo, Peru.,Centro de Investigación en Atención Primaria en Salud, Universidad Peruana Cayetano Heredia, Lima, Peru.,Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luccio Romaní
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru.,Centro de Investigación en Atención Primaria en Salud, Universidad Peruana Cayetano Heredia, Lima, Peru.,Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Timothy D McHugh
- UCL Centre for Clinical Microbiology, Royal Free Campus, UCL, London, UK
| | - Hakan Leblebicioglu
- Department of Infectious Diseases, VM Medicalpark Samsun Hospital, Samsun, Turkey
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324
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Walter EB, Talaat KR, Gurtman A. More on BNT162b2 Covid-19 Vaccine in Children 5 to 11 Years of Age. Reply. N Engl J Med 2022; 386:1192-1193. [PMID: 35235724 DOI: 10.1056/nejmc2201556] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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325
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Fang E, Liu X, Li M, Zhang Z, Song L, Zhu B, Wu X, Liu J, Zhao D, Li Y. Advances in COVID-19 mRNA vaccine development. Signal Transduct Target Ther 2022; 7:94. [PMID: 35322018 PMCID: PMC8940982 DOI: 10.1038/s41392-022-00950-y] [Citation(s) in RCA: 186] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/10/2022] [Accepted: 03/03/2022] [Indexed: 12/15/2022] Open
Abstract
To date, the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has determined 399,600,607 cases and 5,757,562 deaths worldwide. COVID-19 is a serious threat to human health globally. The World Health Organization (WHO) has declared COVID-19 pandemic a major public health emergency. Vaccination is the most effective and economical intervention for controlling the spread of epidemics, and consequently saving lives and protecting the health of the population. Various techniques have been employed in the development of COVID-19 vaccines. Among these, the COVID-19 messenger RNA (mRNA) vaccine has been drawing increasing attention owing to its great application prospects and advantages, which include short development cycle, easy industrialization, simple production process, flexibility to respond to new variants, and the capacity to induce better immune response. This review summarizes current knowledge on the structural characteristics, antigen design strategies, delivery systems, industrialization potential, quality control, latest clinical trials and real-world data of COVID-19 mRNA vaccines as well as mRNA technology. Current challenges and future directions in the development of preventive mRNA vaccines for major infectious diseases are also discussed.
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Affiliation(s)
- Enyue Fang
- National Institute for Food and Drug Control, Beijing, 102629, China
- Wuhan Institute of Biological Products, Co., Ltd., Wuhan, 430207, China
| | - Xiaohui Liu
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Miao Li
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Zelun Zhang
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Lifang Song
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Baiyu Zhu
- Texas A&M University, College Station, TX, 77843, USA
| | - Xiaohong Wu
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Jingjing Liu
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Danhua Zhao
- National Institute for Food and Drug Control, Beijing, 102629, China
| | - Yuhua Li
- National Institute for Food and Drug Control, Beijing, 102629, China.
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326
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Yamashita E, Takita M, Kami M. Time-Dependent Changes in Death Reports and the Sex Ratio in the Safety Surveillance of SARS-CoV-2 Vaccination in Japan, the United States, and European Countries. Cureus 2022; 14:e23380. [PMID: 35475057 PMCID: PMC9022046 DOI: 10.7759/cureus.23380] [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] [Accepted: 03/22/2022] [Indexed: 11/20/2022] Open
Abstract
The national safety surveillance of vaccines is a fundamental measure to ensure vaccination safety and maintain transparency and public trust. Our previous study revealed an early increase in death reports after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in Japanese surveillance despite our hypothesis that no time-dependent variations in the number of death reports would be seen if the vaccination is not related to serious adverse events. This study is an extensive investigation to determine whether the number of death reports varied consistently over time after vaccination in the older population in Japan, the US, and European countries. We collected the death reports after BNT162b2 mRNA vaccination in individuals aged 65 years or older using the open databases in Japan, the US (Vaccine Adverse Event Reporting System, VAERS), and European countries (EudraVigilance). We observed an early increase of death reports on Day 2 after the vaccination in all three databases. The female-to-male ratio was also assessed and showed a certain degree of time-dependence (R2 of linear regression 0.54, p =0.01) in Japan but not in the US and European countries. The findings suggest the existence of unknown predictors of the adverse events of the SARS-CoV-2 vaccination, especially for the older Japanese population. The continuous and careful monitoring safety aspects of the vaccines are warranted.
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327
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Das SK, Paul M, Behera BC, Thatoi H. Current status of COVID-19 vaccination: safety and liability concern for children, pregnant and lactating women. Expert Rev Vaccines 2022; 21:825-842. [PMID: 35313785 DOI: 10.1080/14760584.2022.2056025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION : Since its inception, Coronavirus disease-19 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has claimed a significant number of lives around the world. AREA COVERED : COVID-19 vaccine development involves several vaccine platforms, including traditional live-attenuated or killed viral particles, viral vectors or DNA, and mRNA-based vaccines. The efficacy and effectiveness (EV) of these vaccines must be assessed in order to determine the extent to which they can protect us against infection. Despite the fact that some affluent countries attempted to vaccinate the majority of their inhabitants, children and pregnant women were first excluded. EXPERT OPINION : While the severity of COVID-19 is less severe in children, the COVID-19-related complications are more severe.SARS-CoV-2 infection is also dangerous for pregnant women. The key to limiting disease spread is early discovery, isolation, and the development of safe and efficient vaccinations. As a result, the purpose of this study is to highlight the current development of various COVID-19 vaccine platforms for different groups of people at higher risk of COVID-19, with a special focus on children, pregnant and lactating women, as well as structural and pathogenicity elements of SARS CoV-2.
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Affiliation(s)
- Swagat Kumar Das
- Department of Biotechnology, College of Engineering and Technology, Biju Patnaik University of Technology, Bhubaneswar, Odisha, India-751001
| | - Manish Paul
- Department of Biotechnology, Maharaja Sriram Chandra Bhanja Deo University, Sri Ram Chandra Vihar, Baripada, Odisha, India-757003
| | - Bikash Chandra Behera
- School of Biological Sciences, National Institute of Science Education and Research, Bhubaneswar-752050
| | - Hrudayanath Thatoi
- Department of Biotechnology, Maharaja Sriram Chandra Bhanja Deo University, Sri Ram Chandra Vihar, Baripada, Odisha, India-757003
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328
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Fowlkes AL, Yoon SK, Lutrick K, Gwynn L, Burns J, Grant L, Phillips AL, Ellingson K, Ferraris MV, LeClair LB, Mathenge C, Yoo YM, Thiese MS, Gerald LB, Solle NS, Jeddy Z, Odame-Bamfo L, Mak J, Hegmann KT, Gerald JK, Ochoa JS, Berry M, Rose S, Lamberte JM, Madhivanan P, Pubillones FA, Rai RP, Dunnigan K, Jones JT, Krupp K, Edwards LJ, Bedrick EJ, Sokol BE, Lowe A, McLeland-Wieser H, Jovel KS, Fleary DE, Khan SM, Poe B, Hollister J, Lopez J, Rivers P, Beitel S, Tyner HL, Naleway AL, Olsho LE, Caban-Martinez AJ, Burgess JL, Thompson MG, Gaglani M. Effectiveness of 2-Dose BNT162b2 (Pfizer BioNTech) mRNA Vaccine in Preventing SARS-CoV-2 Infection Among Children Aged 5-11 Years and Adolescents Aged 12-15 Years - PROTECT Cohort, July 2021-February 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:422-428. [PMID: 35298453 PMCID: PMC8942308 DOI: 10.15585/mmwr.mm7111e1] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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329
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BNT162b2-Impfstoff gegen SARS-CoV-2 effektiv bei Kindern. Pneumologie 2022. [DOI: 10.1055/a-1697-9755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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330
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COVID-19 Vaccine Hesitancy among Adolescents: Cross-Sectional School Survey in Four Chinese Cities Prior to Vaccine Availability. Vaccines (Basel) 2022; 10:vaccines10030452. [PMID: 35335083 PMCID: PMC8952375 DOI: 10.3390/vaccines10030452] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023] Open
Abstract
To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy (“not sure”) and resistance (“do not want it”). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40–1.88; OR = 1.81; 95% CI: 1.44–2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14–1.55; OR = 1.57; 95% CI: 1.25–1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50–1.97; OR = 3.57; 95% CI: 2.86–4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56–4.11; OR = 27.68; 95% CI: 21.81–35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72–0.98; OR = 0.66; 95% CI: 0.52–0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09–1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68–0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73–0.96), and having doctors’ recommendation (OR = 0.86; 95% CI: 0.76–0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.
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331
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Li M, Zu J, Zhang Y, Ma L, Shen M, Li Z, Ji F. COVID-19 epidemic in New York City: development of an age group-specific mathematical model to predict the outcome of various vaccination strategies. Virol J 2022; 19:43. [PMID: 35292054 PMCID: PMC8922400 DOI: 10.1186/s12985-022-01771-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Since December 14, 2020, New York City (NYC) has started the first batch of COVID-19 vaccines. However, the shortage of vaccines is currently an inevitable problem. Therefore, optimizing the age-specific COVID-19 vaccination is an important issue that needs to be addressed as a priority. Objective Combined with the reported COVID-19 data in NYC, this study aimed to construct a mathematical model with five age groups to estimate the impact of age-specific vaccination on reducing the prevalence of COVID-19. Methods We proposed an age-structured mathematical model and estimated the unknown parameters based on the method of Markov Chain Monte Carlo (MCMC). We also calibrated our model by using three different types of reported COVID-19 data in NYC. Moreover, we evaluated the reduced cumulative number of deaths and new infections with different vaccine allocation strategies. Results Compared with the current vaccination strategy in NYC, if we gradually increased the vaccination coverage rate for only one age groups from March 1, 2021 such that the vaccination coverage rate would reach to 40% by June 1, 2021, then as of June 1, 2021, the cumulative deaths in the 75–100 age group would be reduced the most, about 72 fewer deaths per increased 100,000 vaccinated individuals, and the cumulative new infections in the 0–17 age group would be reduced the most, about 21,591 fewer new infections per increased 100,000 vaccinated individuals. If we gradually increased the vaccination coverage rate for two age groups from March 1, 2021 such that the vaccination coverage rate would reach to 40% by June 1, 2021, then as of June 1, 2021, the cumulative deaths in the 65–100 age group would be reduced the most, about 36 fewer deaths per increased 100,000 vaccinated individuals, and the cumulative new infections in the 0–44 age group would be reduced the most, about 17,515 fewer new infections per increased 100,000 vaccinated individuals. In addition, if we had an additional 100,000 doses of vaccine for 0–17 and 75–100 age groups as of June 1, 2021, then the allocation of 80% to the 0–17 age group and 20% to the 75–100 age group would reduce the maximum numbers of new infections and deaths simultaneously in NYC. Conclusions The COVID-19 burden including deaths and new infections would decrease with increasing vaccination coverage rate. Priority vaccination to the elderly and adolescents would minimize both deaths and new infections. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01771-9.
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Affiliation(s)
- Miaolei Li
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, People's Republic of China
| | - Jian Zu
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, People's Republic of China.
| | - Yue Zhang
- Department of Internal Medicine, The Second Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, 710004, China
| | - Le Ma
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xi Wu Road, Xi'an, 710004, Shaanxi Province, People's Republic of China
| | - Mingwang Shen
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, 710006, China
| | - Zongfang Li
- National and Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.,Key Laboratory of Environment and Genes Related To Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, 710006, China
| | - Fanpu Ji
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xi Wu Road, Xi'an, 710004, Shaanxi Province, People's Republic of China. .,National and Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China. .,Key Laboratory of Environment and Genes Related To Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, 710006, China. .,Shaanxi Clinical Research Center of Infectious Diseases, Xi'an, 710006, China.
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332
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Torres-Estrella CU, Reyes-Montes MDR, Duarte-Escalante E, Sierra Martínez M, Frías-De-León MG, Acosta-Altamirano G. Vaccines Against COVID-19: A Review. Vaccines (Basel) 2022; 10:414. [PMID: 35335046 PMCID: PMC8953736 DOI: 10.3390/vaccines10030414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 12/13/2022] Open
Abstract
As a result of the COVID-19 pandemic, various joint efforts have been made to support the creation of vaccines. Different projects have been under development, of which some are in the clinical evaluation stage and others in are in phase III with positive results. The aim of this paper was to describe the current situation of the development and production of vaccines available to the population to facilitate future research and continue developing and proposing ideas for the benefit of the population. So, we carried out a systematic review using databases such as PubMed, ScienceDirect, SciELO, and MEDLINE, including keywords such as "vaccines," "COVID-19," and "SARS-CoV-2". We reviewed the development and production of the anti-COVID vaccine and its different platforms, the background leading to the massive development of these substances, and the most basic immune aspects for a better understanding of their physiological activity and the immune response in those who receive the vaccine. We also analyzed immunization effects in populations with any medical or physiological conditions (such as immunosuppression, people with comorbidities, and pregnancy), as well as the response to immunization with heterologous vaccines and the hybrid immunity (the combination of natural immunity to SARS-CoV-2 with immunity generated by the vaccine). Likewise, we address the current situation in Mexico and its role in managing the vaccination process against SARS-CoV-2 at the national and international levels. There are still many clinical and molecular aspects to be described, such as the duration of active immunity and the development of immunological memory, to mention some of the most important ones. However, due to the short time since the global vaccination roll-out and that it has been progressive (not counting children and people with medical conditions), it is premature to say whether a second vaccination schedule will be necessary for the near future. Thus, it is essential to continue with health measures.
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Affiliation(s)
- Carlos U. Torres-Estrella
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ciudad de México PC 56530, Mexico; (C.U.T.-E.); (M.S.M.); (M.G.F.-D.-L.)
- Unidad Profesional Interdisciplinaria de Biotecnología, Instituto Politécnico Nacional (IPN), Ciudad de México PC 07340, Mexico
| | - María del Rocío Reyes-Montes
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México PC 04510, Mexico; (M.d.R.R.-M.); (E.D.-E.)
| | - Esperanza Duarte-Escalante
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México PC 04510, Mexico; (M.d.R.R.-M.); (E.D.-E.)
| | - Mónica Sierra Martínez
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ciudad de México PC 56530, Mexico; (C.U.T.-E.); (M.S.M.); (M.G.F.-D.-L.)
| | - María Guadalupe Frías-De-León
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ciudad de México PC 56530, Mexico; (C.U.T.-E.); (M.S.M.); (M.G.F.-D.-L.)
| | - Gustavo Acosta-Altamirano
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ciudad de México PC 56530, Mexico; (C.U.T.-E.); (M.S.M.); (M.G.F.-D.-L.)
- Escuela Superior de Medicina, Instituto Politécnico Nacional (IPN), Ciudad de México PC 11340, Mexico
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333
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Gao P, Cai S, Liu Q, Du M, Liu J, Liu M. Effectiveness and Safety of SARS-CoV-2 Vaccines among Children and Adolescents: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:421. [PMID: 35335053 PMCID: PMC8953823 DOI: 10.3390/vaccines10030421] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 01/14/2023] Open
Abstract
Background: The proportion of children and adolescents with COVID-19 had gradually increased according to data reported by WHO. However, there was no meta-analysis of effectiveness and safety of SARS-CoV-2 vaccines in children and adolescents. We aimed to provide investigation-based medical evidence and reference recommendations for children and adolescents in regard to SARS-CoV-2 vaccines. Methods: We systematically searched PubMed, Embase, and Web of Science from inception to 5 January 2022. RCTs and observational studies that examined the effectiveness and safety were included. Results: A total of 13 eligible studies were included for analysis. For the first dose, the effectiveness of SARS-CoV-2 vaccines against SARS-CoV-2 infection and COVID-19 was 88.5% (95% CI:15.7−98.4%, p = 0.033) and 84.3% (95% CI: 66.6−92.6%, p < 0.001) separately. For the second dose, the effectiveness against SARS-CoV-2 infection and COVID-19 was 91.6% (95% CI: 37.8−99.5%, p = 0.083) and 92.7 (95% CI: 82.2−97.0, p < 0.001) separately. Injection-site pain, fatigue, headache, anorexia, and axillary swelling were the top five adverse events after the first dose of SARS-CoV-2 vaccines. Fatigue, injection-site pain, headache, chills, and myalgia/muscle pain were the top five adverse events after the second dose of SARS-CoV-2 vaccines. Conclusions: SARS-CoV-2 vaccines had good effectiveness and safety in children and adolescents. We suggest that children and adolescents should get vaccinated as soon as possible to protect themselves and slow the spread of the pandemic.
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Affiliation(s)
- Peng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (P.G.); (Q.L.); (M.D.); (J.L.)
| | - Shan Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China;
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (P.G.); (Q.L.); (M.D.); (J.L.)
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (P.G.); (Q.L.); (M.D.); (J.L.)
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (P.G.); (Q.L.); (M.D.); (J.L.)
- Institute for Global Health and Development, Peking University, Beijing 100871, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (P.G.); (Q.L.); (M.D.); (J.L.)
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334
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Esposito S. Manifesto of the pediatricians of Emilia-Romagna region, Italy, in favor of vaccination against COVID in children 5–11 years old. Ital J Pediatr 2022; 48:40. [PMID: 35248142 PMCID: PMC8898060 DOI: 10.1186/s13052-022-01229-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/15/2022] [Indexed: 01/12/2023] Open
Abstract
Background Following the authorization by the regulatory authorities of vaccination against COVID for children aged between 5 and 11, in Emilia-Romagna Region, Italy, the pediatricians of the Italian Society of Pediatrics (SIP), the Italian Society of Neonatology (SIN), the Cultural Association of Pediatrics, the Italian Federation of Pediatricians (FIMP) and the Italian Union of Family Pediatricians (SIMPeF), who work in the hospital and in the territorial setting, have made a univocal and convinced appeal in favor of vaccination also in this age group. Main findings In order to contribute to a conscious choice, on the part of parents, based on exhaustive and correct information, a 24-point manifesto was developed. The manifesto showed that vaccines against COVID are the most effective and safest tool we have to counter the spread of SARS-CoV-2 and vaccination against COVID is a right of children just as it is for adults. Children between 5 and 11 years are not protected from the virus and a large part of the newly infected is this age. Although SARS-CoV-2 infection is certainly more benign in children, in some cases it can cause a serious pathology and long COVID. The stress caused by the pandemic, the prolonged closure of schools and the interruption of sports and recreational activities have had a devastating effect on the mental health of children and on the development of their personality. Vaccinating children against COVID serves to protect them from severe forms of disease and long COVID, allowing them to attend school face-to-face and lead a normal social life. The safety of vaccinatin is very high and vaccines against COVID have no influence on fertility nor can they cause developmental or growth side effects. Conclusions The manifesto highlighted that the vaccine against COVID for children aged between 5 and 11 is effective and safe and represents an extraordinary gift for safeguarding health of the younger ones. The invitation, therefore, to parents is to have their children vaccinated against COVID as early as possible.
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Klein NP, Stockwell MS, Demarco M, Gaglani M, Kharbanda AB, Irving SA, Rao S, Grannis SJ, Dascomb K, Murthy K, Rowley EA, Dalton AF, DeSilva MB, Dixon BE, Natarajan K, Stenehjem E, Naleway AL, Lewis N, Ong TC, Patel P, Konatham D, Embi PJ, Reese SE, Han J, Grisel N, Goddard K, Barron MA, Dickerson M, Liao IC, Fadel WF, Yang DH, Arndorfer J, Fireman B, Griggs EP, Valvi NR, Hallowell C, Zerbo O, Reynolds S, Ferdinands J, Wondimu MH, Williams J, Bozio CH, Link-Gelles R, Azziz-Baumgartner E, Schrag SJ, Thompson MG, Verani JR. Effectiveness of COVID-19 Pfizer-BioNTech BNT162b2 mRNA Vaccination in Preventing COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Nonimmunocompromised Children and Adolescents Aged 5-17 Years - VISION Network, 10 States, April 2021-January 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:352-358. [PMID: 35239634 PMCID: PMC8893336 DOI: 10.15585/mmwr.mm7109e3] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The efficacy of the BNT162b2 (Pfizer-BioNTech) vaccine against laboratory-confirmed COVID-19 exceeded 90% in clinical trials that included children and adolescents aged 5-11, 12-15, and 16-17 years (1-3). Limited real-world data on 2-dose mRNA vaccine effectiveness (VE) in persons aged 12-17 years (referred to as adolescents in this report) have also indicated high levels of protection against SARS-CoV-2 (the virus that causes COVID-19) infection and COVID-19-associated hospitalization (4-6); however, data on VE against the SARS-CoV-2 B.1.1.529 (Omicron) variant and duration of protection are limited. Pfizer-BioNTech VE data are not available for children aged 5-11 years. In partnership with CDC, the VISION Network* examined 39,217 emergency department (ED) and urgent care (UC) encounters and 1,699 hospitalizations† among persons aged 5-17 years with COVID-19-like illness across 10 states during April 9, 2021-January 29, 2022,§ to estimate VE using a case-control test-negative design. Among children aged 5-11 years, VE against laboratory-confirmed COVID-19-associated ED and UC encounters 14-67 days after dose 2 (the longest interval after dose 2 in this age group) was 46%. Among adolescents aged 12-15 and 16-17 years, VE 14-149 days after dose 2 was 83% and 76%, respectively; VE ≥150 days after dose 2 was 38% and 46%, respectively. Among adolescents aged 16-17 years, VE increased to 86% ≥7 days after dose 3 (booster dose). VE against COVID-19-associated ED and UC encounters was substantially lower during the Omicron predominant period than the B.1.617.2 (Delta) predominant period among adolescents aged 12-17 years, with no significant protection ≥150 days after dose 2 during Omicron predominance. However, in adolescents aged 16-17 years, VE during the Omicron predominant period increased to 81% ≥7 days after a third booster dose. During the full study period, including pre-Delta, Delta, and Omicron predominant periods, VE against laboratory-confirmed COVID-19-associated hospitalization among children aged 5-11 years was 74% 14-67 days after dose 2, with wide CIs that included zero. Among adolescents aged 12-15 and 16-17 years, VE 14-149 days after dose 2 was 92% and 94%, respectively; VE ≥150 days after dose 2 was 73% and 88%, respectively. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations, including a booster dose for those aged 12-17 years.
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Maciel E, Fernandez M, Calife K, Garrett D, Domingues C, Kerr L, Dalcolmo M. The SARS-CoV-2 vaccination campaign in Brazil and the invisibility of science evidences. CIENCIA & SAUDE COLETIVA 2022; 27:951-956. [PMID: 35293472 DOI: 10.1590/1413-81232022273.21822021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 01/05/2022] [Indexed: 11/21/2022] Open
Abstract
This paper reflects on the vaccination campaign against COVID-19 in Brazil in light of the consideration of scientific evidence in the decision-making process. Brazil has one of the largest and most complete vaccination programs in the world, the National Immunization Program (Programa Nacional de Imunizações or PNI). Unfortunately, in the current context, with the political interference of the federal government, the PNI lost its role in conducting the vaccination campaign against COVID-19. Despite being a vaccination campaign with a lot of potential and one of the most accepted by the population among countries in the world, it presented many problems and left several gaps in the Brazilian scenario. In this sense, it is essential that the quality scientific evidence produced during this period can guide a constant remodeling of the vaccination strategy. Four points deserve to be highlighted: 1) the interval between doses; 2) the interchangeability between vaccines; 3) vaccination in children and adolescentes; and 4) the need for better evidence to define the vaccination strategy in certain groups and age groups.
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Affiliation(s)
- Ethel Maciel
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo. Av. Marechal Campos 1.468, Maruípe. 29040-091 Vitória ES Brasil.
| | - Michelle Fernandez
- Instituto de Ciência Política, Universidade de Brasília. Brasília DF Brasil
| | | | | | | | - Ligia Kerr
- Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará. Fortaleza CE Brasil
| | - Margareth Dalcolmo
- Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz. Rio de Janeiro RJ Brasil
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337
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Yamamoto S, Arita Y, Ogasawara N. Myocarditis Following the Second Dose of COVID-19 Vaccination in a Japanese Adolescent. Cureus 2022; 14:e23474. [PMID: 35475062 PMCID: PMC9035236 DOI: 10.7759/cureus.23474] [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] [Accepted: 03/25/2022] [Indexed: 02/01/2023] Open
Abstract
As COVID-19 vaccines continue to be deployed worldwide, countries are now planning to vaccinate their pediatric populations as well. However, several vaccine-related adverse events, including myocarditis, have been reported. Although the incidence of myocarditis after BNT162b2 vaccination is low, it is higher, particularly after receiving the second dose, among young male recipients. A 13-year-old male adolescent presented with chest pain after the second dose of the BNT162b2 vaccination. Electrocardiography, echocardiography, cardiac magnetic resonance imaging, and blood examinations were consistent with myocarditis. He was treated conservatively because his symptoms were relatively mild. In Japan, it is expected that the chances of diagnosing vaccine-related myocarditis will increase as more children are getting vaccinated. Our case report raises concerns to physicians that the COVID-19 vaccination may cause rare cases of myocarditis, which must always be considered as a differential diagnosis.
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Affiliation(s)
- Shohei Yamamoto
- Department of Cardiology, Japan Community Healthcare Organization Osaka Hospital, Osaka, JPN
| | - Yoh Arita
- Department of Cardiology, Japan Community Healthcare Organization Osaka Hospital, Osaka, JPN
| | - Nobuyuki Ogasawara
- Department of Cardiology, Japan Community Healthcare Organization Osaka Hospital, Osaka, JPN
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338
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Consensus on COVID-19 Vaccination in Pediatric Oncohematological Patients, on Behalf of Infectious Working Group of Italian Association of Pediatric Hematology Oncology. J Clin Med 2022; 11:jcm11051235. [PMID: 35268326 PMCID: PMC8911119 DOI: 10.3390/jcm11051235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/05/2022] [Accepted: 02/22/2022] [Indexed: 02/07/2023] Open
Abstract
Vaccines represent the best tool to prevent the severity course and fatal consequences of the pandemic by the new Coronavirus 2019 infection (SARS-CoV-2). Considering the limited data on vaccination of pediatric oncohematological patients, we developed a Consensus document to support the Italian pediatric hematological oncological (AIEOP) centers in a scientifically correct communication with families and patients and to promote vaccination. The topics of the Consensus were: SARS-CoV-2 infection and disease (COVID-19) in the pediatric subjects; COVID-19 vaccines (type, schedule); who and when to vaccinate; contraindications and risk of serious adverse events; rare adverse events; third dose and vaccination after COVID-19; and other general prevention measures. Using the Delphi methodology for Consensus, 21 statements and their corresponding rationale were elaborated and discussed with the representatives of 31 centers, followed by voting. A high grade of Consensus was obtained on topics such as the potential risk of severe COVID-19 outcome in pediatric oncohematological patients, the need for vaccination as a preventative measure, the type, schedule and booster dose of vaccine, the eligibility of the patients for vaccination, and the timing, definition, and management of contraindications and serious adverse events, and other general prevention measures. All 21 of the statements were approved. This consensus document highlights that children and adolescents affected by hematological and oncological diseases are a fragile category. Vaccination plays an important role to prevent COVID-19, to permit the regular administration of chemotherapy or other treatments, to perform control visits and hospital admissions, and to prevent treatment delays.
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339
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Taina-González L, de la Fuente M. The Potential of Nanomedicine to Unlock the Limitless Applications of mRNA. Pharmaceutics 2022; 14:460. [PMID: 35214191 PMCID: PMC8879057 DOI: 10.3390/pharmaceutics14020460] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 01/27/2023] Open
Abstract
The year 2020 was a turning point in the way society perceives science. Messenger RNA (mRNA) technology finally showed and shared its potential, starting a new era in medicine. However, there is no doubt that commercialization of these vaccines would not have been possible without nanotechnology, which has finally answered the long-term question of how to deliver mRNA in vivo. The aim of this review is to showcase the importance of this scientific milestone for the development of additional mRNA therapeutics. Firstly, we provide a full description of the marketed vaccine formulations and disclose LNPs' pharmaceutical properties, including composition, structure, and manufacturing considerations Additionally, we review different types of lipid-based delivery technologies currently in preclinical and clinical development, namely lipoplexes and cationic nanoemulsions. Finally, we highlight the most promising clinical applications of mRNA in different fields such as vaccinology, immuno-oncology, gene therapy for rare genetic diseases and gene editing using CRISPR Cas9.
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Affiliation(s)
- Laura Taina-González
- Nano-Oncology and Translational Therapeutics Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, 15706 Santiago de Compostela, Spain;
- Universidad de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - María de la Fuente
- Nano-Oncology and Translational Therapeutics Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, 15706 Santiago de Compostela, Spain;
- Cancer Network Research (CIBERONC), 28029 Madrid, Spain
- DIVERSA Technologies, 15782 Santiago de Compostela, Spain
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340
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Le T, Sun C, Chang J, Zhang G, Yin X. mRNA Vaccine Development for Emerging Animal and Zoonotic Diseases. Viruses 2022; 14:401. [PMID: 35215994 PMCID: PMC8877136 DOI: 10.3390/v14020401] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023] Open
Abstract
In the prevention and treatment of infectious diseases, mRNA vaccines hold great promise because of their low risk of insertional mutagenesis, high potency, accelerated development cycles, and potential for low-cost manufacture. In past years, several mRNA vaccines have entered clinical trials and have shown promise for offering solutions to combat emerging and re-emerging infectious diseases such as rabies, Zika, and influenza. Recently, the successful application of mRNA vaccines against COVID-19 has further validated the platform and opened the floodgates to mRNA vaccine's potential in infectious disease prevention, especially in the veterinary field. In this review, we describe our current understanding of the mRNA vaccines and the technologies used for mRNA vaccine development. We also provide an overview of mRNA vaccines developed for animal infectious diseases and discuss directions and challenges for the future applications of this promising vaccine platform in the veterinary field.
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Affiliation(s)
- Ting Le
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
| | - Chao Sun
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
| | - Jitao Chang
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
| | - Guijie Zhang
- Departments of Animal Science, School of Agriculture, Ningxia University, Yinchuan 750021, China
| | - Xin Yin
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
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341
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Evolution of SARS-CoV-2 IgG Seroprevalence in Children and Factors Associated with Seroconversion: Results from a Multiple Time-Points Study in Friuli-Venezia Giulia Region, Italy. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020246. [PMID: 35204966 PMCID: PMC8870333 DOI: 10.3390/children9020246] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 12/26/2022]
Abstract
Data on the effective burden of the SARS-CoV-2 pandemic in the pediatric population are limited. We aimed at assessing the prevalence of SARS-CoV-2 IgG antibodies in children at three subsequent time-points. The study was conducted between January 2021 and July 2021 among children referring to the Research Institute for Maternal and Child Health “Burlo Garofolo” in Trieste, a referral regional hospital in Friuli Venezia Giulia, Italy. A multivariate analysis was conducted to assess factors independently associated with seroconversion. A total of 594 children were included. Anti-SARS-CoV-2 trimeric Spike protein IgG antibodies were found in 32 (15.4%) children tested in April-May and in 20 (11.8%) in June–July 2021, compared with 24 (11.1%) of those tested in January–February 2021 (p = 0.37, Armitage exact test for trend over time p = 0.76). A subgroup analysis and a multivariate logistic regression analysis were performed considering sociodemographic, clinical, and historical variables. Three categories of children showed statistically significant increased odds of positive anti-SARS-CoV-2 IgG antibodies: children previously positive to a nasopharyngeal swab (AdjOR 15.41, 95%CI 3.44–69.04, p < 0.001), cohabitant with a person with an history of a previous positive nasopharyngeal swab (AdjOR 9.95, 95%CI 5.35–18.52, p < 0.001), and children with a foreign citizenship (AdjOR 2.4, 95%CI 1.05–5.70, p = 0.002). The study suggests that seroprevalence studies may be of limited help in estimating the prevalence of the COVID-19 pandemic in children. Further studies are needed to identify other markers of previous SARS-CoV-2 infection in children, such as CD4+ T cells or memory B-cells.
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342
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Affiliation(s)
| | - Nan Liu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Hou-Wei Du
- Fujian Medical University Union Hospital, Fuzhou, China
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343
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Williams S, Michie S, Pagel C, Squires A. The UK is an international outlier in its approach to covid in children. BMJ 2022; 376:o327. [PMID: 35140072 DOI: 10.1136/bmj.o327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Simon Williams
- School of Psychology, Swansea University
- School of Psychology, University of Sussex
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344
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Giardina J, Bilinski A, Fitzpatrick MC, Kendall EA, Linas BP, Salomon J, Ciaranello AL. Model-Estimated Association Between Simulated US Elementary School-Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels. JAMA Netw Open 2022; 5:e2147827. [PMID: 35157056 PMCID: PMC8845023 DOI: 10.1001/jamanetworkopen.2021.47827] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/17/2021] [Indexed: 12/20/2022] Open
Abstract
Importance With recent surges in COVID-19 incidence and vaccine authorization for children aged 5 to 11 years, elementary schools face decisions about requirements for masking and other mitigation measures. These decisions require explicit determination of community objectives (eg, acceptable risk level for in-school SARS-CoV-2 transmission) and quantitative estimates of the consequences of changing mitigation measures. Objective To estimate the association between adding or removing in-school mitigation measures (eg, masks) and COVID-19 outcomes within an elementary school community at varying student vaccination and local incidence rates. Design, Setting, and Participants This decision analytic model used an agent-based model to simulate SARS-CoV-2 transmission within a school community, with a simulated population of students, teachers and staff, and their household members (ie, immediate school community). Transmission was evaluated for a range of observed local COVID-19 incidence (0-50 cases per 100 000 residents per day, assuming 33% of all infections detected). The population used in the model reflected the mean size of a US elementary school, including 638 students and 60 educators and staff members in 6 grades with 5 classes per grade. Exposures Variant infectiousness (representing wild-type virus, Alpha variant, and Delta variant), mitigation effectiveness (0%-100% reduction in the in-school secondary attack rate, representing increasingly intensive combinations of mitigations including masking and ventilation), and student vaccination levels were varied. Main Outcomes and Measures The main outcomes were (1) probability of at least 1 in-school transmission per month and (2) mean increase in total infections per month among the immediate school community associated with a reduction in mitigation; multiple decision thresholds were estimated for objectives associated with each outcome. Sensitivity analyses on adult vaccination uptake, vaccination effectiveness, and testing approaches (for selected scenarios) were conducted. Results With student vaccination coverage of 70% or less and moderate assumptions about mitigation effectiveness (eg, masking), mitigation could only be reduced when local case incidence was 14 or fewer cases per 100 000 residents per day to keep the mean additional cases associated with reducing mitigation to 5 or fewer cases per month. To keep the probability of any in-school transmission to less than 50% per month, the local case incidence would have to be 4 or fewer cases per 100 000 residents per day. Conclusions and Relevance In this study, in-school mitigation measures (eg, masks) and student vaccinations were associated with substantial reductions in transmissions and infections, but the level of reduction varied across local incidence. These findings underscore the potential role for responsive plans that deploy mitigation strategies based on local COVID-19 incidence, vaccine uptake, and explicit consideration of community objectives.
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Affiliation(s)
- John Giardina
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alyssa Bilinski
- Department of Health Services, Policy, and Practice, Department of Biostatistics, Brown School of Public Health, Providence, Rhode Island
| | - Meagan C. Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore
| | - Emily A. Kendall
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin P. Linas
- Boston University Schools of Medicine and Public Health, Boston Medical Center, Boston, Massachusetts
| | - Joshua Salomon
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California
| | - Andrea L. Ciaranello
- Division of Infectious Disease and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
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345
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Nonvignon J, Owusu R, Asare B, Adjagba A, Aund W, Karene Hoi Ting Y, Naa Korkoi Azeez J, Gyansa-Lutterodt M, Gulbi G, Amponsa-Achiano K, Dadzie F, Armah GE, Brenzel L, Hutubessy R, Resch SC. Estimating the cost of COVID-19 vaccine deployment and introduction in Ghana using the CVIC Tool. Vaccine 2022; 40:1879-1887. [PMID: 35190206 PMCID: PMC8813551 DOI: 10.1016/j.vaccine.2022.01.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/11/2022]
Abstract
Current COVID-19 vaccine supply market means LMICs will have to rely on a combination of different sources/types of vaccines to meet their demand. Deployment of COVID-19 vaccine plans in Ghana will cost $348.7–$436.1 million for coverage of 17.5 million of eligible Ghanaians. Vaccine cost constitute 78–83% of total cost whereas the total vaccination cost is 0.48–0.60% of the country’s 2020 GDP. The WHO-UNICEF CVIC tool is useful for comprehensive COVID-19 vaccine deployment costing and resource planning.
Background This study estimated cost of COVID-19 vaccine introduction and deployment in Ghana. Methods Using the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool Ghana’s Ministry of Health Technical Working Group for Health Technology Assessment (TWG-HTA) in collaboration with School of Public Health, University of Ghana, organized an initial two-day workshop that brought together partners to deliberate and agree on input parameters to populate the CVIC tool. A further 2–3 days validation with the Expanded Program of Immunization (EPI) and other partners to finalize the analysis was done. Three scenarios, with different combinations of vaccine products and delivery modalities, as well as time period were analyzed. The scenarios included AstraZeneca (40%), Johnson & Johnson (J&J) (30%), Moderna, Pfizer, and Sputnik V at 10% each; with primary schedule completed by second half of 2021 (Scenario 1); AstraZeneca (30%), J&J (40%), Moderna, Pfizer, and Sputnik V at 10% each with primary schedule completed by first half of 2022 (Scenario 2); and equal distribution (20%) among AstraZeneca, J&J, Moderna, Pfizer, and Sputnik V with primary schedule completed by second half of 2022 (Scenario 3). Results The estimated total cost of COVID-19 vaccination ranges between $348.7 and $436.1 million for the target population of 17.5 million. These translate into per person completed primary schedule cost of $20.9–$26.2 and per dose (including vaccine cost) of $10.5–$13.1. Again, per person completed primary schedule excluding vaccine cost was $4.5 and $4.6, thus per dose excluding vaccine also ranged from $2.2 – $2.3. The main cost driver was vaccine doses, including shipping, which accounts for between 78% and 83% of total cost. Further, an estimated 8,437–10,247 vaccinators (non-FTEs) would be required during 2021–2022 to vaccinate using a mix of delivery strategies, accounting for 8–10% of total cost. Conclusion These findings provide the estimates to inform resource mobilization efforts by government and other partners.
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346
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Abrams EM, Jordan K, Szefler SJ. School Asthma Care During COVID-19: What We Have Learned and What We Are Learning. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:453-459. [PMID: 34848382 PMCID: PMC8626345 DOI: 10.1016/j.jaip.2021.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 02/07/2023]
Abstract
The focus of this article is to review school asthma care during coronavirus disease 2019 (COVID-19). Asthma is listed as a risk factor in some guidelines, although children with asthma appear to not be at increased risk of severe respiratory outcomes compared with children without asthma during the pandemic. Differentiating COVID-19 from allergic disease is very difficult in the school-aged children. For school management, there is firm evidence that masks do not exacerbate underlying lung conditions including asthma, and evidence to date supports that children with asthma can learn in-person at school because they do not appear to be at increased risk of COVID-19 morbidity or mortality. For children and adolescents, the COVID-19 vaccine has been demonstrated to be safe and well tolerated. School asthma management includes remaining on prescribed asthma medications. Asthma management, as with management of all pediatric conditions, must also factor in the impact of adverse social determinants and health disparities. Broadly, the pandemic has also served as a call to resource stewardship and innovation and allowed practitioners to consider how this may impact asthma care moving forward.
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Affiliation(s)
- Elissa M Abrams
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Man, Canada.
| | - Kamyron Jordan
- Department of Pediatrics, Section of Pediatric Pulmonary and Sleep Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo
| | - Stanley J Szefler
- Department of Pediatrics, Section of Pediatric Pulmonary and Sleep Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo
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347
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Wratil PR, Stern M, Priller A, Willmann A, Almanzar G, Vogel E, Feuerherd M, Cheng CC, Yazici S, Christa C, Jeske S, Lupoli G, Vogt T, Albanese M, Mejías-Pérez E, Bauernfried S, Graf N, Mijocevic H, Vu M, Tinnefeld K, Wettengel J, Hoffmann D, Muenchhoff M, Daechert C, Mairhofer H, Krebs S, Fingerle V, Graf A, Steininger P, Blum H, Hornung V, Liebl B, Überla K, Prelog M, Knolle P, Keppler OT, Protzer U. Three exposures to the spike protein of SARS-CoV-2 by either infection or vaccination elicit superior neutralizing immunity to all variants of concern. Nat Med 2022; 28:496-503. [PMID: 35090165 DOI: 10.1038/s41591-022-01715-4] [Citation(s) in RCA: 161] [Impact Index Per Article: 80.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/25/2022] [Indexed: 11/09/2022]
Abstract
Infection-neutralizing antibody responses after SARS-CoV-2 infection or COVID-19 vaccination are an essential component of antiviral immunity. Antibody-mediated protection is challenged by the emergence of SARS-CoV-2 variants of concern (VoCs) with immune escape properties, such as omicron (B.1.1.529) that is rapidly spreading worldwide. Here, we report neutralizing antibody dynamics in a longitudinal cohort of COVID-19 convalescent and infection-naive individuals vaccinated with mRNA BNT162b2 by quantifying anti-SARS-CoV-2-spike antibodies and determining their avidity and neutralization capacity in serum. Using live-virus neutralization assays, we show that a superior infection-neutralizing capacity against all VoCs, including omicron, developed after either two vaccinations in convalescents or after a third vaccination or breakthrough infection of twice-vaccinated, naive individuals. These three consecutive spike antigen exposures resulted in an increasing neutralization capacity per anti-spike antibody unit and were paralleled by stepwise increases in antibody avidity. We conclude that an infection-plus-vaccination-induced hybrid immunity or a triple immunization can induce high-quality antibodies with superior neutralization capacity against VoCs, including omicron.
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Affiliation(s)
- Paul R Wratil
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany.,German Centre for Infection Research (DZIF), Partner Site, Munich, Germany
| | - Marcel Stern
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany
| | - Alina Priller
- Institute of Molecular Immunology and Experimental Oncology, University Hospital rechts der Isar, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Annika Willmann
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Giovanni Almanzar
- Pediatric Rheumatology / Special Immunology, Pediatrics Department, University Hospital Würzburg, Würzburg, Germany
| | - Emanuel Vogel
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Martin Feuerherd
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Cho-Chin Cheng
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Sarah Yazici
- Institute of Molecular Immunology and Experimental Oncology, University Hospital rechts der Isar, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Catharina Christa
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Samuel Jeske
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Gaia Lupoli
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany
| | - Tim Vogt
- Pediatric Rheumatology / Special Immunology, Pediatrics Department, University Hospital Würzburg, Würzburg, Germany
| | - Manuel Albanese
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany.,National Institute of Molecular Genetics (INGM), Milano, Italy
| | - Ernesto Mejías-Pérez
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany
| | - Stefan Bauernfried
- Gene Center and Department of Biochemistry, LMU München, Munich, Germany
| | - Natalia Graf
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Hrvoje Mijocevic
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Martin Vu
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Kathrin Tinnefeld
- Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Jochen Wettengel
- German Centre for Infection Research (DZIF), Partner Site, Munich, Germany.,Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Dieter Hoffmann
- German Centre for Infection Research (DZIF), Partner Site, Munich, Germany.,Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Maximilian Muenchhoff
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany.,German Centre for Infection Research (DZIF), Partner Site, Munich, Germany
| | - Christopher Daechert
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany
| | - Helga Mairhofer
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany
| | - Stefan Krebs
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Volker Fingerle
- Bavarian Health and Food Safety Authority (LGL (LGL), Oberschleißheim, Germany
| | - Alexander Graf
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Helmut Blum
- Laboratory for Functional Genome Analysis, Gene Center, LMU München, Munich, Germany
| | - Veit Hornung
- Gene Center and Department of Biochemistry, LMU München, Munich, Germany
| | - Bernhard Liebl
- Bavarian Health and Food Safety Authority (LGL (LGL), Oberschleißheim, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Martina Prelog
- Pediatric Rheumatology / Special Immunology, Pediatrics Department, University Hospital Würzburg, Würzburg, Germany
| | - Percy Knolle
- Institute of Molecular Immunology and Experimental Oncology, University Hospital rechts der Isar, Technical University of Munich (TUM), School of Medicine, Munich, Germany
| | - Oliver T Keppler
- Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU München, Munich, Germany. .,German Centre for Infection Research (DZIF), Partner Site, Munich, Germany.
| | - Ulrike Protzer
- German Centre for Infection Research (DZIF), Partner Site, Munich, Germany. .,Institute of Virology, Helmholtz Center Munich, Technical University of Munich (TUM), School of Medicine, Munich, Germany.
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348
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Chen LL, Chua GT, Lu L, Chan BPC, Wong JSC, Chow CCK, Yu TC, Leung ASY, Lam SY, Wong TW, Tsang HW, Wong ICK, Chan KH, Yuen KY, Ip P, Kwan MYW, To KKW. Omicron variant susceptibility to neutralizing antibodies induced in children by natural SARS-CoV-2 infection or COVID-19 vaccine. Emerg Microbes Infect 2022; 11:543-547. [PMID: 35084295 PMCID: PMC8843159 DOI: 10.1080/22221751.2022.2035195] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The novel SARS-CoV-2 Omicron variant may increase the risk of re-infection and vaccine breakthrough infections as it possesses key mutations in the spike protein that affect neutralizing antibody response. Most studies on neutralization susceptibility were conducted using specimens from adult COVID-19 patients or vaccine recipients. However, since the paediatric population has an antibody response to SARS-CoV-2 infection that is distinct from the adult population, it is critical to assess the neutralization susceptibility of pediatric serum specimens. This study compared the neutralization susceptibility of serum specimens collected from 49 individuals of <18 years old, including 34 adolescent BNT162b2 (Pfizer-BioNTech) vaccine recipients, and 15 recovered COVID-19 patients aged between 2 and 17. We demonstrated that only 38.2% of BNT162b2 vaccine recipients and 26.7% of recovered COVID-19 patients had their serum neutralization titre at or above the detection threshold in our live virus microneutralization assay. Furthermore, the neutralizing antibody titer against the Omicron variant was substantially lower than those against the ancestral virus or the Beta variant. Our results suggest that vaccine recipients and COVID-19 patients in the pediatric age group will likely be more susceptible to vaccine breakthrough infections or reinfections due to the Omicron variant than previous variants.
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Affiliation(s)
- Lin-Lei Chen
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Gilbert T Chua
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.,Department of Pediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Lu Lu
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Brian Pui-Chun Chan
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Joshua Sung-Chih Wong
- Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Calvin Chit-Kwong Chow
- Department of Pediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Tak-Ching Yu
- Department of Pediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Agnes Sze-Yin Leung
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Shu-Yan Lam
- Department of Pediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Tak-Wai Wong
- Department of Pediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Hing-Wai Tsang
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Ian Chi-Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong.,Laboratory of Data Discovery for Health (D 4H), Hong Kong Science and Technology Park.,Research Department of Practice and Policy, School of Pharmacy, University College London
| | - Kwok-Hung Chan
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Kwok-Yung Yuen
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.,Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Patrick Ip
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.,Department of Pediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Mike Yat-Wah Kwan
- Department of Pediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong Special Administrative Region, People's Republic of China.,Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Kelvin Kai-Wang To
- State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.,Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People's Republic of China
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349
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Kasi SG, Dhir SK, Shah A, Shivananda S, Verma S, Marathe S, Chatterjee K, Agarwalla S, Srirampur S, Kalyani S, Pemde HK, Balasubramanian S, Basavaraja GV, Parekh BJ, Kumar R, Gupta P. Coronavirus Disease 2019 (COVID-19) Vaccination for Children: Position Statement of Indian Academy of Pediatrics Advisory Committee on Vaccination and Immunization Practices. Indian Pediatr 2022; 59:51-57. [PMID: 34927603 PMCID: PMC8821846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
JUSTIFICATION Data generated after the first wave has revealed that some children with coronavirus 19 (COVID-19) can become seriously ill. Multi-inflammatory syndrome in children (MIS-C) and long COVID cause significant morbidity in children. Prolonged school closures and quarantine have played havoc with the psychosocial health of children. Many countries in the world have issued emergency use authorisation (EUA) of selected Covid-19 vaccines for use in children. In India, a Subject Expert Committee (SEC) has recommended the use of Covaxin (Bharat Biotech) for children from the ages of 2-18 years. The recommendation has been given to the Drugs Controller General of India (DCGI) for final approval. OBJECTIVE To provide an evidence-based document to guide the pediatricians on the recommendation to administer COVID vaccines to children, as and when they are available for use. PROCESS Formulation of key questions was done by the committee, followed by review of literature on epidemiology and burden of Covid-19 in children, review of the studies on COVID vaccines in children, and the IAP stand on Covid-19 vaccination in children. The available data was discussed in the ACVIP focused WhatsApp group followed by an online meeting on 24 October, 2021, wherein the document was discussed in detail and finalized. RECOMMENDATIONS The IAP supports the Government of India's decision to extend the COVID-19 vaccination program to children between 2-18 years of age. Children with high-risk conditions may be immunized on a priority basis. The IAP and its members should be a partner with the Government of India, in the implementation of this program and the surveillance that is necessary following the roll-out.
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Affiliation(s)
- Srinivas G Kasi
- Kasi Clinic, 2nd Cross, 3rd Block, Jayanagar, Bengaluru, Karnataka. Correspondence to: Dr Srinivas G Kasi, Convener, ACVIP of IAP, Kasi Clinic, 2nd Cross, 3rd Block, Jayanagar, Bengaluru, Karnataka.
| | - Shashi Kant Dhir
- Department of Pediatrics, Guru Gobind Singh Medical College, Faridkot, Punjab
| | - Abhay Shah
- Dr Abhay K Shah Children Hospital, Ahmedabad, Gujarat
| | - S Shivananda
- Department of Pediatrics, Fortis Hospital, Banneraghatta Road, Bengaluru, Karnataka
| | - Sanjay Verma
- Division of Infectious Diseases, Department of Pediatrics, PGIMER, Chandigarh
| | - S Marathe
- Marathe Child Care Hospital, Nagpur, Maharashtra
| | | | - Sunil Agarwalla
- Department of Pediatrics, SCB Medical College and Hospital, Cuttack, Odisha
| | - Sanjay Srirampur
- Department of Pediatrics, Aditya Super Speciality Hospital, Hyderabad, Telangana
| | - Srinivas Kalyani
- Department of Pediatrics, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana
| | - Harish K Pemde
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi
| | - S Balasubramanian
- Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu
| | | | | | | | - Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, New Delhi
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350
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Leung EH, Fan J, Flynn HW, Albini TA. Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare. Clin Ophthalmol 2022; 16:1-13. [PMID: 35018092 PMCID: PMC8742614 DOI: 10.2147/opth.s336963] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022] Open
Abstract
There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.
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Affiliation(s)
| | - Jason Fan
- Bascom Palmer Eye Institute/University of Miami, Miami, FL, USA
| | - Harry W Flynn
- Bascom Palmer Eye Institute/University of Miami, Miami, FL, USA
| | - Thomas A Albini
- Bascom Palmer Eye Institute/University of Miami, Miami, FL, USA
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