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Marfoh K, Samba A, Okyere E, Acheampong F, Owusu E, Darko DNA, Zakariah J, Mensa H, Aidoo E, Mohammed Y. Adverse events following immunisation (AEFI) of COVISHIELD vaccination among healthcare workers in Ghana. BMJ Open 2023; 13:e061643. [PMID: 37380201 PMCID: PMC10410798 DOI: 10.1136/bmjopen-2022-061643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
OBJECTIVE To describe the incidence of adverse events following immunisation (AEFI) and determine the factors that affect the onset and duration of AEFI after COVISHIELD vaccination among healthcare workers. DESIGN Prospective cohort study. SETTING Tertiary healthcare, Korle-Bu, Ghana. PARTICIPANT Three thousand and twenty-two healthcare workers at least 18 years of age were followed up for 2 months after receiving two doses of the COVISHIELD vaccine. PRIMARY OUTCOME The occurrence of the AEFI was identified by self-reporting to the AEFI team members. RESULTS A total of 3022 healthcare workers had at least one AEFI (incidence rate of 706.0 (95% CI 676.8 to 736.1) per 1000 doses) with an incidence rate of 703.0 (95% CI 673.0 to 732.0) per 1000 doses for non-serious AEFI and an incidence rate of 3.3 (95% CI 1.6 to 6.1) per 1000 doses for serious AEFI. The most commonly reported systemic adverse events were headache (48.6%), fever (28.5%), weakness (18.4%) and body pains (17.9%). The estimated median time to onset of the AEFI following the first-dose vaccination was 19 hours and the median AEFI duration was 40 hours or 2 days. Delayed-onset AEFI occurred in 0.3% after first dose and 0.1% after second dose. Age, sex, previous SARS-CoV-2 infection, history of allergies and comorbidity were not significantly associated with the onset and duration of AEFI. However, participants who used paracetamol seemed to be significantly protected (HR 0.15; 95% CI 0.14, 0.17) from having a long duration of AEFI. CONCLUSION The results of our study indicate a high incidence of non-serious AEFI and the rare occurrence of serious AEFI after COVISHIELD vaccination in healthcare workers. The rate of AEFI was higher after the first dose than after the second dose. Sex, age, previous SARS-CoV-2 infection, allergies and comorbidity were not significantly associated with the onset and duration of AEFI.
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Affiliation(s)
- Kissinger Marfoh
- Public Health Department, Korle-Bu Teaching Hospital, Accra, Ghana
- Epidemiology and Enviromental Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Ali Samba
- Obstetric and Gynaecology, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Eunice Okyere
- Public Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | | | - Elsie Owusu
- Public Health Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Joseph Zakariah
- Public Health Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Hillary Mensa
- Public Health Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Ernestina Aidoo
- Public Health Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Yasmin Mohammed
- Public Health Department, Korle-Bu Teaching Hospital, Accra, Ghana
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Haji A, Alkattan A, Mahmoud N, Elkagam E, Hassanein M, Alfaifi A, Al-Tawfiq JA, Alabdulkareem K, Jokhdar H, Radwan N. Does ChAdOx1-S and BNT162b2 heterologous prime-boost vaccination trigger higher rates of vaccine-related adverse events? IJID REGIONS 2023; 7:159-163. [PMID: 37025346 PMCID: PMC10005969 DOI: 10.1016/j.ijregi.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 04/18/2023]
Abstract
Background There has been significant international interest in heterologous prime-boost COVID-19 vaccination. However, it is linked with different intensity and frequency of adverse events. This study aimed to assess the safety of ChAdOx1-S and BNT162b2 vaccines when given as heterologous prime-boost vaccination in Saudi Arabia. Methods A cross-sectional study was conducted during the period October 2021 to March 2022. The study included two groups of people based on the type of vaccination regimen. The first group (heterologous) was subjected to different prime-boost vaccination schedules irrespective of the prime and boost vaccine types. The second group included people vaccinated with the same type of COVID-19 vaccine (homologous). Results The overall sample included 334 participants. Those included in the heterologous group were at about 1.5 fold -increased risk for developing local and systemic adverse events compared to the homologous group. Fever, headache, and vomiting were significantly more frequent among the heterologous group compared to the homologous group (p-value<0.05). In both groups, more than half of the recorded adverse events were mild/moderate in severity. Conclusion Heterologous prime-post vaccination is associated with a slightly increased risk for the development of local and systemic adverse events compared to the homologous regimen. However, most of these adverse events are mild/moderate in nature and recede within two days with no serious adverse events documented.
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Affiliation(s)
- Alhan Haji
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdallah Alkattan
- Department of Research and Development, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
- Corresponding author: Abdullah Alkattan Tel. 00966540745588
| | - Nagla Mahmoud
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
- Corresponding author: Nagla Mahmoud: Tel. 00966550853708
| | - Elfadil Elkagam
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Mustafa Hassanein
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Amal Alfaifi
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Patient Safety Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Diseases Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Infectious Diseases Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Khaled Alabdulkareem
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
- Department of Family Medicine, College of Medicine, Al-Imam Mohammad bin Saud Islamic University, Riyadh, Saudi Arabia
| | - Hani Jokhdar
- Deputyship of Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Nashwa Radwan
- Department of Training, Research and Development, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Egypt
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Wali R, Alhindi H, Saber A, Algethami K, Alhumaidah R. The Effect of COVID-19 Vaccine on Women's Reproductive Health: A Cross-Sectional Study. Cureus 2023; 15:e40076. [PMID: 37425538 PMCID: PMC10326796 DOI: 10.7759/cureus.40076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) vaccine was developed to stimulate acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms of reproductive health abnormalities have been reported following the administration of the adenovirus and mRNA-containing vaccine. Such complaints included irregular menstrual cycles, miscarriages, changes in sexual interest, vaginal bleeding, and decreased milk supply in breastfeeding mothers. This study aimed to explore the effect of the COVID-19 vaccine on the reproductive health of women attending five primary healthcare centers in the western region of Saudi Arabia. METHODS A cross-sectional study was conducted with 300 women between 15 and 50 years. Five primary healthcare centers were included from May to September 2022. Non-probability convenient sampling technique was used; data were collected via a self-administered questionnaire from women who received any number or type of COVID-19 vaccine. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics, Armonk, NY, USA). RESULTS Of those who responded to the questionnaire (297 participants), 74% were married, and 52% had 1-3 children. Of the pregnant women, only 4% lost their pregnancy. In addition, of the breastfeeding mothers, 10% noticed a decrease in milk production after the vaccination. The effect of the vaccination status on decreased libido was 11%. A small proportion (18%) of the participants reported worsening dietary habits after the vaccine. Less than half of the participants (44%) reported a change in the length and amount of the menstrual cycle, and 29% worsened premenstrual syndrome (PMS). There was no significant association between the type and the number of doses on the rate of miscarriage (p=0.47), breastmilk production (p=0.47), libido (p=0.11), health diet habits (p=0.15), monthly cycle (p=0.570), heavy menses (p=0.999), and PMS symptoms in the study participants. CONCLUSION COVID-19 vaccination remains necessary to prevent severe infection and is safe for females of reproductive age, whether trying to get pregnant or lactating, and has no significant effect on the menstrual cycle. This research can be used as a basis when deciding on vaccines in case of future pandemics and remove misinformation and doubts regarding the vaccines that should be adequately addressed.
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Affiliation(s)
- Razaz Wali
- Family Medicine, King Abdulaziz Medical City, National Guard Hospital, Jeddah, SAU
- Family Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
- Family Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Hayat Alhindi
- Family Medicine, King Abdulaziz Medical City, National Guard Hospital, Jeddah, SAU
| | - Arwa Saber
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Khowlah Algethami
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Reem Alhumaidah
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
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Teófilo VSG, Pinho PRA, Cordeiro GJ, Saldanha NAF, Matos PMM, Ribeiro RAM, Moreira SM, Miller MSF, Dias ARM, Couto MFR, Norton PMPNS. Spontaneous reporting of adverse reactions associated with the COVID-19 vaccine in health care professionals: A descriptive observational study conducted in a Portuguese hospital. Porto Biomed J 2023; 8:e219. [PMID: 37383526 PMCID: PMC10299789 DOI: 10.1097/j.pbj.0000000000000219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) was classified as a pandemic in March 2020 by the World Health Organization. The Pfizer-BioNTech COVID-19 vaccine was the first to be authorized in the European Union, based on data from phase 1, 2, and 3 clinical trials of limited duration. Concerns have been raised regarding the vaccine's safety profile. Some of the adverse drug reactions (ADRs) associated with vaccines may not have been identified during clinical trials. This study aimed to identify ADRs associated with the Pfizer-BioNTech vaccine in health care professionals at a Portuguese tertiary university hospital. Methods The data used in this analysis consist of ADRs reported through a spontaneous notification system from vaccines administered between December 27, 2020, and January 31, 2021. ADRs were categorized according to the MedDRA terminology. Results A total of 8,605 Pfizer-BioNTech vaccines were administered to 4568 health care professionals. ADRs were reported among 520 of the vaccines, with an incidence of 13.56% in women and 5.31% in men. The mean age of the population reporting ADRs was 41.52 years, with a standard deviation of 9.83 years. The most frequent ADRs were myalgia (n = 274), headache (n = 199), pyrexia (n = 164), injection site pain (n = 160), fatigue (n = 84), nausea (n = 81), chills (n = 65), lymphadenopathy (n = 64), and arthralgia (n = 53). Hypersensitivity reactions occurred in 15 health care professionals, with no anaphylactic reactions observed. A total of four Important Medical Events were observed, which consisted of two cases of syncope, one case of sudden hearing loss, and one case of transverse myelitis. Conclusion The vaccine was well-tolerated among the study participants. Reactogenicity was greater after the second dose. The incidence of ADRs was higher in women and individuals aged between 40 to 49 years. Systemic adverse reactions were most frequently reported. Systematic monitoring of ADRs of COVID-19 vaccines in real-life context is essential for a more robust establishment of its safety profile.
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Affiliation(s)
- Vanessa S G Teófilo
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Paulo R A Pinho
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Gonçalo J Cordeiro
- Clinical Pharmacology Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Nuno A F Saldanha
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro M M Matos
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Rui A M Ribeiro
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Salomé M Moreira
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Mariana S F Miller
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Andreia R M Dias
- Clinical Pharmacology Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Marta F R Couto
- Clinical Pharmacology Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro M P N S Norton
- Occupational Health Service, Centro Hospitalar Universitário São João, Porto, Portugal
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Acute Reactions After a Homologous Primary COVID-19 Vaccination Series: Analysis of Taiwan V-Watch Data. Vaccine 2023; 41:2853-2859. [PMID: 37029003 PMCID: PMC10043967 DOI: 10.1016/j.vaccine.2023.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
Introduction The ChAdOx1 nCoV-19 (ChAd), mRNA-1273 (m1273), MVC-COV1901 (MVC), and BNT162b2 (BNT) COVID-19 vaccines received authorization for emergency use in Taiwan beginning in February 2021. We investigated acute reactions to homologous primary COVID-19 vaccination series in adults aged ≥18 years. Methods In this prospective observational study based on smartphone data (Taiwan V-Watch), we calculated the frequencies of self-reported local and systemic acute reactions within 7 days of a COVID-19 vaccination, and the health effects up to 3 weeks after each dose. Those who reported adverse reactions after both doses were assessed by the McNemar test. Results During 22 March 2021–13 December 2021, 77,468 adults were enrolled; 59.0% were female and 77.8% were aged 18–49 years. For both doses of all four vaccines, the local and systemic reactions were minor in severity and highest on days 1 and 2 after vaccination, and declined markedly until day 7. For 65,367 participants who provided data after the first and second doses, systemic reactions were more frequent after dose 2 of the BNT and m1273 vaccines (McNemar tests: both p < 0.001), while local reactions were more frequent after dose 2 of the m1273 and MVC vaccines (both p < 0.001), compared with dose 1 of the homologous vaccine. Among the participants aged 18–49 years, the percentage who missed work on the day after vaccination was slightly higher among women (9.3%) than among men (7.0%). Conclusions Acute reactogenicity and impact of work absenteeism for the four COVID vaccines in the T-Watch survey were mild and of short duration.
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Alkhalifah JM, Al Seraihi A, Al-Tawfiq JA, Alshehri BF, Alhaluli AH, Alsulais NM, Alessa MM, Seddiq W, Aljeri T, Qahtani MH, Barry M, Al-Otaiby M. Pattern of self-reported adverse events related to COVID-19 vaccines in Saudi Arabia: A nationwide study. Front Public Health 2023; 11:1043696. [PMID: 36908451 PMCID: PMC9995884 DOI: 10.3389/fpubh.2023.1043696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Background Vaccination against coronavirus disease 2019 (COVID-19) is the most effective way to end the pandemic. Any development of adverse events (AEs) from various vaccines should be reported. We therefore aimed to explore major and minor AEs among vaccinated individuals in Saudi Arabia. Methods This is a nationwide report based on the Saudi Arabian Ministry of Health (MOH) registry. It included those who received COVID-19 vaccines from 17th December 2020 to 31st December 2021. The study included spontaneous self-reported adverse effects to COVID-19 vaccines where the study participants used a governmental mobile app (Sehhaty) to report their AEs following vaccination using a checklist option that included a selection of side-effects. The primary outcome was to determine AEs reported within 14 days of vaccination which included injection site itching, pain, reaction, redness, swelling, anxiety, dizziness, fever, headache, hoarseness, itchiness, loss of consciousness, nausea, heartburn, sleep disruption, fatigue, seizures, anaphylaxis, shortness of breath, wheezing, swelling of lips, face, and throat, loss of consciousness, and admissions into the intensive care unit (ICU). Results The study included a total number of 28,031 individuals who reported 71,480 adverse events (AEs); which were further classified into minor and major adverse events including ICU admissions post vaccination. Of the reported AEs, 38,309 (53. 6%) side-effects were reported following Pfizer-BioNTech, 32,223 (45%) following Oxford-AstraZeneca, and 948 (1.3%) following Moderna. The following reported AEs were statistically significant between the different vaccine types: shortness of breath\difficulty of breathing, dizziness, fever above 39°C, headache, hoarseness, injection site reactions, itchiness, nausea, sleep disruption, fatigue, wheezing, swelling of lips/face and\or throat, and loss of consciousness (p-value < 0.05). Fever and seizure were the only statistically significant AEs amongst the number of vaccine doses received (p-value < 0.05). Ten ICU admissions were reported in the 14 days observation period post-COVID-19 vaccination with the following diagnoses: acute myocardial infarction, pneumonia, atherosclerosis, acute respiratory failure, intracranial hemorrhage, grand mal seizure, Guillain-Barré syndrome, abnormal blood gas levels, and septic shock. Conclusion This study demonstrated that the most prevalent SARS-CoV-2 vaccine side-effects among adults in Saudi Arabia were mild in nature. This information will help reduce vaccine hesitancy and encourage further mass vaccination to combat the COVID-19 pandemic, especially as booster doses are now available. Further studies are warranted to obtain a better understanding of the association between risk factors and the experiencing of side-effects post vaccination.
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Affiliation(s)
| | | | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | | | | | | | - Waleed Seddiq
- Center for Stem Cell and Translational Immunotherapy (CSTI), Harvard Medical School, Boston, MA, United States.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | | | | | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Infectious Diseases, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Maram Al-Otaiby
- The Saudi Ministry of Health, Riyadh, Saudi Arabia.,Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Duijster JW, Lieber T, Pacelli S, Van Balveren L, Ruijs LS, Raethke M, Kant A, Van Hunsel F. Sex-disaggregated outcomes of adverse events after COVID-19 vaccination: A Dutch cohort study and review of the literature. Front Immunol 2023; 14:1078736. [PMID: 36793715 PMCID: PMC9922710 DOI: 10.3389/fimmu.2023.1078736] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
Background Albeit the need for sex-disaggregated results of adverse events after immunization (AEFIs) is gaining attention since the COVID-19 pandemic, studies with emphasis on sexual dimorphism in response to COVID-19 vaccination are relatively scarce. This prospective cohort study aimed to assess differences in the incidence and course of reported AEFIs after COVID-19 vaccination between males and females in the Netherlands and provides a summary of sex-disaggregated outcomes in published literature. Methods Patient reported outcomes of AEFIs over a six month period following the first vaccination with BioNTech-Pfizer, AstraZeneca, Moderna or the Johnson&Johnson vaccine were collected in a Cohort Event Monitoring study. Logistic regression was used to assess differences in incidence of 'any AEFI', local reactions and the top ten most reported AEFIs between the sexes. Effects of age, vaccine brand, comorbidities, prior COVID-19 infection and the use of antipyretic drugs were analyzed as well. Also, time-to-onset, time-to-recovery and perceived burden of AEFIs was compared between the sexes. Third, a literature review was done to retrieve sex-disaggregated outcomes of COVID-19 vaccination. Results The cohort included 27,540 vaccinees (38.5% males). Females showed around two-fold higher odds of having any AEFI as compared to males with most pronounced differences after the first dose and for nausea and injection site inflammation. Age was inversely associated with AEFI incidence, whereas a prior COVID-19 infection, the use of antipyretic drugs and several comorbidities were positively associated. The perceived burden of AEFIs and time-to-recovery were slightly higher in females. Discussion The results of this large cohort study correspond to existing evidence and contribute to the knowledge gain necessary to disentangle the magnitude of the effect sex in response to vaccination. Whilst females have a significant higher probability of experiencing an AEFI than males, we observed that the course and burden is only to a minor extent different between the sexes.
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Affiliation(s)
- Janneke W Duijster
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Thomas Lieber
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Silvia Pacelli
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands.,School of Pharmacy, Biotechnology, and Sport Sciences, University of Bologna, Bologna, Italy
| | | | - Loes S Ruijs
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Monika Raethke
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Agnes Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
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Adverse Events of COVID-19 Vaccination among the Saudi Population: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10122089. [PMID: 36560499 PMCID: PMC9783010 DOI: 10.3390/vaccines10122089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
This systematic review and meta-analysis aimed to synthesize the evidence on the adverse events (AEs) of coronavirus disease 2019 (COVID-19) vaccinations in Saudi Arabia. A computerized search in MEDLINE via PubMed and OVID, Scopus, CENTRAL, and Web of Science was conducted using relevant keywords. The NIH tools were used for the quality assessment. A total of 14 studies (16 reports) were included. The pooled analysis showed that the incidence of AEs post-COVID-19 vaccination was 40.4% (95% CI:6.4% to 87%). Compared to the AstraZeneca vaccine, the Pfizer-BioNTech vaccine was associated with a lower risk ratio (RR) of wheezing (RR = 0.04), fever (RR = 0.32), chills (RR = 0.41), headache (RR = 0.47), dizziness (RR = 0.49), and joint pain (RR = 0.51). The Pfizer-BioNTech vaccine was associated with significantly higher RR of general allergic reactions (RR = 1.62), dyspnea (RR = 1.68), upper respiratory tract symptoms (RR = 1.71), and lymphadenopathy (RR = 8.32). The current evidence suggests that the incidence of AEs following COVID-19 vaccines is 40%; however, most of these AEs were mild and for a short time. The overall number of participants with AEs was higher in the Pfizer group compared to the AstraZeneca group; however, the AstraZeneca vaccine was associated with a higher RR of several AEs.
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Adverse events following administration of COVID-19 vaccines in Saudi Arabia. Sci Rep 2022; 12:19551. [PMID: 36379996 PMCID: PMC9664034 DOI: 10.1038/s41598-022-23471-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
Previous studies investigated the frequency of different adverse events of COVID-19 vaccines. However, this study compares these adverse events between the two main COVID-19 vaccines used in Saudi Arabia (Pfizer-BioNTech and Oxford-AstraZeneca) using telemedicine technology. A cross-sectional study was conducted among 958 individuals, 7 days after receiving either Pfizer-BioNTech or Oxford-AstraZeneca vaccines during June 2021. Immediate adverse events were reported by 1.04% and 2.09% for Pfizer-BioNTech and Oxford-AstraZeneca vaccines, respectively, with no serious events. Recipients of Pfizer-BioNTech vaccine had a higher percentage of local adverse events (24.8% versus 9.8% in AstraZeneca vaccine). The most common reported systemic adverse events in both vaccines respectively were general fatigue (23.1% and 25.1%), fever (18.5% and 27.2%), myalgia (20.6% and 20.3%), and headache (15.2% and 17.2%). No significant difference was recorded between both vaccines regarding overall systemic adverse events; however, they were more frequent following the first dose of AstraZeneca vaccine compared to Pfizer-BioNTech vaccine, while the reverse was observed for the second dose. Adverse events were more frequent in females and younger age groups for both vaccines. Most of systemic and local adverse events were mild in nature. Further cohort studies are recommended to investigate the long-term adverse events of COVID-19 vaccines.
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Bellinato F, Fratton Z, Girolomoni G, Gisondi P. Cutaneous Adverse Reactions to SARS-CoV-2 Vaccines: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10091475. [PMID: 36146553 PMCID: PMC9504216 DOI: 10.3390/vaccines10091475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background: An increasing number of cutaneous adverse reactions (CARs) to SARS-CoV-2 vaccines have been reported, but their incidence is debated. Objective: To estimate the pooled incidence of CARs to SARS-CoV-2 vaccines in the general adult population. Methods: A systematic review and meta-analysis of original articles published on MEDLINE via PubMed and Web Of Science from 1 January 2020 to 18 July 2022 was undertaken. Studies reporting the incidence proportion of CARs (defined as number of new cases of CARs on the total of vaccinated people) were included. All types of SARS-CoV-2 vaccine were included. People receiving at least one dose were considered eligible. Local cutaneous reactions were excluded. Results: A total of 970 records were identified and screened by title and abstract; 22 observational studies were included with aggregate data on 93,165 participants. The pooled incidence of overall CARs was 5% (95%CI 4−6%; I2 = 99%; p < 0.001), ranging from <0.01 to 19.00%. Most CARs were new onset dermatitis including rash, urticaria and vascular lesions; one case of Steven−Johnson syndrome and six cases of erythema multiforme were reported. In the sensitivity analysis we found that the incidence of CARs after the first and second dose was similar, i.e., 3% (95%CI 2−3%; I2 = 96%; p < 0.001) and 3% (95%CI 2−4%; I2 = 97%; p < 0.001), respectively. The magnitude of incidence of CARs remained unchanged independently of vaccine platform and in the general population versus healthcare workers. Conclusions: CARs associated with SARS-CoV-2 vaccines are frequent but mild and self-remitting, whereas severe CARs are rare.
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Incidence and Characteristics of Adverse Events after COVID-19 Vaccination in a Population-Based Programme. Vaccines (Basel) 2022; 10:vaccines10071111. [PMID: 35891275 PMCID: PMC9324067 DOI: 10.3390/vaccines10071111] [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: 05/12/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 12/13/2022] Open
Abstract
Compliance with vaccination is linked to its safety. In Italy, a plan to identify people who could be at an increased risk of adverse events (AEs) was defined so they could be vaccinated in a protected setting. We conducted an audit to describe the process of AE risk assessment and occurrence in the Reggio Emilia Province in Italy in people who received any of the four COVID-19 vaccines currently used in Italy. Incidence of AEs was calculated by dose and type of vaccine and type of setting (standard vs. protected). After 182,056 first doses were administered, 521 (0.3%) AEs were reported. Most of the AEs were non-serious (91.4%) and non-allergic (92.7%). The percentage of AEs was similar in both settings: 0.3% in the standard setting and 0.2% in the protected setting. However, the incidence of AEs was higher among those who had an allergist visit than among those who did not (IR 666.7 vs. 124.9). All deaths (1.6/100.000) occurred in standard settings and after the Pfizer and Moderna vaccines. The incidence of AEs was lower after the second dose (IR 286.2 vs. 190.3), except for mRNA vaccines, for which it was higher after the second dose (IR 169.8 vs. 251.8). Although vaccination in a protected medical setting could reassure patients with a history of allergies to be vaccinated, allergy history and other anamnestic information is not useful in predicting the risk of COVID-19 vaccine-related AEs in the general population.
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Akaishi T, Takahashi T, Sato S, Jin X, Masamune A, Ishii T. Prolonged Diarrhea Following COVID-19 Vaccination: A Case Report and Literature Review. TOHOKU J EXP MED 2022; 257:251-259. [PMID: 35644543 DOI: 10.1620/tjem.2022.j043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Vaccination against coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently underway across countries worldwide. However, the prevalence and characteristics of prolonged adverse events lasting for several months after receiving the vaccine remain largely unknown. We herein report a 46-year-old woman with prolonged diarrhea and vomiting after receiving the BNT162b2 mRNA vaccine for COVID-19. She had no notable medical history, including that of gastrointestinal diseases. She developed vomiting several hours after receiving the first vaccine dose and further developed severe diarrhea after 7 days. Several days after the second vaccine dose, her condition deteriorated, unrelieved by symptomatic therapies, including anti-diarrheal drugs. Abdominal computed tomography (CT) revealed inflammatory changes in the entire segment of the small intestine with wall thickening. The upper and lower gastrointestinal and capsule endoscopies were unremarkable. The patient's symptoms persisted for more than 6 months after the second vaccine dose. A Vaccine Adverse Event Reporting System (VAERS) database search suggested that diarrhea is observed in approximately 3% of all vaccine recipients, but a literature review indicated that prolonged gastrointestinal symptoms lasting for several months is very rare. In summary, a case of prolonged unexplained gastrointestinal symptoms, possibly based on inflammatory changes in the small intestine, is described. A literature search revealed that this type of manifestation is very rare, and further evidence is needed to determine the causality between vaccination and gastrointestinal symptoms.
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Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital.,Division of General Medicine, Tohoku University Hospital
| | - Takahiro Takahashi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Satoko Sato
- Department of Pathology, Tohoku University Hospital
| | - Xiaoyi Jin
- Division of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Tohoku University Hospital.,Division of General Medicine, Tohoku University Hospital
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13
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Maruyama A, Sawa T, Teramukai S, Katoh N. Adverse reactions to the first and second doses of Pfizer-BioNTech COVID-19 vaccine among healthcare workers. J Infect Chemother 2022; 28:934-942. [PMID: 35361536 PMCID: PMC8947941 DOI: 10.1016/j.jiac.2022.03.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/22/2022] [Accepted: 03/22/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION In the current coronavirus infection 2019 (COVID-19) pandemic, the messenger RNA vaccines have been shown to help protect high-risk groups from COVID-19. Among healthcare workers vaccinated with Pfizer-BioNTech COVID-19 vaccine, a survey was conducted to analyze the relationship between the incidence and severity of adverse reactions after vaccination. METHODS We conducted a prospective self-reported survey of adverse reactions among healthcare workers vaccinated with the Pfizer-BioNTech COVID-19 vaccine (Comirnaty®) in Japan. After the first and second dose of vaccine, local and systemic reactions for 8 days after vaccination were reported by volunteer participants using a website. After receiving vaccination, 374 respondents participated in this matched-pair study. RESULTS Both the incidence and severity of adverse reactions tended to be higher after the second vaccine dose than after the first dose. However, the incidence and numeric rating scale (NRS) score of muscle and skin pain were nearly the same after the first and second doses. In a comparison by sex, women had significantly higher incidence and NRS scores for adverse reactions such as headache, skin pain, erythema, and itching. The results also showed that younger age groups had higher incidence rates and NRS scores for all adverse reactions investigated, except for muscle pain, compared with older age groups. CONCLUSION Some adverse reactions to the Pfizer-BioNTech Comirnaty® COVID-19 vaccine showed gender and age differences. However, generally speaking, all side reactions disappear within a week. Therefore, these side reactions are not a significant concern in recommending vaccination.
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Affiliation(s)
- Ayano Maruyama
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
| | - Teiji Sawa
- Medical Safety Promotion Division of the University Hospital, and Department of Anesthesiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
| | - Norito Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
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14
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Alhazza SF, Altalhi AM, Alamri KM, Alenazi SS, Alqarni BA, Almohaya AM. Parents' Hesitancy to Vaccinate Their Children Against COVID-19, a Country-Wide Survey. Front Public Health 2022; 10:755073. [PMID: 35570948 PMCID: PMC9095949 DOI: 10.3389/fpubh.2022.755073] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Parents' hesitancy (PH) toward childhood vaccination, including the vaccine of coronavirus disease (COVID-19), is one of the top public health threats. We aim to assess the PH toward children COVID-19 vaccination as compared to PH toward children routine vaccination among the residents of Saudi Arabia. Method Before the official approval of children's COVID-19 vaccination in the country, a cross-sectional study using an electronically distributed survey was performed. Responses from parents of children younger than 18 years of age were accepted. The Oxford COVID-19 vaccine hesitancy scale (OC19-VHS) and the routine vaccination hesitancy scale (R-VHS) were used. Parents were classified as hesitant, non-hesitant, and unsure. Results Between June 18th-30th, 2021, we included 1,052 parents. More than half of the parents were positive toward the childhood COVID-19 vaccination (63%) while 10% were unsure. Higher parental hesitancy toward children COVID-19 vaccination among mothers, parents younger than 40 years, did not receive COVID-19 nor influenza vaccines, had higher educational levels, and parents who recovered from COVID-19 infection. Hesitancy was mainly driven by the novelty of the vaccines and the fear of serious adverse effects. Compared to the routine vaccination, parents were more hesitant toward COVID-19 vaccination (6 vs. 27%). Conclusion Generally, parents in Saudi Arabia were positive toward children's COVID-19 vaccination. Focused education to reassure hesitant parents on the safety of the vaccine is essential to achieve larger vaccination coverage.
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Affiliation(s)
- Sultan F Alhazza
- Internal Medicine Department, Security Forces Hospital, Ministry of Interior, Riyadh, Saudi Arabia
| | - Ali M Altalhi
- Pediatric Cardiology Department, Prince Mohammed Medical City, Ministry of Health, Aljouf, Saudi Arabia
| | - Khaled M Alamri
- General Pediatric Department, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, Saudi Arabia
| | - Saleh S Alenazi
- Pediatric Cardiology Department, Prince Mohammed Medical City, Ministry of Health, Aljouf, Saudi Arabia
| | - Bader A Alqarni
- Pediatrics Department, Ad-Diriyah Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdulellah M Almohaya
- Division of Infectious Diseases, Department of Internal Medicine, Ad-Diriyah Hospital, Ministry of Health, Riyadh, Saudi Arabia
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Acute unsolicited adverse events following BNT162b2 vaccine in Saudi Arabia, a real-world data. Vaccine 2021; 40:477-482. [PMID: 34916104 PMCID: PMC8668155 DOI: 10.1016/j.vaccine.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 12/20/2022]
Abstract
Background Acute adverse events and anaphylaxis were reported after the administration of coronavirus disease (COVID-19) mRNA vaccines. We aim to explore the nature and outcome of adverse events following BNT162B2 vaccine in a community vaccination center, Riyadh, Saudi Arabia. Method Within 30 min post vaccination, all acute adverse events (AAEs) that occurred before March 31st, 2021, and in people older than 16 years were reviewed (AAE group). We used the case definition of Brighton collaboration on vaccine safety to define anaphylaxis. Patients’ demographics, comorbidities, allergy history, and outcome at disposition were collected. Observation duration after vaccination was short (<15 min) or extended (<3 h). Statistical analysis was performed to study AAEs association with the study variables and outcomes. Results Out of 71,221 vaccine recipients, 144 (0.002%) had developed 345 AAEs, at a rate of 48.4 events per 10,000 dose administered. The majority of cases in AAE group were first dose recipients (93.8%) and previously healthy (59%), while the minority had a previous history of allergy (6.3%) or a laboratory-confirmed COVID-19 (4.2%). We found a significant association between female gender and the occurrence of any AAE (p-value = 0.002). Per every 10,000 doses administered, non-anaphylactic AAEs were dizziness (17.8), headache (9.7), nausea (7.1), or syncope (3.2). Only one in every ten AAEs was considered serious and resulted in an extended observation (4.8 per 10,000 doses), but only 1/144 required hospitalization for non-anaphylaxis reasons (0.1 per 10,000 doses). According to the Brighton collaboration definition of anaphylaxis, no single case of high certainty anaphylaxis was recorded. No death was documented in this cohort. Conclusion Acute adverse events due to BNT162b2 vaccine were rare and mostly non-serious with a tendency to occur more in women. Further prospective studies on larger vaccine recipients to evaluate the incidence of anaphylaxis in the Saudi population are warranted.
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Almudarra S, Kamel S, Saleh E, Alaswad R, Alruwaily A, Almowald S, Alqunaibet AM, Almudiaheem A, Almutlaq H, Alserehi H, Almalki S, Bahlaq MA, Alsahafi AJ, Alsaif F, Khojah AT, Al-Tawfiq JA, Asiri SI, Assiri A, Jokhdar H. High seroprevalence of SARS-CoV-2 among high-density communities in Saudi Arabia. Infection 2021; 50:643-649. [PMID: 34881415 PMCID: PMC8653801 DOI: 10.1007/s15010-021-01726-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
Background The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection had been investigated utilizing serology. Materials and methods This community-based sero-survey was carried out in the neighborhoods of three cities in Saudi Arabia. Results Of 5629 participants, 2766 (49.1%) were women; and 2148 (38.1%) were 18–34 years of age, and 3645 (64.7%) were from South East Asia. Positive serology was seen in 2825 (50.2% (95% CI: 48.8–51.5%) for SARS-CoV-2 anti-S1 IgG antibodies by ECLIA. Being in the age category of 18–34 years and being from Eastern Mediterranean Region (country A) were associated with higher COVID-19 seropositivity with estimated odds ratio of 1.3 [95% CI 1.1–1.8] and 2.5 [95% CI 1.1.5–4.2] respectively. Gender, social status, education, nationality, symptoms, presence of comorbidities and activity style were positively associated with increased seropositivity. Factors associated negatively with the rate of seropositivity were higher education and having outdoor activity with estimated OR of 0.92 [95% CI 0.46–0.95] and 0.59 [95% CI 0.47–0.74], respectively. Conclusion The study showed high seroprevalence of SARS-CoV-2 among high density population. Health education campaigns should target middle-aged, those with low education, those living in lower standards and indoor workers.
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Affiliation(s)
- Sami Almudarra
- Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Shady Kamel
- Field Epidemiology Training Program, Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Eman Saleh
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rehab Alaswad
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Amaal Alruwaily
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Shaza Almowald
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | | | | | - Hind Almutlaq
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Haleema Alserehi
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Safar Almalki
- Ministry of Health Laboratories, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Mohannad Abdulhafiz Bahlaq
- Public Health Deputy, Madinah Directorate of Health Affairs, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Jaber Alsahafi
- Public Health Deputy, Jeddah Directorate of Health Affairs, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal Alsaif
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah T Khojah
- Faculty of Medicine, Al Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
- Infectious Disease Division, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | | | - Abdullah Assiri
- Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Hani Jokhdar
- Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
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