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Zuo Z, Mu Y, Qi F, Zhang H, Li Z, Zhou T, Guo W, Guo K, Hu X, Yao Z. Influenza Vaccination Mediates SARS-CoV-2 Spike Protein Peptide-Induced Inflammatory Response via Modification of Histone Acetylation. Vaccines (Basel) 2024; 12:731. [PMID: 39066369 PMCID: PMC11281326 DOI: 10.3390/vaccines12070731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/05/2024] [Accepted: 06/15/2024] [Indexed: 07/28/2024] Open
Abstract
The effectiveness of coronavirus disease 2019 (COVID-19) vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain rapidly wanes over time. Growing evidence from epidemiological studies suggests that influenza vaccination is associated with a reduction in the risk of SARS-CoV-2 infection and COVID-19 severity. However, the underlying mechanisms remain elusive. Here, we investigate the cross-reactive immune responses of influenza vaccination to SARS-CoV-2 spike protein peptides based on in vitro study. Our data indicate enhanced activation-induced-marker (AIM) expression on CD4+ T cells in influenza-vaccination (IV)-treated peripheral blood mononuclear cells (PBMCs) upon stimulation with spike-protein-peptide pools. The fractions of other immune cell subtypes, including CD8+ T cells, monocytes, NK cells, and antigen-presenting cells, were not changed between IV-treated and control PBMCs following ex vivo spike-protein-peptide stimulation. However, the classical antiviral (IFN-γ) and anti-inflammatory (IL-1RA) cytokine responses to spike-protein-peptide stimulation were still enhanced in PBMCs from both IV-immunized adult and aged mice. Decreased expression of proinflammatory IL-1β, IL-12p40, and TNF-α is associated with inhibited levels of histone acetylation in PBMCs from IV-treated mice. Remarkably, prior immunity to SARS-CoV-2 does not result in modification of histone acetylation or hemagglutinin-protein-induced cytokine responses. This response is antibody-independent but can be mediated by manipulating the histone acetylation of PBMCs. These data experimentally support that influenza vaccination could induce modification of histone acetylation in immune cells and reveal the existence of potential cross-reactive immunity to SARS-CoV-2 antigens, which may provide insights for the adjuvant of influenza vaccine to limit COVID-19-related inflammatory responses.
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Affiliation(s)
- Zejie Zuo
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; (Z.Z.)
| | - Yating Mu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; (Z.Z.)
| | - Fangfang Qi
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Hongyang Zhang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhihui Li
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Tuo Zhou
- Guangzhou Women and Children’s Medical Center, Guangzhou 510620, China
| | - Wenhai Guo
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Kaihua Guo
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiquan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; (Z.Z.)
| | - Zhibin Yao
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
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Akmatova R, Ebama MS, Temirbekov S, Alymkulova V, Otorbaeva D. A comparative analysis of knowledge, attitude, and practice (KAP) towards influenza and influenza vaccination among healthcare workers in Kyrgyzstan prior to and during the COVID-19 pandemic. Vaccine 2024:S0264-410X(24)00420-1. [PMID: 38594119 DOI: 10.1016/j.vaccine.2024.04.008] [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: 02/22/2024] [Revised: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Influenza, a globally significant respiratory illness with pandemic potential, affects around 1 billion individuals annually, leading to increased risk for severe illness and mortality. Despite recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) and MoH prioritization, influenza vaccination coverage rate among HCWs in Kyrgyzstan remains low, ranging between 16 % and 46 % over the past five years. Understanding the Knowledge, Attitudes, and Practices (KAP) dynamics of HCWs regarding influenza vaccinations, both before and during the COVID-19 pandemic is crucial for refining national strategies and institutional approaches to enhance vaccination coverage rates in this important risk group. METHOD This study employed cross sectional investigations aimed at assessing KAPs among HCWs regarding influenza disease and vaccination. Conducted prior to and during the initial phase of the COVID-19 pandemic, the project involved 2400 participants from diverse medical disciplines. EPI Info was utilized to run biostatistical analyses, with descriptive and logistic regression models, to elucidate the dynamics of KAP over time. RESULTS The findings indicate that HCWs with over 5 years of experience were more likely to get vaccinated or recommend it to patients (p = 0.000). Low confidence in vaccine effectiveness influenced on recommendations of influenza vaccination in pre-pandemic time, where insufficient (95 %CI 0.08-0.6; p = 0.003) or uncertain assurance in vaccine effectiveness (95 %CI 0.007-0.18; p = 0.000) was a barrier for vaccine promotion during the pandemic. The study underscores to consider mandatory influenza vaccination for HCWs which may impact on likelihood of flu vaccination (p = 0.001). Priority groups for influenza vaccination shifted during the COVID-19 period, emphasizing older adults, individuals with existing conditions, and HCWs, compared to the pre-pandemic focus on HCWs, children, and patients with pre-existing conditions. CONCLUSION Our investigation provides valuable insights into HCWs KAP concerning influenza vaccination in Kyrgyzstan, highlighting the need for targeted interventions addressing factors influencing vaccine acceptance. The study suggests policy implications, advocating for the revision of national strategies to strengthen capacity building for medical staff.
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Affiliation(s)
- Rakhat Akmatova
- Center for Vaccine Equity, Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, United States.
| | - Malembe S Ebama
- Center for Vaccine Equity, Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, United States.
| | - Sanjar Temirbekov
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan
| | - Venera Alymkulova
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan
| | - Dinara Otorbaeva
- Department of Disease Prevention and State Sanitary and Epidemiology Surveillance under the Ministry of Health, 535 Frunze Street, 720033 Bishkek, Kyrgyzstan.
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Pontiroli AE, Scovenna F, Carlini V, Tagliabue E, Martin-Delgado J, Sala LL, Tanzi E, Zanoni I. Vaccination against influenza viruses reduces infection, not hospitalization or death, from respiratory COVID-19: A systematic review and meta-analysis. J Med Virol 2024; 96:e29343. [PMID: 38163281 PMCID: PMC10924223 DOI: 10.1002/jmv.29343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and has brought a huge burden in terms of human lives. Strict social distance and influenza vaccination have been recommended to avoid co-infections between influenza viruses and SARS-CoV-2. Scattered reports suggested a protective effect of influenza vaccine on COVID-19 development and severity. We analyzed 51 studies on the capacity of influenza vaccination to affect infection with SARS-CoV-2, hospitalization, admission to Intensive Care Units (ICU), and mortality. All subjects taken into consideration did not receive any anti-SARS-CoV-2 vaccine, although their status with respect to previous infections with SARS-CoV-2 is not known. Comparison between vaccinated and not-vaccinated subjects for each of the four endpoints was expressed as odds ratio (OR), with 95% confidence intervals (CIs); all analyses were performed by DerSimonian and Laird model, and Hartung-Knapp model when studies were less than 10. In a total of 61 029 936 subjects from 33 studies, influenza vaccination reduced frequency of SARS-CoV-2 infection [OR plus 95% CI = 0.70 (0.65-0.77)]. The effect was significant in all studies together, in health care workers and in the general population; distance from influenza vaccination and the type of vaccine were also of importance. In 98 174 subjects from 11 studies, frequency of ICU admission was reduced with influenza vaccination [OR (95% CI) = 0.71 (0.54-0.94)]; the effect was significant in all studies together, in pregnant women and in hospitalized subjects. In contrast, in 4 737 328 subjects from 14 studies hospitalization was not modified [OR (95% CI) = 1.05 (0.82-1.35)], and in 4 139 660 subjects from 19 studies, mortality was not modified [OR (95% CI) = 0.76 (0.26-2.20)]. Our study emphasizes the importance of influenza vaccination in the protection against SARS-CoV-2 infection.
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Affiliation(s)
- Antonio E. Pontiroli
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Francesco Scovenna
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Valentina Carlini
- IRCCS MultiMedica, Laboratory of Cardiovascular and Dysmetabolic Disease, 20138 Milan, Italy
| | - Elena Tagliabue
- IRCCS MultiMedica, Value-Based Healthcare Unit, 20099 Milan, Italy
| | - Jimmy Martin-Delgado
- Hospital Luis Vernaza, Junta de Beneficiencia de Guayaquil 090603, Ecuador
- Instituto de Investigacion e Innovacion en Salud Integral, Universidad Catolica de Santiago de Guayaquil, Guayaquil 090603, Ecuador
| | - Lucia La Sala
- IRCCS MultiMedica, Laboratory of Cardiovascular and Dysmetabolic Disease, 20138 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Ivan Zanoni
- Harvard Medical School, Boston Children’s Hospital, Division of Immunology and Division of Gastroenterology, Boston, MA 02115, USA
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Coulongeat M, Marlet J, Aidoud A, Donati F, Jamard S, Van Der Werf S, Debacq C, Leroy V, Lemaignen A, Munier S, Fougère B. Impact of influenza immunity on the mortality among older adults hospitalized with COVID-19: a retrospective cohort study. Clin Exp Med 2023; 23:4955-4965. [PMID: 37906387 DOI: 10.1007/s10238-023-01203-0] [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: 05/19/2023] [Accepted: 09/21/2023] [Indexed: 11/02/2023]
Abstract
It has been suggested that the outcomes of coronavirus disease 2019 (COVID-19) are better in individuals having recently received an influenza vaccine than in non-vaccinated individuals. We hypothesized that this association depends on the humoral responses against influenza viruses. We aim to assess the relationship between the humoral immunity against influenza and the 3-month all-cause mortality among hospitalized older patients with COVID-19. We performed an exploratory retrospective study of older patients (aged 65 and over) hospitalized for confirmed COVID-19 between November 2020 and June 2021. Previous humoral responses to influenza viruses were assessed using a hemagglutination inhibition assay on routinely collected blood samples. The study's primary outcome was the 3-month all-cause mortality, and the secondary outcomes were severe COVID-19 (oxygen requirement ≥ 6 L/min or ventilatory support) and complications (kidney or heart failure, thrombosis and bacterial infection). In the cohort of 95 patients with COVID-19, immunity against influenza vaccine subtypes/lineages was not significantly associated with 3-month all-cause mortality, with an OR [95%CI] of 0.22 [0.02-1.95] (p = 0.174) for the H1N1pdm09 subtype, 0.21 [0.03-1.24] (p = 0.081) for A/Hong Kong/2671/2019 H3N2 subtype, 1.98 [0.51-8.24] (p = 0.329) for the B/Victoria lineage, and 1.82 [0.40-8.45] (p = 0.437) for the B/Yamagata lineage. Immunity against influenza vaccine subtypes/lineages was also not significantly associated with severity and complication. Immunity against influenza subtypes/lineages included in the 2020-2021 vaccine was not associated with a lower 3-month all-cause mortality among COVID-19 hospitalized patients.Trial registration: The study was approved by a hospital committee with competency for research not requiring approval by an institutional review board (Tours University Medical Center, Tours, France: reference: 2021_015). All patients give the informed consent.
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Affiliation(s)
- Matthieu Coulongeat
- Division of Geriatric Medicine, Tours University Medical Center, 37044, Tours, France.
- Division of Geriatric Medicine, University Hospital Center of ORLEANS, 45100, Orléans, France.
| | - Julien Marlet
- Service de Bactériologie-Virologie-Hygiène, CHRU de Tours, Tours, France
- INSERM U1259, Université de Tours, 37044, Tours, France
| | - Amal Aidoud
- Division of Geriatric Medicine, Tours University Medical Center, 37044, Tours, France
- Tours University, EA4245 Transplantation, Immunologie, Inflammation, Tours, France
| | - Flora Donati
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Unité de Génétique Moléculaire Des Virus À ARN, 75015, Paris, France
- Institut Pasteur, CNR Virus Des Infections Respiratoires, 75015, Paris, France
| | - Simon Jamard
- Service de Maladies Infectieuses Et Tropicales (SMIT), Centre Hospitalier Universitaire de Tours, 37044, Tours, France
| | - Sylvie Van Der Werf
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Unité de Génétique Moléculaire Des Virus À ARN, 75015, Paris, France
- Institut Pasteur, CNR Virus Des Infections Respiratoires, 75015, Paris, France
| | - Camille Debacq
- Division of Geriatric Medicine, Tours University Medical Center, 37044, Tours, France
| | - Victoire Leroy
- Division of Geriatric Medicine, Tours University Medical Center, 37044, Tours, France
- Centre Mémoire Ressources Et Recherche (CMRR), Centre Hospitalier Universitaire de Tours, 37044, Tours, France
- Education, Ethics, Health (EA 7505), Tours University, 37044, Tours, France
| | - Adrien Lemaignen
- Service de Maladies Infectieuses Et Tropicales (SMIT), Centre Hospitalier Universitaire de Tours, 37044, Tours, France
| | - Sandie Munier
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Unité de Génétique Moléculaire Des Virus À ARN, 75015, Paris, France
- Institut Pasteur, CNR Virus Des Infections Respiratoires, 75015, Paris, France
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Medical Center, 37044, Tours, France
- Education, Ethics, Health (EA 7505), Tours University, 37044, Tours, France
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5
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Wong A, Barrero Guevara LA, Goult E, Briga M, Kramer SC, Kovacevic A, Opatowski L, Domenech de Cellès M. The interactions of SARS-CoV-2 with cocirculating pathogens: Epidemiological implications and current knowledge gaps. PLoS Pathog 2023; 19:e1011167. [PMID: 36888684 PMCID: PMC9994710 DOI: 10.1371/journal.ppat.1011167] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Despite the availability of effective vaccines, the persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggests that cocirculation with other pathogens and resulting multiepidemics (of, for example, COVID-19 and influenza) may become increasingly frequent. To better forecast and control the risk of such multiepidemics, it is essential to elucidate the potential interactions of SARS-CoV-2 with other pathogens; these interactions, however, remain poorly defined. Here, we aimed to review the current body of evidence about SARS-CoV-2 interactions. Our review is structured in four parts. To study pathogen interactions in a systematic and comprehensive way, we first developed a general framework to capture their major components: sign (either negative for antagonistic interactions or positive for synergistic interactions), strength (i.e., magnitude of the interaction), symmetry (describing whether the interaction depends on the order of infection of interacting pathogens), duration (describing whether the interaction is short-lived or long-lived), and mechanism (e.g., whether interaction modifies susceptibility to infection, transmissibility of infection, or severity of disease). Second, we reviewed the experimental evidence from animal models about SARS-CoV-2 interactions. Of the 14 studies identified, 11 focused on the outcomes of coinfection with nonattenuated influenza A viruses (IAVs), and 3 with other pathogens. The 11 studies on IAV used different designs and animal models (ferrets, hamsters, and mice) but generally demonstrated that coinfection increased disease severity compared with either monoinfection. By contrast, the effect of coinfection on the viral load of either virus was variable and inconsistent across studies. Third, we reviewed the epidemiological evidence about SARS-CoV-2 interactions in human populations. Although numerous studies were identified, only a few were specifically designed to infer interaction, and many were prone to multiple biases, including confounding. Nevertheless, their results suggested that influenza and pneumococcal conjugate vaccinations were associated with a reduced risk of SARS-CoV-2 infection. Finally, fourth, we formulated simple transmission models of SARS-CoV-2 cocirculation with an epidemic viral pathogen or an endemic bacterial pathogen, showing how they can naturally incorporate the proposed framework. More generally, we argue that such models, when designed with an integrative and multidisciplinary perspective, will be invaluable tools to resolve the substantial uncertainties that remain about SARS-CoV-2 interactions.
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Affiliation(s)
- Anabelle Wong
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, Berlin, Germany
- Institute of Public Health, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Laura Andrea Barrero Guevara
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, Berlin, Germany
- Institute of Public Health, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Elizabeth Goult
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Michael Briga
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Sarah C. Kramer
- Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Aleksandra Kovacevic
- Epidemiology and Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris Cité, Paris, France
- Anti-infective Evasion and Pharmacoepidemiology Team, CESP, Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1018 Montigny-le-Bretonneux, France
| | - Lulla Opatowski
- Epidemiology and Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris Cité, Paris, France
- Anti-infective Evasion and Pharmacoepidemiology Team, CESP, Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1018 Montigny-le-Bretonneux, France
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Kim J, Yoo D, Hong K, Chun BC. Health behaviors and the risk of COVID-19 incidence: A Bayesian hierarchical spatial analysis. J Infect Public Health 2023; 16:190-195. [PMID: 36580692 PMCID: PMC9773785 DOI: 10.1016/j.jiph.2022.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Effective infection control measures, based on a sound understanding of geographical community-specific health behavioral characteristics, should be implemented from the early stage of disease transmission. However, few studies have explored health behaviors as a possible contributor to COVID-19 infection in the spatial context. We investigated health behaviors as potential factors of COVID-19 incidence in the early phase of transmission in the spatial context. METHODS We extracted COVID-19 cumulative case data as of February 25, 2021-one day prior to nationwide COVID-19 vaccination commencement-regarding health behaviors and covariates, including health condition and socio-economic factors, at the municipal level from publicly available datasets. The spatial autocorrelation of incidence was analyzed using Global Moran's I statistics. The associations between health behaviors and COVID-19 incidence were examined using Besag-York-Mollie models to deal with spatial autocorrelation of residuals. RESULTS The COVID-19 incidence had positive spatial autocorrelation across South Korea (I = 0.584, p = 0.001). The results suggest that individuals vaccinated against influenza in the preceding year had a negative association with COVID-19 incidence (relative risk=0.913, 95 % Credible Interval=0.838-0.997), even after adjusting for covariates. CONCLUSIONS Our ecological study suggests an association between COVID-19 infection and health behaviors, especially influenza vaccination, in the early stage of COVID-19 transmission at the municipal level.
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Affiliation(s)
- Jeehyun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea
| | - Daesung Yoo
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,Animal and Plant Quarantine Agency, Gimcheon, South Korea
| | - Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea,Correspondence to: Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, South Korea
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7
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Tofarides AG, Christaki E, Milionis H, Nikolopoulos GK. Effect of Vaccination against SARS-CoV-2 on Long COVID-19: A Narrative Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122057. [PMID: 36556422 PMCID: PMC9785763 DOI: 10.3390/life12122057] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
Vaccines against SARS-CoV-2 have saved millions of lives and played an important role in containing the COVID-19 pandemic. Vaccination against SARS-CoV-2 is also associated with reduced disease severity and, perhaps, with COVID-19 symptom burden. In this narrative review, we present, in a clinically relevant question-and-answer manner, the evidence regarding the association between vaccination against SARS-CoV-2 and long COVID-19. We discuss how the mechanism of action of vaccines could interplay with the pathophysiology of post-COVID-19 condition. Furthermore, we describe how specific factors, such as the number of vaccine doses and the type of SARS-CoV-2 variants, may affect post-COVID-19 condition. We also discuss the role of timing for vaccination in relation to the onset of long COVID-19 symptoms, as it seems to affect the frequency and severity of the condition. Additionally, we describe the potential modifying effect of age, as well as the association of type and level of immune response with long COVID-19. We also describe how system-specific long COVID-19 sequelae, namely neurocognitive-psychologic symptoms and cardiovascular pathology, could be altered by vaccination. Last, we address the question of whether seasonal influenza vaccination has a meaningful impact on the frequency of long COVID-19.
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Affiliation(s)
- Andreas G. Tofarides
- Department of Internal Medicine, Nicosia General Hospital, Nicosia 2029, Cyprus
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Eirini Christaki
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
- Correspondence: (E.C.); (G.K.N.)
| | - Haralampos Milionis
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
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8
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Kapoula GV, Vennou KE, Bagos PG. Influenza and Pneumococcal Vaccination and the Risk of COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:3086. [PMID: 36553093 PMCID: PMC9776999 DOI: 10.3390/diagnostics12123086] [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: 10/11/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
A number of studies have investigated the potential on-specific effects of some routinely administered vaccines (e.g., influenza, pneumococcal) on COVID-19 related outcomes, with contrasting results. In order to elucidate this discrepancy, we conducted a systematic review and meta-analysis to assess the association between seasonal influenza vaccination and pneumococcal vaccination with SARS-CoV-2 infection and its clinical outcomes. PubMed and medRxiv databases were searched up to April 2022. A random effects model was used in the meta-analysis to pool odds ratio (OR) and adjusted estimates with 95% confidence intervals (CIs). Heterogeneity was quantitatively assessed using the Cochran's Q and the I2 index. Subgroup analysis, sensitivity analysis and assessment of publication bias were performed for all outcomes. In total, 38 observational studies were included in the meta-analysis and there was substantial heterogeneity. Influenza and pneumococcal vaccination were associated with lower risk of SARS-CoV-2 infection (OR: 0.80, 95% CI: 0.75-0.86 and OR: 0.70, 95% CI: 0.57-0.88, respectively). Regarding influenza vaccination, it seems that the majority of studies did not properly adjust for all potential confounders, so when the analysis was limited to studies that adjusted for age, gender, comorbidities and socioeconomic indices, the association diminished. This is not the case regarding pneumococcal vaccination, for which even after adjustment for such factors the association persisted. Regarding harder endpoints such as ICU admission and death, current data do not support the association. Possible explanations are discussed, including trained immunity, inadequate matching for socioeconomic indices and possible coinfection.
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Affiliation(s)
- Georgia V. Kapoula
- Department of Biochemistry, General Hospital of Lamia, 35131 Lamia, Greece
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
| | - Konstantina E. Vennou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
| | - Pantelis G. Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
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9
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Jiang B, Huang Q, Jia M, Xue X, Wang Q, Yang W, Feng L. Association between influenza vaccination and SARS-CoV-2 infection and its outcomes: systematic review and meta-analysis. Chin Med J (Engl) 2022; 135:2282-2293. [PMID: 36378238 PMCID: PMC9771237 DOI: 10.1097/cm9.0000000000002427] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND World Health Organization recommends that influenza vaccines should benefit as much of the population as possible, especially where resources are limited. Corona virus disease 2019 (COVID-19) has become one of the greatest threats to health systems worldwide. The present study aimed to extend the evidence of the association between influenza vaccination and COVID-19 to promote the former. METHODS In this systematic review, four electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, were searched for related studies published up to May 2022. All odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by meta-analysis. RESULTS A total of 36 studies, encompassing 55,996,841 subjects, were included in this study. The meta-analysis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection provided an OR of 0.80 (95% CI: 0.73-0.87). The statistically significant estimates for clinical outcomes were 0.83 (95% CI: 0.72-0.96) for intensive care unit admission, 0.69 (95% CI: 0.57-0.84) for ventilator support, and 0.69 (95% CI: 0.52-0.93) for fatal infection, while no effect seen in hospitalization with an OR of 0.87 (95% CI: 0.68-1.10). CONCLUSION Influenza vaccination helps limit SARS-CoV-2 infection and severe outcomes, but further studies are needed. REGISTRATION PROSPERO, CRD42022333747.
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Affiliation(s)
- Binshan Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Qiangru Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xinai Xue
- Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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10
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Su W, Wang H, Sun C, Li N, Guo X, Song Q, Liang Q, Liang M, Ding X, Sun Y. The Association Between Previous Influenza Vaccination and COVID-19 Infection Risk and Severity: A Systematic Review and Meta-analysis. Am J Prev Med 2022; 63:121-130. [PMID: 35410774 PMCID: PMC8920881 DOI: 10.1016/j.amepre.2022.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The association between influenza vaccination and COVID-19 remains controversial. This meta-analysis aimed to investigate whether influenza vaccination reduces the susceptibility and severity of SARS-CoV-2 infection. METHODS A systematic literature search of PubMed, Web of Science, the Cochrane Library, Embase, China National Knowledge Infrastructure, SinoMed, Wanfang Data Knowledge Service Platform, and China Science and Technology Journal VIP Database was conducted from database inception to August 2021. The pooled RR with 95% CI was used to estimate the effect of influenza vaccination on COVID-19. The I2 value was used to assess heterogeneity. If I2>50%, the random-effects model was used as the pooling method. RESULTS A total of 23 published articles with 1,037,445 participants were identified. This meta-analysis showed that influenza vaccination was associated with reduced risk of COVID-19 infection (RR=0.83, 95% CI=0.76, 0.90) and hospitalization (RR=0.71, 95% CI=0.59, 0.84), although not significantly associated with intensive care unit admission and death (risk of intensive care unit admission: RR=0.93, 95% CI=0.64, 1.36; risk of death: RR=0.83, 95% CI=0.68, 1.01). Further analysis suggested that the tetravalent influenza vaccine may be associated with a reduced risk of COVID-19 infection (RR=0.74, 95% CI=0.65, 0.84). DISCUSSION The results suggest that influenza vaccination is associated with reduced susceptibility to or disease severity of COVID-19 and that influenza vaccination may reduce the risk of COVID-19 and improve clinical outcomes.
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Affiliation(s)
- Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Chenyu Sun
- Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China; Center for Evidence-Based Practice, Anhui Medical University, Anhui, P. R. China.
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11
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Clinical characteristics and risk factors for COVID-19 infection and disease severity: A nationwide observational study in Estonia. PLoS One 2022; 17:e0270192. [PMID: 35709192 PMCID: PMC9202832 DOI: 10.1371/journal.pone.0270192] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/06/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND COVID-19 pandemic has led to overloading of health systems all over the world. For reliable risk stratification, knowledge on factors predisposing to SARS-CoV-2 infection and to severe COVID-19 disease course is needed for decision-making at the individual, provider, and government levels. Data to identify these factors should be easily obtainable. METHODS AND FINDINGS Retrospective cohort study of nationwide e-health databases in Estonia. We used longitudinal health records from 66,295 people tested positive for SARS-CoV-2 RNA from 26 February 2020 to 28 February 2021 and 254,958 randomly selected controls from the reference population with no known history of SARS-CoV-2 infection or clinical COVID-19 diagnosis (case to control ratio 1:4) to predict risk factors of infection and severe course of COVID-19. We analysed sociodemographic and health characteristics of study participants. The SARS-CoV-2 infection risk was slightly higher among women, and was higher among those with comorbid conditions or obesity. Dementia (RRR 3.77, 95%CI 3.30⎼4.31), renal disease (RRR 1.88, 95%CI 1.56⎼2.26), and cerebrovascular disease (RRR 1.81, 95%CI 1.64⎼2.00) increased the risk of infection. Of all SARS-CoV-2 infected people, 92% had a non-severe disease course, 4.8% severe disease (requiring hospitalisation), 1.7% critical disease (needing intensive care), and 1.5% died. Male sex, increasing age and comorbid burden contributed significantly to more severe COVID-19, and the strength of association for male sex increased with the increasing severity of COVID-19 outcome. The strongest contributors to critical illness (expressed as RRR with 95% CI) were renal disease (7.71, 4.71⎼12.62), the history of previous myocardial infarction (3.54, 2.49⎼5.02) and obesity (3.56, 2.82⎼4.49). The strongest contributors to a lethal outcome were renal disease (6.48, 3.74⎼11.23), cancer (3.81, 3.06⎼4.75), liver disease (3.51, 1.36⎼9.02) and cerebrovascular disease (3.00, 2.31⎼3.89). CONCLUSIONS We found divergent effect of age and gender on infection risk and severity of COVID-19. Age and gender did not contribute substantially to infection risk, but did so for the risk of severe disease Co-morbid health conditions, especially those affecting renin-angiotensin system, had an impact on both the risk of infection and severe disease course. Age and male sex had the most significant impact on the risk of severe COVID-19. Taking into account the role of ACE2 receptors in the pathogenesis of SARS-CoV-2 infection, as well as its modulating action on the renin-angiotensin system in cardiovascular and renal diseases, further research is needed to investigate the influence of hormonal status on ACE2 expression in different tissues, which may be the basis for the development of COVID-19 therapies.
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12
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Correlates of influenza vaccination among underserved Latinx middle-aged and older adults: a cross-sectional survey. BMC Public Health 2022; 22:907. [PMID: 35524229 PMCID: PMC9077953 DOI: 10.1186/s12889-022-13121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx. Methods In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination. Results Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, thirty percent (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p-value=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p-value=0.008) or dissatisfaction with these experiences (p-value=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 – 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions. Conclusion The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.
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13
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Paganoti CDF, Rodrigues AS, Francisco RPV, da Costa RA. The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19. Vaccines (Basel) 2022; 10:vaccines10020206. [PMID: 35214665 PMCID: PMC8875780 DOI: 10.3390/vaccines10020206] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
The SARS-CoV-2 pandemic has imposed a huge challenge on the antenatal care of pregnant women worldwide, with the maternal mortality rate being raised to alarming levels. While COVID-19 vaccines were developed, some studies highlighted a possible relationship between influenza vaccination and lower odds of COVID-19 infection. As obstetric patients belong to a high-risk group for respiratory diseases, this study evaluated whether influenza vaccination reduces the severity of COVID-19 infection and mortality among pregnant and postpartum women. We conducted a retrospective cohort study on 3370 pregnant and postpartum women from the Brazilian national database, where they were grouped according to their influenza vaccination status before the onset of COVID-19 symptoms. The intensive care unit admission and intubation rates were significantly higher among subjects in the unvaccinated group (p = 0.002 and p < 0.001, respectively). The odds of mortality risk among those who received the vaccine was 0.33, with a 95% confidence interval of 0.23–0.47. The numbers of patients who needed to be vaccinated to avoid a case of intensive care unit admission, intubation, or death due to COVID-19 were 11, 15, and 11, respectively. Influenza vaccines could confer protection against severe COVID-19 infection in pregnant and postpartum women.
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Affiliation(s)
- Cristiane de Freitas Paganoti
- Division of Clinical Obstetrics, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil;
- Correspondence: ; Tel.: +55-11-2661-6209
| | | | - Rossana Pulcineli Vieira Francisco
- Discipline of Obstetrics, Department of Obstetrics and Gynecology, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil;
| | - Rafaela Alkmin da Costa
- Division of Clinical Obstetrics, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil;
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14
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Hupert N, Marín-Hernández D, Gao B, Águas R, Nixon DF. Heterologous vaccination interventions to reduce pandemic morbidity and mortality: Modeling the US winter 2020 COVID-19 wave. Proc Natl Acad Sci U S A 2022; 119:e2025448119. [PMID: 35012976 PMCID: PMC8784160 DOI: 10.1073/pnas.2025448119] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/02/2021] [Indexed: 12/12/2022] Open
Abstract
COVID-19 remains a stark health threat worldwide, in part because of minimal levels of targeted vaccination outside high-income countries and highly transmissible variants causing infection in vaccinated individuals. Decades of theoretical and experimental data suggest that nonspecific effects of non-COVID-19 vaccines may help bolster population immunological resilience to new pathogens. These routine vaccinations can stimulate heterologous cross-protective effects, which modulate nontargeted infections. For example, immunization with Bacillus Calmette-Guérin, inactivated influenza vaccine, oral polio vaccine, and other vaccines have been associated with some protection from SARS-CoV-2 infection and amelioration of COVID-19 disease. If heterologous vaccine interventions (HVIs) are to be seriously considered by policy makers as bridging or boosting interventions in pandemic settings to augment nonpharmaceutical interventions and specific vaccination efforts, evidence is needed to determine their optimal implementation. Using the COVID-19 International Modeling Consortium mathematical model, we show that logistically realistic HVIs with low (5 to 15%) effectiveness could have reduced COVID-19 cases, hospitalization, and mortality in the United States fall/winter 2020 wave. Similar to other mass drug administration campaigns (e.g., for malaria), HVI impact is highly dependent on both age targeting and intervention timing in relation to incidence, with maximal benefit accruing from implementation across the widest age cohort when the pandemic reproduction number is >1.0. Optimal HVI logistics therefore differ from optimal rollout parameters for specific COVID-19 immunizations. These results may be generalizable beyond COVID-19 and the US to indicate how even minimally effective heterologous immunization campaigns could reduce the burden of future viral pandemics.
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Affiliation(s)
- Nathaniel Hupert
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065;
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY 10065
- Cornell Institute for Disease and Disaster Preparedness, Cornell University, New York, NY 10065
| | - Daniela Marín-Hernández
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10065
| | - Bo Gao
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, United Kingdom
| | - Ricardo Águas
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, United Kingdom
| | - Douglas F Nixon
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10065
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15
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Merzon E, Green I, Somekh E, Vinker S, Golan-Cohen A, Israel A, Gorohovski A, Frenkel-Morgenstern M, Stein M. The Association of Previous Vaccination with Live-Attenuated Varicella Zoster Vaccine and COVID-19 Positivity: An Israeli Population-Based Study. Vaccines (Basel) 2022; 10:vaccines10010074. [PMID: 35062735 PMCID: PMC8777897 DOI: 10.3390/vaccines10010074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/19/2021] [Accepted: 12/25/2021] [Indexed: 12/12/2022] Open
Abstract
The Bacillus Calmette–Guérin (BCG) vaccine affords indirect protection against COVID-19, which is presumably due to priming of the innate immune system. It was hypothesized that the live attenuated Varicella Zoster (LAVZ) vaccine, recommended for the elderly population, would also protect against COVID-19 infection. A retrospective population-based cross-sectional study was conducted using the Leumit Health Services (LHS) database. LAVZ-vaccinated patients were matched with controls based on a propensity score model using 1:9 nearest-neighbor matching. Matching was based on age, gender, and the presence of some chronic disorders, which were selected according to their association with COVID-19 infection. Multivariate logistic regression analyses, adjusted for sex, age, smoking status, comorbidities, and chronic medications associated with COVID-19 risk, were used to estimate the association between LAVZ vaccination and COVID-19 RT-PCR results. Subjects (625) vaccinated with LAVZ and RT-PCR-tested for COVID-19 were identified. After 1:9 matching of subjects who received the LAVZ vaccine, 6250 subjects were included in the study. Multivariate logistic regression analysis demonstrated a significant and independent negative association between having received the LAVZ vaccine and the likelihood of COVID-19 infection (adjusted OR = 0.47 (95% CI 0.33–0.69, p < 0.001)). This association was further strengthened after separate analysis based on the time of LAVZ vaccination before COVID-19 RT-PCR testing. Individuals aged ≥50 years vaccinated with LAVZ had a decreased likelihood of being tested positive for COVID-19.
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Affiliation(s)
- Eugene Merzon
- Leumit Health Services, Tel Aviv 6473817, Israel; (E.M.); (I.G.); (S.V.); (A.G.-C.); (A.I.)
- Adelson School of Medicine, Ariel University, Ariel 4076414, Israel
| | - Ilan Green
- Leumit Health Services, Tel Aviv 6473817, Israel; (E.M.); (I.G.); (S.V.); (A.G.-C.); (A.I.)
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Eli Somekh
- Department of Paediatrics, Mayanei Hayeshuah Medical Centre, Bnei Brak 5154475, Israel;
| | - Shlomo Vinker
- Leumit Health Services, Tel Aviv 6473817, Israel; (E.M.); (I.G.); (S.V.); (A.G.-C.); (A.I.)
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Avivit Golan-Cohen
- Leumit Health Services, Tel Aviv 6473817, Israel; (E.M.); (I.G.); (S.V.); (A.G.-C.); (A.I.)
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ariel Israel
- Leumit Health Services, Tel Aviv 6473817, Israel; (E.M.); (I.G.); (S.V.); (A.G.-C.); (A.I.)
| | | | | | - Michal Stein
- Infectious Disease and Infection Control Unit, Hillel Yaffe Medical Center, Hadera 38100, Israel;
- Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3525433, Israel
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16
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Tissue-resident immunity in the lung: a first-line defense at the environmental interface. Semin Immunopathol 2022; 44:827-854. [PMID: 36305904 PMCID: PMC9614767 DOI: 10.1007/s00281-022-00964-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/08/2022] [Indexed: 12/15/2022]
Abstract
The lung is a vital organ that incessantly faces external environmental challenges. Its homeostasis and unimpeded vital function are ensured by the respiratory epithelium working hand in hand with an intricate fine-tuned tissue-resident immune cell network. Lung tissue-resident immune cells span across the innate and adaptive immunity and protect from infectious agents but can also prove to be pathogenic if dysregulated. Here, we review the innate and adaptive immune cell subtypes comprising lung-resident immunity and discuss their ontogeny and role in distinct respiratory diseases. An improved understanding of the role of lung-resident immunity and how its function is dysregulated under pathological conditions can shed light on the pathogenesis of respiratory diseases.
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Stańczak-Mrozek KI, Sobczak A, Lipiński L, Sienkiewicz E, Makarewicz D, Topór-Mądry R, Pinkas J, Sierpiński RA. The Potential Benefits of the Influenza Vaccination on COVID-19 Mortality Rate-A Retrospective Analysis of Patients in Poland. Vaccines (Basel) 2021; 10:vaccines10010005. [PMID: 35062666 PMCID: PMC8778897 DOI: 10.3390/vaccines10010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 12/19/2022] Open
Abstract
In this study, we used publicly available data from the Centrum e-Zdrowia (CeZ) Polish Databank proposing a possible correlation between influenza vaccination and mortality due to COVID-19. We limited our search to the patients with positive COVID-19 laboratory tests from 1 January 2020 to 31 March 2021 and who filled a prescription for any influenza vaccine during the 2019–2020 influenza season. In total, we included 116,277 patients and used a generalized linear model to analyze the data. We found out that patients aged 60+ who received an influenza vaccination have a lower probability of death caused by COVID-19 in comparison to unvaccinated, and the magnitude of this difference grows with age. For people below 60 years old, we did not observe an influence of the vaccination. Our results suggest a potential protective effect of the influenza vaccine on COVID-19 mortality of the elderly. Administration of the influenza vaccine before the influenza season would reduce the burden of increased influenza incidence, the risk of influenza and COVID-19 coinfection and render the essential medical resources accessible to cope with another wave of COVID-19. To our knowledge, this is the first study showing a correlation between influenza vaccination and the COVID-19 mortality rate in Poland.
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Affiliation(s)
| | - Adam Sobczak
- Medical Research Agency, Stanislawa Moniuszki 1a St., 00-014 Warsaw, Poland; (K.I.S.-M.); (A.S.); (L.L.); (D.M.)
| | - Leszek Lipiński
- Medical Research Agency, Stanislawa Moniuszki 1a St., 00-014 Warsaw, Poland; (K.I.S.-M.); (A.S.); (L.L.); (D.M.)
| | - Elżbieta Sienkiewicz
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Pl. Politechniki 1 St., 00-661 Warsaw, Poland;
| | - Dorota Makarewicz
- Medical Research Agency, Stanislawa Moniuszki 1a St., 00-014 Warsaw, Poland; (K.I.S.-M.); (A.S.); (L.L.); (D.M.)
| | - Roman Topór-Mądry
- The Agency for Health Technology Assessment and Tariff System, Przeskok 2 St., 00-032 Warsaw, Poland;
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland;
| | - Radosław Adam Sierpiński
- Medical Research Agency, Stanislawa Moniuszki 1a St., 00-014 Warsaw, Poland; (K.I.S.-M.); (A.S.); (L.L.); (D.M.)
- Correspondence:
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Demirci I, Haymana C, Salman S, Tasci I, Corapcioglu D, Kirik A, Yetkin İ, Altay M, Sabuncu T, Bayram F, Satman I, Sonmez A. Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study). World J Diabetes 2021; 12:2107-2118. [PMID: 35047124 PMCID: PMC8696642 DOI: 10.4239/wjd.v12.i12.2107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/13/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.
AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.
METHODS In this cross-sectional, nationwide, multicenter study, adult patients with type 1 diabetes (T1DM) (n = 454) and type 2 diabetes (T2DM) (n = 4721), who were under follow-up for at least a year in the outpatient clinics, were consecutively enrolled. Sociodemographic, clinical, and laboratory parameters of patients were recorded. Vaccination histories were documented according to the self-statements of the patients.
RESULTS Patients with T1DM and T2DM had similar vaccination rates for influenza (23.6% vs 21.2%; P = 0.240) and pneumococcus (8% vs 7%; P = 0.451) vaccinations. Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients. Higher education level, using statin treatment, and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.
CONCLUSION TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey. The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.
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Affiliation(s)
- Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Liv Hospital, Istanbul 34000, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06018, Turkey
| | - Demet Corapcioglu
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara 06560, Turkey
| | - Ali Kirik
- Department of Internal Medicine, Balıkesir University, Faculty of Medicine, Balikesir 10145, Turkey
| | - İlhan Yetkin
- Department of Endocrinology and Metabolism, Gazi University, Faculty of Medicine, Ankara 06190, Turkey
| | - Mustafa Altay
- Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, Ankara 06190, Turkey
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Harran University, Faculty of Medicine, Sanliurfa 63050, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University, Faculty of Medicine, Kayseri 38000, Turkey
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul 34000, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06190, Turkey
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Chen AT, Stacey HD, Marzok A, Singh P, Ang J, Miller MS, Loeb M. Effect of inactivated influenza vaccination on human coronavirus infection: Secondary analysis of a randomized trial in Hutterite colonies. Vaccine 2021; 39:7058-7065. [PMID: 34756613 PMCID: PMC8520850 DOI: 10.1016/j.vaccine.2021.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 01/07/2023]
Abstract
Background Although influenza vaccines provide protection against influenza viruses, concern has been raised that they may increase susceptibility to non-influenza respiratory viruses. As pandemic lockdowns end, temporal overlap of circulation of seasonal influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is expected. Understanding the impact of influenza vaccination on risk of coronavirus infection is therefore of considerable public health importance. Methods We performed a secondary analysis of a randomized trial where children and adolescents in Canadian Hutterite colonies were randomly assigned by colony to receive the 2008–2009 seasonal inactivated trivalent influenza vaccine (TIV) or a control hepatitis A (HepA) vaccine. All 3273 colony members (vaccinated children and nonvaccine recipients) were followed for the primary outcome of RT-PCR confirmed seasonal coronavirus infection. Serum collected pre- and post-vaccination was analyzed for titers of IgG antibodies towards human coronaviruses (HCoV). Results The incidence of coronavirus infection was 0·18/1000 person-days in the colonies that received TIV vs 0.36/1000 person-days in the control group, hazard ratio (HR) 0.49 [0.21–1.17]. The risk reduction among non-vaccine recipients in the TIV group compared to the control group was HR 0.55 [0.24–1.23]. There was an increase in the geometric mean fold change of HCoV-OC43 antibody titers following TIV compared to HepA vaccine (mean difference 1.2 [0.38–2.06], p = 0.007), and an increase in geometric mean HCoV-NL63 antibody titers post-TIV (262.9 vs 342.9, p = 0.03). Conclusion The influenza vaccine does not increase the risk of a coronavirus infection. Instead, the influenza vaccine may reduce the rate of coronavirus infections by inducing cross-reactive anti-coronavirus IgG antibodies.
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Affiliation(s)
- Andrew T Chen
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Hannah D Stacey
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada; McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | - Art Marzok
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada; McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | - Pardeep Singh
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Jann Ang
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada; McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | - Matthew S Miller
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada; McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada
| | - Mark Loeb
- Department of Medicine, McMaster University, Hamilton, ON, Canada; Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Mathematics and Statistics, McMaster University, Hamilton, ON, Canada.
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20
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Teich N, Ludewig C, Schmelz R, Bästlein EC, Geißler S, Nagl S, Walldorf J, Krause T, Maaser C, Mohl W, Wedemeyer HH, Bauer T, Büning C, Grunert P, Hasselblatt P, Hänschen M, Kahl M, Engelke O, Schubert S, Holler B, Streetz K, Arnim UV, Schmidt K, Stallmach A. [Effects of SARS-CoV-2 Infection on Symptoms and Therapy of Inflammatory Bowel Disease]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 59:1189-1196. [PMID: 34748206 DOI: 10.1055/a-1508-6734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The influence of a SARS-CoV-2 infection on inflammatory bowel disease (IBD) has not yet been well characterized and it is unclear whether this requires an adaptation of the immunosuppressive therapy. METHODS A national register was established for the retrospective documentation of clinical parameters and changes in immunosuppressive therapy in SARS-CoV-2 infected IBD patients. RESULTS In total, only 3 of 185 IBD patients (1.6 %) were tested for SARS-CoV-2 infection because of abdominal symptoms. In the course of COVID-19 disease, 43.5 % developed diarrhea, abdominal pain or hematochezia (risk of hospitalization with vs. without abdominal symptoms: 20.0 % vs. 10.6 %, p < 0.01). With active IBD at the time of SARS-CoV-2 detection, there was an increased risk of hospitalization (remission 11.2 %, active IBD 23.3 % p < 0.05). IBD-specific therapy remained unchanged in 115 patients (71.4 %); the most common change was an interruption of systemic therapy (16.2 %). DISCUSSION New abdominal symptoms often appeared in SARS-CoV-2 infected IBD patients. However, these only rarely led to SARS-CoV-2 testing. A high IBD activity at the time of SARS-CoV-2 detection was associated with an increased risk of hospitalization.
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Affiliation(s)
- Niels Teich
- Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig, Germany
| | - Clara Ludewig
- Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig, Germany
| | - Renate Schmelz
- Medizinische Klinik und Poliklinik 1, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | | | - Sven Geißler
- Praxisgemeinschaft für Rheumatologie und Gastroenterologie, Cottbus, Germany
| | - Sandra Nagl
- III. Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Jens Walldorf
- Universitätsklinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany
| | | | - Christian Maaser
- Ambulanzzentrum Gastroenterologie am Klinikum Lüneburg, Lüneburg, Germany
| | - Wolfgang Mohl
- Zentrum für Gastroenterologie Saar MVZ GmbH Saarbrücken, Saarbrücken, Germany
| | - Heiner H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Tilman Bauer
- Gemeinschaftspraxis für Gastroenterologie und Kindergastroenterologie, Freinurg, Germany
| | | | - Philip Grunert
- Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie und Infektiologie), Universitatsklinikum Jena, Jena, Germany
| | - Peter Hasselblatt
- Department of Medicine II, University Hospital Freiburg, Freiburg, Germany
| | | | - Matthias Kahl
- Fachinternistische Schwerpunktpraxis, Hamburg, Germany
| | - Olaf Engelke
- Internistische Gemeinschaftspraxis Wanne-Eickel, Herne, Germany
| | - Stefan Schubert
- MVZ für Gastroenterologie am Bayerischen Platz, Berlin, Germany
| | - Babett Holler
- Klinik und Poliklinik für Onkologie, Gastroenterologie, Hepatologie, Pneumologie und Infektiologie, Universitätsklinikum Leipzig, Germany
| | | | - Ulrike von Arnim
- Department of Gastroenterology, Hepatology and Infectious diseases, Universitätsklinikum Magdeburg AöR, Magdeburg, Germany
| | | | - Andreas Stallmach
- Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie und Infektiologie), Universitatsklinikum Jena, Jena, Germany
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Influenza vaccine during the 2019-2020 season and COVID-19 risk: A case-control study in Québec. Can Commun Dis Rep 2021; 47:430-434. [PMID: 34737675 DOI: 10.14745/ccdr.v47i10a05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background We carried out a case-control study that examined whether receipt of the inactivated influenza vaccine during the 2019-2020 season impacted on the risk of coronavirus disease 2019 (COVID-19), as there was a concern that the vaccine could be detrimental through viral interference. Methods A total of 920 cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (diagnosed between March and October 2020) and 2,123 uninfected controls were recruited from those who were born in Québec between 1956 and 1976 and who had received diagnostic services at two hospitals (Montréal and Sherbrooke, Québec). After obtaining consent, a questionnaire was administered by phone. Data were analyzed by logistic regression. Results Among healthcare workers, inactivated influenza vaccine received during the previous influenza season was not associated with increased COVID-19 risk (AOR: 0.99, 95% CI: 0.69-1.41). Among participants who were not healthcare workers, influenza vaccination was associated with lower odds of COVID-19 (AOR: 0.73, 95% CI 0.56-0.96). Conclusion We found no evidence that seasonal influenza vaccine increased the risk of developing COVID-19.
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HIV self-testing in Ottawa, Canada used by persons at risk for HIV: The GetaKit study. CANADA COMMUNICABLE DISEASE REPORT = RELEVÉ DES MALADIES TRANSMISSIBLES AU CANADA 2021; 47:435-441. [PMID: 34737676 DOI: 10.14745/ccdr.v47i10a06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background The Public Health Agency of Canada estimates that about 87% of persons living with human immunodeficiency virus (HIV) in Canada have been diagnosed, which is well below the Joint United Nations Programme on HIV/AIDS target to have 95% of HIV-positive persons diagnosed. Research has shown that HIV self-testing may help increase such diagnoses, especially among the populations who are most affected by HIV. The objective of the study was to determine the uptake and diagnosis outcomes associated with free HIV self-testing. Methods We developed the first online mailout free HIV self-testing program in Canada and implemented it in Ottawa. This project ran through the website, www.GetaKit.ca. We intended to recruit 150-400 participants over a 6-12-month period, estimating that this number would yield between 0-1 positive test results (expected positivity rate of 0.08%). Results Between July 20, 2020 and April 1, 2021, 1,268 people accessed the GetaKit website and verified their eligibility. In total, 600 persons were eligible and 405 ordered an HIV kit. Of those who ordered a kit, 399 completed a baseline survey. Overall, 71% of these participants were members of HIV priority groups. For test results, 228 persons reported test results, with one being positive, for a positivity rate of 0.24% overall and 0.44% of reported results. These rates exceed that normally observed in Ottawa. Conclusion Self-testing of HIV can be effectively delivered through a website. Such an intervention will also be used by persons with undiagnosed infections and appears to do so at a rate higher than that observed by other means of testing. Self-testing of HIV may therefore help Canada achieve the United Nations 95-95-95 targets.
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Massari M, Spila-Alegiani S, Fabiani M, Belleudi V, Trifirò G, Kirchmayer U, Poggi FR, Mancuso P, Menniti-Ippolito F, Gini R, Bartolini C, Leoni O, Ercolanoni M, Da-Re F, Guzzinati S, Luxi N, Riccardo F, Giorgi-Rossi P. Association of Influenza Vaccination and Prognosis in Patients Testing Positive to SARS-CoV-2 Swab Test: A Large-Scale Italian Multi-Database Cohort Study. Vaccines (Basel) 2021; 9:716. [PMID: 34358133 PMCID: PMC8310185 DOI: 10.3390/vaccines9070716] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022] Open
Abstract
To investigate the association of the 2019-2020 influenza vaccine with prognosis of patients positive for SARS-CoV-2A, a large multi-database cohort study was conducted in four Italian regions (i.e., Lazio, Lombardy, Veneto, and Tuscany) and the Reggio Emilia province (Emilia-Romagna). More than 21 million adults were residing in the study area (42% of the population). We included 115,945 COVID-19 cases diagnosed during the first wave of the pandemic (February-May, 2020); 34.6% of these had been vaccinated against influenza. Three outcomes were considered: hospitalization, death, and intensive care unit (ICU) admission/death. The adjusted relative risk (RR) of being hospitalized in the vaccinated group when compared with the non-vaccinated group was 0.87 (95% CI: 0.86-0.88). This reduction in risk was not confirmed for death (RR = 1.04; 95% CI: 1.01-1.06), or for the combined outcome of ICU admission or death. In conclusion, our study, conducted on the vast majority of the population during the first wave of the pandemic in Italy, showed a 13% statistically significant reduction in the risk of hospitalization in some geographical areas and in the younger population. No impact of seasonal influenza vaccination on COVID-19 prognosis in terms of death and death or ICU admission was estimated.
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Affiliation(s)
- Marco Massari
- Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation (CNRVF), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.M.); (F.M.-I.)
| | - Stefania Spila-Alegiani
- Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation (CNRVF), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.M.); (F.M.-I.)
| | - Massimo Fabiani
- Department of Infectious Diseases (DMI), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.F.); (F.R.)
| | - Valeria Belleudi
- Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00147 Rome, Italy; (V.B.); (U.K.); (F.R.P.)
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 3, 37134 Verona, Italy;
- Italian Society of Pharmacology, Via Giovanni Pascoli 3, 20129 Milan, Italy
| | - Ursula Kirchmayer
- Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00147 Rome, Italy; (V.B.); (U.K.); (F.R.P.)
| | - Francesca Romana Poggi
- Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00147 Rome, Italy; (V.B.); (U.K.); (F.R.P.)
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy; (P.M.); (P.G.-R.)
| | - Francesca Menniti-Ippolito
- Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation (CNRVF), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.M.); (F.M.-I.)
| | - Rosa Gini
- Agenzia Regionale di Sanità della Toscana, Via Pietro Dazzi 1, 50141 Florence, Italy; (R.G.); (C.B.)
| | - Claudia Bartolini
- Agenzia Regionale di Sanità della Toscana, Via Pietro Dazzi 1, 50141 Florence, Italy; (R.G.); (C.B.)
| | - Olivia Leoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Piazza Città di Lombardia 1, 20124 Milan, Italy; (O.L.); (M.E.)
| | - Michele Ercolanoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Piazza Città di Lombardia 1, 20124 Milan, Italy; (O.L.); (M.E.)
| | - Filippo Da-Re
- Regional Directorate of Prevention, Food Safety, Veterinary Public Health, Regione del Veneto, Rio Novo-Dorsoduro 3493, 30123 Venice, Italy;
| | - Stefano Guzzinati
- Azienda Zero, Regione del Veneto, Passaggio Luigi Gaudenzio, 1, 35131 Padova, Italy;
| | - Nicoletta Luxi
- Department BIOMORF, University of Messina, Piazza Pugliatti 1, 98122 Messina, Italy;
| | - Flavia Riccardo
- Department of Infectious Diseases (DMI), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.F.); (F.R.)
| | - Paolo Giorgi-Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy; (P.M.); (P.G.-R.)
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The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Vaccines (Basel) 2021; 9:vaccines9050529. [PMID: 34065294 PMCID: PMC8161076 DOI: 10.3390/vaccines9050529] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022] Open
Abstract
Influenza could circulate in parallel with COVID-19. In the context of COVID-19, some studies observed inverse associations between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, while others did not. We conducted a meta-analysis to assess the association between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, aiming to provide evidence for COVID-19 prevention and vaccination promotion. We searched four databases from inception to 10 March, 2021. Random effects and fixed effects models were used to pool odds ratios (ORs) and adjusted estimates with 95% confidence intervals (CIs). We used funnel plots to evaluate the publication bias, I2 statistics to evaluate the heterogeneity, and conducted subgroup analyses. Sixteen observational studies involving 290,327 participants were included. Influenza vaccination was associated with a lower risk of SARS-CoV-2 infection (pooled adjusted OR: 0.86, 95%CI: 0.81–0.91), while not significantly associated with adverse outcomes (intensive care: adjusted OR 0.63, 95%CI: 0.22–1.81; hospitalization: adjusted OR 0.74, 95%CI: 0.51–1.06; mortality: adjusted OR 0.89, 95%CI: 0.73–1.09). Our findings suggest that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection. It is crucial for policy makers to implement strategies on influenza vaccination, for it may also have benefits for COVID-19 prevention.
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Luo R, Delaunay‐Moisan A, Timmis K, Danchin A. SARS-CoV-2 biology and variants: anticipation of viral evolution and what needs to be done. Environ Microbiol 2021; 23:2339-2363. [PMID: 33769683 PMCID: PMC8251359 DOI: 10.1111/1462-2920.15487] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022]
Abstract
The global propagation of SARS-CoV-2 and the detection of a large number of variants, some of which have replaced the original clade to become dominant, underscores the fact that the virus is actively exploring its evolutionary space. The longer high levels of viral multiplication occur - permitted by high levels of transmission -, the more the virus can adapt to the human host and find ways to success. The third wave of the COVID-19 pandemic is starting in different parts of the world, emphasizing that transmission containment measures that are being imposed are not adequate. Part of the consideration in determining containment measures is the rationale that vaccination will soon stop transmission and allow a return to normality. However, vaccines themselves represent a selection pressure for evolution of vaccine-resistant variants, so the coupling of a policy of permitting high levels of transmission/virus multiplication during vaccine roll-out with the expectation that vaccines will deal with the pandemic, is unrealistic. In the absence of effective antivirals, it is not improbable that SARS-CoV-2 infection prophylaxis will involve an annual vaccination campaign against 'dominant' viral variants, similar to influenza prophylaxis. Living with COVID-19 will be an issue of SARS-CoV-2 variants and evolution. It is therefore crucial to understand how SARS-CoV-2 evolves and what constrains its evolution, in order to anticipate the variants that will emerge. Thus far, the focus has been on the receptor-binding spike protein, but the virus is complex, encoding 26 proteins which interact with a large number of host factors, so the possibilities for evolution are manifold and not predictable a priori. However, if we are to mount the best defence against COVID-19, we must mount it against the variants, and to do this, we must have knowledge about the evolutionary possibilities of the virus. In addition to the generic cellular interactions of the virus, there are extensive polymorphisms in humans (e.g. Lewis, HLA, etc.), some distributed within most or all populations, some restricted to specific ethnic populations and these variations pose additional opportunities for/constraints on viral evolution. We now have the wherewithal - viral genome sequencing, protein structure determination/modelling, protein interaction analysis - to functionally characterize viral variants, but access to comprehensive genome data is extremely uneven. Yet, to develop an understanding of the impacts of such evolution on transmission and disease, we must link it to transmission (viral epidemiology) and disease data (patient clinical data), and the population granularities of these. In this editorial, we explore key facets of viral biology and the influence of relevant aspects of human polymorphisms, human behaviour, geography and climate and, based on this, derive a series of recommendations to monitor viral evolution and predict the types of variants that are likely to arise.
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Affiliation(s)
- Ruibang Luo
- Department of Computer ScienceThe University of Hong KongBonham RoadPokfulamHong Kong
| | - Agnès Delaunay‐Moisan
- Université Paris‐Saclay, CEA, CNRS, Institute for Integrative Biology of the Cell (I2BC)Gif‐sur‐Yvette91198France
| | - Kenneth Timmis
- Institute of MicrobiologyTechnical University of BraunschweigBraunschweigGermany
| | - Antoine Danchin
- Kodikos Labs, Institut Cochin, 24 rue du Faubourg Saint‐JacquesParis75014France
- School of Biomedical Sciences, Li Kashing Faculty of MedicineUniversity of Hong Kong21 Sassoon RoadHong Kong
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Zanettini C, Omar M, Dinalankara W, Imada EL, Colantuoni E, Parmigiani G, Marchionni L. Influenza Vaccination and COVID-19 Mortality in the USA: An Ecological Study. Vaccines (Basel) 2021; 9:vaccines9050427. [PMID: 33923159 PMCID: PMC8145634 DOI: 10.3390/vaccines9050427] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 mortality rate is higher in the elderly and in those with pre-existing chronic medical conditions. The elderly also suffer from increased morbidity and mortality from seasonal influenza infections; thus, an annual influenza vaccination is recommended for them. In this study, we explore a possible county-level association between influenza vaccination coverage in people aged 65 years and older and the number of deaths from COVID-19. To this end, we used COVID-19 data up to 14 December 2020 and US population health data at the county level. We fit quasi-Poisson regression models using influenza vaccination coverage in the elderly population as the independent variable and the COVID-19 mortality rate as the outcome variable. We adjusted for an array of potential confounders using different propensity score regression methods. Results show that, on the county level, influenza vaccination coverage in the elderly population is negatively associated with mortality from COVID-19, using different methodologies for confounding adjustment. These findings point to the need for studying the relationship between influenza vaccination and COVID-19 mortality at the individual level to investigate any underlying biological mechanisms.
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Affiliation(s)
- Claudio Zanettini
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Mohamed Omar
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Wikum Dinalankara
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Eddie Luidy Imada
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Elizabeth Colantuoni
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Giovanni Parmigiani
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA 02215, USA;
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Luigi Marchionni
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
- Correspondence: ; Tel.: +001-646-962-8767
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Ozdemir N, Bayraktar-Ekincioglu A, Kilickap S. The effect of the COVID-19 pandemic on routine adult vaccination in cancer patients. Med Oncol 2021; 38:62. [PMID: 33891205 PMCID: PMC8062818 DOI: 10.1007/s12032-021-01512-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/16/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Nesligul Ozdemir
- Faculty of Pharmacy, Department of Clinical Pharmacy, Hacettepe University, Ankara, Turkey.
| | | | - Saadettin Kilickap
- Faculty of Medicine, Department of Medical Oncology, Hacettepe University, Ankara, Turkey
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