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Soetikno AG, Lundberg AL, Ozer EA, Wu SA, Welch SB, Mason M, Liu Y, Havey RJ, Murphy RL, Hawkins C, Moss CB, Post LA. Updated Surveillance Metrics and History of the COVID-19 Pandemic (2020-2023) in the Middle East and North Africa: Longitudinal Trend Analysis. JMIR Public Health Surveill 2024; 10:e53219. [PMID: 38568184 PMCID: PMC11208839 DOI: 10.2196/53219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND This study updates the COVID-19 pandemic surveillance in the Middle East and North Africa (MENA) we first conducted in 2020 with 2 additional years of data for the region. OBJECTIVE The objective of this study is to determine whether the MENA region meets the criteria for moving from a pandemic to endemic. In doing so, this study considers pandemic trends, dynamic and genomic surveillance methods, and region-specific historical context for the pandemic. These considerations continue through the World Health Organization (WHO) declaration of the end of the public health emergency for the COVID-19 pandemic on May 5, 2023. METHODS In addition to updates to traditional surveillance data and dynamic panel estimates from the original study by Post et al, this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a 1-sided t test to determine whether regional weekly speed of COVID-19 spread was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data from September 4, 2020, to May 12, 2023. RESULTS The speed of COVID-19 spread for the region had remained below the outbreak threshold for 7 continuous months by the time of the WHO declaration. Acceleration and jerk were also low and stable. Although the 1- and 7-day persistence coefficients remained statistically significant and positive, the weekly shift parameters suggested the coefficients had most recently turned negative, meaning the clustering effect of new COVID-19 cases became even smaller in the 2 weeks around the WHO declaration. From December 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t test of the speed of spread equal to 10 became entirely insignificant from October 2022 onward. CONCLUSIONS The COVID-19 pandemic had far-reaching effects on MENA, impacting health care systems, economies, and social well-being. Although COVID-19 continues to circulate in the MENA region, the rate of transmission remained well below the threshold of an outbreak for over 1 year ahead of the WHO declaration. COVID-19 is endemic in the region and no longer reaches the threshold of the pandemic definition. Both standard and enhanced surveillance metrics confirm that the pandemic had transitioned to endemic by the time of the WHO declaration.
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Affiliation(s)
- Alan G Soetikno
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Alexander L Lundberg
- Buehler Center for Health Policy and Economics, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Egon A Ozer
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
| | - Scott A Wu
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sarah B Welch
- Buehler Center for Health Policy and Economics, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Maryann Mason
- Buehler Center for Health Policy and Economics, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Yingxuan Liu
- Buehler Center for Health Policy and Economics, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Robert J Havey
- Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
- Department of Medicine, General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Robert L Murphy
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
| | - Claudia Hawkins
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Global Communicable and Emerging Infectious Diseases, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
| | - Charles B Moss
- Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Lori Ann Post
- Buehler Center for Health Policy and Economics, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL, United States
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Meraya AM, Syed MH, Shabi AA, Madkhali HA, Yatimi YA, Khobrani KY, Mubarki YA, Khardali A, Thaibah H, Yasmeen A. Assessment of community pharmacists' knowledge, attitudes and their willingness to provide vaccination services in Saudi Arabia. PLoS One 2024; 19:e0304287. [PMID: 38805488 PMCID: PMC11132504 DOI: 10.1371/journal.pone.0304287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Community pharmacists play an important role in increasing vaccination rates especially in countries where they offer vaccination services and administration. However, little is known about community pharmacist's willingness to provide vaccination services in Saudi Arabia. The objective of this study was to assess knowledge, attitudes, willingness and beliefs of community pharmacists in Saudi Arabia towards providing vaccines at pharmacies. METHODS A cross-sectional, online questionnaire-based study using convenience sampling (Snowball technique) was used to obtain responses from community pharmacists across Saudi Arabia. The survey collected information on participants' demographics, knowledge about vaccine, attitude towards vaccine and their attitude to be immunization providers. Bivariate analysis and multiple linear regression models were employed to assess the relationships between demographic variables and outcomes. RESULTS The study sample consisted of 384 community pharmacists. More than half of participants had poor knowledge about vaccines (54%). Only 8.4% of participants had good knowledge about vaccines. The results indicated that community pharmacists in the study sample have positive attitude toward vaccines and are willing to provide vaccination services. There was a significant relationship between knowledge about vaccine and attitude toward vaccines. Pharmacists with poor knowledge about vaccines had negative attitude toward vaccines as compared to those with high knowledge (β = -1.743; P-value = 0.024). Additionally, there was a significant relationship between knowledge about vaccine and attitude to be immunization providers. Pharmacists with poor knowledge about vaccines had negative attitude to be immunization providers as compared to those with high knowledge (β = -2.631; P-value = 0.002). Furthermore, a significant number of the community pharmacists reported facing critical barriers to provide vaccines including legal liability, lack of personal resources and lack of appropriate training. CONCLUSION Comprehensive training and certification programs for pharmacists are crucial to improve their competencies in handling and administering vaccines to increase the rate of vaccinations in Saudi Arabia.
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Affiliation(s)
- Abdulkarim M. Meraya
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Mamoon H. Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Abdulwahab A. Shabi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Huthaifa A. Madkhali
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Younis A. Yatimi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Khalied Y. Khobrani
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Yahia A. Mubarki
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Amani Khardali
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Hilal Thaibah
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Ayesha Yasmeen
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
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Alhraiwil NJ, Alghaith L, Alharbi W, AlAjaji S, Alhumaid A, Aldossary MS. Mobilizing a Kingdom During a Pandemic: The Health Marketing Campaigns Applied by the Saudi Ministry of Health to Promote (COVID-19) Vaccine Confidence and Uptake. Cureus 2024; 16:e53734. [PMID: 38455787 PMCID: PMC10919942 DOI: 10.7759/cureus.53734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND COVID-19 vaccination hesitancy is threatening the global intended herd immunity. Social marketing integration rocketed in promoting public health through awareness campaigns. Saudi Arabia was one of the countries that used social marketing to promote COVID-19 vaccinations for all age groups through successive campaigns. This study aims to describe the content of the campaigns held by the Saudi Ministry of Health to promote COVID-19 vaccine uptake. METHODS A track's working strategy was created to contain COVID-19 spread in Saudi Arabia followed by a vaccination track. Six tracks were maintained over six months extended from June 2020 to December 2020. As a result, different campaigns were launched, and key performance indicators were identified and collected. Data from campaigns and key indicators were collected to determine outreach and impact. RESULTS Five campaigns were initiated receiving high interactions from governmental entities and the public. The individuals' percentage who received full vaccination doses and booster vaccinations increased. Moreover, the last campaign promoting vaccinations in children achieved a 60% willingness rate among adults to vaccinate their children. CONCLUSION COVID-19 awareness campaigns achieved successful outcomes in Saudi Arabia and currently the Kingdom sustained higher vaccination proportions than the average vaccination attainment worldwide.
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Affiliation(s)
| | - Lamay Alghaith
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
| | - Walid Alharbi
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
| | - Sarah AlAjaji
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
| | - Anas Alhumaid
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
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Alotaibi MM, Aldandan EM, Alfredan BE, Almohammed SH, Almousa ZH. Pharmacists' perceptions about providing COVID-19 vaccines in community settings. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100326. [PMID: 37743853 PMCID: PMC10511797 DOI: 10.1016/j.rcsop.2023.100326] [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: 02/12/2023] [Revised: 08/23/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Background Community pharmacists were underutilized in Saudi Arabia. At the start of the coronavirus disease 2019 (COVID-19) outbreak, global healthcare systems experienced significant pressure. To combat the pandemic effectively, there was a need to involve other healthcare providers, such as community pharmacists. As a result, community pharmacists were enlisted to provide vaccines. Objectives This study aims to explore community pharmacists' perceptions about providing COVID-19 vaccines in Saudi community settings. Methods Ethical approval was granted by the Research Ethics Committee of King Faisal University in January 2022. A qualitative methodology was used to explore the opinions of community pharmacists. Semi-structured interviews were conducted via face-to-face qualitative interviewing. Participants were recruited purposively and represented different types of community pharmacy settings. Results A total of 15 face-to-face individual interviews were conducted. The cohort included pharmacists who provided the service (n = 5) and those who did not (n = 10). The results showed that providing the service in a community setting was advantageous to patients, community pharmacy sector, and healthcare system. Moreover, the participants identified several barriers to providing the service. Conclusion Although providing the service had several advantages to several parties, the identified barriers need to be considered for the service to be provided appropriately.
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Affiliation(s)
- Mansour M. Alotaibi
- Pharmacy Practice Department, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Eman M. Aldandan
- Pharm-D intern, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Bashayer E. Alfredan
- Pharm-D intern, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Samar H. Almohammed
- Pharm-D intern, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Zahra H. Almousa
- Pharm-D intern, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
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Murished GM, Dandachi I, Aljabr W. Side effects of COVID-19 vaccines in the middle eastern population. Front Immunol 2023; 14:1270187. [PMID: 38022593 PMCID: PMC10654979 DOI: 10.3389/fimmu.2023.1270187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.
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Affiliation(s)
| | | | - Waleed Aljabr
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Aldawish S, Abusaris R, Almohammadi E, Althobiti F, Albarrag A. Effectiveness of COVID-19 vaccines against ICU admission during Omicron surge in Saudi Arabia: a nationwide retrospective cohort study. BMC Infect Dis 2023; 23:746. [PMID: 37907859 PMCID: PMC10617033 DOI: 10.1186/s12879-023-08686-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused significant economic damage and forced a slew of limitations to be placed by regulatory bodies worldwide. As the SARS-CoV-2 virus continuously mutates over time, it's crucial to understand how well the vaccines are effective against a new variant. OBJECTIVES To measure COVID-19 vaccine effectiveness against ICU admission with the Omicron variant in Saudi Arabia regions. METHODS AND MATERIALS A retrospective cohort study was conducted of vaccinated and non-vaccinated individuals who tested positive during Omicron dominant period (Jan 1, 2020- Jun 11, 2022). We used a Cox proportional hazards model based on calendar time to assess the vaccine's effectiveness while controlling for age and gender. RESULTS A total of 14103 individuals who were divided into fully vaccinated included 8388 (59.5%) individuals, partially vaccinated included 1851 (13.5%) individuals, and un-vaccinated included 3864 (27.4%) individuals. Higher age was associated with a higher risk of ICU admission (HR = 1.03, 95% CI: 1.02, 1.04). Three doses are associated with a lower risk of ICU admission compared to the single dose (HR = 0.09, 95% CI: 0.04, 0.20). By studying the distribution of Omicron infection among different regions, Al-Madinah Al-Monawarah had the highest proportion at 60.23 per 100,000 population (95% CI: 57.05, 63.53). In contrast, Al-jouf had the lowest proportion at 4.51 per 100,000 population (95%CI: 2.891, 6.713). The vaccination status was significantly different in different regions, as the highest proportion of fully vaccinated participants inhabited in Tabouk region, with 71.8% of its cases. Out of all regions, Najran had the highest proportion of ICU admission among Omicron cases with 20% (95% CI: 9.94%, 34.22%). While the lowest rates existed in Riyadh with 0.86% (95%CI: 0.61%, 1.17%). CONCLUSION We found that a booster significantly enhanced protection against severe COVID-19. The partially vaccinated and unvaccinated participants were at significantly higher risk of ICU admission when compared to the fully vaccinated participants. Furthermore, in future, it is worth investigating the effectiveness of a booster when other potential factors (e.g., region, comorbidities, etc.) are included, particularly among future variants of COVID-19.
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Affiliation(s)
- Shaymah Aldawish
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- Public Health Authority, Riyadh, Saudi Arabia.
| | - Raghib Abusaris
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMARC), Riyadh, Saudi Arabia
| | | | | | - Ahmed Albarrag
- Public Health Authority, Riyadh, Saudi Arabia
- Collage of Medicine, King Saud University, Riyadh, Saudi Arabia
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Alghamdi A, Ramsay AIG, Abrams R, Bailey JV. The impact of COVID-19 on patient engagement with primary healthcare: lessons from the saudi primary care setting. BMC PRIMARY CARE 2023; 24:177. [PMID: 37674122 PMCID: PMC10483780 DOI: 10.1186/s12875-023-02131-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND There have been significant achievements in controlling COVID-19 in Saudi Arabia (SA), but as in most healthcare settings worldwide, health services have been seriously disrupted. Also, with pandemic control measures such as lockdowns and curfews, and innovations such as digital health services, the delivery of primary healthcare (PHC) services has dramatically changed. However, little is known about patients' experiences of PHCs during the pandemic, their views on the pandemic-related interventions in SA, and patient views on impact on their medical care. METHODS Qualitative semi-structured online interviews were conducted for twenty-four Saudi patients across SA aged 18 and above who were diverse in terms of age, gender, education and health status. Data were analysed using thematic analysis yielding four major themes as an impact of COVID-19 on patient engagement with PHCs. RESULTS The COVID-19 pandemic has had profound mixed impacts on patient engagement with PHC in SA. Fear of infection or of breaking lockdown rules has negatively impacted the utilisation of PHCs but positively changed patients' attitudes towards seeking medical help for self-limiting conditions. The pandemic has also negatively impacted routine preventive care at PHCs, especially for patients with long-term health conditions. The mandatory use of some digital health services in SA that existed pre-pandemic has provided patients with a perception of better care during the pandemic. Yet, a lack of awareness of optional digital health services, such as virtual clinics, hindered optimal use. Despite pandemic-related disruption of patient engagement with PHCs, the reduced waiting time in PHC centres and healthcare providers' communication and empathy during the pandemic contributed to patients' perceptions of better care compared to pre-pandemic. However, patients living outside the main cities in SA perceived care quality as less good during the pandemic compared to PHCs in the main cities in SA. CONCLUSION The lessons learned from patients' experiences and views of PHCs during the pandemic were beneficial in promoting patient engagement with PHCs. The digital health services mandated in response to the pandemic have accelerated digital health innovation in SA and allowed patients to recognise the benefits of digital health. This has huge potential for increasing continuous patient engagement with PHCs. Yet, patients' experiences of digital health services during the pandemic are essential for informing appropriate implementation and utilisation of e-health services. Patients' positive experiences of PHCs during the pandemic, such as the reduction in waiting times and the perception of improved healthcare providers' professionalism, communication and empathy, can be built on to sustain engagement with PHC services. These findings might have significance for clinicians and policymakers to support patient engagement with PHCs, particularly in healthcare systems like SA that struggle with the overuse of emergency departments (EDs) for PHC-treatable conditions.
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Affiliation(s)
- Alaa Alghamdi
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK.
- Department of Family and Community Medicine, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Angus I G Ramsay
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ruth Abrams
- Faculty of Health and Medical Sciences, School of Health Sciences, University of Surrey, Surrey, UK
| | - Julia V Bailey
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
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Mahmoud MA, Ibrahim A, Alharbi F, Alalawi AM, Alnezary F, Aldafiri A, Alahmadi Y, Alolayan SO, Althaqfan SS, Alsultan MM, Omer S, Alsahly MB. Uptake, Safety and Attitudes Towards COVID-19 Vaccination: A Cross-Sectional Study on First and Second Doses Among the General Public. Risk Manag Healthc Policy 2023; 16:1633-1643. [PMID: 37614963 PMCID: PMC10443679 DOI: 10.2147/rmhp.s418300] [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: 05/08/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023] Open
Abstract
Objective To investigate public uptake, attitudes and the safety of the first and second doses of COVID-19 vaccination. Methods This was a cross-sectional web-based survey study. A self-administered questionnaire was prepared from a literature search and information about COVID-19 available at various resources. The developed questionnaire was validated for readability by experts and refined in light of the feedback received from the experts and the final version was prepared. The reliability of the questionnaire was 0.7 which shows an acceptable level of scale internal consistency. The data analysis was performed using IBM SPSS software (version 25). Results A total of 513 participants completed the survey, including 311 (60.6%) women and 202 (39.4%) men. The mean age was (31.5±12.8) years. It was found that 493 (96.1%) took the first and second doses of COVID-19 and 376 (73.3%) suffered from side effects, of these 14% (56/376) reported the side effects to the health authorities. The most common side effects were fatigue (51.5%), fever (42.3%), headache (39.5%), and injection site pain (37.6%). Half of the participants (50.5%) had a positive attitude towards COVID-19 preventive measures. Females had higher odds of experiencing side effects than males OR (95% CI); 2.002 (1.312-3.056). Individuals living in urban areas had lower odds of experiencing side effects than those living in rural areas OR (95% CI); 0.364 (0.142-0.933). Conclusion Vaccine uptake was massive and side effects due to the COVID-19 vaccine were common but minor. The majority of the participants had positive attitudes towards recommended COVID-19 preventive measures. Being female and living in rural areas were associated with experiencing side effects.
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Affiliation(s)
- Mansour A Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Alnada Ibrahim
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O.Box 84428, Riyadh, 11671, Saudi Arabia
| | - Fawaz Alharbi
- AlHaram Hospital, Ministry of Health, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ali Mohammed Alalawi
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Faris Alnezary
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ahmed Aldafiri
- AlHaram Hospital, Ministry of Health, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Yaser Alahmadi
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Sultan Othman Alolayan
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Sultan S Althaqfan
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Mohammed M Alsultan
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Safaa Omer
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Musaad B Alsahly
- College of Medicine, Department of Physiology, King Saud University, Riyadh, Saudi Arabia
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AlBahrani S, AlBarrak A, AlGubaisi N, Alkurdi H, Alburaiki D, AlGhamdi A, AlOthaiqy M, Tayeb S, Tayeb N, Abdraboh S, Khairi A, Alshareef L, AlHarbi A, AlRabeeah S, Alqahtani AS, Alqahtani JS, Hakami FH, Al-Maqati TN, Alkhrashi SA, Almershad MM, AlAbbadi A, Hakami MH, Faqihi O, Altawfiq KJA, Jebakumar AZ, Al-Tawfiq JA. Self-reported long COVID-19 symptoms are rare among vaccinated healthcare workers. J Infect Public Health 2023; 16:1276-1280. [PMID: 37315430 DOI: 10.1016/j.jiph.2023.05.037] [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: 03/01/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION COVID-19 pandemic adversely affected healthcare workers (HCWs). Here, we evaluate the occurence of long-COVID-19 symtoms among HCWs. METHODS This is a questionnaire-based study of HCWs who had COVID-19 in two medical centers in Saudi Arabia and were mostly vaccinated. RESULTS The study included 243 HCWs with a mean age (+ SD) of 36.1 (+ 7.6) years. Of them, 223 (91.8%) had three doses of COVID-19 vaccine, 12 (4.9%) had four doses, and 5 (2.1%) had two doses. The most common symptoms at the start of the illness were cough (180, 74.1%), shortness of breath (124, 51%), muscle ache (117, 48.1%), headache (113, 46.5%), sore throat (111, 45.7%), diarrhea (109, 44.9%) and loss of taste (108, 44.4%). Symptoms lasted for< one week in 117 (48.1%),> one week and< 1 month in 89 (36.6%),> 2 months and< 3 months in 9 (3.7%), and> 3 months in 15 (6.2%). The main symptoms present> 3 months were hair loss (8, 3.3%), cough (5, 2.1%), and diarrhea (5, 2.1%). A binomial regression analysis showed no relationship between persistence of symptoms for> 3 months and other demographic or clinical symptoms characteristics. CONCLUSION The study showed a low rate of the occurence of long-COVID> 3 months during the Omicron-wave among mostly vaccinated HCWs with no significant comorbidities. Furhter studies are needed to examine the effect of different vaccines on long-COVID-19 among HCWs.
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Affiliation(s)
- Salma AlBahrani
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Ali AlBarrak
- Infectious disease division, Internal Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Nawal AlGubaisi
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Hamoud Alkurdi
- Respiratory therapy department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Dalia Alburaiki
- Respiratory therapy department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Abdulrahaman AlGhamdi
- Respiratory therapy department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Mohammed AlOthaiqy
- Respiratory therapy department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Sarah Tayeb
- Infection Control Department, King Fahad Armed Forces Hospital Jeddah, Saudi Arabia
| | - Nesreen Tayeb
- Infection Control Department, King Fahad Armed Forces Hospital Jeddah, Saudi Arabia
| | - Salimah Abdraboh
- Infection Control Department, King Fahad Armed Forces Hospital Jeddah, Saudi Arabia
| | - Amani Khairi
- Infection Control Department, King Fahad Armed Forces Hospital Jeddah, Saudi Arabia
| | - Lujain Alshareef
- Infection Control Department, King Fahad Armed Forces Hospital Jeddah, Saudi Arabia
| | - Asma AlHarbi
- Infection Control Department, King Fahad Armed Forces Hospital Jeddah, Saudi Arabia
| | - Saad AlRabeeah
- Department of Respiratory care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah S Alqahtani
- Department of Respiratory care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Fatimah Hassan Hakami
- Infection Control Department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Thekra N Al-Maqati
- Department of Clinical Laboratory Science, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | | | - Asmaa AlAbbadi
- Infection Control Department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Mariam Hassan Hakami
- Infection Control Department, King Fahad Military Medical Complex, Dharan, Saudi Arabia
| | - Osama Faqihi
- Respiratory therapy department, King Fahad Military Medical Complex, Dharan, 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 School of Medicine, Baltimore, MD, USA.
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10
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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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11
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Tong C, Shi W, Zhang A, Shi Z. Predicting onset risk of COVID-19 symptom to support healthy travel route planning in the new normal of long-term coexistence with SARS-CoV-2. ENVIRONMENT AND PLANNING. B, URBAN ANALYTICS AND CITY SCIENCE 2023; 50:1212-1227. [PMID: 38603316 PMCID: PMC9482944 DOI: 10.1177/23998083221127703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Due to the increased outdoor transmission risk of new SARS-COV-2 variants, the health of urban residents in daily travel is being threatened. In the new normal of long-term coexistence with SARS-CoV-2, how to avoid being infected by SARS-CoV-2 in daily travel has become a key issue. Hence, a spatiotemporal solution has been proposed to assist healthy travel route planning. Firstly, an enhanced urban-community-scale geographic model was proposed to predict daily COVID-19 symptom onset risk by incorporating the real-time effective reproduction numbers, and daily population variation of fully vaccinated. On-road onset risk predictions in the next following days were then extracted for searching healthy routes with the least onset risk values. The healthy route planning was further implemented in a mobile application. Hong Kong, one of the representative highly populated cities, has been chosen as an example to apply the spatiotemporal solution. The application results in the four epidemic waves of Hong Kong show that based on the high accurate prediction of COVID-19 symptom onset risk, the healthy route planning could reduce people's exposure to the COVID-19 symptoms onset risk. To sum, the proposed solution can be applied to support the healthy travel of residents in more cities in the new normalcy.
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Affiliation(s)
- Chengzhuo Tong
- Otto Poon Charitable Foundation Smart Cities Research Institute and Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wenzhong Shi
- Otto Poon Charitable Foundation Smart Cities Research Institute and Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Anshu Zhang
- Otto Poon Charitable Foundation Smart Cities Research Institute and Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Zhicheng Shi
- Research Institute for Smart Cities, School of Architecture and Urban Planning, Shenzhen University, China
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12
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Alkhalifah M, AlHusseini N, McGhee J. COVID-19 Vaccine Hesitancy Among Pregnant Women. Cureus 2023; 15:e41126. [PMID: 37519564 PMCID: PMC10382906 DOI: 10.7759/cureus.41126] [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: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Background COVID-19 has struck the world severely and caused much damage, losses, and a massive impact on different aspects of life. It is an airborne disease that spreads rapidly among populations and can cause severe illness or death. The rapid nature of its spread led to significant challenges to control it. With the introduction of vaccines, strategies need to be developed to prioritize high-risk populations to lower complication rates, hospitalization, and death. Pregnant women are considered a group of high-risk populations. Misinformation about the vaccination efficacy or side effects contributed to general hesitancy, especially among pregnant women. Purpose This study aims to describe the drivers of COVID-19 vaccine hesitancy among pregnant women in Saudi Arabia. Methodology This is a cross-sectional study among pregnant women in the OB/Gyn clinic in King Abdulaziz Medical City, Riyadh, Ministry of National Guard Health Affairs (MNG-HA), using an online survey. Descriptive statistics (univariate analysis) was used to examine the population characteristics. The Chi-square test was used for categorical variables, and t-test for continuous variables. Further, we used the logistics regression model (multivariate analysis), adjusted for potential confounders, to examine factors associated with women's hesitancy to take the COVID-19 vaccine. All statistical tests were two-sided, and findings were considered statistically significant at p < 0.05. All analyses were conducted using SAS statistical software version 9.4 (SAS Institute Inc., Cary, NC). Result The study included 303 pregnant women. Nearly half of the respondents had their vaccine during their pregnancy (42.24%), believing that the current vaccines' effectiveness for the coronavirus is good (41.25%). More than 73% of participants have received their COVID-19 vaccine before pregnancy. The mean hesitancy and anxiety score was 2 (agree), which concluded that the respondents were hesitant and anxious to receive the COVID-19 vaccine. Conclusion The study showed a significant correlation between pregnant women's worries and the intention to take the vaccine. The concerns were mainly about the impact of the vaccine on themselves, their babies, and the pregnancy.
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Affiliation(s)
| | | | - John McGhee
- Public Health, Center for Improving Value in Health Care, Riyadh, SAU
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13
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AlLehaibi LH, Alomar M, Almulhim A, Al-Makki S, Alrwaili NR, Al-Bassam S, Alsultan S, Al Saeed J, Alsheef M, Abraham I, Alamer A. Effectiveness and Safety of Enoxaparin Versus Unfractionated Heparin as Thromboprophylaxis in Hospitalized COVID-19 Patients: Real-World Evidence. Ann Pharmacother 2023; 57:361-374. [PMID: 35942505 PMCID: PMC9996167 DOI: 10.1177/10600280221115299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Coronavirus 2019 (COVID-19) patients are at risk of thrombosis. Literature that compares the effectiveness of enoxaparin to unfractionated heparin (UFH) in COVID-19 patients is scarce. OBJECTIVE We aimed to evaluate the effectiveness and safety of enoxaparin compared with UFH when used at their standard/intermediate dosing in COVID-19 patients. METHODS This was a retrospective study conducted at a large COVID-19 center located in Eastern Province, Saudi Arabia. Confirmed COVID-19 cases (≥18 years old) admitted between January and December 2020 were randomly screened for inclusion. Exclusion criteria were patients receiving therapeutic anticoagulation, on chronic anticoagulation, had active bleeding, a platelet count <25 × 109/L, or an incomplete electronic file. The primary endpoint was the occurrence of any thrombotic event (pulmonary embolism, deep venous thrombosis, stroke, or myocardial infarction) or mortality. Secondary endpoints were major or minor bleeding. We applied inverse propensity score weighting (IPTW) with survival analysis to analyze the primary endpoint. Logistic regression was used for the secondary endpoint. RESULTS A total of 980 patients were included (enoxaparin, n = 470 and UFH, n = 510) with a mean age (±SD) of 47.7 (± 12.3) for the enoxaparin arm and 52 (±13.9) for the UFH arm. There was a statistically significant difference in the primary endpoint with an adjusted hazard ratio (aHR) of 0.46 (95%CI: 0.22 to 0.96, P = 0.039) in favor of the enoxaparin arm. There was no statistically significant difference in major or minor bleeding rates between the two arms. CONCLUSION AND RELEVANCE When compared with UFH, enoxaparin was associated with a significant reduction in thrombotic events or mortality among COVID-19 patients. The results need confirmation from randomized controlled trials.
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Affiliation(s)
- Lina H. AlLehaibi
- Eastern Health Cluster, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Mukhtar Alomar
- Eastern Health Cluster, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Abdulaziz Almulhim
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Sarah Al-Makki
- Eastern Health Cluster, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Nazar R. Alrwaili
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahad Al-Bassam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Semat Alsultan
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jenan Al Saeed
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Alsheef
- Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ivo Abraham
- Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA
| | - Ahmad Alamer
- Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA
- Department of Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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Alhaddad MJ, Alsaeed A, Alkhalifah RH, Alkhalaf MA, Altriki MY, Almousa AA, Alqassim MJ, Alibrahim F. A Surge in Malaria Cases in the Eastern Health Region of Saudi Arabia During the COVID-19 Pandemic. Cureus 2023; 15:e37740. [PMID: 37213951 PMCID: PMC10192777 DOI: 10.7759/cureus.37740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/23/2023] Open
Abstract
Background Malaria transmission was stopped on most of the vast area of the Kingdom of Saudi Arabia. However, the pandemic of coronavirus disease (COVID-19) has negatively affected the efforts to control malaria. For instance, COVID-19 was reported to induce a relapse of malaria that is caused by Plasmodium vivax. Furthermore, physicians' attention toward COVID-19 can only result in neglect and delayed diagnosis of complicated malaria cases. These factors, among others, might have contributed to an increase of malaria cases in Dammam, Saudi Arabia. Thus, this study was conducted to examine the effects of COVID-19 on malarial cases. Methods The medical records of all patients who were treated at Dammam Medical Complex for malaria between July 1, 2018, and June 30, 2022, were reviewed. Malaria cases were compared between the pre-COVID-19 period (between July 1, 2018, and June 30, 2020) and the COVID-19 period (between July 1, 2020, and June 30, 2022). Results A total of 92 malaria cases occurred in the total study period. There were 60 cases of malaria in the COVID-19 period as opposed to only 32 cases in the pre-COVID-19 period. All the cases were imported from the endemic Saudi southern areas or from outside the country. Eighty-two patients (89.1%) were males. Most of them were Sundaneses (39 patients, 42.4%), Saudis (21 patients, 22.8%), and tribal peoples (14 patients, 15.2%). Fifty-four patients (58.7%) were infected with Plasmodium falciparum. Seventeen patients (18.5%) were infected with Plasmodium vivax. Another 17 patients (18.5%) had a mixed infection with both Plasmodium falciparum and Plasmodium vivax. A trend toward more infected stateless tribal patients was observed in the COVID-19 period compared to the pre-COVID-19 period (21.7% vs 3.1%). A similar trend was noticed for mixed malarial infections with both Plasmodium falciparum and Plasmodium vivax (29.8% vs 0%) with a P value of less than 0.01. Conclusion Malaria cases were almost doubled during the COVID-19 pandemic as compared to the pre-pandemic era signifying the negative effects of the pandemic on malaria epidemiology. The cases increased for a variety of causes that include alternation of health-seeking behaviors, changes in healthcare structures and regulations, and the interruption of malaria preventive services. Future research is needed to study the long-term effects of the changes imposed by the COVID-19 pandemic and to mitigate the effects of any future pandemic on malaria control. As two patients from our cohort were diagnosed with malaria based on blood smears, although they had negative rapid detection tests (RDTs), we recommend testing all the patients who are suspected to have malaria with both RDTs and peripheral blood smears.
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Affiliation(s)
- Mousa J Alhaddad
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
| | - Ali Alsaeed
- Department of Internal Medicine, Infectious Disease Division, Dammam Medical Complex, Dammam, SAU
| | | | - Makarem A Alkhalaf
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | - Arif A Almousa
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
| | | | - Fatimah Alibrahim
- Department of Internal Medicine, Infectious Disease Division, Dammam Medical Complex, Dammam, SAU
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15
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Saleh Alzahrani H, Ali Algashami S, Abdulaziz Alharkan A, Sultan Alotaibi N, Waseem Algahs N. The Effect of COVID-19 Vaccination on the menstrual cycle in female in Riyadh, Saudi Arabia. Saudi Pharm J 2023; 31:746-751. [PMID: 37128295 PMCID: PMC10063452 DOI: 10.1016/j.jsps.2023.03.015] [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: 02/06/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Background Recently, few studies have mentioned minor changes in women's menstrual cycle after the COVID-19 vaccination. There were many reported cases of female menstrual cycle problems in primary healthcare clinics in Riyadh, Saudi Arabia. The study aimed to explore the prevalence of menstrual irregularities after the COVID-19 vaccine among females of childbearing age in Riyadh, Saudi Arabia. Materials and Methods This observational cross-sectional study was conducted from dec 2021 to June 2022 in Saudi Arabia. The study was carried out by using a convenience sampling technique. Results Our analysis includes 1066 participants. Abnormal menstruation was significantly associated with hypertension (p-value = 0.024), polycystic ovary syndrome (p-value = 0.001), and at least one gynaecological condition (p-value < 0.001). However, the multivariate regression analysis showed that menstrual abnormality before receiving the COVID-19 vaccine (OR = 0.09, 95% CI, 0.06 to 0.14, p-value <0.001) was more likely to be associated with abnormal menstruation after receiving the vaccine. Conclusions Our study findings showed a significant association between covid-19 vaccination and menstruation irregularity before administering the covid-19 vaccine, irrespective of vaccine type or the number of doses administered. Future and ongoing clinical trials should investigate menstrual abnormalities, other abnormal vaginal bleeding and hormonal changes post-vaccination, especially the COVID-19 vaccine.
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Affiliation(s)
- Hayat Saleh Alzahrani
- Family Medicine and Medical Education, Department of Clinical Science, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Corresponding author at: Family Medicine and Medical Education, Princess Nourah Bint Abdulrahman University, P.O. box: 84428, Riyadh 11671, Saudi Arabia.
| | - Saba Ali Algashami
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Noura Sultan Alotaibi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Naelah Waseem Algahs
- Family Medicine Resident - King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
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16
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Alhuzaimi AN, Alrasheed AA, Al-Eyadhy A, Aljamaan F, Alhasan K, Batais MA, Jamal A, Alshahrani FS, Alenezi S, Alhaboob A, AlZamil F, Bashumeel YY, Banaeem AM, Aldawood A, Halwani R, Barry M, Al-Tawfiq JA, Temsah MH. Exploring Determinants of COVID-19 Vaccine Acceptance, Uptake, and Hesitancy in the Pediatric Population: A Study of Parents and Caregivers in Saudi Arabia during the Initial Vaccination Phase. Healthcare (Basel) 2023; 11:972. [PMID: 37046901 PMCID: PMC10094388 DOI: 10.3390/healthcare11070972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES This study aims to assess COVID-19 vaccine acceptance, uptake, and hesitancy among parents and caregivers of children in Saudi Arabia during the initial rollout of pediatric COVID-19 vaccination. METHODS An electronic survey was used to collect data from participants who visited a COVID-19 vaccine center. The survey included demographic data, COVID-19 vaccine status among participants and their children, and reasons for vaccine acceptance or rejection. The Vaccine Hesitancy Scale (VHS) tool was also employed to assess vaccine hesitancy and attitudes toward the COVID-19 vaccine and routine childhood vaccination. Multivariate binary regression analysis was used to identify predictors of actual COVID-19 vaccine uptake among children. RESULTS Of the 873 respondents included in the analysis, 61.5% were parents and 38.5% were other caregivers. Of the participants, 96.9% had received the COVID-19 vaccine. Six hundred and ninety-four participants accepted the vaccine for their children, with the main reasons being an endorsement by the Saudi Ministry of Health (60%) and the importance of going back to school (55%). One hundred and seventy-nine participants would not vaccinate their children, with the most common reasons being fear of adverse effects (49%) and inadequate data about vaccine safety (48%). Factors such as age, COVID-19 vaccination status, self-rated family commitment level, attitudes toward routine children's vaccines, and participants' generalized anxiety disorder (GAD7) score did not significantly correlate with children's COVID-19 vaccination status. Parents were less likely to vaccinate their children compared to other caregivers, and participants with a higher socioeconomic status were more likely to vaccinate their children. CONCLUSION Vaccine acceptance and uptake were high during the initial pediatric COVID-19 vaccination rollout in Saudi Arabia. Still, the ongoing endorsement of the Ministry of Health and healthcare authorities should continue to advocate for better vaccine uptake in children.
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Affiliation(s)
- Abdullah N. Alhuzaimi
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Division of Pediatric Cardiology, Cardiac Science Department, College of Medicine, King Saud University Medical City, Riyadh 11362, Saudi Arabia
- Pediatric Cardiology Section, Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh 11211, Saudi Arabia
| | - Abdullah A. Alrasheed
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Pediatric Department, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Critical Care Department, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Khalid Alhasan
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Pediatric Department, King Saud University Medical City, Riyadh 11362, Saudi Arabia
- Solid Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Mohammed A. Batais
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh 11362, Saudi Arabia
- Family Medicine Center, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh 11362, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Fatimah S. Alshahrani
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Division of Infectious Diseases, Department of Internal Medicine, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Shuliweeh Alenezi
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Department of Psychiatry, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Pediatric Department, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Fahad AlZamil
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Pediatric Department, King Saud University Medical City, Riyadh 11362, Saudi Arabia
| | - Yaser Y. Bashumeel
- College of Medicine, Sulaiman Al Rajhi University, Al-Bukayriah 51941, Saudi Arabia
| | - Ahmad M. Banaeem
- College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia
| | - Abdulrahman Aldawood
- College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia
| | - Rabih Halwani
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Mazin Barry
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Evidence-Based Health Care & Knowledge Translation Research Chair, Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Department of Internal Medicine, College of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia (M.-H.T.)
- Pediatric Department, King Saud University Medical City, Riyadh 11362, Saudi Arabia
- Prince Abdullah bin Khaled Coeliac Disease Research Chair, King Saud University, Riyadh 11362, Saudi Arabia
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17
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Alfosail EK, Alghamdi M. Perception and Acceptance of COVID-19 Vaccine Among Healthcare Workers in Jeddah, Saudi Arabia. Cureus 2023; 15:e35673. [PMID: 37012961 PMCID: PMC10066419 DOI: 10.7759/cureus.35673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction The COVID-19 pandemic has resulted in significant hospitalizations and deaths, particularly among healthcare workers (HCWs). Various therapeutic and preventive measures have been introduced, with vaccination considered the primary preventive measure. This study aims to assess the perceptions and acceptance of COVID-19 vaccination among HCWs. Methods We conducted an analytical cross-sectional study on HCWs in hospitals located in Jeddah, Saudi Arabia. The study included physicians, nurses, pharmacists, lab technicians, and radiologists who work in the Ministry of Health's general hospitals. A total of 394 participants were included in the study. Data were analyzed using SPSS v26, and a p-value less than 0.05 was considered significant. Results A majority of the participants (72.6%) were female, aged between 31-40 years (55.3%), and married (59.6%). More than half of the participants (55.6%) had received training on dealing with COVID-19. The mean scores for COVID-19 vaccine refusal, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived effectiveness of COVID-19 vaccination were 18.36 ± 7.02, 14.48 ± 3.62, 11.51 ± 2.99, 12.39 ± 3.5, 8.25 ± 2.35, and 8.40 ± 2.46, respectively. Age was found to be correlated with the perceived severity of COVID-19 in non-vaccination (p=0.048), while gender was associated with the perceived severity of COVID-19 (p=0.015). Marital status (p=0.001), years of experience (p=0.009), profession (p=0.019), and education (p=0.028) were found to be correlated with perceived susceptibility. Education levels were found to be correlated with the perceived benefits of vaccination (p=0.007), perceived barriers to vaccines (p=0.002), and vaccine views (p=0.002). Years of experience (p=0.017) were found to be correlated with perceived severity of COVID-19, while profession type was significantly associated with perceived severity of COVID-19 (p=0.016) and vaccine view (p=0.008) Conclusion The study found that participants had a positive perception and high acceptance of COVID-19 vaccination. The results also indicated that various sociodemographic factors were associated with the perception and acceptance of COVID-19 vaccines among HCWs. These findings could help in formulating effective strategies to improve vaccination uptake rates among HCWs, thereby reducing transmission and mortality among Health Care Workers due to COVID-19.
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Islam MA, Alshayban DM, Naqvi AA, Maqsood MB, Ishaqui AA, Kashif M, Ali M, Haseeb A. How anxiety attributed to COVID-19, disease knowledge, and intention to vaccinate against SARS-CoV-2 viral infection prevail in general public of Saudi Arabia? Front Public Health 2023; 11:1078023. [PMID: 36825138 PMCID: PMC9941530 DOI: 10.3389/fpubh.2023.1078023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/18/2023] [Indexed: 02/09/2023] Open
Abstract
Aim The study aimed to document the anxiety attributed to COVID-19, disease knowledge, and intention to vaccinate against the disease in general public. Moreover, the interplay among these three outcomes was also investigated. Methods A cross-sectional study was conducted for 2 months in three cities of Dammam Region of Saudi Arabia. The target segment was the adult population of Saudi Arabia. Convenience sampling was used and all adults aged ≥18 were invited to participate. The questionnaire used in the study was available in both Arabic and English languages. It included a demographic section, a section dedicated to vaccination intention and, a section containing coronavirus anxiety scale (CAS). The data analysis was carried out using IBM SPSS version 23. The study was approved by an ethics committee (IRB-2021-05-297). Results A total of 542 responses were analyzed. Most respondents had no anxiety attributed to COVID-19 (92.1%), self-reported good knowledge of COVID-19 (79.7%) and intended to administer a vaccine (57.4%). Age groups 18-29 years and 30-45 years, and having a chronic medical condition, were found to be determinants of having COVID-19 anxiety (p < 0.05). The variables of self-rated good knowledge of disease, never contracted COVID-19, and incomes of SAR 5,000 (i.e., USD 1333), and SAR 7,500-10,000 (i.e., USD 1999.5-2666), were found to be determinants of having positive intention toward vaccination (p < 0.05). Conclusion The anxiety due to COVID-19 was present in a few participants. Besides, self-reported knowledge about COVID-19 and intention to administer a vaccine, were positively linked to each other. However, both variables had no effect on COVID-19 anxiety. It is important to review and address the determinants of positive intention to further increase vaccine acceptance rate.
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Affiliation(s)
- Md. Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,*Correspondence: Md. Ashraful Islam ✉
| | - Dhfer Mahdi Alshayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Atta Abbas Naqvi
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | | | | | - Muhammad Kashif
- Pharmaceutical Care Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Majid Ali
- Department of Basic Sciences, College of Medicine, Sulaiman Al-Rajhi University, Al-Bukayriyah, Saudi Arabia
| | - Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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19
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Alissa DA, Aburas W, Almasuood R, Almudaiheem HY, Al Aseri Z, Alrabiah F, Ezzat H, Moulana AA, Alawi MM, Al-Mutairy E, Alaama T, Alamri MS, Bamousa MS, Alshehri AA, Alosaimi MH, Alali A, Nori R, Devol EB, Mohamed G, Al-Jedai AH. Prevalence and epidemiological trends in mortality due to COVID-19 in Saudi Arabia. Public Health 2023; 215:31-38. [PMID: 36634404 DOI: 10.1016/j.puhe.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This article describes the prevalence and epidemiological trends of COVID-19 mortality in the largest registry in the Kingdom of Saudi Arabia (KSA). STUDY DESIGN A prospective epidemiological cohort study using data from all healthcare facilities in KSA collected between March 23, 2020, and April 30, 2022. Data on the number of daily deaths directly related to COVID-19 were gathered, analyzed, and reported. METHOD Data analysis was carried out using national and regional crude case fatality rate and death per 100,000 population. Descriptive statistics using numbers and proportions were used to describe age, gender, nationality, and comorbidities. The mortality trend was plotted and compared with international figures. In addition, the most common comorbidities associated with mortality and the proportion of patients who received COVID-19 vaccine were reported. RESULTS The total reported number of deaths between March 23, 2020, and April 30, 2022, was 9085. Crude case fatality rate was 1.21%, and death per 100,000 population was 25.38, which compared favorably to figures reported by several developed countries. The highest percentages of deaths were among individuals aged between 60 and 69 years, males (71%), and individuals with diabetes (60%). Only 2.8% of mortalities occur in patients who received COVID-19 vaccine. Diabetes, hypertension, and heart failure had the highest attributable risk of mortality among patients who died due to COVID-19. CONCLUSION Case fatality rate and death per 100,000 population in KSA are among the lowest in the world due to multiple factors. Several comorbidities have been identified, namely, diabetes, hypertension, obesity, and cardiac arrhythmias.
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Affiliation(s)
- D A Alissa
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia; Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
| | - W Aburas
- University of Hail, College of Pharmacy, Hail, Saudi Arabia
| | - R Almasuood
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia
| | - H Y Almudaiheem
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia
| | - Z Al Aseri
- Department of Emergency Medicine and Critical Care, King Saud University, Riyadh, Saudi Arabia; Adult Critical Care, Ministry of Health, Riyadh, Saudi Arabia
| | - F Alrabiah
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - H Ezzat
- Hematology Programs, Ministry of Health, Saudi Arabia; John Hopkins Aramco Healthcare, Dharan, Saudi Arabia; University of British Columbia, Canada
| | - A A Moulana
- Forensic Medicine Center, Makkah Al Mukarramah, Saudi Arabia
| | - M M Alawi
- Infection Control & Environmental Health Unit, Department of Medical Microbiology & Parasitology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - E Al-Mutairy
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - T Alaama
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia; Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
| | - M S Alamri
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia
| | - M S Bamousa
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia; Forensic Medicine General Directorate, Ministry of Health, Riyadh, Saudi Arabia
| | - A A Alshehri
- Forensic Medicine Center, Ministry of Health, Riyadh, Saudi Arabia
| | - M H Alosaimi
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia; Mortality Affairs, Ministry of Health, Riyadh, Saudi Arabia
| | - A Alali
- Internal Medicine and Infectious Diseases, King Saud Medical City, Riyadh, Saudi Arabia
| | - R Nori
- Internal Medicine Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - E B Devol
- Department of Biostatistics, Epidemiology & Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - G Mohamed
- Department of Biostatistics, Epidemiology & Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - A H Al-Jedai
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia; Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia.
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Marcassoli A, Leonardi M, Passavanti M, De Angelis V, Bentivegna E, Martelletti P, Raggi A. Lessons Learned from the Lessons Learned in Public Health during the First Years of COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1785. [PMID: 36767152 PMCID: PMC9914715 DOI: 10.3390/ijerph20031785] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
(1) Objectives: to investigate the main lessons learned from the public health (PH) response to COVID-19, using the global perspective endorsed by the WHO pillars, and understand what countries have learned from their practical actions. (2) Methods: we searched for articles in PubMed and CINAHL from 1 January 2020 to 31 January 2022. 455 articles were included. Inclusion criteria were PH themes and lessons learned from the COVID-19 pandemic. One hundred and forty-four articles were finally included in a detailed scoping review. (3) Findings: 78 lessons learned were available, cited 928 times in the 144 articles. Our review highlighted 5 main lessons learned among the WHO regions: need for continuous coordination between PH institutions and organisations (1); importance of assessment and evaluation of risk factors for the diffusion of COVID-19, identifying vulnerable populations (2); establishment of evaluation systems to assess the impact of planned PH measures (3); extensive application of digital technologies, telecommunications and electronic health records (4); need for periodic scientific reviews to provide regular updates on the most effective PH management strategies (5). (4) Conclusion: lessons found in this review could be essential for the future, providing recommendations for an increasingly flexible, fast and efficient PH response to a healthcare emergency such as the COVID-19 pandemic.
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Affiliation(s)
- Alessia Marcassoli
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Marco Passavanti
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Valerio De Angelis
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, 00189 Rome, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit and Coma Research Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
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Rehman AU, Mian SH, Usmani YS, Abidi MH, Mohammed MK. Modeling Consequences of COVID-19 and Assessing Its Epidemiological Parameters: A System Dynamics Approach. Healthcare (Basel) 2023; 11:healthcare11020260. [PMID: 36673628 PMCID: PMC9858678 DOI: 10.3390/healthcare11020260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
In 2020, coronavirus (COVID-19) was declared a global pandemic and it remains prevalent today. A necessity to model the transmission of the virus has emerged as a result of COVID-19's exceedingly contagious characteristics and its rapid propagation throughout the world. Assessing the incidence of infection could enable policymakers to identify measures to halt the pandemic and gauge the required capacity of healthcare centers. Therefore, modeling the susceptibility, exposure, infection, and recovery in relation to the COVID-19 pandemic is crucial for the adoption of interventions by regulatory authorities. Fundamental factors, such as the infection rate, mortality rate, and recovery rate, must be considered in order to accurately represent the behavior of the pandemic using mathematical models. The difficulty in creating a mathematical model is in identifying the real model variables. Parameters might vary significantly across models, which can result in variations in the simulation results because projections primarily rely on a particular dataset. The purpose of this work was to establish a susceptible-exposed-infected-recovered (SEIR) model describing the propagation of the COVID-19 outbreak throughout the Kingdom of Saudi Arabia (KSA). The goal of this study was to derive the essential COVID-19 epidemiological factors from actual data. System dynamics modeling and design of experiment approaches were used to determine the most appropriate combination of epidemiological parameters and the influence of COVID-19. This study investigates how epidemiological variables such as seasonal amplitude, social awareness impact, and waning time can be adapted to correctly estimate COVID-19 scenarios such as the number of infected persons on a daily basis in KSA. This model can also be utilized to ascertain how stress (or hospital capacity) affects the percentage of hospitalizations and the number of deaths. Additionally, the results of this study can be used to establish policies or strategies for monitoring or restricting COVID-19 in Saudi Arabia.
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Affiliation(s)
- Ateekh Ur Rehman
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh 11421, Saudi Arabia
- Correspondence:
| | - Syed Hammad Mian
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
| | - Yusuf Siraj Usmani
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh 11421, Saudi Arabia
| | - Mustufa Haider Abidi
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
| | - Muneer Khan Mohammed
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
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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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23
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Muacevic A, Adler JR, Alasfour JA, Alaali TM, Alghamdi AS, Mohammed RA. Association Between COVID-19 Vaccination and Abortion: A Cross-Sectional Study in Jeddah. Cureus 2023; 15:e33836. [PMID: 36819432 PMCID: PMC9931027 DOI: 10.7759/cureus.33836] [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: 01/16/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Clinical trials for COVID-19 vaccines initially excluded pregnant women. However, observational studies revealed a relative safety of the vaccine during pregnancy therefore association between different types of COVID-19 vaccination and the risk of abortion must be studied. Objectives: The objective is to explore the possible association between abortion and different types of COVID-19 vaccination in Jeddah. METHODS This was a retrospective cross-sectional study done in three private general hospitals in Jeddah using electronic medical records and phone interviews of pregnant women who were admitted with abortion. Women were then interviewed for their vaccination data (type, dose) and their current pregnancy outcome (aborted or not). RESULTS Medical records of 214 women diagnosed with abortion were included; 13.1% of them managed to continue their pregnancy. Vaccinated women (86%) had significantly earlier gestational age (p=0.031), higher hypertension (<0.001), and lower positive consanguinity (<0.001) compared to non-vaccinated women. The type (p=0.636) and number (p=0.331) of vaccination did not differ significantly among vaccinated women with and without abortion. Significant predictors of abortion were age>35 years (OR: 3.1, 95% CI: 1.34-6.97, p=0.008), diabetes (OR: 0.09, 95% CI: 0.01-0.89, p=0.040), and positive consanguinity (OR: 0.12, 95% CI: 0.02-0.63, p=0.012). However, spontaneous abortion did not have an increased odds of exposure to COVID-19 vaccines (OR: 1.07, 95% CI: 0.21-5.49, p=0.937). CONCLUSION COVID-19 vaccination is not associated with an increased risk of abortion in women vaccinated during their first or second trimesters. Further clinical trials are needed to support the evidence of the safety of early vaccination of pregnant women.
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Alqatari S, Ismail M, Hasan M, Bukhari R, Al Argan R, Alwaheed A, Alkhafaji D, Ahmed SE, Hadhiah K, Alamri T, Nemer A, Albeladi F, Bumurah NN, Sharofna K, Albaggal Z, Alghamdi R, AlSulaiman RS. Emergence of Post COVID-19 Vaccine Autoimmune Diseases: A Single Center Study. Infect Drug Resist 2023; 16:1263-1278. [PMID: 36910517 PMCID: PMC9994665 DOI: 10.2147/idr.s394602] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) became a major concern since the announcement that it is a pandemic in early 2020. Vaccine trials were started in November 2020, and completed rapidly due to the urgency to get over the infection. Side effects to vaccines started to be reported. There were minor side effects including site of injection pain and heaviness and constitutional symptoms like fever which are considered minor. One of the rare adverse events is post vaccine new onset autoimmune diseases. Methods Data were obtained from one center in the eastern province of Saudi Arabia (King Fahd Hospital of University). All patient events reported occurred in the study period March 2021 to February 2022. We identified patients presenting with autoimmune diseases with exclusively new onset presentations. Results We identified 31 cases of immune-mediated disease: 18 females (58%); 13 males (42%). Only 4 of them (13%) had an autoimmune background before COVID-19 vaccination. The average time between vaccination and new-onset disease symptoms was 7 days. Among all the cases in our study, 7 patients (22.5%) had new-onset vasculitis, 2 cases had IgA vasculitis and 5 cases had ANCA vasculitis, 6 cases had neurological diseases (19.3%), 4 cases (12.9%) had new-onset systemic lupus erythematosus (SLE), 3 cases (9.6%) presented with new-onset inflammatory arthritis, and one had Sjogren's syndrome (3.2%). Conclusion Our study is unique as it is the first study to include the largest number (31 patients) of new onsets of confirmed autoimmune diseases related to Covid-19 vaccines.
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Affiliation(s)
- Safi Alqatari
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Mona Ismail
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Manal Hasan
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Raed Bukhari
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem Al Argan
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Abrar Alwaheed
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Dania Alkhafaji
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Syed Essam Ahmed
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Kawther Hadhiah
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Turki Alamri
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Ameera Nemer
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Fedaa Albeladi
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Noor N Bumurah
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Khalid Sharofna
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Zainab Albaggal
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Raghad Alghamdi
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem S AlSulaiman
- Department of Internal Medicine- College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahad Hospital of the University, Khobar, Eastern Province, Saudi Arabia
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Parental Perceptions and Barriers towards Childhood COVID-19 Vaccination in Saudi Arabia: A Cross-Sectional Analysis. Vaccines (Basel) 2022; 10:vaccines10122093. [PMID: 36560503 PMCID: PMC9785967 DOI: 10.3390/vaccines10122093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction: The vaccination of children against Coronavirus disease (COVID-19) is a prime area of focus around the globe and is considered a pivotal challenge during the ongoing pandemic. This study aimed to assess parents′ intentions to vaccinate their children and the barriers related to pediatric COVID-19 vaccination. Methodology: An online web-based survey was conducted to recruit parents with at least one child under the age of 12 years from Saudi Arabia’s Al-Jouf region. The parental intentions to vaccinate children were assessed via six items, while barriers against vaccination were assessed through seven items in validated study instrument. A 5-point Likert scale was used to record the responses of parents regarding both their intentions and barriers. Results: In total, 444 parents (28.41 ± 7.4 years, 65% females) participated in this study. Almost 90% of parents were vaccinated against COVID-19 but only 42% of parents intended to vaccinate their children. The mean intention score was 2.9 ± 1.36. More than one-third of study participants had no plan to vaccinate their children against COVID-19. The majority of the respondents agreed to vaccinate their children if vaccination was made compulsory by the government (relative index: 0.76, 73%). Out of seven potential barriers analyzed, concerns over vaccine safety and side effects were ranked highest (RII: 0.754), reported by 290 (65%) participants. In multivariate logistic regression, significant predictors of parental intention to vaccinate children were the increased education level of the parents (secondary education: OR = 3.617, p = 0.010; tertiary education: OR = 2.775, p = 0.042), COVID-19 vaccination status (vaccinated: OR = 7.062, p = 0.003), mother’s involvement in decisions regarding the child’s healthcare (mother: OR 4.353, p < 0.001; both father and mother: OR 3.195, p < 0.001) and parents’ trust in the vaccine’s safety (OR = 2.483, p = 0.022). Conclusions: This study underscored the low intention among parents to vaccinate their children against COVID-19. Vaccination intention was found to be associated with education, parents’ vaccination status, the mother’s involvement in healthcare decisions, and parents’ trust in the vaccine’s safety. On the other hand, parents’ concerns over the safety and efficacy of the COVID-19 vaccine were widely reported as barriers to childhood vaccination. The health authorities should focus on addressing parental concerns about vaccines to improve their COVID-19 vaccination coverage.
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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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AlBahrani S, AlBarrak A, Al-Musawi T, AlGubaisi NA, Almalki M, Hakami FH, Alghamdi T, AlBeiuruti Z, Alkhrashi S, Almershad M, Alzahrani S, AlQuraiaan A, AlTourifi H, Jebakumar AZ, Al-Tawfiq JA. COVID-19 vaccine had a significant positive impact on patients with SARS-COV-2 during the third (Omicron) wave in Saudi Arabia. J Infect Public Health 2022; 15:1169-1174. [PMID: 36215800 PMCID: PMC9490953 DOI: 10.1016/j.jiph.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/31/2022] [Accepted: 09/18/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The third (Omicron) wave had caused significant increase in the number of COVID-19 cases around the globe. The severity of the disease dependeds on the extent of the vaccination status. METHODS This is a retrospective study of infected COVID-19 patients during the third (Omicron) wave in a hospital in Saudi Arabia. RESULTS A total of 400 patients were included with 220 (55 %) males and 180 (45 %) females, and a mean age (+/- SD) of 36.34 + 16.47 years. The most common presenting symptoms were: sore throat 159 (39.8 %), cough 158 (39.5 %), fever 132 (33 %), headache 122 (30.5 %), and muscle ache 124 (31%). There was no difference in underlying conditions, signs and symptoms between males and females apart from the occurrence of sore throat with an OR of 2.014 (95 % CI: 1.103-3.677, P = 0.023) and need of hospitalization OR 2.457 (95 % CI: 1.168-5.167, P value =.018) in a binary logistic regression comparison. The need for hospitalization was inversely related to the number of COVID-19 vaccination doses. The rate of admission was 8 (72.7 %), 34 (12 %), 4 (5.4 %) for one, two, and three doses of COVID-19 vaccine, respectively (P < 0.0001). Of all the patients, 14 (3.5 %) and 8 (2 %) required intensive care (ICU) admission and mechanical ventilation, respectively. The median Ct-value of SARS-CoV-2 was higher in those who had 2 or 3 doses compared to those who had one dose of the COVID-19 vaccine, but the difference did not reach statistical significance. None of the included patients died during the study period. CONCLUSION Omicron variant symptoms among infected patients are generally milder compared to other variants. Prior COVID-19 vaccination may limit disease severity and need for hospitalization.
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Affiliation(s)
- Salma AlBahrani
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Ali AlBarrak
- Infectious Disease Division, Internal Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Tariq Al-Musawi
- Critical Care Department, Dr. Sulaiman Alhabib Hospital, Alkhobar, Saudi Arabia; Royal College of Surgeons in Ireland-Medical University of Bahrain, Bahrain
| | | | - Maram Almalki
- King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | | | - Turki Alghamdi
- King Fahd Military Medical Complex, Dhahran, 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 School of Medicine, Baltimore, MD, USA.
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Al-Tawfiq JA, Kattan RF, Memish ZA. Escalating the 2022 Hajj during the third year of the COVID-19 pandemic. J Travel Med 2022; 29:6582521. [PMID: 35532301 PMCID: PMC9129225 DOI: 10.1093/jtm/taac059] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
Abstract
The escalation of the number of pilgrims for the 2022 Hajj season comes as KSA had succeeded in reaching an excellent percentage in vaccine coverage and subsequently eased the restrictions. KSA adopted an extensive surveillance, implemented risk mitigation, and maximized COVID-19 vaccines coverage.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.,Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Department of Medicine, Johns Hopkins University, Baltimore, MD 21093, USA
| | - Rana F Kattan
- Pediatric Department, King Abdullah Specialist Children's Hospital(KASH), Riyadh 14611, Saudi Arabia.,Department of Medicine, King Saud Bin Abdulaziz University for -Health Sciences Riyadh 14611, Saudi Arabia
| | - Ziad A Memish
- Department of Medicine, King Saud Medical City, Ministry of Health, Al-Faisal University, Riyadh 11533, Saudi Arabia.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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Farhat M, Al-Ibrahim R, Almohammedali A, Aljishi R, Alalwan B. Study of the Side Effects of Pfizer and Oxford COVID-19 Vaccines in the Eastern Province of Saudi Arabia. Int J Gen Med 2022; 15:7547-7558. [PMID: 36196371 PMCID: PMC9527030 DOI: 10.2147/ijgm.s379204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/12/2022] [Indexed: 12/16/2022] Open
Abstract
Background & Objective The COVID-19 pandemic imposed global concern and became one of the deadliest pandemics of the twenty-first century. Several vaccines were developed against SARS-CoV-2 to counteract the effects of this virus. This study aims to determine the post-vaccination side effects of the most common COVID-19 vaccines used in the Eastern province of Saudi Arabia. Methods This is a cross-sectional study using an online questionnaire distributed randomly through social media. Frequencies were calculated to determine participants’ demographic information, vaccination details, and post-vaccination side effects. Univariate and multiple regression analysis were applied to test the association between individuals’ willingness to receive a booster dose and different categorical variables. Results A total of 1004 participants were included in the survey, of which 0.6%, 85.3% and 14.1% completed either one, two or three doses of the Pfizer mRNA vaccine and Oxford AstraZeneca vaccines, respectively. The similar common side effects between the first and the second doses were significantly associated with the type of vaccine received; these included fatigue (Pfizer 54.4%, Oxford 73.2%; p < 0.001), headache (Pfizer 33.2%, Oxford 44.7%; p = 0.002), and fever (Pfizer 25.1%, Oxford 57.6%; p < 0.001). Additionally, unusual side effects were also reported (palpitations and menstrual abnormalities). Getting SARS-CoV2 infection after vaccination was significantly associated with the type of vaccine received at the first dose (Chi-Square=5.496, p = 0.019). A statistically significant association was found between the individuals’ willingness to receive a booster dose and their gender (Chi-Square = 39.493, p < 0.001), age (Chi-Square = 11.668, p = 0.02), presence of allergies (Chi-Square = 5.602, p = 0.018), and previous COVID-19 infection (Chi-Square = 9.495, p = 0.002). Conclusion Despite the described side effects, further studies should be done to investigate the unusual and rare side effects to assess COVID-19 vaccines effectiveness and safety over longer period of time within a more diverse population.
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Affiliation(s)
- Maha Farhat
- Department of Biochemistry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Correspondence: Maha Farhat, Department of Biochemistry, Faculty of Medicine, Imam AbdulRahman Bin Faisal University, King Faisal Ibn Abd Al Aziz, King Faysal University, Dammam, 34212, Saudi Arabia, Tel +966 507107411, Email
| | - Rabab Al-Ibrahim
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abrar Almohammedali
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Roaa Aljishi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Baneen Alalwan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Alzahrani AM, Magliah SF, Turkistani HA, Abulaban BA, Sabban MF, Mashat MA, Al Shaikh AM. Perception of primary caregiver toward virtual pediatric clinics for type 1 diabetes mellitus during COVID-19 pandemic in Jeddah, Saudi Arabia: A cross-sectional study. Ann Med Surg (Lond) 2022; 81:104550. [PMID: 36147155 PMCID: PMC9486846 DOI: 10.1016/j.amsu.2022.104550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/24/2022] [Accepted: 08/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background Virtual phone clinics were adopted at King Abdulaziz Medical City, Jeddah, Saudi Arabia, as an alternative to in-person routine outpatient visits amid the COVID-19 pandemic. This study aimed to assess primary caregiver perceptions of the virtual phone clinics towards routine care of pediatric patients with type 1 diabetes mellitus (T1DM). Methods A cross-sectional research design was employed through a web-based research tool where the primary caregivers of pediatric patients with T1DM participated. Data were analyzed descriptively and statistically using independent t-tests and one-way analysis of variance. Results In total, 214 participants were included in this study. The average primary caregiver perception value towards virtual phone clinics was 66.71 ± 23.1%, which suggested a satisfactory perception of their experience. Statistically significant differences (p > 0.05) were not found between the mean perception values and demographic characteristics. Higher mean primary caregiver perception values were associated with those who: (1) agreed or strongly agreed to be contented with their current state of health, (2) did not ask their physicians to be physically seen during a virtual visit, (3) preferred having four virtual visits or more, and (4) preferred having single to no in-person visits at all. Conclusion This study revealed a generally acceptable primary caregiver perception regarding virtual clinics. Telemedicine is recommended for routine treatment alongside regular in-clinic appointments to improve the quality of care for pediatric patients with T1DM. Most subjects showed interest in having many as four or more virtual visits per year. Almost three-fourths of subjects demonstrated satisfaction with phone consultations. Virtual clinics may be implemented for diabetes care alongside regular in-clinic visits.
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Affiliation(s)
- Abdullah M. Alzahrani
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Sultan F. Magliah
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- Corresponding author.
| | - Haneen A. Turkistani
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Bahaa A. Abulaban
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Mahmoud F. Sabban
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Manar A. Mashat
- Department of Family Medicine, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
| | - Adnan M. Al Shaikh
- Department of Pediatrics, Ministry of the National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 9515, Jeddah, 21423, Saudi Arabia
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Dandachi I, Aljabr W. Prognosis of COVID-19 in the middle eastern population, knowns and unknowns. Front Microbiol 2022; 13:974205. [PMID: 36118201 PMCID: PMC9471247 DOI: 10.3389/fmicb.2022.974205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 01/08/2023] Open
Abstract
Since its emergence in China in 2019, the SARS-CoV-2 virus has affected all countries worldwide. The virus is easily transmitted from one person to another via infected aerosols or contaminated surfaces. Unlike its counterparts, the prognosis of COVID-19 ranges from asymptomatic to critical disease or death. Several factors play a role in determining the severity of the disease in infected patients. Among others, is the pre-existence of an underlying medical condition such as diabetes, cancer, and others. Furthermore, although children are less prone to the severe form of the COVID-19 disease, they require attention due to the report of many atypical presentations of the infection, post-asymptomatic exposure. In the Middle East, little is known about the prognosis of the SARS-CoV-2 infection in high-risk categories, notably patients with diabetes, cancer, and pregnant women. The aim of this review is to summarize the current knowledge about this group of population in the middle eastern region as well as to highlight the gap in the literature. We have found that the majority of the papers were from the Gulf countries. Although, few studies were conducted; high-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts. Higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were also observed. Children are often asymptomatic or present with atypical presentations. More studies should be conducted to determine the clinical biomarkers of COVID-19 in high-risk categories to help in patient risk stratification and management in the middle eastern population.
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Pires C. Global Predictors of COVID-19 Vaccine Hesitancy: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10081349. [PMID: 36016237 PMCID: PMC9415631 DOI: 10.3390/vaccines10081349] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/11/2022] [Accepted: 08/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background: vaccine hesitancy is defined as a delay in the acceptance or refusal of vaccination, even though immunisation is a determinant in reducing the mortality and morbidity associated with Coronavirus Disease 2019 (COVID-19). Aim: to identify and analyse the predictors of COVID-19 vaccine acceptance and/or hesitancy. Methods: a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Keywords: vaccine and (COVID or SARS) and (acceptance or acceptability or willingness or hesitancy or refusal) and (multivariate or regression) and (questionnaire or survey) and national. Databases/resources: PubMed, DOAJ, SciELO and b-on. Timeframe: March 2020–2022. Inclusion criteria: general population, questionnaire-based, calculation of a multivariate regression model and national studies. Quality assessment: application of the National Heart, Lung, and Blood institute (NHLBI) tool. Results: a total of 37 studies were selected, whose overall rate was fair. The most predominant predictors of vaccine hesitancy were a lower perceived risk of getting infected, a lower level of institutional trust, not being vaccinated against influenza, lower levels of perceived severity of COVID-19, or stronger beliefs that the vaccination would cause side effects or be unsafe. Discussion and conclusion: the identified predictors can be used to design tailored health policies and/or public health interventions, or to evaluate subjects’ vaccine hesitancy.
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Affiliation(s)
- Carla Pires
- Escola de Ciências e Tecnologias da Saúde, CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Campo Grande, 376, 1749-024 Lisbon, Portugal
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Attitudes toward Receiving COVID-19 Booster Dose in the Middle East and North Africa (MENA) Region: A Cross-Sectional Study of 3041 Fully Vaccinated Participants. Vaccines (Basel) 2022; 10:vaccines10081270. [PMID: 36016158 PMCID: PMC9414713 DOI: 10.3390/vaccines10081270] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 01/14/2023] Open
Abstract
COVID-19 vaccines are crucial to control the pandemic and avoid COVID-19 severe infections. The rapid evolution of COVID-19 variants such as B.1.1.529 is alarming, especially with the gradual decrease in serum antibody levels in vaccinated individuals. Middle Eastern countries were less likely to accept the initial doses of vaccines. This study was directed to determine COVID-19 vaccine booster acceptance and its associated factors in the general population in the MENA region to attain public herd immunity. We conducted an online survey in five countries (Egypt, Iraq, Palestine, Saudi Arabia, and Sudan) in November and December 2021. The questionnaire included self-reported information about the vaccine type, side effects, fear level, and several demographic factors. Kruskal−Wallis ANOVA was used to associate the fear level with the type of COVID-19 vaccine. Logistic regression was performed to confirm the results and reported as odds ratios (ORs) and 95% confidence intervals. The final analysis included 3041 fully vaccinated participants. Overall, 60.2% of the respondents reported willingness to receive the COVID-19 booster dose, while 20.4% were hesitant. Safety uncertainties and opinions that the booster dose is not necessary were the primary reasons for refusing the booster dose. The willingness to receive the booster dose was in a triangular relationship with the side effects of first and second doses and the fear (p < 0.0001). Females, individuals with normal body mass index, history of COVID-19 infection, and influenza-unvaccinated individuals were significantly associated with declining the booster dose. Higher fear levels were observed in females, rural citizens, and chronic and immunosuppressed patients. Our results suggest that vaccine hesitancy and fear in several highlighted groups continue to be challenges for healthcare providers, necessitating public health intervention, prioritizing the need for targeted awareness campaigns, and facilitating the spread of evidence-based scientific communication.
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Alghamdi NS, Alghamdi SM. The Role of Digital Technology in Curbing COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148287. [PMID: 35886139 PMCID: PMC9320375 DOI: 10.3390/ijerph19148287] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 02/01/2023]
Abstract
Introduction: Using digital technology to provide support, medical consultations, healthcare services, and to track the spread of the coronavirus has been identified as an important solution to curb the transmission of the virus. This research paper aims to (1) summarize the digital technologies used during the COVID-19 pandemic to mitigate the transmission of the COVID-19; (2) establish the extent to which digital technology applications have facilitated mitigation of the spread of COVID-19; and (3) explore the facilitators and barriers that impact the usability of digital technologies throughout the pandemic. Methods: A rapid electronic search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted of available records up to June 2022 on the medical databases PubMed, Ovid, Embase, CINHAIL, the Cochrane Library, Web of Science, and Google Scholar. Results: An increasing number and variety of digital health applications have been available throughout the pandemic, such as telehealth, smartphone mobile health apps, machine learning, and artificial intelligence. Each technology has played a particular role in curbing COVID-19 transmission. Different users have gained benefits from using digital technology during the COVID-19 pandemic and different determinants have contributed to accelerating the wheel of digital technology implementation during the pandemic. Conclusion: Digital health during the COVID-19 pandemic has evolved very rapidly, with different applications and roles aimed at curbing the pandemic.
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Affiliation(s)
| | - Saeed M. Alghamdi
- National Heart and Lung Institution, Imperial College London, London SW3 6LY, UK
- Respiratory Care Program, Clinical Technology Department, College of Applied Medical Science, Umm Al-Qura University, Makkah 24382, Saudi Arabia
- Correspondence:
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Al-Tawfiq JA, Temsah MH. Perspective on the challenges of COVID-19 facing healthcare workers. Infection 2022; 51:541-544. [PMID: 35781868 DOI: 10.1007/s15010-022-01882-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/25/2022] [Indexed: 12/23/2022]
Abstract
The emergence of COVID-19 has caused a significant impact on healthcare workers (HCWs) across the globe. A few of these challenges include high workload, lack of coordination and direction, changing information, shortage of personal protective equipment (PPE), managing isolation, fear, and increased anxiety, adapting to changes in healthcare practice and policy, coping strategies, and emotional and physical needs. Here, we shed light on some aspects of these challenges among healthcare workers.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality 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.
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine, Ben Khaled Celiac Disease Research Chair, King Saud University, Prince Abdullah, Riyadh, Saudi Arabia
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Predictors of the Third (Booster) Dose of COVID-19 Vaccine Intention among the Healthcare Workers in Saudi Arabia: An Online Cross-Sectional Survey. Vaccines (Basel) 2022; 10:vaccines10070987. [PMID: 35891150 PMCID: PMC9317226 DOI: 10.3390/vaccines10070987] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 12/19/2022] Open
Abstract
Objective: The COVID-19 pandemic is still continuing throughout the world, with newer genetic variants regularly appearing from different parts of the world. Considering the waning of immunity against COVID-19 infection even with two doses of the COVID-19 vaccine, regulatory authorities have authorised booster COVID-19 vaccination in many countries, especially for vulnerable populations, including healthcare workers. The current study analysed factors predicting the third (booster) dose of COVID-19 vaccine intention, including the health belief model (HBM), among the healthcare workers in Saudi Arabia. Methods: The current study was a cross-sectional online survey performed from 1st October 2021 to 30th November 2021, using a questionnaire prepared in GoogleTM form among healthcare workers in Saudi Arabia. The questionnaire asked demographic factors, COVID-19 experience of participants, subjective assessment of health, intention of COVID-19 booster dose vaccination, preferences for local/foreign-made vaccines, and health belief of the study population related to COVID-19 infection and COVID-19 booster dose. Results: This study received 2059 complete responses. The study population reported mixed health belief with respect to the susceptibility of COVID-19 infection, and higher health belief perception regarding the severity. The perceptions of the study participants regarding the benefits of COVID-19 booster dose were positive. There were few barriers to COVID-19 booster dose expressed by study participants. A total of 1464 (71.1%) study participants reported positive intent for receiving a COVID-19 booster dose. The study showed significant association between definite intention to receive a booster dose and nationality (p = 0.001), marital status (p = 0.017), gender (p < 0.001), education level (p = 0.001), monthly income (p < 0.001), and co-morbid medical illness (p = 0.045). The perception of the COVID-19 booster vaccine as a good idea to minimise worries about getting COVID-19 (OR = 2.28, CI 1.89−2.76), and perceptions that receiving the third (booster) dose reduces the risk of COVID-19 infection and associated complications (OR= 2.69, CI = 2.17−3.34), of the perceived benefit construct of HBM, predicted significantly higher definite intention to receive a booster dose. The concern with the safety of the vaccine (OR= 0.40, CI 0.34−0.47) under the perceived barriers construct of HBM predicted as significantly higher no definite intention to receive a booster dose. Conclusions: The results of the present study can guide policy makers in their efforts to promote booster doses of COVID-19 vaccination among the healthcare workers in Saudi Arabia.
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Maqsood MB, Islam MA, Al Qarni A, Nisa ZU, Ishaqui AA, Alharbi NK, Almukhamel M, Hossain MA, Fatani N, Mahrous AJ, Arab MA, Alfehaid FSA, Akbar Z. Assessment of COVID-19 Vaccine Acceptance and Reluctance Among Staff Working in Public Healthcare Settings of Saudi Arabia: A Multicenter Study. Front Public Health 2022; 10:847282. [PMID: 35712310 PMCID: PMC9196634 DOI: 10.3389/fpubh.2022.847282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The study aimed to evaluate the novel coronavirus disease 2019 (COVID-19) vaccination acceptance and reluctance among staff working in Saudi healthcare facilities. Methods A cross-sectional study was conducted during April - May 2021, among healthcare workers in five public hospitals under the National Guards Health Association located in Alahsa, Dammam, Jeddah, Madinah, and Riyadh. The study used a questionnaire in English language, which was distributed through official email communication among healthcare staff currently working at study venues. The data was analyzed using IBM SPSS v23. An ethical approval was obtained. Results A total of 1,031 responses were recorded. Most of the staff had both doses of COVID-19 vaccine (89%). The mean score for vaccine acceptance on a scale of 1 (strongly disagree) to 5 (strongly agree) was 3.55 ± 1.6. The mean score for vaccine reluctance on the same scale was 2.71 ± 1.05. Most participants mentioned safety (76.9%) and efficacy (56.3%) as vaccine concerns and believed that COVID-19 vaccine may not be effective because of changes in virus strain (55.5%). The variables of gender and nationality significantly affected vaccine acceptance, while age, gender, nationality, and profession significantly affected vaccine reluctance (p < 0.05). Conclusion Most healthcare staff were vaccinated, and a high acceptance for COVID-19 vaccination was reported. Several demographic factors affected the vaccine acceptance and reluctance.
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Affiliation(s)
- Muhammad Bilal Maqsood
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Md. Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali Al Qarni
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Zeb-un- Nisa
- Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan
| | - Azfar Athar Ishaqui
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Pharmacy, Iqra University, Karachi, Pakistan
| | - Naif Khalaf Alharbi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Murtaja Almukhamel
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Akbar Hossain
- Department of Pharmacology and Toxicology, Al Qunfudah Medical College, Umm Al Qura University, Al Qunfudah, Saudi Arabia
| | - Nayyra Fatani
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Jamal Mahrous
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Muhammad Al Arab
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Zahida Akbar
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Obstetric and Gynaecology, King Abdulaziz Hospital, National Guard Health Authority, Jeddah, Saudi Arabia
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Alharbi NK, Al-Tawfiq JA, Alghnam S, Alwehaibe A, Alasmari A, Alsagaby SA, Alsubaie F, Alshomrani M, Farahat FM, Bosaeed M, Alharbi A, Aldibasi O, Assiri AM. Outcomes of single dose COVID-19 vaccines: Eight month follow-up of a large cohort in Saudi Arabia. J Infect Public Health 2022; 15:573-577. [PMID: 35472755 PMCID: PMC8986276 DOI: 10.1016/j.jiph.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2022] [Accepted: 04/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Two vaccines for COVID-19 have been approved and administered in the Kingdom of Saudi Arabia (KSA); Pfizer-BioNtech BNT162b2 and AstraZeneca-Oxford AZD1222 vaccines. The purpose of this study was to describe the real-world data on the outcome of single dose of these COVID-19 vaccines in a large cohort in KSA and to analyse demographics and co-morbidities as risk factors for infection post one-dose vaccination. METHODS In this prospective cohort study, a total of 18,543 subjects received one dose of either of the vaccines at a vaccination centre in KSA, and were followed up for three to eight months. Data were collected from three sources; clinical data from medical records, adverse events (AEs) from a self-reporting system, and COVID-19 infection data from the national databases. The study was conducted during the pandemic restrictions on travel, mobility, and social interactions. RESULTS The median age of participants was 33 years with an average body mass index of 27.3. The majority were males (60.1%). Results showed that 92.17% of the subjects had no COVID-19 infection post-vaccination as infection post-vaccination was documented for 1452 (7.83%). Diabetes mellitus 03), organ transplantation (p = 0.02), and obesity (p < 0.01) were associated with infection post-vaccination. Unlike vaccine type, being Saudi, male, or obese was associated with the occurrence breakthrough infections more than other parameters. AEs included injection site pain, fatigue, fever, myalgia, headache and was reported by 5.8% of the subjects. CONCLUSION Single dose COVID-19 vaccines showed a protection rate of 92.17% up to eight months follow-up in this cohort. This rate in AZD1222 was higher than what have been previously reported in effectiveness studies and clinical trials. Obese, male, and Saudi were at higher risk of contracting the infection post-vaccination, Saudi and male might have more social interaction with the public when mobility and social interactions were limited during the pandemic. Side effects and AEs were within what has been reported in clinical trials.
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Affiliation(s)
- Naif Khalaf Alharbi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia.
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, 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 School of Medicine, Baltimore, MD, USA
| | - Suliman Alghnam
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Amal Alwehaibe
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Abrar Alasmari
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Suliman A Alsagaby
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Faisal Alsubaie
- Assistant Agency for Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Majid Alshomrani
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia; King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Fayssal M Farahat
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia; King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Mohammad Bosaeed
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia; King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Ahmad Alharbi
- King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Omar Aldibasi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Abdullah M Assiri
- Assistant Agency for Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
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Spatial Analysis of COVID-19 Vaccine Centers Distribution: A Case Study of the City of Jeddah, Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063526. [PMID: 35329216 PMCID: PMC8948971 DOI: 10.3390/ijerph19063526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic is one of the most devastating public health emergencies in history. In late 2020 and after almost a year from the initial outbreak of the novel coronavirus (SARS-CoV-2), several vaccines were approved and administered in most countries. Saudi Arabia has established COVID-19 vaccination centers in all regions. Various facilities were selected to set up these vaccination centers, including conference and exhibition centers, old airport terminals, pre-existing medical facilities, and primary healthcare centers. Deciding the number and locations of these facilities is a fundamental objective for successful epidemic responses to ensure the delivery of vaccines and other health services to the entire population. This study analyzed the spatial distribution of COVID-19 vaccination centers in Jeddah, a major city in Saudi Arabia, by using GIS tools and methods to provide insight on the effectiveness of the selection and distribution of the COVID-19 vaccination centers in terms of accessibility and coverage. Based on a spatial analysis of vaccine centers’ coverage in 2020 and 2021 in Jeddah presented in this study, coverage deficiency would have been addressed earlier if the applied GIS analysis methods had been used by authorities while gradually increasing the number of vaccination centers. This study recommends that the Ministry of Health in Saudi Arabia evaluated the assigned vaccination centers to include the less-populated regions and to ensure equity and fairness in vaccine distribution. Adding more vaccine centers or reallocating some existing centers in the denser districts to increase the coverage in the uncovered sparse regions in Jeddah is also recommended. The methods applied in this study could be part of a strategic vaccination administration program for future public health emergencies and other vaccination campaigns.
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Garout MA, Saleh SAK, Adly HM, Abdulkhaliq AA, Khafagy AA, Abdeltawab MR, Rabaan AA, Rodriguez-Morales AJ, Al-Tawfiq JA, Alandiyjany MN. Post-COVID-19 syndrome: assessment of short- and long-term post-recovery symptoms in recovered cases in Saudi Arabia. Infection 2022; 50:1431-1439. [PMID: 35294728 PMCID: PMC8924350 DOI: 10.1007/s15010-022-01788-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/22/2022] [Indexed: 12/12/2022]
Abstract
Introduction Recent studies investigated the endurance of symptoms and occurrence of complications three months after SARS-CoV-2 infection. This study aims to examine the prevalence, variation, and severity of continual symptoms in the post‐COVID-19 using a single-center questionnaire. Methods The questionnaire was distributed among population in Saudi Arabia who recovered from COVID‐19 between April 1, 2020 and December 31, 2021. Results A total of 744 participants completed the questionnaire, 318 (42.8%) recovered less than 3 months, 75 (10.1%) recovered 3–6 months, while 351 (47.2%) recovered more than 6 months. About half of the participants 353 (47.5%) had incessant symptoms and of those patients, more than half had two or more symptoms. Common symptoms included fatigue 189 (25.4%), headache 118 (15.9%), and myalgia 63 (8.5%). Of the participants, 189 (21.4%) experienced continual symptoms including anxiety in 98 (13.2%) and depression in 70 (9.5%). Conclusion The current study showed a high proportion of individuals with long-COVID-19 symptoms. Thus, proper assessment of the individuals in the post-recovery period can guide the patients to the relevant clinics for rehabilitation. Moreover, there is a great importance to decrease COVID-19 infection, populations should be targeted to boost vaccine efficiency.
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Affiliation(s)
- Mohammed A Garout
- Community Medicine and Pilgrims Health Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saleh A K Saleh
- Biochemisty Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.,Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba M Adly
- Community Medicine and Pilgrims Health Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Altaf A Abdulkhaliq
- Biochemisty Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah A Khafagy
- Community Medicine and Pilgrims Health Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Magda R Abdeltawab
- Medical Microbiology and Immunology Department, Aim Shams University, Cairo, Egypt
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, 31311, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, 11533, Saudi Arabia.,Department of Public Health and Nutrition, The University of Haripur, Haripur, 22610, Pakistan
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, 660003, Pereira, Risaralda, Colombia.,Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, 4861, Peru.,School of Medicine, Universidad Privada Franz Tamayo (UNIFRANZ), 4780, Cochabamba, Bolivia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality 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.
| | - Maher N Alandiyjany
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, 21955, Saudi Arabia.,Quality and Development Affair, Batterjee Medical College, Jeddah, 21442, Saudi Arabia
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AlBahrani S, AlAhmadi N, Hamdan S, Elsheikh N, Osman A, Almuthen S, Almajed GN, Alkhuraim AH, Jebakumar AZ, Al-Tawfiq JA. Clinical Presentation and Outcome of Hospitalized Patients With COVID-19 in the First and Second Waves in Saudi Arabia. Int J Infect Dis 2022; 118:104-108. [PMID: 35227868 PMCID: PMC8875857 DOI: 10.1016/j.ijid.2022.02.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction The world had witnessed the occurrence of multiple waves of the SARS-CoV-2. Data comparing the clinical characteristics and outcomes of hospitalized patients in Saudi Arabia during the first and second waves are lacking. This study compares the characteristics and the outcomes of patients in these 2 waves. Methods This is a retrospective case series of hospitalized patients with confirmed SARS-CoV-2. We compared epidemiological, demographic, laboratory, and clinical data. Results The study included hospitalized patients admitted up to February 28, 2021 as the first wave and those admitted from March 1, 2021 as the second wave. There were 378 patients in the first wave and 241 patients in the second wave. Patients in the first wave were significantly younger (mean age and SD of 47.5 ± 20 vs 55.3 ± 18.2 years; p <0.001). In relation to symptoms, shortness of breath, wheezes, myalgia, tachypnea, and respiratory distress were significantly more common in the second wave than the first wave. On the other hand, sore throat was more common in the first wave than the second wave. Patients in the second wave had higher mean values of lymphocytes count, platelet counts, and ALT than those in the first wave. Patients in the first wave were more likely to receive antibiotics and antiviral therapy and had higher death rate (16.2% vs 8.4%; p = 0.001). Conclusion The study showed that patients in the second wave were younger and had a lower rate of death than the first wave.
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Affiliation(s)
- Salma AlBahrani
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Nayef AlAhmadi
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Safa Hamdan
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Noura Elsheikh
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Assim Osman
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Sharifah Almuthen
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Ghadeer N Almajed
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Arwa H Alkhuraim
- Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, 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 School of Medicine, Baltimore, MD, USA.
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Prevalence of COVID-19 Infection among Patients with Diabetes and Their Vaccination Coverage Status in Saudi Arabia: A Cross-Sectional Analysis from a Hospital-Based Diabetes Registry. Vaccines (Basel) 2022; 10:vaccines10020310. [PMID: 35214769 PMCID: PMC8878518 DOI: 10.3390/vaccines10020310] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/23/2022] Open
Abstract
Patients with diabetes have a higher risk of severe infection and mortality due to COVID-19. Considering the current limited effective pharmacological treatments, vaccination remains one of the most effective means to control the pandemic. The current study aimed to determine the prevalence of COVID-19 infection and the rate of COVID-19 vaccination coverage among patients with type 2 diabetes mellitus. The patients were identified from a diabetes hospital registry at Prince Sultan Military Medical City, Riyadh, Saudi Arabia in July 2021. The history of COVID-19 infection and the vaccination status were retrieved from the National Health Electronic Surveillance Network (HESN) program and the Seha platform, respectively. A total of 11,573 patients were included in this study (representing 99.5% of all patients in the registry). A total of 1981 patients (17.1%) had a history of confirmed COVID-19 infection. The rate of vaccination with a 1st dose was 84.8% (n = 9811), while the rate of full vaccination with the 2nd dose was 55.5% (n = 6422). The analysis showed that a higher proportion of male patients were fully vaccinated than female patients (61.0% versus 51.2%, p < 0.001). There were statistically significant differences among the age groups, with the full vaccination rate ranging from 59.0% for the 61–70-year-old age group to 49.0% for the > 80-year-old age group (p < 0.001). The patients with no previous history of COVID-19 infection were more likely to get fully vaccinated than those with a previous history of the infection (63.9% versus 14.6%, respectively, p < 0.001). The factors associated with a higher likelihood of unvaccinated status included the female gender (adjusted odds ratio (aOR) = 1.705 (95% confidence interval (CI): 1.528–1.902)), elderly patients in the age group of 61–70 (aOR (95% CI) = 1.390 (1.102–1.753)), the age group of 71–80 (aOR (95% CI) = 1.924 (1.499–2.470)) and the age group of >80 (aOR (95% CI) = 3.081 (2.252–4.214), and prior history of COVID-19 infection (aOR (95% CI) = 2.501 (2.223–2.813)). In conclusion, a considerable proportion of patients with type 2 diabetes had confirmed COVID-19 infection. Continued targeted efforts are needed to accelerate vaccination coverage rates among patients with diabetes in general and the particular subgroups identified in this study.
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Alfaleh A, Alkattan A, Radwan N, Elzohri M, Alzaher A, Ibrahim M, Alsalameen E, Alsultan A, Alhabib D, Alshelwah A, Mahmoud N, Sagor K, Alabdulkareem K. Adverse drug reactions from two COVID-19 vaccines reported in Saudi Arabia. DRUGS & THERAPY PERSPECTIVES 2022; 38:84-92. [PMID: 35095267 PMCID: PMC8783585 DOI: 10.1007/s40267-022-00893-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/23/2022]
Abstract
Background Several reports have been published about the impact of coronavirus disease 2019 (COVID-19) vaccines on human health, and each vaccine has a different safety and efficacy profile. The aim of this study was to reveal the nature and classification of reported adverse drug reactions (ADRs) of the two COVID-19 vaccines (tozinameran and ChAdOx1) among citizens and residents living in Saudi Arabia, and show possible differences between the two vaccines and the differences between each batch on the health of populations. Methods A cross-sectional study was conducted in Saudi Arabia between December 2020 and March 2021. Saudi citizens and residents aged ≥ 16 years who had at least one dose of any batch of either of the two approved COVID-19 vaccines (tozinameran and ChAdOx1) and who reported at least one ADR from the vaccines were included. The study excluded people who reported ADRs after receiving tozinameran or ChAdOx1 vaccines but no information was provided about the vaccine’s batch number. Results During the study period, 12,868 vaccinated people, including a high-risk group (i.e., those with chronic illness or pregnant women), reported COVID-19 vaccine ADRs that had been documented in the General Directorate of Medical Consultations, Saudi Ministry of Health. The study reported several ADRs associated with COVID-19 vaccines, with the most common (> 25%) being fever/chills, general pain/weakness, headache, and injection site reactions. Among healthy and high-risk people, the median onset of all reported ADRs for tozinameran and ChAdOx1 vaccine batches were 1.96 and 1.64 days, respectively (p < 0.01). Furthermore, significant differences (p < 0.05) were recorded between the two studied vaccines in regard to fever/chills, gastrointestinal symptoms, headache, general pain/weakness, and neurological symptoms, with higher incidence rates of these ADRs observed with the ChAdOx1 vaccine than the tozinameran vaccine. However, the tozinameran vaccine was found to cause significantly (p < 0.05) more palpitation, blood pressure variations, upper respiratory tract symptoms, lymph node swelling, and other unspecified ADRs than the ChAdOx1 vaccine. Among patients vaccinated with seven different batches of the tozinameran vaccine, people vaccinated with the T4 and T5 batches reported the most ADRs. Conclusion There were significant differences regarding most of the reported ADRs and their onset among tozinameran and ChAdOx1 vaccines on both healthy people and high-risk individuals living in Saudi Arabia. Moreover, the study found that the frequencies of most listed ADRs were statistically different when seven batches of tozinameran vaccine were compared.
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Affiliation(s)
- Amjad Alfaleh
- Department of Research, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Alkattan
- Department of Research, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Nashwa Radwan
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
- Department of Research, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Mona Elzohri
- Department of Research, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
- Department of Internal Medicine, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Assiut University, Asyût, Egypt
| | - Abrar Alzaher
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Mona Ibrahim
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman Alsalameen
- Department of Pharmacy, King Khalid University Hospital, Medical City King Saud University, Riyadh, Saudi Arabia
| | - Amani Alsultan
- Department of Sales, Sanofi Aventis Arabia, Jeddah, Saudi Arabia
| | - Dina Alhabib
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Alanood Alshelwah
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Nagla Mahmoud
- Department of Research, Assisting Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Khlood Sagor
- Research and Development Department, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Khaled Alabdulkareem
- Department of Research, 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
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Filfilan NNA, Alhibshi AH, Khan MA, Alsukhayri DA, Alzhrani AJ. Measuring the Factors Influencing the Acceptance of COVID-19 Vaccines in the Western Region of Saudi Arabia. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/npwbdt5enr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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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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Mohammed RA, Garout RM, Wahid S, Ayub F, Firas ZinAlddin LM, Sultan I. A Survey on the Side Effects of Pfizer/BioNTech COVID-19 Vaccine Among Vaccinated Adults in Saudi Arabia. Cureus 2021; 13:e19222. [PMID: 34873547 PMCID: PMC8640570 DOI: 10.7759/cureus.19222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Pfizer-BioNTech vaccine was the first of all coronavirus disease (COVID) vaccines to be used in Saudi Arabia. There have been over 17 million doses already administered to the general public in order to successfully reach herd immunity. Objective: The study aimed to explore the side effects of the Pfizer-BioNTech vaccine. Materials and methods: This is a cross-sectional study comprising a sample of 386 participating adults of different age groups and genders. A validated modified questionnaire was distributed as a Google form to residents of the kingdom via social networking sites from February to March 2021. The questionnaire included questions regarding participants’ socio-demographic details, vaccination details, and symptom analyses items. Results: The most common to least reported symptoms were local pain (79.3%), fatigue (42%), muscle pain (39.1%), local swelling (27.7%), joint pain (23.1%), headache (21.8%), fever (21.0%), chills (15.5%), local redness (14.8%), nausea (7.3%), with no reports of anaphylaxis, facial paralysis or syncope. There were more side effects after the second dose than the first (p<0.001). Significant predictors of a higher number of side effects after both doses of the vaccine were the female gender ((p<0.001)) and the presence of allergies (p=0.044). Conclusion: Pfizer/BioNTech vaccination was quite safe with no reported anaphylaxis or serious events. The most common reported side effects were local pain and fatigue. Symptoms began within 24 hours and were mild to moderate in nature with a regressive course, especially after analgesics. More side effects were experienced after the second dose than the first. The significant predictors of side effects were the female gender and a history of allergies.
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Affiliation(s)
- Rehab A Mohammed
- Internal Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU.,Internal Medicine, Al-Azhar University Faculty of Medicine for Girls, Cairo, EGY
| | - Rana M Garout
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Sherehan Wahid
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Fatema Ayub
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | - Intessar Sultan
- Internal Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
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Almohaya AM, Qari F, Zubaidi GA, Alnajim N, Moustafa K, Alshabi MM, Alsubaie FM, Almutairi I, Alwazna Q, Al-Tawfiq JA, Barry M. Early solicited adverse events following the BNT162b2 mRNA vaccination, a population survey from Saudi Arabia. Prev Med Rep 2021; 24:101595. [PMID: 34976653 PMCID: PMC8683974 DOI: 10.1016/j.pmedr.2021.101595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 01/07/2023] Open
Abstract
Post rollout safety for the coronavirus disease vaccines is crucial and recommended. To explore the early solicited adverse events (AE) following BNT162b2 mRNA vaccination in Saudi Arabia, we distributed an online survey to adults vaccinated with BNT162b2 over the first week of June 2021, to collect data on first (V1), second doses (V2), symptoms, severity, and outcome after an informed consent was obtained. We recruited 3639 BNT162b2 vaccinated individuals, of which one-third had received two doses, 63.3% were female, 77% were healthy, and 89% had 18-55 years of age, while only 9.8% had a history of allergy. Overall, 50.3% had any AEs after any dose, especially those younger than 55 years of age, female, history of comorbidity, and when adjusted for age and gender, lung or cardiovascular diseases. Overall, the most common AE were pain at the injection site (44%), tiredness (39%), or body ache (31%). Compared to V1, a higher rate of post-V2 systemic AE (36% vs. 51%). Most AEs started very early (within 3 days), and rarely delayed in recovery (>2 weeks). Anti-pyretic was the most commonly used (51.7%), a third of which was unnecessary. Only 1.7% required hospital admission. By multivariate analysis, predictors for admission were the presence of lung or immunocompromising diseases. In conclusion, common AEs after BNT162b2 in the real world were generally mild, self-limiting, higher after the second dose, and largely mimicking that reported in clinical trials. The causality of these AE and the persistence of post-vaccination symptoms needs to be investigated further.
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Affiliation(s)
- Abdulellah M. Almohaya
- Division of Infectious Diseases, Department of Internal Medicine, Ad-Diriyah Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Farah Qari
- College of Medicine, Almaarefa University, Riyadh, Saudi Arabia
| | | | - Noura Alnajim
- College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | | | - Faleh M. Alsubaie
- College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Qusai Alwazna
- Ad-Diriyah Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, 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 School of Medicine, Baltimore, MD, USA
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, Saudi Arabia
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Mahallawi WH, Mumena WA. Reactogenicity and Immunogenicity of the Pfizer and AstraZeneca COVID-19 Vaccines. Front Immunol 2021; 12:794642. [PMID: 34925378 PMCID: PMC8671995 DOI: 10.3389/fimmu.2021.794642] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/16/2021] [Indexed: 12/13/2022] Open
Abstract
Background The relationships of the coronavirus disease 2019 (COVID-19) vaccination with reactogenicity and the humoral immune response are important to study. The current study aimed to assess the reactogenicity and immunogenicity of the Pfizer and AstraZeneca COVID-19 vaccines among adults in Madinah, Saudi Arabia. Methods A cross-sectional study, including 365 randomly selected adult Pfizer or AstraZeneca vaccine recipients who received a homologous prime-boost vaccination between February 1st and June 30th, 2021. Data of height and weight were collected to assess the weight status of percipients. An evaluation of seropositivity for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies was assessed using enzyme-linked immunosorbent assay (ELISA). Results Among the participants, 69% (n = 250) reported at least one vaccine-related symptom. Pain at the injection site was the most frequently reported vaccine-related symptom. The mean total score for vaccine-related symptoms was significantly higher among participants who received the AstraZeneca vaccine, women, and participants with no previous COVID-19 infection (p < 0.05). Spike-specific IgG antibodies were detected in 98.9% of participants after the receipt of two vaccine doses, including 99.5% of Pfizer vaccine recipients and 98.3% of AstraZeneca vaccine recipients. Significantly, higher proportions of participants in the <35-year age group developed a humoral immune response after the first vaccine dose compared with the participants in other age groups. Conclusion Participants who received the Pfizer COVID-19 vaccine reported fewer vaccine-related complications compared with those who received the AstraZeneca COVID-19 vaccine, but no serious side effects were reported in response to either vaccine. Health status and age were factors that may influence COVID-19 vaccine effectiveness for the generation of antibodies against the SARS-CoV-2 spike protein.
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Affiliation(s)
- Waleed H. Mahallawi
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Walaa A. Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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Barry M, Temsah MH, Alhuzaimi A, Alamro N, Al-Eyadhy A, Aljamaan F, Saddik B, Alhaboob A, Alsohime F, Alhasan K, Alrabiaah A, Alaraj A, Halwani R, Jamal A, Alsubaie S, Al-Shahrani FS, Memish ZA, Al-Tawfiq JA. COVID-19 vaccine confidence and hesitancy among health care workers: A cross-sectional survey from a MERS-CoV experienced nation. PLoS One 2021; 16:e0244415. [PMID: 34843462 PMCID: PMC8629228 DOI: 10.1371/journal.pone.0244415] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 10/13/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives This study aimed to identify coronavirus disease 2019 (COVID-19) vaccine perception, acceptance, confidence, hesitancy, and barriers among health care workers (HCWs). Methods An online national cross-sectional pilot-validated questionnaire was self-administered by HCWs in Saudi Arabia, which is a nation with MERS-CoV experience. The main outcome variable was HCWs’ acceptance of COVID-19 vaccine candidates. The factors associated with vaccination acceptance were identified through a logistic regression analysis, and the level of anxiety was measured using a validated instrument to measure general anxiety levels. Results Out of the 1512 HCWs who completed the study questionnaire—of which 62.4% were women—70% were willing to receive COVID-19 vaccines. A logistic regression analysis revealed that male HCWs (ORa = 1.551, 95% CI: 1.122–2.144), HCWs who believe in vaccine safety (ORa = 2.151; 95% CI: 1.708–2.708), HCWs who believe that COVID vaccines are the most likely way to stop the pandemic (ORa = 1.539; 95% CI: 1.259–1.881), and HCWs who rely on the Centers for Disease Control and Prevention website for COVID 19 updates (ORa = 1.505, 95% CI: 1.125–2.013) were significantly associated with reporting a willingness to be vaccinated. However, HCWs who believed that the vaccines were rushed without evidence-informed testing were found to be 60% less inclined to accept COVID-19 vaccines (ORa = 0.394, 95% CI: 0.298–0.522). Conclusion Most HCWs are willing to receive COVID-19 vaccines once they are available; the satisfactoriness of COVID-19 vaccination among HCWs is crucial because health professionals’ knowledge and confidence toward vaccines are important determining factors for not only their own vaccine acceptance but also recommendation for such vaccines to their patients.
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Affiliation(s)
- Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
- * E-mail:
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alhuzaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Pediatric Cardiology, Cardiac Science Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nurah Alamro
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical Care Dept, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulkarim Alrabiaah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Rabih Halwani
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah Alsubaie
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fatimah S. Al-Shahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ziad A. Memish
- Director Research and Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Health Care, Dhahran, Saudi Arabia
- Infectious disease division, Department of Medicine, Indiana University School of Medicine, Indiana, United States of America
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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