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Sun T, Li L, Mues KE, Georgieva MV, Kirk B, Mansi JA, Van de Velde N, Beck EC. Real-World Effectiveness of a Third Dose of mRNA-1273 Versus BNT162b2 on Inpatient and Medically Attended COVID-19 Among Immunocompromised US Adults. Infect Dis Ther 2024:10.1007/s40121-024-01005-1. [PMID: 38916690 DOI: 10.1007/s40121-024-01005-1] [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] [Accepted: 06/06/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION Recent data have shown elevated infection rates in several subpopulations at risk of SARS-CoV-2 infection and COVID-19, including immunocompromised (IC) individuals. Previous research suggests that IC persons have reduced risks of hospitalization and medically attended COVID-19 with two doses of mRNA-1273 (SpikeVax; Moderna) compared to two doses of BNT162b2 (Comirnaty; Pfizer/BioNTech). The main objective of this retrospective cohort study was to compare real-world effectiveness of third doses of mRNA-1273 versus BNT162b2 at multiple time points on occurrence of COVID-19 hospitalization and medically attended COVID-19 among IC adults in the United States (US). METHODS This retrospective, observational comparative effectiveness study identified patients from the US HealthVerity database from December 11, 2020, through August 31, 2022. Medically attended SARS-CoV-2 infections and hospitalizations were assessed following a three-dose mRNA-1273 versus BNT162b2 regimen. Inverse probability weighting was applied to balance baseline confounders between vaccine groups. Relative risk (RR) and risk difference were calculated for subgroup and sensitivity analyses using a non-parametric method. RESULTS In propensity score-adjusted analyses, receiving mRNA-1273 vs. BNT162b2 as third dose was associated with 32.4% (relative risk 0.676; 95% confidence interval 0.506-0.887), 29.3% (0.707; 0.573-0.858), and 23.4% (0.766; 0.626-0.927) lower risk of COVID-19 hospitalization after 90, 180, and 270 days, respectively. Corresponding reductions in medically attended COVID-19 were 8.4% (0.916; 0.860-0.976), 6.4% (0.936; 0.895-0.978), and 2.4% (0.976; 0.935-1.017), respectively. CONCLUSIONS Our findings suggest a third dose of mRNA-1273 is more effective than a third dose of BNT162b2 in preventing COVID-19 hospitalization and breakthrough medically attended COVID-19 among IC adults in the US.
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Affiliation(s)
- Tianyu Sun
- Moderna, Inc., 325 Binney Street, Cambridge, MA, 02142, USA.
| | - Linwei Li
- Moderna, Inc., 325 Binney Street, Cambridge, MA, 02142, USA
| | | | | | | | - James A Mansi
- Moderna, Inc., 325 Binney Street, Cambridge, MA, 02142, USA
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Keane A, Tippett A, Taylor EG, Reese O, Salazar L, De Castro K, Choi C, Ciric C, Taylor M, Mitchell A, Gibson T, Puzniak L, Hubler R, Valluri SR, Wiemken TL, Lopman BA, Kamidani S, Anderson LJ, McLaughlin JM, Rostad CA, Anderson EJ. Effectiveness of BNT162b2 Vaccine for Preventing COVID-19-Related Hospitalizations: A Test-Negative Case-Control Study. Vaccines (Basel) 2024; 12:657. [PMID: 38932386 DOI: 10.3390/vaccines12060657] [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: 04/23/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
It is important to understand real-world BNT162b2 COVID-19 vaccine effectiveness (VE), especially among racial and ethnic minority groups. We performed a test-negative case-control study to measure BNT162b2 COVID-19 VE in the prevention of COVID-19-associated acute respiratory illness (ARI) hospitalizations at two Atlanta hospitals from May 2021-January 2023 and adjusted for potential confounders by multivariate analysis. Among 5139 eligible adults with ARI, 2763 (53.8%) were enrolled, and 1571 (64.5%) were included in the BNT162b2 analysis. The median age was 58 years (IQR, 44-68), 889 (56.6%) were female, 1034 (65.8%) were African American, 359 (22.9%) were White, 56 (3.6%) were Hispanic ethnicity, 645 (41.1%) were SARS-CoV-2-positive, 412 (26.2%) were vaccinated with a primary series, and 273 (17.4%) had received ≥1 booster of BNT162b2. The overall adjusted VE of the BNT162b2 primary series was 58.5% (95% CI 46.0, 68.1), while the adjusted VE of ≥1 booster was 78.9% (95% CI 70.0, 85.1). The adjusted overall VE of primary series for African American/Black individuals was 64.0% (95% CI 49.9, 74.1) and 82.7% (95% CI 71.9, 89.4) in those who received ≥1 booster. When analysis was limited to the period of Omicron predominance, overall VE of the primary series decreased with widened confidence intervals (24.5%, 95% CI -4.5, 45.4%), while VE of ≥1 booster was maintained at 60.9% (95% CI 42.0, 73.6). BNT162b2 primary series and booster vaccination provided protection against COVID-19-associated ARI hospitalization among a predominantly African American population.
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Affiliation(s)
- Amy Keane
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ashley Tippett
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | | | - Olivia Reese
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Luis Salazar
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Khalel De Castro
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Chris Choi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Caroline Ciric
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Meg Taylor
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Anna Mitchell
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Theda Gibson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | | | | | | | | | - Ben A Lopman
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Satoshi Kamidani
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Larry J Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | | | - Christina A Rostad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Evan J Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
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Hechter RC, Qian L, Liu ILA, Sy LS, Ryan DS, Xu S, Williams JTB, Klein NP, Kaiser RM, Liles EG, Glanz JM, Jackson LA, Sundaram ME, Weintraub ES, Tseng HF. COVID-19 Vaccination Coverage and Factors Associated With Vaccine Uptake Among People With HIV. JAMA Netw Open 2024; 7:e2415220. [PMID: 38842808 PMCID: PMC11157350 DOI: 10.1001/jamanetworkopen.2024.15220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/03/2024] [Indexed: 06/07/2024] Open
Abstract
Importance People with HIV (PWH) may be at increased risk for severe outcomes with COVID-19 illness compared with people without HIV. Little is known about COVID-19 vaccination coverage and factors associated with primary series completion among PWH. Objectives To evaluate COVID-19 vaccination coverage among PWH and examine sociodemographic, clinical, and community-level factors associated with completion of the primary series and an additional primary dose. Design, Setting, and Participants This retrospective cohort study used electronic health record data to assess COVID-19 vaccination information from December 14, 2020, through April 30, 2022, from 8 health care organizations of the Vaccine Safety Datalink project in the US. Participants were adults diagnosed with HIV on or before December 14, 2020, enrolled in a participating site. Main Outcomes and Measures The percentage of PWH with at least 1 dose of COVID-19 vaccine and PWH who completed the COVID-19 vaccine primary series by December 31, 2021, and an additional primary dose by April 30, 2022. Rate ratios (RR) and 95% CIs were estimated using Poisson regression models for factors associated with completing the COVID-19 vaccine primary series and receiving an additional primary dose. Results Among 22 058 adult PWH (mean [SD] age, 52.1 [13.3] years; 88.8% male), 90.5% completed the primary series by December 31, 2021. Among 18 374 eligible PWH who completed the primary series by August 12, 2021, 15 982 (87.0%) received an additional primary dose, and 4318 (23.5%) received a booster dose by April 30, 2022. Receipt of influenza vaccines in the last 2 years was associated with completion of the primary series (RR, 1.17; 95% CI, 1.15-1.20) and an additional primary dose (RR, 1.61; 95% CI, 1.54-1.69). PWH with uncontrolled viremia (HIV viral load ≥200 copies/mL) (eg, RR, 0.90 [95% CI, 0.85-0.95] for viral load 200-10 000 copies/mL vs undetected or <200 copies/mL for completing the primary series) and Medicaid insurance (eg, RR, 0.89 [95% CI, 0.87-0.90] for completing the primary series) were less likely to be fully vaccinated. By contrast, greater outpatient utilization (eg, RR, 1.07 [95% CI, 1.05-1.09] for ≥7 vs 0 visits for primary series completion) and residence in counties with higher COVID-19 vaccine coverage (eg, RR, 1.06 [95% CI, 1.03-1.08] for fourth vs first quartiles for primary series completion) were associated with primary series and additional dose completion (RRs ranging from 1.01 to 1.21). Conclusions and Relevance Findings from this cohort study suggest that, while COVID-19 vaccination coverage was high among PWH, outreach efforts should focus on those who did not complete vaccine series and those who have uncontrolled viremia.
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Affiliation(s)
- Rulin C. Hechter
- Kaiser Permanente Southern California, Pasadena, California
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Lei Qian
- Kaiser Permanente Southern California, Pasadena, California
| | - In-Lu Amy Liu
- Kaiser Permanente Southern California, Pasadena, California
| | - Lina S. Sy
- Kaiser Permanente Southern California, Pasadena, California
| | | | - Stanley Xu
- Kaiser Permanente Southern California, Pasadena, California
| | | | | | | | | | - Jason M. Glanz
- Institute for Health Research, Kaiser Permanente, Denver, Colorado
| | | | | | | | - Hung Fu Tseng
- Kaiser Permanente Southern California, Pasadena, California
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Sacco C, Manica M, Marziano V, Fabiani M, Mateo-Urdiales A, Guzzetta G, Merler S, Pezzotti P. The impact of underreported infections on vaccine effectiveness estimates derived from retrospective cohort studies. Int J Epidemiol 2024; 53:dyae077. [PMID: 38847783 PMCID: PMC11157963 DOI: 10.1093/ije/dyae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 05/30/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Surveillance data and vaccination registries are widely used to provide real-time vaccine effectiveness (VE) estimates, which can be biased due to underreported (i.e. under-ascertained and under-notified) infections. Here, we investigate how the magnitude and direction of this source of bias in retrospective cohort studies vary under different circumstances, including different levels of underreporting, heterogeneities in underreporting across vaccinated and unvaccinated, and different levels of pathogen circulation. METHODS We developed a stochastic individual-based model simulating the transmission dynamics of a respiratory virus and a large-scale vaccination campaign. Considering a baseline scenario with 22.5% yearly attack rate and 30% reporting ratio, we explored fourteen alternative scenarios, each modifying one or more baseline assumptions. Using synthetic individual-level surveillance data and vaccination registries produced by the model, we estimated the VE against documented infection taking as reference either unvaccinated or recently vaccinated individuals (within 14 days post-administration). Bias was quantified by comparing estimates to the known VE assumed in the model. RESULTS VE estimates were accurate when assuming homogeneous reporting ratios, even at low levels (10%), and moderate attack rates (<50%). A substantial downward bias in the estimation arose with homogeneous reporting and attack rates exceeding 50%. Mild heterogeneities in reporting ratios between vaccinated and unvaccinated strongly biased VE estimates, downward if cases in vaccinated were more likely to be reported and upward otherwise, particularly when taking as reference unvaccinated individuals. CONCLUSIONS In observational studies, high attack rates or differences in underreporting between vaccinated and unvaccinated may result in biased VE estimates. This study underscores the critical importance of monitoring data quality and understanding biases in observational studies, to more adequately inform public health decisions.
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Affiliation(s)
- Chiara Sacco
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Mattia Manica
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | | | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giorgio Guzzetta
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Merler
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Abdeen S, Abed Alah M, Al-Zaidan M, Mohamed Ibrahim MI, Abdulmajeed J, Al-Nuaimi AA, Al-Kuwari MG. Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study. Front Public Health 2024; 12:1384327. [PMID: 38660363 PMCID: PMC11039914 DOI: 10.3389/fpubh.2024.1384327] [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: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Background Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar. Methods A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects. Results Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose. Conclusion The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.
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Affiliation(s)
- Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Manal Al-Zaidan
- Department of Pharmacy and Therapeutics Supply, Primary Health Care Corporation, Doha, Qatar
| | | | - Jazeel Abdulmajeed
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Asma Ali Al-Nuaimi
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Mohamed Ghaith Al-Kuwari
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
- Collège of Medicine, Qatar University, Doha, Qatar
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Blumenfeld O, Rosenberg A, Reuven M, Caspi I, Sharoni E, Leviner DB. The effect of COVID-19 vaccination on 30-day mortality after cardiac surgery - Insights from the Israel national registries. Infect Prev Pract 2024; 6:100334. [PMID: 38235125 PMCID: PMC10792629 DOI: 10.1016/j.infpip.2023.100334] [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: 10/04/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024] Open
Abstract
Background We compared the effect of perioperative COVID-19, before and after vaccination, on 30-day mortality after cardiac surgery. Methods Data was extracted from several national registries. The study period was March 1st, 2020-March 31st, 2022. Results 2594 adult patients underwent cardiac surgery before the availability of a universal COVID-19 vaccine. 33 patients were diagnosed with COVID-19 prior to surgery (mean age 58.3±10.0, mean length of time 73.6±60.1 days) and 7 patients were diagnosed with COVID-19 0-14 days after surgery (age 66.4±7.6). These were compared to 4426 patients who underwent cardiac surgery after the availability of a universal vaccine: 469 patients were diagnosed with COVID-19 prior to surgery (age 62.1±10.1, length of time 175.8±158.2) and 32 patients diagnosed with COVID-19 0-14 days after surgery (age 60.8±14.5). In patients diagnosed with COVID-19 prior to surgery, there was no excess 30-day mortality either before or after vaccination (1 (3.0%) vs. 57 (2.2%), respectively, P<0.8, and 8 (1.7%) vs. 87 (2.2%), respectively, P<0.5). Patients diagnosed with COVID-19 after surgery, but before vaccination, had significantly higher 30-day mortality compared to COVID-19 negative patients (2 (28.6%) vs. 56 (2.2%) respectively, P<0.0001). This excess mortality disappeared after universal vaccination (1 (3.1%) vs. 94 (2.1%) respectively, P<0.7). Conclusions COVID-19, when diagnosed in the early post-operative period, was a risk factor for mortality before available vaccinations, but not after vaccination was widely available. Pre-surgery screening and post-surgical isolation is essential until vaccines are available. This data may be useful for patient management in future respiratory pandemics.
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Affiliation(s)
- Orit Blumenfeld
- Israel Center for Disease Control, Ministry of Health, Ramat-Gan, Israel
| | - Alina Rosenberg
- Israel Center for Disease Control, Ministry of Health, Ramat-Gan, Israel
| | - Michal Reuven
- Israel Center for Disease Control, Ministry of Health, Ramat-Gan, Israel
| | - Inbar Caspi
- Internal Medicine Department, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Erez Sharoni
- Department of Cardiac Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth & Baruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dror B. Leviner
- Department of Cardiac Surgery, Carmel Medical Center, Haifa, Israel
- The Ruth & Baruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Fujieda K, Tanaka A, Kikuchi R, Takai N, Saito S, Yasuda Y, Sano Y, Kato M, Furuhashi K, Maruyama S. Changes in antibody titer after four and five doses of the SARS-CoV-2 vaccine in Japanese post-kidney transplant patients. Ther Apher Dial 2024. [PMID: 38385762 DOI: 10.1111/1744-9987.14114] [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: 10/29/2023] [Revised: 01/19/2024] [Accepted: 02/06/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Immunosuppressed patients exhibit low antibody acquisition rates following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Kidney transplant recipients previously exhibited low antibody acquisition rates after two vaccine doses, which increased after the third dose. We evaluated antibody titers of Japanese post-kidney transplant patients after the fourth and fifth vaccinations. METHODS Antibody titers for SARS-CoV-2 spike protein were measured between 3 weeks and 3 months after the fourth or fifth vaccination. RESULTS Increased antibody acquisition rates were observed after the fourth (75.0% antibody-positive) and fifth (81.5% antibody-positive) vaccinations. The antibody-acquired group after the fourth vaccination exhibited a higher body mass index and estimated glomerular filtration rate (eGFR) than the non-acquired group. A higher eGFR was associated with antibody acquisition after the fifth vaccination. CONCLUSION In Japanese post-kidney transplant patients, the antibody acquisition rate increased with each vaccine additional dose. Additional vaccinations are recommended to protect against SARS-CoV-2 infection.
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Affiliation(s)
- Kumiko Fujieda
- Department of Nephrology, Nagoya University Hospital, Nagoya, Japan
| | - Akihito Tanaka
- Department of Nephrology, Nagoya University Hospital, Nagoya, Japan
| | - Ryosuke Kikuchi
- Department of Medical Technique, Nagoya University Hospital, Nagoya, Japan
- Division of Clinical Laboratory, Gifu University Hospital, Gifu, Japan
| | - Nami Takai
- Department of Nursing, Nagoya University Hospital, Nagoya, Japan
| | - Shoji Saito
- Department of Nephrology, Nagoya University Hospital, Nagoya, Japan
| | - Yoshinari Yasuda
- Department of Nephrology, Nagoya University Hospital, Nagoya, Japan
| | - Yuta Sano
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Zhang X, Zhan H, Wang L, Liu Y, Guo X, Li C, Li X, Li B, Li H, Li Y, Chen Q, Gao H, Feng F, Li Y, Dai E. COVID-19 vaccination willingness among people living with HIV in Shijiazhuang, China: a cross-sectional survey. Front Med (Lausanne) 2024; 11:1322440. [PMID: 38314204 PMCID: PMC10835989 DOI: 10.3389/fmed.2024.1322440] [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: 10/16/2023] [Accepted: 01/02/2024] [Indexed: 02/06/2024] Open
Abstract
Objectives The COVID-19 pandemic imposed an enormous disease and economic burden worldwide. SARS-CoV-2 vaccination is essential to containing the pandemic. People living with HIV (PLWH) may be more vulnerable to severe COVID-19 outcomes; thus, understanding their vaccination willingness and influencing factors is helpful in developing targeted vaccination strategies. Methods A cross-sectional study was conducted between 15 June and 30 August 2022 in Shijiazhuang, China. Variables included socio-demographic characteristics, health status characteristics, HIV-related characteristics, knowledge, and attitudes toward COVID-19 vaccination and COVID-19 vaccination status. Multivariable logistic regression was used to confirm factors associated with COVID-19 vaccination willingness among PLWH. Results A total of 1,428 PLWH were included, with a 90.48% willingness to receive the COVID-19 vaccination. PLWH were more unwilling to receive COVID-19 vaccination for those who were female or had a fair/poor health status, had an allergic history and comorbidities, were unconvinced and unsure about the effectiveness of vaccines, were unconvinced and unsure about the safety of vaccines, were convinced and unsure about whether COVID-19 vaccination would affect ART efficacy, or did not know at least a type of domestic COVID-19 vaccine. Approximately 93.00% of PLWH have received at least one dose of the COVID-19 vaccine among PLWH, and 213 PLWH (14.92%) reported at least one adverse reaction within 7 days. Conclusion In conclusion, our study reported a relatively high willingness to receive the COVID-19 vaccination among PLWH in Shijiazhuang. However, a small number of PLWH still held hesitancy; thus, more tailored policies or guidelines from the government should be performed to enhance the COVID-19 vaccination rate among PLWH.
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Affiliation(s)
- Xihong Zhang
- Center for Disease Control and Prevention of Yunyan District in Guiyang, Guiyang, China
| | - Haoting Zhan
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lijing Wang
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
| | - Yongmei Liu
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xinru Guo
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Chen Li
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Beilei Li
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
| | - Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yingxia Li
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
| | - Qian Chen
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
| | - Huixia Gao
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
| | - Fumin Feng
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China
| | - Erhei Dai
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Shijiazhuang, China
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Han Z, Chen L, Hao Q, He Q, Budeski K, Jin D, Xu F, Tang K, Li Y. How enlightened self-interest guided global vaccine sharing benefits all: A modeling study. J Glob Health 2023; 13:06038. [PMID: 38115726 PMCID: PMC10731134 DOI: 10.7189/jogh.13.06038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Background Despite consensus that vaccines play an important role in combatting the global spread of infectious diseases, vaccine inequity is still a prevalent issue due to a deep-seated mentality of self-priority. We aimed to evaluate the existence and possible outcomes of a more equitable global vaccine distribution and explore a concrete incentive mechanism that promotes vaccine equity. Methods We designed a metapopulation epidemiological model that simultaneously considers global vaccine distribution and human mobility, which we then calibrated by the number of infections and real-world vaccination records during the coronavirus disease 2019 (COVID-19) pandemic from March 2020 to July 2021. We explored the possibility of the enlightened self-interest incentive mechanism, which comprises improving one's own epidemic outcomes by sharing vaccines with other countries, by evaluating the number of infections and deaths under various vaccine sharing strategies using the proposed model. To understand how these strategies affect the national interests, we distinguished imported from local cases for further cost-benefit analyses that rationalise the enlightened self-interest incentive mechanism behind vaccine sharing. Results The proposed model accurately reproduces the real-world cumulative infections for both global and regional epidemics (R2>0.990), which can support the following evaluations of different vaccine sharing strategies: High-income countries can reduce 16.7 (95% confidence interval (CI) = 8.4-24.9, P < 0.001) million infection cases and 82.0 (95% CI = 76.6-87.4, P < 0.001) thousand deaths on average by more actively sharing vaccines in an enlightened self-interest manner, where the reduced internationally imported cases outweigh the threat from increased local infections. Such vaccine sharing strategies can also reduce 4.3 (95% CI = 1.2-7.5, P < 0.01) million infections and 7.0 (95% CI = 5.7-8.3, P < 0.001) thousand deaths in middle- and low-income countries, effectively benefiting the whole global population. Lastly, the more equitable vaccine distribution could help largely reduce the global mobility reduction needed for pandemic control. Conclusions The incentive mechanism of enlightened self-interest we explored here could motivate vaccine equity by realigning the national interest to more equitable vaccine distributions. The positive results could promote multilateral collaborations in global vaccine redistribution and reconcile conflicted national interests, which could in turn benefit the global population.
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Affiliation(s)
- Zhenyu Han
- Beijing National Research Center for Information Science and Technology (BNRist), Beijing, P. R. China
- Department of Electronic Engineering, Tsinghua University, Beijing, P. R. China
| | - Lin Chen
- Department of Electronic Engineering, Tsinghua University, Beijing, P. R. China
| | - Qianyue Hao
- Beijing National Research Center for Information Science and Technology (BNRist), Beijing, P. R. China
- Department of Electronic Engineering, Tsinghua University, Beijing, P. R. China
| | - Qiwei He
- Vanke School of Public Health, Tsinghua University, Beijing, P. R. China
- Institute for Healthy China, Tsinghua University, Beijing, P. R. China
| | | | - Depeng Jin
- Beijing National Research Center for Information Science and Technology (BNRist), Beijing, P. R. China
- Department of Electronic Engineering, Tsinghua University, Beijing, P. R. China
| | - Fengli Xu
- Department of Electronic Engineering, Tsinghua University, Beijing, P. R. China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, P. R. China
- Institute for Healthy China, Tsinghua University, Beijing, P. R. China
| | - Yong Li
- Beijing National Research Center for Information Science and Technology (BNRist), Beijing, P. R. China
- Department of Electronic Engineering, Tsinghua University, Beijing, P. R. China
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10
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Martins C, Silveira VNDC, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Clinical-epidemiological characteristics and survival of cases of severe acute respiratory syndrome (SARS) due to COVID-19, according to the COVID-19 vaccination schedule in Brazil, 2021-2022: a prospective study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2023128. [PMID: 38126542 PMCID: PMC10727126 DOI: 10.1590/s2237-96222023000400003.en] [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: 03/07/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022. METHODS This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival. RESULTS Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67). CONCLUSION Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well. MAIN RESULTS Prevalence was found to be high among unvaccinated individuals. Risk of death was lower among those vaccinated with a booster dose, compared to those not vaccinated, in all age groups analyzed. IMPLICATIONS FOR SERVICES The number of hospitalizations of unvaccinated individuals with severe acute respiratory syndrome was high, which increases the demand for health services to care for these individuals. PERSPECTIVES It is necessary to promote widespread vaccination of the entire population of Brazil, in addition to the regular provision of booster doses for the different population groups.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | | | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
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11
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Avlasevich V, McCarthy K. Comparison of COVID-19 Vaccination and Infection Rates in Adult Patients With Autoimmune Inflammatory Disease on b/tsDMARD Therapy. Ann Pharmacother 2023; 57:1455-1458. [PMID: 37021350 PMCID: PMC10080168 DOI: 10.1177/10600280231164109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
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12
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Strelkova Petersen DM, Chaudhary N, Arral ML, Weiss RM, Whitehead KA. The mixing method used to formulate lipid nanoparticles affects mRNA delivery efficacy and organ tropism. Eur J Pharm Biopharm 2023; 192:126-135. [PMID: 37838143 PMCID: PMC10826902 DOI: 10.1016/j.ejpb.2023.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 10/16/2023]
Abstract
mRNA is a versatile drug molecule with therapeutic applications ranging from protein replacement therapies to in vivo gene engineering. mRNA delivery is often accomplished using lipid nanoparticles, which are formulated via mixing of aqueous and organic solutions. Although this has historically been accomplished by manual mixing for bench scale science, microfluidic mixing is required for scalable continuous manufacturing and batch to batch control. Currently, there is limited understanding on how the mixing process affects mRNA delivery efficacy, particularly in regard to tropism. To address this knowledge gap, we examined the influence of the type of mixing and microfluidic mixing parameters on the performance of lipid nanoparticles in mice. This was accomplished with a Design of Experiment approach using four nanoparticle formulations with varied ionizable lipid chemistry. We found that each formulation required unique optimization of mixing parameters, with the total delivery efficacy of each lipid nanoparticle generated with microfluidics ranging from 100-fold less to 4-fold more than manually mixed LNPs. Further, mixing parameters influenced organ tropism, with the most efficacious formulations disproportionately increasing liver delivery compared to other organs. These data suggest that mixing parameters for lipid nanoparticle production may require optimization for each unique chemical formulation, complicating translational efforts. Further, microfluidic parameters must be chosen carefully to balance overall mRNA delivery efficacy with application-specific tropism requirements.
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Affiliation(s)
- Daria M Strelkova Petersen
- Department of Biomedical Engineering, Carnegie Mellon University, 5000, Forbes Ave, Pittsburgh, PA 15213, USA
| | - Namit Chaudhary
- Department of Chemical Engineering, Carnegie Mellon University, 5000, Forbes Ave, Pittsburgh, PA 15213, USA
| | - Mariah L Arral
- Department of Chemical Engineering, Carnegie Mellon University, 5000, Forbes Ave, Pittsburgh, PA 15213, USA
| | - Ryan M Weiss
- Department of Chemical Engineering, Carnegie Mellon University, 5000, Forbes Ave, Pittsburgh, PA 15213, USA
| | - Kathryn A Whitehead
- Department of Biomedical Engineering, Carnegie Mellon University, 5000, Forbes Ave, Pittsburgh, PA 15213, USA; Department of Chemical Engineering, Carnegie Mellon University, 5000, Forbes Ave, Pittsburgh, PA 15213, USA.
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13
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Ben-Tov A, Lebwohl B, Banon T, Chodick G, Kariv R, Assa A, Gazit S, Patalon T. BNT162b2 mRNA COVID-19 Vaccine Effectiveness in Patients with Coeliac Disease Autoimmunity: Real-World Data from Mass Vaccination Campaign. Viruses 2023; 15:1968. [PMID: 37766374 PMCID: PMC10534420 DOI: 10.3390/v15091968] [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: 08/16/2023] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Data on COVID-19 vaccine effectiveness among patients with coeliac disease are currently lacking because patients with immune conditions were excluded from clinical trials. We used our coeliac disease autoimmunity (CDA) cohort to explore the effectiveness of the BNT162b2 mRNA COVID-19 vaccine in preventing SARS-CoV-2 infection among patients with CDA. METHODS This retrospective cohort study included patients with positive autoantibodies against tissue transglutaminase (tTG-IgA). In the primary analysis, the cohort included CDA patients who received two vaccine doses against COVID-19 and matched patients in a 1:3 ratio. Patients were divided into subgroups based on their positive tTG-IgA level at diagnosis and their current serology status. RESULTS The cohort included 5381 vaccinated patients with CDA and 14,939 matched vaccinated patients. The risk for breakthrough SARS-CoV-2 infection evaluated with Kaplan-Meier survival analysis via log-rank tests was similar between groups (p = 0.71). In a Cox regression survival analysis, the hazard ratio for breakthrough infection among patients with CDA compared to matched patients was 0.91 (95% confidence interval = 0.77-1.09). CONCLUSIONS COVID-19 vaccination is effective in patients with coeliac disease autoimmunity. Vaccine effectiveness was comparable to the reference population.
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Affiliation(s)
- Amir Ben-Tov
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 68125, Israel
| | - Benjamin Lebwohl
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Tamar Banon
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
| | - Gabriel Chodick
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 68125, Israel
| | - Revital Kariv
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 68125, Israel
- Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv 68125, Israel
| | - Amit Assa
- The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University, Jerusalem 91905, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv 68125, Israel
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14
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Stewart-Jones GBE, Elbashir SM, Wu K, Lee D, Renzi I, Ying B, Koch M, Sein CE, Choi A, Whitener B, Garcia-Dominguez D, Henry C, Woods A, Ma L, Montes Berrueta D, Avena LE, Quinones J, Falcone S, Hsiao CJ, Scheaffer SM, Thackray LB, White P, Diamond MS, Edwards DK, Carfi A. Domain-based mRNA vaccines encoding spike protein N-terminal and receptor binding domains confer protection against SARS-CoV-2. Sci Transl Med 2023; 15:eadf4100. [PMID: 37703353 DOI: 10.1126/scitranslmed.adf4100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/17/2023] [Indexed: 09/15/2023]
Abstract
With the success of messenger RNA (mRNA) vaccines against coronavirus disease 2019, strategies can now focus on improving vaccine potency, breadth, and stability. We designed and evaluated domain-based mRNA vaccines encoding the wild-type spike protein receptor binding domain (RBD) or N-terminal domain (NTD) alone or in combination. An NTD-RBD-linked candidate vaccine, mRNA-1283, showed improved antigen expression, antibody responses, and stability at refrigerated temperatures (2° to 8°C) compared with the clinically available mRNA-1273, which encodes the full-length spike protein. In BALB/c mice administered mRNA-1283 as a primary series, booster, or variant-specific booster, similar or greater immune responses from viral challenge were observed against wild-type, beta, delta, or omicron (BA.1) viruses compared with mRNA-1273-immunized mice, especially at lower vaccine dosages. K18-hACE2 mice immunized with mRNA-1283 or mRNA-1273 as a primary series demonstrated similar degrees of protection from challenge with SARS-CoV-2 Delta and Omicron variants at all vaccine dosages. These results support clinical assessment of mRNA-1283, which has now entered clinical trials (NCT05137236).
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Affiliation(s)
| | | | - Kai Wu
- Moderna, Inc., Cambridge, MA 02139, USA
| | - Diana Lee
- Moderna, Inc., Cambridge, MA 02139, USA
| | | | - Baoling Ying
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | | | | | | | - Bradley Whitener
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | | | | | | | | | | | | | | | | | | | - Suzanne M Scheaffer
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Larissa B Thackray
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | | | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
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15
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Xu C, Lahiri M, Santosa A, Chew LC, Angkodjojo S, Sriranganathan M, Fong W, Arkachaisri T, Suresh E, Kong KO, Lateef A, Lee TH, Leong KH, Low A, Tan TC, Leung YY. Recommendations for enhanced primary series (third dose) COVID-19 vaccination for people with rheumatic diseases: Chapter of Rheumatologists, College of Physicians, Singapore. Singapore Med J 2023:382525. [PMID: 37530384 DOI: 10.4103/singaporemedj.smj-2022-070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Introduction This review aims to provide evidence-based recommendations for an enhanced primary series (third dose) coronavirus disease 2019 (COVID-19) vaccination in people with rheumatic diseases (PRDs) in the local and regional context. Methods Literature reviews were performed regarding the necessity, efficacy, safety and strategies for enhanced primary series COVID-19 vaccination in PRDs. Recommendations were developed based on evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Evidence was synthesised by eight working group members, and the consensus was achieved by a Delphi method with nine members of an expert task force panel. Results Two graded recommendations and one ungraded position statement were developed. PRDs have impaired immunogenicity from the COVID-19 vaccine and are at an increased risk of postvaccine breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and poor clinical outcomes, compared to the general population. We strongly recommend that PRDs on immunomodulatory drugs be offered a third dose of the messenger RNA (mRNA) vaccine as part of an enhanced primary series, after the standard two-dose regimen. We conditionally recommend that the third dose of mRNA vaccine against SARS-CoV-2 be given at least 4 weeks after the second dose or as soon as possible thereafter. There is insufficient data to inform whether the third mRNA vaccine should be homologous or heterologous in PRDs. Conclusion These recommendations that were developed through evidence synthesis and formal consensus process provide guidance for an enhanced primary series COVID-19 vaccination in PRDs.
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Affiliation(s)
- Chuanhui Xu
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Manjari Lahiri
- Division of Rheumatology, Department of Medicine, National University Hospital; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Amelia Santosa
- Division of Rheumatology, Department of Medicine, National University Hospital; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Li-Ching Chew
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Rheumatology and Immunology, Singapore General Hospital; Duke-NUS School of Medicine, Sengkang General Hospital, Singapore
| | - Stanley Angkodjojo
- Department of General Medicine (Rheumatology), Sengkang General Hospital, Singapore
| | | | - Warren Fong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Rheumatology and Immunology, Singapore General Hospital; Duke-NUS School of Medicine, Sengkang General Hospital, Singapore
| | - Thaschawee Arkachaisri
- Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore
| | - Ernest Suresh
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
| | - Kok Ooi Kong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Aisha Lateef
- Division of Rheumatology, Department of Medicine, National University Hospital; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Medicine, Woodlands Health, Singapore
| | - Tau Hong Lee
- National Centre for Infectious Diseases, Singapore
| | | | - Andrea Low
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Rheumatology and Immunology, Singapore General Hospital; Duke-NUS School of Medicine, Sengkang General Hospital, Singapore
| | - Teck Choon Tan
- Division of Rheumatology, Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Ying-Ying Leung
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Department of Rheumatology and Immunology, Singapore General Hospital; Duke-NUS School of Medicine, Sengkang General Hospital, Singapore
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16
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Turley CB, Tables L, Fuller T, Sanders LJ, Scott H, Moodley A, Woodward Davis A, Leav B, Miller J, Schoemaker K, Vandebosch A, Sadoff J, Woo W, Cho I, Dunkle LM, Li S, van der Laan L, Gilbert PB, Follmann D, Jaynes H, Kublin JG, Baden LR, Goepfert P, Kotloff K, Gay CL, Falsey AR, El Sahly HM, Sobieszczyk ME, Huang Y, Neuzil KM, Corey L, Grinsztejn B, Gray G, Rouphael N, Luedtke A. Modifiers of COVID-19 vaccine efficacy: Results from four COVID-19 prevention network efficacy trials. Vaccine 2023; 41:4899-4906. [PMID: 37385888 PMCID: PMC10288314 DOI: 10.1016/j.vaccine.2023.06.066] [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: 04/16/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
Questions remain regarding the effect of baseline host and exposure factors on vaccine efficacy (VE) across pathogens and vaccine platforms. We report placebo-controlled data from four Phase 3 COVID-19 trials during the early period of the pandemic. This was a cross-protocol analysis of four randomized, placebo-controlled efficacy trials (Moderna/mRNA1273, AstraZeneca/AZD1222, Janssen/Ad26.COV2.S, and Novavax/NVX-CoV2373) using a harmonized design. Trials were conducted in the United States and international sites in adults ≥ 18 years of age. VE was assessed for symptomatic and severe COVID-19. We analyzed 114,480 participants from both placebo and vaccine arms, enrolled July 2020 to February 2021, with follow up through July 2021. VE against symptomatic COVID-19 showed little heterogeneity across baseline socio-demographic, clinical or exposure characteristics, in either univariate or multivariate analysis, regardless of vaccine platform. Similarly, VE against severe COVID-19 in the single trial (Janssen) with sufficient endpoints for analysis showed little evidence of heterogeneity. COVID-19 VE is not influenced by baseline host or exposure characteristics across efficacy trials of different vaccine platforms and countries when well matched to circulating virus strains. This supports use of these vaccines, regardless of platform type, as effective tools in the near term for reducing symptomatic and severe COVID-19, particularly for older individuals and those with common co-morbidities during major variant shifts. Clinical trial registration numbers: NCT04470427, NCT04516746, NCT04505722, and NCT04611802.
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Affiliation(s)
- Christine B Turley
- Atrium Health Wake Forest School of Medicine, Charlotte, NC, United States
| | - LaKesha Tables
- Morehouse School of Medicine, Atlanta, GA, United States
| | - Trevon Fuller
- Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil
| | - Lisa J Sanders
- University of South Florida Morsani College of Medicine, Tampa, FL, United States
| | - Hyman Scott
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Amaran Moodley
- Division of Infectious Diseases, University of California San Diego and Rady Children's Hospital, San Diego, CA, United States
| | - Amanda Woodward Davis
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Brett Leav
- Moderna Inc., Cambridge, MA, United States
| | | | - Kathryn Schoemaker
- Biometrics, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, United States
| | - An Vandebosch
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Jerald Sadoff
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Wayne Woo
- Novavax, Gaithersburg, MD, United States
| | - Iksung Cho
- Novavax, Gaithersburg, MD, United States
| | | | - Sijia Li
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Lars van der Laan
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Peter B Gilbert
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Dean Follmann
- Biostatistics Research Branch, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States
| | - Holly Jaynes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - James G Kublin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | | | - Paul Goepfert
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Karen Kotloff
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, and the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Cynthia L Gay
- Department of Medicine, Division of Infectious Diseases, UNC HIV Cure Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Ann R Falsey
- Department of Medicine, Infectious Disease Division, University of Rochester, Rochester, NY, United States
| | - Hana M El Sahly
- Department of Molecular Virology and Microbiology and Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Magdalena E Sobieszczyk
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Yunda Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Kathleen M Neuzil
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, and the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Beatriz Grinsztejn
- Evandro Chagas National Institute of Infectious Diseases-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; South African Medical Research Council, Cape Town, South Africa
| | | | - Alex Luedtke
- Department of Biostatistics, University of Washington, Seattle, WA, United States.
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Gu Y, Yang J, He C, Zhao T, Lu R, Liu J, Mo X, Wen F, Shi H. Incorporation of a Toll-like receptor 2/6 agonist potentiates mRNA vaccines against cancer and infectious diseases. Signal Transduct Target Ther 2023; 8:273. [PMID: 37455272 DOI: 10.1038/s41392-023-01479-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/12/2023] [Accepted: 04/27/2023] [Indexed: 07/18/2023] Open
Abstract
mRNA vaccines have emerged rapidly in recent years as a prophylactic and therapeutic agent against various diseases including cancer and infectious diseases. Improvements of mRNA vaccines have been underway, among which boosting of efficacy is of great importance. Pam2Cys, a simple synthetic metabolizable lipoamino acid that signals through Toll-like receptor (TLR) 2/6 pathway, eliciting both humoral and cellular adaptive immune responses, is an interesting candidate adjuvant. To investigate the enhancement of the efficacies of mRNA vaccines by Pam2Cys, the adjuvant was incorporated into mRNA-lipid nanoparticles (LNPs) to achieve co-delivery with mRNA. Immunization with the resulting mRNA-LNPs (Pam2Cys) shaped up the immune milieu in the draining lymph nodes (dLNs) through the induction of IL-12 and IL-17, among other cytokines. Antigen presentation was carried out mainly by migratory and dLN-resident conventional type 2 DCs (cDC2s) and significantly more potent antitumor responses were triggered in both prophylactic and therapeutic tumor models in a CD4+ and CD8+ T cell-dependent fashion. Accompanying memory antitumor immunity was also established. Moreover, the vaccine also stimulated much more robust humoral and cellular immunity in a surrogate COVID-19 prophylactic model. Last but not the least, the new vaccines exhibited good preliminary safety profiles in murine models. These facts warrant future development of Pam2Cys-incorporated mRNA vaccines or relevant mRNA therapeutics for clinical application.
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Affiliation(s)
- Yangzhuo Gu
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China.
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Jingyun Yang
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China
| | - Cai He
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China
| | - Tingmei Zhao
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China
| | - Ran Lu
- Laboratory of Stem Cell Biology and Department of Pediatric Surgery, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China
| | - Jian Liu
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China
| | - Xianming Mo
- Laboratory of Stem Cell Biology and Department of Pediatric Surgery, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China
| | - Fuqiang Wen
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy and Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Huashan Shi
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, 610041, China.
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Zhao S, Luo K, Guo Y, Fang M, Sun Q, Dai Z, Yang H, Zhan Z, Hu S, Chen T, Li X. Analysis of Factors Influencing the Clinical Severity of Omicron and Delta Variants. Trop Med Infect Dis 2023; 8:330. [PMID: 37368748 DOI: 10.3390/tropicalmed8060330] [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: 05/17/2023] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The Omicron variant is the dominant strain circulating globally, and studies have shown that Omicron cases have milder symptoms than Delta cases. This study aimed to analyze the factors that affect the clinical severity of Omicron and Delta variants, evaluate and compare the effectiveness of COVID-19 vaccines with different technological platforms, and assess the vaccine effectiveness against different variants. We retrospectively collected the basic information of all local COVID-19 cases reported by Hunan Province to the National Notifiable Infectious Disease Reporting System from January 2021 to February 2023, including gender, age, clinical severity, and COVID-19 vaccination history. From 1 January 2021 to 28 February 2023, Hunan Province reported a total of 60,668 local COVID-19 cases, of which, 134 were infected with the Delta variant and 60,534 were infected with the Omicron variant. The results showed that infection with the Omicron variant (adjusted OR (aOR): 0.21, 95% CI: 0.14-0.31), getting vaccinated (booster immunization vs. unvaccinated aOR: 0.30, 95% CI: 0.23-0.39) and being female (aOR: 0.82, 95% CI: 0.79-0.85) were protective factors for pneumonia, while old age (≥60 years vs. <3 years aOR: 4.58, 95% CI: 3.36-6.22) was a risk factor for pneumonia. Being vaccinated (booster immunization vs. unvaccinated aOR: 0.11, 95% CI: 0.09-0.15) and female (aOR: 0.54, 95% CI: 0.50-0.59) were protective factors for severe cases, while older age (≥60 years vs. < 3 years aOR: 4.95, 95% CI: 1.83-13.39) was a risk factor for severe cases. The three types of vaccines had protective effects on both pneumonia and severe cases, and the protective effect on severe cases was better than that on pneumonia. The recombinant subunit vaccine booster immunization had the best protective effect on pneumonia and severe cases, with ORs of 0.29 (95% CI: 0.2-0.44) and 0.06 (95% CI: 0.02-0.17), respectively. The risk of pneumonia from Omicron variant infection was lower than that from Delta. Chinese-produced vaccines had protective effects on both pneumonia and severe cases, with recombinant subunit vaccines having the best protective effect on pneumonia and severe pneumonia cases. Booster immunization should be advocated in COVID-19 pandemic-related control and prevention policies, especially for the elderly, and booster immunization should be accelerated.
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Affiliation(s)
- Shanlu Zhao
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Kaiwei Luo
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Yichao Guo
- School of Public Health, Xiamen University, Xiamen 361102, China
| | - Mingli Fang
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Qianlai Sun
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Zhihui Dai
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Hao Yang
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Zhifei Zhan
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Shixiong Hu
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
| | - Tianmu Chen
- School of Public Health, Xiamen University, Xiamen 361102, China
| | - Xiaojun Li
- Hunan Provincial Center for Disease Control and Prevention (Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences), Changsha 410005, China
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Wang X, Yuen TTT, Dou Y, Hu J, Li R, Zeng Z, Lin X, Gong H, Chan CHC, Yoon C, Shuai H, Ho DTY, Hung IFN, Zhang BZ, Chu H, Huang JD. Vaccine-induced protection against SARS-CoV-2 requires IFN-γ-driven cellular immune response. Nat Commun 2023; 14:3440. [PMID: 37301910 PMCID: PMC10257169 DOI: 10.1038/s41467-023-39096-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
The overall success of worldwide mass vaccination in limiting the negative effect of the COVID-19 pandemics is inevitable, however, recent SARS-CoV-2 variants of concern, especially Omicron and its sub-lineages, efficiently evade humoral immunity mounted upon vaccination or previous infection. Thus, it is an important question whether these variants, or vaccines against them, induce anti-viral cellular immunity. Here we show that the mRNA vaccine BNT162b2 induces robust protective immunity in K18-hACE2 transgenic B-cell deficient (μMT) mice. We further demonstrate that the protection is attributed to cellular immunity depending on robust IFN-γ production. Viral challenge with SARS-CoV-2 Omicron BA.1 and BA.5.2 sub-variants induce boosted cellular responses in vaccinated μMT mice, which highlights the significance of cellular immunity against the ever-emerging SARS-CoV-2 variants evading antibody-mediated immunity. Our work, by providing evidence that BNT162b2 can induce significant protective immunity in mice that are unable to produce antibodies, thus highlights the importance of cellular immunity in the protection against SARS-CoV-2.
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Affiliation(s)
- Xiaolei Wang
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, China
| | - Terrence Tsz-Tai Yuen
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Ying Dou
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Jingchu Hu
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Renhao Li
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Zheng Zeng
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Xuansheng Lin
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Huarui Gong
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Celia Hoi-Ching Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Chaemin Yoon
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Huiping Shuai
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Deborah Tip-Yin Ho
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Ivan Fan-Ngai Hung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
- Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China
| | - Bao-Zhong Zhang
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Hin Chu
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
- Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China.
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
- Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
| | - Jian-Dong Huang
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China.
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
- Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen University, Guangzhou, China.
- Clinical Oncology Center, Shenzhen Key Laboratory for cancer metastasis and personalized therapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
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20
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Sanchez‐Vargas A, Mendez‐Astudillo J, López‐Vidal Y, López‐Carr D, Estrada F. Assessing the Effect of the U.S. Vaccination Program on the Coronavirus Positivity Rate With a Multivariate Framework. GEOHEALTH 2023; 7:e2022GH000771. [PMID: 37287700 PMCID: PMC10243209 DOI: 10.1029/2022gh000771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 06/09/2023]
Abstract
The factors influencing the incidence of COVID-19, including the impact of the vaccination programs, have been studied in the literature. Most studies focus on one or two factors, without considering their interactions, which is not enough to assess a vaccination program in a statistically robust manner. We examine the impact of the U.S. vaccination program on the SARS-CoV-2 positivity rate while simultaneously considering a large number of factors involved in the spread of the virus and the feedbacks among them. We consider the effects of the following sets of factors: socioeconomic factors, public policy factors, environmental factors, and non-observable factors. A time series Error Correction Model (ECM) was used to estimate the impact of the vaccination program at the national level on the positivity rate. Additionally, state-level ECMs with panel data were combined with machine learning techniques to assess the impact of the program and identify relevant factors to build the best-fitting models. We find that the vaccination program reduced the virus positivity rate. However, the program was partially undermined by a feedback loop in which increased vaccination led to increased mobility. Although some external factors reduced the positivity rate, the emergence of new variants increased the positivity rate. The positivity rate was associated with several forces acting simultaneously in opposite directions such as the number of vaccine doses administered and mobility. The existence of complex interactions, between the factors studied, implies that there is a need to combine different public policies to strengthen the impact of the vaccination program.
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Affiliation(s)
- A. Sanchez‐Vargas
- Institute of Economic ResearchNational Autonomous University of MexicoMexico CityMexico
| | - J. Mendez‐Astudillo
- Institute of Economic ResearchNational Autonomous University of MexicoMexico CityMexico
| | - Y. López‐Vidal
- Programa de Inmunología Molecular MicrobianaDepartamento de Microbiología y ParasitologíaFaculty of MedicineNational Autonomous University of MexicoMexico CityMexico
| | - D. López‐Carr
- Department of GeographyUniversity of California, Santa BarbaraSanta BarbaraCAUSA
| | - F. Estrada
- Instituto de Ciencias de la Atmósfera y Cambio ClimáticoNational Autonomous University of MexicoMexico CityMexico
- Institute for Environmental StudiesVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Programa de Investigación en Cambio ClimáticoNational Autonomous University of MexicoMexico CityMexico
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21
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Tene L, Karasik A, Chodick G, Pereira DIA, Schou H, Waechter S, Göhring UM, Drakesmith H. Iron deficiency and the effectiveness of the BNT162b2 vaccine for SARS-CoV-2 infection: A retrospective, longitudinal analysis of real-world data. PLoS One 2023; 18:e0285606. [PMID: 37216375 PMCID: PMC10202294 DOI: 10.1371/journal.pone.0285606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Iron plays a key role in human immune responses; however, the influence of iron deficiency on the coronavirus disease 2019 (COVID-19) vaccine effectiveness is unclear. AIM To assess the effectiveness of the BNT162b2 messenger RNA COVID-19 vaccine in preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19-related hospitalization and death in individuals with or without iron deficiency. METHODS This large retrospective, longitudinal cohort study analyzed real-world data from the Maccabi Healthcare Services database (covering 25% of Israeli residents). Eligible adults (aged ≥16 years) received a first BNT162b2 vaccine dose between December 19, 2020, and February 28, 2021, followed by a second dose as per approved vaccine label. Individuals were excluded if they had SARS-CoV-2 infection before vaccination, had hemoglobinopathy, received a cancer diagnosis since January 2020, had been treated with immunosuppressants, or were pregnant at the time of vaccination. Vaccine effectiveness was assessed in terms of incidence rates of SARS-CoV-2 infection confirmed by real-time polymerase chain reaction assay, relative risks of COVID-19-related hospitalization, and mortality in individuals with iron deficiency (ferritin <30 ng/mL or transferrin saturation <20%). The two-dose protection period was Days 7 to 28 after the second vaccination. RESULTS Data from 184,171 individuals with (mean [standard deviation; SD] age 46.2 [19.6] years; 81.2% female) versus 1,072,019 without (mean [SD] age 46.9 [18.0] years; 46.2% female) known iron deficiency were analyzed. Vaccine effectiveness in the two-dose protection period was 91.9% (95% confidence interval [CI] 83.7-96.0%) and 92.1% (95% CI 84.2-96.1%) for those with versus without iron deficiency (P = 0.96). Of patients with versus without iron deficiency, hospitalizations occurred in 28 and 19 per 100,000 during the reference period (Days 1-7 after the first dose), and in 19 and 7 per 100,000 during the two-dose protection period, respectively. Mortality rates were comparable between study groups: 2.2 per 100,000 (4/181,012) in the population with iron deficiency and 1.8 per 100,000 (19/1,055,298) in those without known iron deficiency. CONCLUSIONS Results suggest that the BNT162b2 COVID-19 vaccine is >90% effective in preventing SARS-CoV-2 infection in the 3 weeks after the second vaccination, irrespective of iron-deficiency status. These findings support the use of the vaccine in populations with iron deficiency.
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Affiliation(s)
- Lilac Tene
- Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Avraham Karasik
- Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Gabriel Chodick
- Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | | | | | | | | | - Hal Drakesmith
- Medical Research Council Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
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22
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Papaioannidou P, Skoumpa K, Bostanitis C, Michailidou M, Stergiopoulou T, Bostanitis I, Tsalidou M. Age, Sex and BMI Relations with Anti-SARS-CoV-2-Spike IgG Antibodies after BNT162b2 COVID-19 Vaccine in Health Care Workers in Northern Greece. Microorganisms 2023; 11:1279. [PMID: 37317253 DOI: 10.3390/microorganisms11051279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 06/16/2023] Open
Abstract
The aim of this work was to study age, sex, and BMI (Body Mass Index)-related differences in the development of anti-SARS-CoV-2-Spike IgG antibodies, after vaccination with the BNT162b2 COVID-19 vaccine, in health care workers of a General Hospital in a city in Northern Greece. Blood sampling was drawn two to four weeks following the second dose of the vaccine, and six months after the first blood sample collection. Measurement of serum IgG antibodies against the spike domain of SARS-CoV-2 was performed using the SARS-CoV-2 IgG II Quant assay. All participants had sufficient serum IgG titers in the first measurement. Women developed higher IgG titers than men. The IgG titers were inversely related to age in both sexes; there was also a small, insignificant tendency to be inversely related to BMI. Six months after the first measurement, the IgG titers decreased dramatically to values less than 5% of the initial. This decrease was observed in both men and women and was inversely related to age. Multivariate regression analysis showed that age and sex explained with statistical significance 9% of the variance in SARS-CoV-2 IgG titers in our study population; the role of BMI was limited and insignificant.
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Affiliation(s)
- Paraskevi Papaioannidou
- 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Kalypso Skoumpa
- Microbiological Department, General Hospital of Katerini, 601 00 Katerini, Greece
| | - Christos Bostanitis
- 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Maria Michailidou
- 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Theodouli Stergiopoulou
- 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ioannis Bostanitis
- 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Maria Tsalidou
- 1st Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Microbiological Department, General Hospital of Katerini, 601 00 Katerini, Greece
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23
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Development of a COVID-19 vaccine effectiveness and safety assessment system in Japan: The VENUS Study. Vaccine 2023; 41:3556-3563. [PMID: 37037707 PMCID: PMC10050280 DOI: 10.1016/j.vaccine.2023.03.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 03/16/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
Background There are currently no COVID-19 vaccine assessment systems in Japan that allow for the active surveillance of both vaccinated and unvaccinated persons. Herein, we describe the development of Japan’s first COVID-19 vaccine effectiveness and safety assessment system with active surveillance capabilities. Methods The Vaccine Effectiveness, Networking, and Universal Safety (VENUS) Study was developed as a multi-source database that links four data types at the individual resident level: Basic Resident Register (base population information), Vaccination Record System (vaccination-related information), Health Center Real-time Information-sharing System on COVID-19 (HER-SYS; information on COVID-19 occurrence), and health care claims data (information on diagnoses, hospitalizations, diagnostic tests, and treatments). These data were obtained from four municipalities. Individual residents were linked across the data types using five matching algorithms based on names, birth dates, and sex; the data were anonymized after linkage. To ascertain the viability of the VENUS Study’s database for COVID-19 vaccine assessments, we examined the trends in COVID-19 vaccinations, COVID-19 cases, and polymerase chain reaction (PCR) test numbers. We also evaluated the linkage rates across the data types. Results Our multi-source database was able to monitor COVID-19 vaccinations, COVID-19 cases, and PCR test numbers throughout the pandemic. Using the five algorithms, the data linkage rates between the COVID-19 occurrence information in the HER-SYS and the Basic Resident Register ranged from 85·4% to 91·7%. Conclusion If used judiciously with an understanding of each data source’s characteristics, the VENUS Study can provide a viable data platform that facilitates active surveillance and comparative analyses for population-based research on COVID-19 vaccine effectiveness and safety in Japan.
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24
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Helfgott DC, Racine-Brzostek S, Short KJ, Zhao Z, Christos P, Nino I, Niu T, Contreras J, Ritchie EK, Desai P, Samuel M, Roboz GJ. Immunogenicity of COVID-19 mRNA vaccines in patients with acute myeloid leukemia and myelodysplastic syndrome. Leuk Lymphoma 2023; 64:662-670. [PMID: 36282213 DOI: 10.1080/10428194.2022.2131414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Immunocompromised patients are susceptible to complications from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The mRNA vaccines BNT162b2 and mRNA-1273 are effective in immunocompetent adults, but have diminished activity in immunocompromised patients. We measured anti-spike SARS-CoV-2 antibody (anti-S) response, avidity, and surrogate neutralizing antibody activity in COVID-19 vaccinated patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Anti-S was induced in 89% of AML and 88% of MDS patients, but median levels were significantly lower than in healthy controls. SARS-CoV-2 antibody avidity and neutralizing activity from AML patients were significantly lower than controls. Antibody avidity was significantly greater in patients after mRNA-1273 versus BNT162b2; there were trends toward higher anti-S levels and greater neutralizing antibody activity after mRNA-1273 vaccination. Patients with AML and MDS are likely to respond to COVID-19 mRNA vaccination, but differences in anti-S levels, avidity, and neutralizing antibody activity may affect clinical outcomes and require further study.
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Affiliation(s)
- David C Helfgott
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Sabrina Racine-Brzostek
- Department of Pathology and Laboratory Medicine, Translational Research Program, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Kelsey J Short
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Zhen Zhao
- Department of Pathology and Laboratory Medicine, Translational Research Program, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Paul Christos
- Department of Biostatistics, Weill Cornell Medicine, New York, NY, USA
| | - Itzel Nino
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Tina Niu
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Jorge Contreras
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Ellen K Ritchie
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Pinkal Desai
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Michael Samuel
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
| | - Gail J Roboz
- Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, The New York Presbyterian Hospital, New York, NY, USA
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25
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Brendolin M, Fuller T, Wakimoto M, Rangel L, Rodrigues GM, Rohloff RD, Guaraldo L, Nielsen-Saines K, Brasil P. Severe maternal morbidity and mortality during the COVID-19 pandemic: a cohort study in Rio de Janeiro. IJID REGIONS 2023; 6:1-6. [PMID: 36407853 PMCID: PMC9646996 DOI: 10.1016/j.ijregi.2022.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/12/2022]
Abstract
Objectives To identify factors associated with adverse maternal outcomes during the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a single-centre prospective cohort study at a maternity department in a public general hospital in Rio de Janeiro. All pregnant women evaluated for emergency care, labour and delivery, respiratory symptoms, obstetric reasons or medical reasons between May 2020 and March 2022 at the study institution were invited to enrol in this study. The endpoint was maternal mortality or intensive care unit (ICU) admission. Results In total, 1609 pregnant women were enrolled in this study. Of these, 25.5% (n=410) were infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) based on reverse transcription polymerase chain reaction or an antigen test. There were 21 deaths and 67 ICU admissions in 4% of the cohort. The incidence of severe maternal morbidity and mortality was higher during the Gamma wave than during the Delta wave (P=0.003). Vaccination conferred protection against the endpoint [relative risk (RR) 0.4, 95% confidence interval (CI) 0.1-0.9; P=0.0169]. Factors associated with severe morbidity and mortality included caesarean section (RR 3.7, 95% CI 1.7-7.9; P=0.0008), SARS-CoV-2 infection in the third trimester (RR 2.4, 95% CI 1.1-5.6; P=0.0006) and comorbidities (RR 3, 95% CI 1.8-5.2; P<0.0001). Conclusions COVID-19 was significantly associated with the risk of severe maternal morbidity and mortality. Immunization of pregnant women against COVID-19 was highly protective against adverse outcomes, and should be encouraged during pregnancy.
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Affiliation(s)
- Michelle Brendolin
- Acute Febrile Illnesses Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Maternity Department, Adão Pereira Nunes Hospital, Duque de Caxias, Brazil
| | - Trevon Fuller
- Acute Febrile Illnesses Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Pediatric Infectious Diseases Division, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Mayumi Wakimoto
- Acute Febrile Illnesses Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Larissa Rangel
- Acute Febrile Illnesses Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Roger D. Rohloff
- Perinatal de Laranjeiras Maternity Hospital, Rio de Janeiro, Brazil
| | - Lusiele Guaraldo
- Acute Febrile Illnesses Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Karin Nielsen-Saines
- Pediatric Infectious Diseases Division, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Patrícia Brasil
- Acute Febrile Illnesses Department, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Vartanian K, Fish D, Gronowski B, Kenton N, Robicsek A. Patient-Reported Outcomes for Fully Vaccinated COVID-19 Patients Over 6 Weeks: The Experiences of Clinical Breakthrough Cases. THE PATIENT 2023; 16:105-116. [PMID: 36336751 PMCID: PMC9638265 DOI: 10.1007/s40271-022-00605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND While coronavirus disease 2019 (COVID-19) vaccines have high rates of efficacy, fully vaccinated individuals can become infected with COVID-19. Among this population, symptoms tend to be less severe and shorter lasting. Less is known about how vaccinated individuals who contract COVID-19 experience the disease through patient-reported outcomes (PROs) and how this changes over time. OBJECTIVE The aim of this study was to describe the physical, mental, and social health PROs for fully vaccinated individuals who contracted COVID-19 over a 6-week period. DESIGN Prospective design using the Patient-Reported Outcomes Measurement Information System short-form (PROMIS-10) collected through a mobile application-based platform. PARTICIPANT 1114 fully vaccinated patients who tested positive for COVID-19 at a large US health system and engaged with the study on or after 1 March 2021 and reported onset of illness prior to 1 November 2021. MAIN MEASURES Global physical and mental health PROMIS-10 T-scores for the 6-week period, component PROMIS-10 questions for the 6-week period, and component PROMIS-10 questions restricted to a subset of participants for the first month to measure individual recovery were analyzed. KEY RESULTS Mean global physical and mental health T-scores increased over time and remained within one standard deviation of the population mean. At baseline, at least 40% of participants reported good health for all component questions except Fatigue (25%), and the proportion reporting good health increased over time for all questions, with the largest improvements in Fatigue (25.5 to 67.5%), Pain (59.1 to 82.8%), and Emotional Problems (42.3 to 62.5%). Over the first month, the greatest positive changes in individual recovery were observed for Fatigue (65.0%), Pain (53.0%), and Emotional Problems (41.1%); at least 30% of respondents reported no change in at least one category, and the greatest decreases were for Usual Social Activities (23.9%), Social Satisfaction (23.2%), and Mental Health (21.8%). CONCLUSIONS This study provides an important step towards better understanding the impact of 'breakthrough' COVID-19 infections on clinically engaged, fully vaccinated patients' physical and mental health to improve support for their treatment and recovery.
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Affiliation(s)
- Keri Vartanian
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA
| | - Daniel Fish
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA
| | - Benjamin Gronowski
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA.
| | - Natalie Kenton
- Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA
| | - Ari Robicsek
- Providence Research Network, 1801 Lind Ave SW, Renton, WA, USA
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Li D, Liu Q, Yang M, Xu H, Zhu M, Zhang Y, Xu J, Tian C, Yao J, Wang L, Liang Y. Nanomaterials for
mRNA
‐based Therapeutics: Challenges and Opportunities. Bioeng Transl Med 2023; 8:e10492. [PMID: 37206219 PMCID: PMC10189457 DOI: 10.1002/btm2.10492] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/31/2023] Open
Abstract
Messenger RNA (mRNA) holds great potential in developing immunotherapy, protein replacement, and genome editing. In general, mRNA does not have the risk of being incorporated into the host genome and does not need to enter the nucleus for transfection, and it can be expressed even in nondividing cells. Therefore, mRNA-based therapeutics provide a promising strategy for clinical treatment. However, the efficient and safe delivery of mRNA remains a crucial constraint for the clinical application of mRNA therapeutics. Although the stability and tolerability of mRNA can be enhanced by directly retouching the mRNA structure, there is still an urgent need to improve the delivery of mRNA. Recently, significant progress has been made in nanobiotechnology, providing tools for developing mRNA nanocarriers. Nano-drug delivery system is directly used for loading, protecting, and releasing mRNA in the biological microenvironment and can be used to stimulate the translation of mRNA to develop effective intervention strategies. In the present review, we summarized the concept of emerging nanomaterials for mRNA delivery and the latest progress in enhancing the function of mRNA, primarily focusing on the role of exosomes in mRNA delivery. Moreover, we outlined its clinical applications so far. Finally, the key obstacles of mRNA nanocarriers are emphasized, and promising strategies to overcome these obstacles are proposed. Collectively, nano-design materials exert functions for specific mRNA applications, provide new perception for next-generation nanomaterials, and thus revolution of mRNA technology.
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Affiliation(s)
- De‐feng Li
- Department of Gastroenterology Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong China
| | - Qi‐song Liu
- National Clinical Research Center for Infectious Diseases Shenzhen Third People's Hospital, Southern University of Science and Technology Shenzhen China
| | - Mei‐feng Yang
- Department of Hematology Yantian District People's Hospital Shenzhen Guangdong China
| | - Hao‐ming Xu
- Department of Gastroenterology and Hepatology Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, School of Medicine, South China University of Technology Guangzhou China
| | - Min‐zheng Zhu
- Department of Gastroenterology and Hepatology the Second Affiliated Hospital, School of Medicine, South China University of Technology Guangzhou Guangdong China
| | - Yuan Zhang
- Department of Medical Administration Huizhou Institute of Occupational Diseases Control and Prevention Huizhou Guangdong China
| | - Jing Xu
- Department of Gastroenterology and Hepatology Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, School of Medicine, South China University of Technology Guangzhou China
| | - Cheng‐mei Tian
- Department of Emergency Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong China
| | - Jun Yao
- Department of Gastroenterology Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong China
| | - Li‐sheng Wang
- Department of Gastroenterology Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong China
| | - Yu‐jie Liang
- Department of Child and Adolescent Psychiatry Shenzhen Kangning Hospital, Shenzhen Mental Health Center Shenzhen China
- Affiliated Hospital of Jining Medical University, Jining Medical University Jining Shandong China
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28
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Mojadadi MS, Javadinia SA, Attarian F, Samami E, Sobhani M. Anti-SARS-CoV-2 spike IgG following injection of the third dose vaccine: A systematic review with meta-analysis of heterologous versus homologous vaccination. Front Public Health 2023; 10:960598. [PMID: 36711369 PMCID: PMC9878157 DOI: 10.3389/fpubh.2022.960598] [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: 06/03/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Background The mass vaccination is a key strategy to prevent and control the coronavirus disease 2019 (COVID-19) pandemic. Today, several different types of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed worldwide. These vaccines are usually administered in a two-dose schedule, and the third dose is currently being administered in most countries. This study aimed to systematically review and meta-analyze the immunogenicity of heterologous vs. homologous vaccination after administration of the third dose of COVID-19 vaccines. Methods Electronic databases and websites including Scopus, PubMed, Web of Science, and Google scholar were searched for relevant randomized clinical trial (RCT) studies. After applying the inclusion and exclusion criteria, a total of three RCTs were included in the study. These RCTs were included 2,613 healthy adults (18 years or older and without a history of laboratory-confirmed COVID-19) with 15 heterologous and five homologous prime-boost vaccination regimens. Anti-SARS-CoV-2-spike IgG levels at day 28 after administration of the third dose, were compared between the heterologous and homologous regimens. Results The highest antibody responses had been reported for the homologous vaccination regimen of m1273/m1273/m1273 (Moderna), followed by the heterologous regimen of BNT/BNT/m1273. In addition, the immunogenicity of viral vector and inactivated vaccines was remarkably enhanced when they had been boosted by a heterologous vaccine, especially mRNA vaccines. Conclusion This systematic review suggests that mRNA vaccines in a homologous regimen induce strong antibody responses to SARS-CoV-2 compared to other vaccine platforms. In contrast, viral vector and inactivated vaccines show a satisfactory immunogenicity in a heterologous regimen, especially in combination with mRNA vaccines.
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Affiliation(s)
- Mohammad-Shafi Mojadadi
- Department of Immunology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran,Leishmaniasis Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Seyed Alireza Javadinia
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Fahimeh Attarian
- Department of Epidemiology and Biostatistics, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,*Correspondence: Fahimeh Attarian ✉
| | - Elham Samami
- University of Florida Health Cancer Center, Gainesville, FL, United States,College of Nursing, University of Florida, Gainesville, FL, United States
| | - Mona Sobhani
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Fujieda K, Tanaka A, Kikuchi R, Takai N, Saito S, Yasuda Y, Fujita T, Kato M, Furuhashi K, Maruyama S. Assessment of Antibody-Titer Changes after Second and Third Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccination in Japanese Post-Kidney-Transplant Patients. Vaccines (Basel) 2023; 11:vaccines11010134. [PMID: 36679979 PMCID: PMC9866315 DOI: 10.3390/vaccines11010134] [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: 10/26/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
Post-renal-transplant patients have a relatively low antibody-acquisition rate following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination. In this study, antibody titers were measured 5−6 months and 3 weeks to 3 months after the second and third SARS-CoV-2 mRNA vaccinations, respectively. Post-renal-transplant patients visiting our hospital who had received three SARS-CoV-2 mRNA vaccine doses were included in the study. SARS-CoV-2 immunoglobulin G antibody titers were measured three times: between 3 weeks and 3 months after the second vaccination, 5−6 months after the second vaccination, and between 3 weeks and 3 months after the third vaccination. A total of 62 (40 men and 22 women) were included, 44 of whom (71.0%) were antibody positive after their third vaccination. On comparing the antibody-acquired and antibody-non-acquired groups, body mass index (BMI, odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.07−1.93, p < 0.05) and the estimated glomerular filtration rate (eGFR, OR: 1.14, 95% CI: 1.06−1.24, p < 0.01) were associated with antibody acquisition. Therefore, in Japanese post-kidney-transplant patients, increases in the antibody-acquisition rate and absolute antibody titer after the third vaccination were observed, with BMI and eGFR associated with the antibody-acquisition rate.
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Affiliation(s)
- Kumiko Fujieda
- Department of Nephrology, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
| | - Akihito Tanaka
- Department of Nephrology, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
| | - Ryosuke Kikuchi
- Department of Medical Technique, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
- Division of Clinical Laboratory, Gifu University Hospital, Gifu 501-1194, Gifu, Japan
| | - Nami Takai
- Department of Nursing, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
| | - Shoji Saito
- Department of Nephrology, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
| | - Yoshinari Yasuda
- Department of Nephrology, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
| | - Takashi Fujita
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Aichi, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Aichi, Japan
| | - Kazuhiro Furuhashi
- Department of Nephrology, Nagoya University Hospital, Nagoya 466-8560, Aichi, Japan
- Correspondence: ; Tel.: +81-52-741-2111; Fax: +81-52-744-2209
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Aichi, Japan
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30
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Prunas O, Weinberger DM, Pitzer VE, Gazit S, Patalon T. Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents in Israel. Clin Infect Dis 2023; 76:113-118. [PMID: 36484301 DOI: 10.1093/cid/ciac315] [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: 01/12/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The short-term effectiveness of a 2-dose regimen of the BioNTech/Pfizer BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, however, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months. METHODS Leveraging the database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where 2 outcomes were evaluated: documented SARS-CoV-2 infection (regardless of symptoms) and symptomatic infection (COVID-19). Cases were defined as individuals aged 12-16 with a positive polymerase chain reaction (PCR) test occurring between 15 June and 8 December 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously. RESULTS We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% (95% confidence interval [CI]: 84-86%) and 90% (95% CI: 89-91%) effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19), respectively. However, in line with findings for adults, waning effectiveness was evident. Long-term protection was reduced to 73% (95% CI: 68-77%) against infection and 79% (95% CI: 73-83%) against COVID-19 3-5 months after the second dose and waned to 53% (95% CI: 46-60%) against infection and 66% (95% CI: 59-72%) against COVID-19 after 5 months. CONCLUSIONS Although vaccine-induced protection against both infection and COVID-19 continues over time in adolescents, the protection wanes with time since vaccination, starting 3 months after inoculation and continuing for more than 5 months.
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Affiliation(s)
- Ottavia Prunas
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Daniel M Weinberger
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Virginia E Pitzer
- Department of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
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31
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Pinto-Álvarez M, Fernández-Niño JA, Arregocés-Castillo L, Rojas-Botero ML, Palacios AF, Galvis-Pedraza M, Ruiz-Gomez F. Real-world Evidence of COVID-19 Vaccines Effectiveness in Solid-organ Transplant Recipient Population in Colombia: A Study Nested in the Esperanza Cohort. Transplantation 2023; 107:216-224. [PMID: 36228269 PMCID: PMC9746232 DOI: 10.1097/tp.0000000000004411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Solid-organ transplant recipients (SOTRs) have a higher risk of coronavirus disease 2019 (COVID-19) complications and death and a less powerful and lasting response to vaccines and to natural infection. In Colombia, this population was prioritized in the National Vaccination Plan against COVID-19 and received vaccines from different platforms. The aim of this study was to estimate the effectiveness of the complete vaccination schedule and of the vaccine booster for COVID-19 administered to SOTRs in Colombia. METHODS A nested-cohort was assembled within the population-based ESPERANZA cohort and included the subset of 16 y and older SOTRs (n = 6963); the follow-up period spanned March 11, 2021, to May 11, 2022. The vaccine effectiveness was estimated with Cox proportional-hazards models so that the overall effectiveness of the complete vaccination schedule, the vaccine booster, each used vaccine, and the homologous and heterologous schedules were estimated, adjusting by the main confounders. RESULTS The overall effectiveness of being fully vaccinated was 73.7% (95% confidence interval [CI], 68.9%-77.0%) to prevent COVID-19 infection, 83.7% (95% CI, 78.7%-87.5%) to prevent hospitalization, and 92.1% (95% CI, 88.8%-94.4%) to prevent death due to COVID-19. Similarly, the effectiveness of the vaccine booster was 76.7% (95% CI, 70.6%-81.5%), 86.9% (95% CI, 79.4%-91.6%), and 94.5% (95% CI, 89.8%-97.1%) to prevent confirmed COVID-19 infection, hospitalization, and death due to COVID-19, respectively. In both cases, there were no statistically significant differences across age groups. CONCLUSIONS Findings from this work show a high protection of vaccination against infection, hospitalization, and death due to COVID-19 in SOTRs, which increases with the vaccine booster.
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Affiliation(s)
- Mariana Pinto-Álvarez
- Dirección de Medicamentos y Tecnologías de Salud, Ministerio de Salud y Protección Social, Bogotá DC, Colombia
| | - Julián A. Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | - Leonardo Arregocés-Castillo
- Dirección de Medicamentos y Tecnologías de Salud, Ministerio de Salud y Protección Social, Bogotá DC, Colombia
| | | | - Andrés F. Palacios
- Dirección de Medicamentos y Tecnologías de Salud, Ministerio de Salud y Protección Social, Bogotá DC, Colombia
| | - Maryory Galvis-Pedraza
- Dirección de Medicamentos y Tecnologías de Salud, Ministerio de Salud y Protección Social, Bogotá DC, Colombia
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Bouza E, Martin M, Alés JE, Aragonés N, Barragán B, de la Cámara R, Pozo JLD, García-Gutiérrez V, García-Sanz R, Gracia D, Guillem V, Jiménez-Yuste V, Martin-Delgado MC, Martínez J, López R, Rodríguez-Lescure Á, Galiana JR, Sureda AM, Tejerina-Picado F, Trilla A, Zapatero A, Palomo E, San-Miguel J. Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:1-25. [PMID: 36322133 PMCID: PMC9910677 DOI: 10.37201/req/087.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.
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Affiliation(s)
- Emilio Bouza
- CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), España. Patrono de la Fundación de Ciencias de la Salud. Servicio de Microbiología y Enfermedades Infecciosas Hospital General Universitario Gregorio Marañón. Catedrático de Medicina. Universidad Complutense. Madrid.,Correspondence: Emilio Bouza MD, PhD. Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46 28007 Madrid, España E-mail:
| | - Miguel Martin
- Universidad Complutense de Madrid. Jefe de Servicio de Oncología del Hospital Gregorio Marañón de Madrid
| | | | | | | | | | - José Luis Del Pozo
- Servicio de Enfermedades Infecciosas. Servicio de Microbiología. Clínica Universidad de Navarra. Pamplona España
| | | | - Ramón García-Sanz
- Laboratorio de HLA y biología molecular en hematología, Universidad de Salamanca. Sociedad Española de Hematología y Hemoterapia
| | | | - Vicente Guillem
- Servicio de Oncología Médica del Instituto Valenciano de Oncología (IVO)
| | | | - Mari Cruz Martin-Delgado
- Servicio Medicina Intensiva Hospital Universitario Torrejón. Universidad Francisco de Vitoria. Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva
| | - Joaquín Martínez
- Servicio de Hematología y Hemoterapia, Hospital 12 de Octubre, Madrid. Universidad Complutense. Madrid
| | - Rafael López
- Oncología Médica del Hospital Clínico Universitario, Santiago de Compostela
| | | | | | - Ana María Sureda
- Servicio de Hematología en Hospital Universitario Quiron Dexeus, Grupo Español de Trasplante y Terapia Celular, Electa del EBMT
| | | | - Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología del Hospital Clínic de Barcelona. Catedrático de Medicina (Salud Pública) Universidad de Barcelona
| | | | | | - Jesús San-Miguel
- Medicina Clínica y Traslacional de la Clínica Universidad de Navarra
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Effectiveness of COVID-19 Vaccines in Adults with Diabetes Mellitus: A Systematic Review. Vaccines (Basel) 2022; 11:vaccines11010024. [PMID: 36679869 PMCID: PMC9861646 DOI: 10.3390/vaccines11010024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Persons with diabetes mellitus may have an increased risk of severe illness or death from COVID-19 compared to persons without diabetes. Prior studies indicate that immune response and thus vaccine effectiveness might be lower in persons with diabetes. We aimed to systematically review the effectiveness of COVID-19 vaccines in adults with diabetes. Pubmed, Embase, Web of Science and Cochrane Library were searched for studies that evaluated the effectiveness of COVID-19 vaccines in adults with diabetes, published before 4 March 2022. Risk of bias in the included studies was evaluated using the ROBINS-I tool. At least two reviewers conducted the study selection, data extraction, and risk of bias assessment independently. After screening of 2196 studies, a total of 17 articles were included. Six different COVID-19 vaccines (Ad5-nCoV-S, AZD1222, BNT162b2, CoronaVac, JNJ-78436735, and mRNA-1273) were included in the synthesis. Vaccine effectiveness was reported for SARS-CoV-2 infection, symptomatic COVID-19, hospitalization, and death, and ranged from 24 to 96% in persons with diabetes, and from 33 to 97% in total study populations; effectiveness was generally lower for persons with diabetes. Odds ratios for breakthrough infection or severe COVID-19 ranged from 1.03 to 2.41 in vaccinated persons with diabetes compared to persons without diabetes. Even though the included studies were very heterogeneous, results from the synthesis indicate that effectiveness of COVID-19 vaccines might be lower in persons with diabetes. More research is needed on the comparison of vaccine effectiveness between persons with and without diabetes, and the effectiveness of repeat COVID-19 vaccinations.
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Marra AR, Kobayashi T, Suzuki H, Alsuhaibani M, Hasegawa S, Tholany J, Perencevich E, Maezato AM, Ricardo VCV, Salinas JL, Edmond MB, Rizzo LV. The effectiveness of coronavirus disease 2019 (COVID-19) vaccine in the prevention of post-COVID-19 conditions: A systematic literature review and meta-analysis. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e192. [PMID: 36505947 PMCID: PMC9726631 DOI: 10.1017/ash.2022.336] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Although multiple studies have revealed that coronavirus disease 2019 (COVID-19) vaccines can reduce COVID-19-related outcomes, little is known about their impact on post-COVID-19 conditions. We performed a systematic literature review and meta-analysis on the effectiveness of COVID-19 vaccination against post-COVID-19 conditions (ie, long COVID). METHODS We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from December 1, 2019, to April 27, 2022, for studies evaluating COVID-19 vaccine effectiveness against post-COVID-19 conditions among individuals who received at least 1 dose of Pfizer/BioNTech, Moderna, AstraZeneca, or Janssen vaccine. A post-COVID-19 condition was defined as any symptom that was present 3 or more weeks after having COVID-19. Editorials, commentaries, reviews, study protocols, and studies in the pediatric population were excluded. We calculated the pooled diagnostic odds ratios (DORs) for post-COVID-19 conditions between vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated as 100% × (1 - DOR). RESULTS In total, 10 studies with 1,600,830 individuals evaluated the effect of vaccination on post-COVID-19 conditions, of which 6 studies were included in the meta-analysis. The pooled DOR for post-COVID-19 conditions among individuals vaccinated with at least 1 dose was 0.708 (95% confidence interval (CI), 0.692-0.725) with an estimated vaccine effectiveness of 29.2% (95% CI, 27.5%-30.8%). The vaccine effectiveness was 35.3% (95% CI, 32.3%-38.1%) among those who received the COVID-19 vaccine before having COVID-19, and 27.4% (95% CI, 25.4%-29.3%) among those who received it after having COVID-19. CONCLUSIONS COVID-19 vaccination both before and after having COVID-19 significantly decreased post-COVID-19 conditions for the circulating variants during the study period although vaccine effectiveness was low.
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Affiliation(s)
- Alexandre R. Marra
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Hiroyuki Suzuki
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Mohammed Alsuhaibani
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Shinya Hasegawa
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Joseph Tholany
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Eli Perencevich
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Aline Miho Maezato
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | | | - Michael B. Edmond
- West Virginia University School of Medicine, Morgantown, West Virginia, United States
| | - Luiz Vicente Rizzo
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Nakashima K, Ishida M, Matsui H, Yoshida C, Nagai T, Shiraga M, Nakaoka H, Otsuka Y, Nakagama Y, Kaku N, Nitahara Y, Kido Y, Hirota Y. Immunogenicity and safety of COVID-19 vaccine in lung cancer patients receiving anticancer treatment: A prospective multicenter cohort study. Hum Vaccin Immunother 2022; 18:2140549. [PMID: 36369871 DOI: 10.1080/21645515.2022.2140549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study assessed the immunogenicity and safety of the BNT162b2 mRNA vaccine in lung cancer patients receiving anticancer treatment. We enrolled lung cancer patients receiving anticancer treatment and non-cancer patients; all participants were fully vaccinated with the BNT162b2 vaccine. Blood samples were collected before the first and second vaccinations and 4 ± 1 weeks after the second vaccination. Anti-severe respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein S1 subunit receptor-binding domain antibody titers were measured using the Architect SARS-CoV-2 IgG II Quant and Elecsys Anti-SARS-CoV-2 S assays. Fifty-five lung cancer patients and 38 non-cancer patients were included in the immunogenicity analysis. Lung cancer patients showed significant increase in the geometric mean antibody concentration, which was significantly lower than that in the non-cancer patients after the first (30 vs. 121 AU/mL, p < .001 on Architect; 4.0 vs 1.2 U/mL, p < .001 on Elecsys) and second vaccinations (1632 vs. 3472 AU/mL, p = .005 on Architect; 213 vs 573 A/mL, p = .002 on Elecsys). The adjusted odds ratio (aOR) for seroprotection was significantly lower (p < .05) in lung cancer patients than that in non-cancer patients. Analysis of the anticancer treatment types showed that the aOR for seroprotection was significantly lower (p < .05) in lung cancer patients receiving cytotoxic agents. They showed no increase in adverse reactions. BNT162b2 vaccination in lung cancer patients undergoing anticancer treatment significantly increased (p < .05) antibody titers and showed acceptable safety. Immunogenicity in these patients could be inadequate compared with that in non-cancer patients.
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Affiliation(s)
- Kei Nakashima
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | | | - Hiroki Matsui
- Clinical Research Support Office, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Chihiro Yoshida
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tatsuya Nagai
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Minoru Shiraga
- Department of Pulmonology, Chikamori Hospital, Kochi, Japan
| | | | - Yoshihito Otsuka
- Department of Laboratory medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Yu Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Natsuko Kaku
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Nitahara
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yasutoshi Kido
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshio Hirota
- Clinical Epidemiology Research Center, SOUSEIKAI Medical Group (Medical Co. LTA), Fukuoka, Japan
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Rosen B, Davidovitch N, Chodick G, Israeli A. The role of Israeli researchers in the scientific literature regarding COVID-19 vaccines. Isr J Health Policy Res 2022; 11:39. [PMID: 36419188 PMCID: PMC9684862 DOI: 10.1186/s13584-022-00548-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The accurate and timely publication of scientific findings is a key component of the global response to the COVID-19 pandemic. This article explores the role of Israeli researchers in the scientific literature regarding COVID-19 vaccines. METHODS Content and bibliometric analysis of articles included in the Web of Science database regarding COVID-19 vaccines, that were published between January 2020 and June 2022. RESULTS The Web of Science includes 18,596 articles regarding COVID-19 vaccines that were published between January 2020 and June 2022. 536 (3%) of those articles had at least one Israeli author. These "Israeli articles" accounted for 11% of the NEJM articles on COVID-19 vaccines, 9% of such articles in Nature Medicine, and 4% of such articles in the Lancet. 80 of the 536 Israeli articles (15%) were recognized as "Highly Cited Papers" (articles that rank in the top 1% by citations for field and publication year). Most of the Israeli Highly Cited Papers (HCPs) analyzed the safety and/or efficacy of the COVID-19 vaccine developed by Pfizer and BioNTech (BNT162b2). Most of the Israeli HCPs made use of detailed and comprehensive individual data available from Israel's health plans, hospitals, or Ministry of Health. The 15% HCP rate (i.e., the number of HCPs divided by the number of all articles) for the Israeli articles was triple the HCP rate for all articles on COVID-19 vaccines (5%). A key factor contributing to Israel's prominent role in rapid publication of vaccination impact studies was Israel's being a world leader in the initial vaccination rollout, the administration of boosters, and the vaccination of pregnant women. Other contributing factors include Israeli researchers' access to well-developed electronic health record systems linking vaccinations and outcomes, the analytic strengths of leading Israeli researchers and research institutions, collaborations with leading research institutions in other countries, and the ability to quickly identify emerging research opportunities and mobilize accordingly. Recent developments in the priorities and selection criteria of leading journals have also played a role; these include an increased openness to well-designed observational studies and to manuscripts from outside of Europe and North America. CONCLUSIONS Israeli researchers, Israeli research institutions, and the Israeli government can, and should, take concrete steps to build upon lessons learned in the course of the recent surge of high-quality publications related to COVID-19 vaccines (such as the value of linking data across organizations). These lessons can be applied to a wide range of fields, including fields that go well beyond vaccines and pandemic responses.
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Affiliation(s)
- Bruce Rosen
- grid.419640.e0000 0001 0845 7919Myers-JDC-Brookdale Institute, Jerusalem, Israel ,grid.9619.70000 0004 1937 0538Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem, Israel
| | - Nadav Davidovitch
- grid.7489.20000 0004 1937 0511School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, Israel ,Taub Center for Social Policy Studies in Israel, Jerusalem, Israel
| | - Gabriel Chodick
- grid.425380.8Maccabi Healthcare Services, Tel Aviv, Israel ,grid.12136.370000 0004 1937 0546Tel Aviv University, Tel Aviv, Israel
| | - Avi Israeli
- grid.9619.70000 0004 1937 0538Hebrew University Hadassah Medical School, Jerusalem, Israel ,grid.414840.d0000 0004 1937 052XMinistry of Health, Jerusalem, Israel
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Decarreaux D, Sevila J, Masse S, Capai L, Fourié T, Villarroel PMS, Amroun A, Nurtop E, Vareille M, Blanchon T, de Lamballerie X, Charrel R, Falchi A. Eight Months of Serological Follow-Up of Anti-SARS-CoV-2 Antibodies in France: A Study among an Adult Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15257. [PMID: 36429974 PMCID: PMC9691066 DOI: 10.3390/ijerph192215257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Uncertainties remain regarding the nature and durability of the humoral immune response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM This study investigated immunoglobulin G response and neutralizing activity to evaluate the mean antibody concentrations and response duration induced by each vaccination regimen in a French adult population. METHODS A study including blood sampling and questionnaires was carried out from November 2020 to July 2021 with three separate follow-up phases. Spike proteins and neutralizing antibodies were quantified using ELISA and a virus-neutralization test. RESULTS Overall, 295 participants were included. Seroprevalences were 11.5% (n = 34), 10.5% (n = 31), and 68.1% (n = 201) in phases 1, 2, and 3, respectively. Importantly, 5.8% (n = 17) of participants lost their natural antibodies. Antibody response of participants with only a prior infection was 88.2 BAU/mL, significantly lower than those vaccinated, which was 1909.3 BAU/mL (p = 0.04). Moreover, the antibody response of vaccinated participants with a prior infection was higher (3593.8 BAU/mL) than those vaccinated without prior infection (3402.9 BAU/mL) (p = 0.78). Vaccinated participants with or without prior infection had a higher seroneutralization rate (91.0%) than those unvaccinated with prior infection (65.0%). CONCLUSION These results demonstrated that single infection does not confer effective protection against SARS-CoV-2.
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Affiliation(s)
- Dorine Decarreaux
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, 75012 Paris, France
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Julie Sevila
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
| | - Shirley Masse
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
| | - Lisandru Capai
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
| | - Toscane Fourié
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Paola Mariela Saba Villarroel
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Abdennour Amroun
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Elif Nurtop
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Matthieu Vareille
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
| | - Thierry Blanchon
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, 75012 Paris, France
| | - Xavier de Lamballerie
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Remi Charrel
- Unité des Virus émergents, Aix Marseille University, IRD 190, INSERM U1207, IHU Méditerranée Infection, 13005 Marseille, France
| | - Alessandra Falchi
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250 Corte, France
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Mues KE, Kirk B, Patel DA, Gelman A, Chavers LS, Talarico CA, Esposito DB, Martin D, Mansi J, Chen X, Gatto NM, Van de Velde N. Real-world comparative effectiveness of mRNA-1273 and BNT162b2 vaccines among immunocompromised adults identified in administrative claims data in the United States. Vaccine 2022; 40:6730-6739. [PMID: 36163093 PMCID: PMC9507810 DOI: 10.1016/j.vaccine.2022.09.025] [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: 05/23/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Head-to-head studies comparing COVID-19 mRNA vaccine effectiveness in immunocompromised individuals, who are vulnerable to severe disease are lacking, as large sample sizes are required to make meaningful inferences. METHODS This observational comparative effectiveness study was conducted in closed administrative claims data from the US HealthVerity database (December 11, 2020-January 10, 2022, before omicron). A 2-dose mRNA-1273 versus BNT162b2 regimen was assessed for preventing medically-attended breakthrough COVID-19 diagnosis and hospitalizations among immunocompromised adults. Inverse probability of treatment weighting was applied to balance baseline characteristics between vaccine groups. Incidence rates from patient-level data and hazard ratios (HRs) using weighted Cox proportional hazards models were calculated. RESULTS Overall, 57,898 and 66,981 individuals received a 2-dose regimen of mRNA-1273 or BNT161b2, respectively. Among the weighted population, mean age was 51 years, 53 % were female, and baseline immunodeficiencies included prior blood transplant (8%-9%), prior organ transplant (7%), active cancer (12%-13%), primary immunodeficiency (5-6%), HIV (20%-21%), and immunosuppressive therapy use (60%-61%). Rates per 1,000 person-years (PYs; 95% confidence intervals [CI]s) of breakthrough medically-attended COVID-19 were 25.82 (23.83-27.97) with mRNA-1273 and 30.98 (28.93, 33.18) with BNT162b2 (HR, 0.83; 95% CI, 0.75-0.93). When requiring evidence of an antigen or polymerase chain reaction test before COVID-19 diagnosis, the HR for medically-attended COVID-19 was 0.78 (0.67-0.92). Breakthrough COVID-19 hospitalization rates per 1,000 PYs (95% CI) were 3.66 (2.96-4.51) for mRNA-1273 and 4.68 (3.91-5.59) for BNT162b2 (HR, 0.78; 0.59-1.03). Utilizing open and closed claims for outcome capture only, or both cohort entry/outcome capture, produced HRs (95% CIs) for COVID-19 hospitalization of 0.72 (0.57-0.92) and 0.66 (0.58-0.76), respectively. CONCLUSIONS Among immunocompromised adults, a 2-dose mRNA-1273 regimen was more effective in preventing medically-attended COVID-19 in any setting (inpatient and outpatient) than 2-dose BNT162b2. Results were similar for COVID-19 hospitalization, although statistical power was limited when using closed claims only. STUDY REGISTRATION NCT05366322.
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Affiliation(s)
- Katherine E. Mues
- Aetion, Inc, 5 Pennsylvania Plaza, New York, NY 10001, USA,Corresponding author
| | - Brenna Kirk
- Aetion, Inc, 5 Pennsylvania Plaza, New York, NY 10001, USA
| | | | - Alice Gelman
- Aetion, Inc, 5 Pennsylvania Plaza, New York, NY 10001, USA
| | | | | | | | - David Martin
- Moderna, Inc, 200 Technology Square, Cambridge, MA 02139, USA
| | - James Mansi
- Moderna, Inc, 200 Technology Square, Cambridge, MA 02139, USA
| | - Xing Chen
- Moderna, Inc, 200 Technology Square, Cambridge, MA 02139, USA
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Homan T, Mazzilli S, Chieti A, Musa A, Roth A, Fortunato F, Bisceglia L, Prato R, Lopalco PL, Martinelli D. Covid-19 vaccination programme effectiveness against SARS-CoV-2 related infections, hospital admissions and deaths in the Apulia region of Italy: a one-year retrospective cohort study. Sci Rep 2022; 12:18597. [PMID: 36329239 PMCID: PMC9632568 DOI: 10.1038/s41598-022-23235-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
Studies reporting vaccine effectiveness against COVID-19 outcomes concentrate mainly on estimates of one single type of vaccine and variant, seldom considering waning effects. We aimed to estimate the effectiveness of the overall COVID-19 vaccination programme implemented in the Apulia region of Italy at preventing SARS-CoV-2 infections, COVID-19-related hospital admissions and deaths during alpha and delta variant dominant periods. We conducted a retrospective cohort study using electronic health records of persons 16 years and older resident in the Apulia region, assessing the effectiveness of the combined use of BNT162b2, mRNA-1273, ChAdOx1-S and Ad26.COV2.S vaccines against confirmed COVID-19 infections, hospitalisations and deaths, for fully and partially vaccinated persons as well as by time since vaccination and variants. Cox regression models yielding hazard ratios were used to calculate the overall vaccination programme effectiveness. From 1 January to 1 December 2021, we included 3,530,967 eligible persons in the cohort, of whom 2,770,299 were fully vaccinated and 158,313 were COVID-19 positive at the end of the study period. The effectiveness of the programme over the entire study period for fully vaccinated persons against COVID-19 infection, hospitalisation and death were 87.69% (CI95% 87.73-88.18), 94.08% (93.58-94.54) and 95.95% (CI95% 95.26-96.54), respectively. The effectiveness against COVID-19 infection of fully vaccinated subjects during the alpha and delta period was respectively 88.20% (CI95% 87.60-99.78) and 59.31% (CI95% 57.91-60.67), against hospitalisation 93.89% (CI95% 92.67-94.90) and 88.32% (CI95% 86.50-89.90) and against death 93.83% (CI95% 91.65-95.45) and 85.91 (CI95% 79.98-90.09). The waning effects of the programme regarding COVID-19 infection during the delta period were stronger than for alpha, with 75.85% (CI95% 74.38-77.24) effectiveness after 1-2 months and 8.35% (CI95% 3.45-13.01) after 5-6 months after full vaccination. The effectiveness against hospitalisation and death during the delta period waned rapidly and at 7-8-months after the full vaccination respectively decreased to 27.67% (CI95% 7.48-43.45) and 48.47 (CI95% 53.97-34.82). Our study suggests that the COVID-19 vaccination program in Apulia was strongly protective against COVID-19 infection, hospitalisation, and death due to alpha as well as delta variants, although its effectiveness is reduced over time.
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Affiliation(s)
- Tobias Homan
- grid.10796.390000000121049995Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D’Avanzo, Viale Degli Aviatori, 2, 71122 Foggia, Italy ,grid.418914.10000 0004 1791 8889ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Sara Mazzilli
- grid.6093.cScuola Normale Superiore - Pisa, Toscana, Italy
| | - Antonio Chieti
- grid.509575.bStrategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Alessandra Musa
- grid.509575.bStrategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Adam Roth
- grid.418914.10000 0004 1791 8889ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden ,grid.418914.10000 0004 1791 8889European Centre for Disease Prevention and Control, Solna, Sweden
| | - Francesca Fortunato
- grid.10796.390000000121049995Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D’Avanzo, Viale Degli Aviatori, 2, 71122 Foggia, Italy
| | - Lucia Bisceglia
- grid.509575.bStrategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Rosa Prato
- grid.10796.390000000121049995Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D’Avanzo, Viale Degli Aviatori, 2, 71122 Foggia, Italy
| | - Pier Luigi Lopalco
- grid.9906.60000 0001 2289 7785Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Domenico Martinelli
- grid.10796.390000000121049995Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D’Avanzo, Viale Degli Aviatori, 2, 71122 Foggia, Italy
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Risk M, Hayek SS, Schiopu E, Yuan L, Shen C, Shi X, Freed G, Zhao L. COVID-19 vaccine effectiveness against omicron (B.1.1.529) variant infection and hospitalisation in patients taking immunosuppressive medications: a retrospective cohort study. THE LANCET. RHEUMATOLOGY 2022; 4:e775-e784. [PMID: 35991760 PMCID: PMC9381025 DOI: 10.1016/s2665-9913(22)00216-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background There is a scarcity of research regarding the effectiveness of the mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech) COVID-19 vaccines in patients taking immunosuppressant medications, and no data are published to date pertaining to their effectiveness against omicron (B.1.1.529) variant SARS-CoV-2 infection and hospitalisation. We aimed to assess the relationship between immunosuppressive medications, mRNA vaccination, omicron infection, and severe COVID-19 outcomes (ie, hospitalisation, ICU admission, death). Methods We did a retrospective cohort study and included vaccinated and unvaccinated people aged 18 years or older in the Michigan Medicine health-care system, USA, during the omicron-dominant period of the pandemic (Dec 16, 2021-March 4, 2022). We collected data from electronic health records (demographics, diagnoses, medications) combined with immunisation data from the Michigan State Registry to determine vaccination status, and we collected COVID-19-related hospitalisation data by chart review. We used a Cox proportional hazards model based on calendar time to assess the effectiveness of the mRNA-1273 and BNT162b2 vaccines in people taking immunosuppressive medications (conventional synthetic disease-modifying antirheumatic drugs [DMARDs], biologic DMARDs, or glucocorticoids within the past 3 months), while controlling for participant characteristics. Using the same model, we assessed the effect of different classes of medication such as immunosuppressive DMARDs, immunomodulatory DMARDs, and glucocorticoids on SARS-CoV-2 infection and hospitalisation due to COVID-19. All analyses were done using complete cases after removing participants with missing covariates. Findings 209 492 people were identified in Michigan Medicine, including 165 913 who were vaccinated and 43 579 who were unvaccinated. 41 078 people were excluded because they were younger than 18 years, partially vaccinated, had received a vaccine other than the two vaccines studied, or had incomplete covariate data. 168 414 people were included in the analysis; 97 935 (58%) were women, 70 479 (42%) were men, and 129 816 (77%) were White. 5609 (3%) people were taking immunosuppressive medications. In patients receiving immunosuppressants, three doses of BNT162b2 had a vaccine effectiveness of 50% (95% CI 31-64; p<0·0001) and three doses of mRNA-1273 had a vaccine effectiveness of 60% (42-73; p<0·0001) against SARS-CoV-2 infection. Three doses of either vaccine had an effectiveness of 87% (95% CI 73-93; p<0·0001) against hospitalisation due to COVID-19. Receipt of immunosuppressive DMARDs (hazard ratio 2·32, 95% CI 1·23-4·38; p=0·0097) or glucocorticoids (2·93, 1·77-4·86; p<0·0001) and a history of organ or bone marrow transplantation (3·52, 2·01-6·16; p<0·0001) were associated with increased risk of hospitalisation due to COVID-19 compared with those who had not received immunosuppressive medications or transplant. Interpretation People taking immunosuppressive DMARDs or glucocorticoids are at substantially higher risk of hospitalisation due to COVID-19 than the general population. However, the mRNA-1273 and BNT162b2 vaccines remain effective within this group, and it is important that patients taking these medications remain up to date with vaccinations to mitigate their risk. Funding National Institute of Allergy and Infectious Diseases, National Institutes of Health.
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Affiliation(s)
- Malcolm Risk
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Salim S Hayek
- Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Elena Schiopu
- Department of Rheumatology, Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Liyang Yuan
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Chen Shen
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Xu Shi
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Gary Freed
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Lili Zhao
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Cacdac R, Jamali A, Jamali R, Nemovi K, Vosoughi K, Bayraktutar Z. Acute pancreatitis as an adverse effect of COVID-19 vaccination. SAGE Open Med Case Rep 2022; 10:2050313X221131169. [PMID: 36313269 PMCID: PMC9608244 DOI: 10.1177/2050313x221131169] [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: 07/25/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
While vaccination against COVID-19 has significantly improved the morbidity and mortality of the disease, with the increase in the administration of COVID-19 vaccines, it is more likely to observe their rare side effects in the clinical settings. Herein, we report a case of an 82-year-old man with history of coronary artery disease, prostate cancer in remission, gastroesophageal reflux disease, and hypothyroidism, who presented with acute pancreatitis few hours after receiving the third dose of Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine, without other identified etiology. His symptoms were mild and he was discharged in a stable condition after improvement in his condition with supportive care.
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Affiliation(s)
- Robert Cacdac
- Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA
| | - Arsia Jamali
- Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA,Arsia Jamali, Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA 92270, USA. Emails: ;
| | - Raika Jamali
- Research Development Center of Sina Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khashayar Nemovi
- Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA
| | - Kia Vosoughi
- Department of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA
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Stewart-Jones GBE, Elbashir SM, Wu K, Lee D, Renzi I, Ying B, Koch M, Sein CE, Choi A, Whitener B, Garcia-Dominguez D, Henry C, Woods A, Ma L, Montes Berrueta D, Avena LE, Quinones J, Falcone S, Hsiao CJ, Scheaffer SM, Thackray LB, White P, Diamond MS, Edwards DK, Carfi A. Development of SARS-CoV-2 mRNA vaccines encoding spike N-terminal and receptor binding domains. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.10.07.511319. [PMID: 36238717 PMCID: PMC9558437 DOI: 10.1101/2022.10.07.511319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
With the success of mRNA vaccines against coronavirus disease 2019 (COVID-19), strategies can now focus on improving vaccine potency, breadth, and stability. We present the design and preclinical evaluation of domain-based mRNA vaccines encoding the wild-type spike-protein receptor-binding (RBD) and/or N-terminal domains (NTD). An NTD-RBD linked candidate vaccine, mRNA-1283, showed improved antigen expression, antibody responses, and stability at refrigerated temperatures (2-8°C) compared with the clinically available mRNA-1273, which encodes the full-length spike protein. In mice administered mRNA-1283 as a primary series, booster, or variant-specific booster, similar or greater immune responses and protection from viral challenge were observed against wild-type, beta, delta, or omicron (BA. 1) compared with mRNA-1273 immunized mice, especially at lower vaccine dosages. These results support clinical assessment of mRNA-1283 ( NCT05137236 ). One Sentence Summary A domain-based mRNA vaccine, mRNA-1283, is immunogenic and protective against SARS-CoV-2 and emerging variants in mice.
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Shoji K, Funaki T, Yamada M, Mikami M, Miyake K, Ueno S, Tao C, Myojin S, Aiba H, Matsui T, Ogimi C, Kato H, Miyairi I. Safety of and antibody response to the BNT162b2 COVID-19 vaccine in adolescents and young adults with underlying disease. J Infect Chemother 2022; 29:61-66. [PMID: 36152928 PMCID: PMC9490955 DOI: 10.1016/j.jiac.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/19/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Data are limited regarding the safety of and antibody response to the BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger ribonucleic acid vaccine in adolescents and young adults with underlying disease. METHODS This prospective observational study enrolled patients age 12-25 years with chronic underlying disease who received 2 doses of BNT162b2. A 18-item questionnaire was used to assess adverse events within 7 days post-vaccination, and data regarding severe adverse events were collected from electronic medical records. An antibody titer for the receptor-binding domain of the spike protein in SARS-CoV-2 was used to assess antibody response after the second vaccine dose. RESULTS Study participants were 429 patients (241 [56.2%] age 12-15 years; 188 [43.8%] age 16-25 years). The most common underlying diseases were genetic or chromosomal abnormalities and/or congenital anomalies, followed by endocrine or metabolic diseases; 32% of participants were immunocompromised. Severe adverse events were observed after the second dose in 1 (0.4%) patient age 12-15 years and in 2 (1.1%) patients age 16-25 years; all patients recovered. Seropositivity after the second vaccine dose was 99.0%. The geometric mean antibody titer was higher in patients age 12-15 years versus 16-25 years (1603.3 [1321.8-1944.7] U/mL vs. 949.4 [744.2-1211.0] U/mL). Compared with immunocompetent patients, immunocompromised patients had a lower antibody titer (2106.8 [1917.5-2314.7] U/mL vs. 467.9 [324.4-674.8] U/mL). CONCLUSIONS Vaccination with BNT162b2 was acceptably safe and immunogenic for adolescents and young adults with underlying disease.
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Affiliation(s)
- Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
| | - Takanori Funaki
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Masaki Yamada
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Department for Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Masashi Mikami
- Biostatistics Unit, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kozue Miyake
- Department of Clinical Research Promotion, National Center for Child Health and Development, Tokyo, Japan
| | - Saki Ueno
- Department of Clinical Research Promotion, National Center for Child Health and Development, Tokyo, Japan
| | - Chiaki Tao
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Shota Myojin
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroyuki Aiba
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiro Matsui
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikara Ogimi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hitoshi Kato
- Former Executive Director, National Center for Child Health and Development, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
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d'Albis H, Etner J, Thuilliez J. Vaccination under pessimistic expectations in clinical trials and immunization campaigns. JOURNAL OF PUBLIC ECONOMIC THEORY 2022; 25:JPET12617. [PMID: 36246735 PMCID: PMC9538933 DOI: 10.1111/jpet.12617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
We provide one of the first formalizations of a vaccination campaign in a decision-theoretic framework. We analyze a model where an ambiguity-averse individual must decide how much effort to invest into prevention in the context of a rampant disease. We study how ambiguity aversion affects the effort and the estimation of the vaccine efficacy in clinical trials and immunization campaigns. We find that the behaviors of individuals participating in a clinical trial differ from individuals not participating. Individuals who are more optimistic toward vaccination participate more in trials. Their behaviors and efforts are also affected. As a result, because vaccine efficacy depends on unobserved behaviors and efforts, the biological effect of the vaccine becomes difficult to evaluate. During the scale-up phase of a vaccination campaign, provided that vaccine efficacy is established, we show that vaccine hesitancy may still be rational.
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Affiliation(s)
| | - Johanna Etner
- EconomiX, UPL, Paris Nanterre UniversityCNRSParisFrance
| | - Josselin Thuilliez
- CNRS—Centre d'Economie de la Sorbonne, UMR8174Université Panthéon‐Sorbonne‐CNRSParisFrance
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Shoji K, Tsuzuki S, Akiyama T, Matsunaga N, Asai Y, Suzuki S, Iwamoto N, Funaki T, Yamada M, Ozawa N, Yamaguchi K, Miyairi I, Ohmagari N. Comparison of clinical characteristics of COVID-19 in pregnant women between the Delta and Omicron variants of concern predominant periods. J Infect Chemother 2022; 29:33-38. [PMID: 36103949 PMCID: PMC9464469 DOI: 10.1016/j.jiac.2022.09.005] [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: 07/23/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
Background Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited. Methods A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19. Results During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified; 111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24–3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08–4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13–0.84]). Conclusions Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods.
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Affiliation(s)
- Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takayuki Akiyama
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Setsuko Suzuki
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Iwamoto
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takanori Funaki
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Masaki Yamada
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Department for Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Nobuaki Ozawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Koushi Yamaguchi
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Gu Y, Duan J, Yang N, Yang Y, Zhao X. mRNA vaccines in the prevention and treatment of diseases. MedComm (Beijing) 2022; 3:e167. [PMID: 36033422 PMCID: PMC9409637 DOI: 10.1002/mco2.167] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
Messenger ribonucleic acid (mRNA) vaccines made their successful public debut in the effort against the COVID-19 outbreak starting in late 2019, although the history of mRNA vaccines can be traced back decades. This review provides an overview to discuss the historical course and present situation of mRNA vaccine development in addition to some basic concepts that underly mRNA vaccines. We discuss the general preparation and manufacturing of mRNA vaccines and also discuss the scientific advances in the in vivo delivery system and evaluate popular approaches (i.e., lipid nanoparticle and protamine) in detail. Next, we highlight the clinical value of mRNA vaccines as potent candidates for therapeutic treatment and discuss clinical progress in the treatment of cancer and coronavirus disease 2019. Data suggest that mRNA vaccines, with several prominent advantages, have achieved encouraging results and increasing attention due to tremendous potential in disease management. Finally, we suggest some potential directions worthy of further investigation and optimization. In addition to basic research, studies that help to facilitate storage and transportation will be indispensable for practical applications.
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Affiliation(s)
- Yangzhuo Gu
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University; Collaborative Innovation Center for BiotherapyChengduChina
| | - Jiangyao Duan
- Department of Life SciencesImperial College LondonLondonUK
| | - Na Yang
- Stem Cell and Tissue Engineering Research Center/School of Basic Medical SciencesGuizhou Medical UniversityGuiyangChina
| | - Yuxin Yang
- Stem Cell and Tissue Engineering Research Center/School of Basic Medical SciencesGuizhou Medical UniversityGuiyangChina
| | - Xing Zhao
- State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University; Collaborative Innovation Center for BiotherapyChengduChina
- Stem Cell and Tissue Engineering Research Center/School of Basic Medical SciencesGuizhou Medical UniversityGuiyangChina
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Saadh MJ, Jaber SA. Efficacy of COVID-19 vaccines. Microb Pathog 2022; 171:105729. [PMID: 36058411 PMCID: PMC9436781 DOI: 10.1016/j.micpath.2022.105729] [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: 03/09/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022]
Abstract
As of 2022, the global population has access to several mRNA and traditional inactivated vaccines. However, their effectiveness in preventing infection, hospitalization, and COVID-associated mortality in Jordan has yet to be evaluated. The purpose of this observational study was to evaluate the relative effectiveness of three approved vaccines against COVID-19 in a sample of the Jordanian population. The study was conducted between July 2021 and 2022 in a sample of adult patients presenting to hospitals across Jordan and receiving one of the three vaccines - Pfizer (BNT162b2), Astra Zeneca (ChAdOx1-S), or Sinopharm (BBIBP-CorV). Data were collected to measure the rates of infection without hospitalization, infection with hospitalization, and death. The sample included patients with one of the following chronic conditions: cardiovascular disease, respiratory disease, or diabetes. Primary data were obtained from patients' health records. The sample included 6132 adults from Jordan, with a mean age 52 ± 17 years. The rates of death in patients receiving two doses of any vaccine ranged between 0.175 and 2.77%, compared with 0.69-13.53% in patients receiving only one dose. The rates of hospitalization were 6-7.97% with two doses, compared to 7.98-25.13% with one dose. The rates of infection without hospitalization were significantly higher in the two-dose group (6-25.1%) compared with those who had received only one dose of any COVID-19 vaccine (0.69-10.61%). In conclusion, receiving two doses of a COVID-19 vaccine was associated with lower odds of mortality and hospitalization and higher odds of infection. More research is needed to evaluate the safety and efficacy of vaccines against SARS-CoV-2.
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SARS-CoV-2-Antikörper-Antwort auf die zweite COVID-19-Impfung bei neuromuskulären Patienten unter immunmodulierender Therapie. DER NERVENARZT 2022; 93:1219-1227. [PMID: 35997783 PMCID: PMC9395911 DOI: 10.1007/s00115-022-01363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 12/04/2022]
Abstract
Einer erfolgreichen Impfung (adäquater Anstieg der Anti-S[Spike]-Protein-Antikörper) gegen SARS-CoV‑2 (engl. severe acute respiratory syndrome coronavirus type 2) wird ein suffizienter Schutz gegen einen schweren Verlauf von COVID-19 (engl. coronavirus disease 2019) zugeschrieben. Bei Patient*innen mit chronisch-inflammatorischen Erkrankungen (engl. „chronic inflammatory diseases“ [CID]) und Immunsuppression ist der Impferfolg weiterhin im wissenschaftlichen Diskurs. Daher evaluierten wir bei Patient*innen mit einer neuromuskulären Erkrankung (NME), die zu regelmäßigen Infusionen von Immunglobulinen in unserer neurologischen Tagesklinik/Ambulanz vorstellig wurden, 2 Wochen nach vollständiger Immunisierung die Antikörpertiter gegen das S1 (S1-Untereinheit des Spike-Proteins) -Antigen von SARS-CoV‑2. Unsere Daten zeigen, dass Patient*innen mit einer chronischen autoimmunen NME und gleichzeitiger immunsuppressiver bzw. immunmodulierender Therapie nach einer Impfung sowohl mit einem mRNA- als auch mit einem Vektorimpfstoff eine Antikörperantwort aufwiesen. Im Vergleich zu gesunden Proband*innen zeigte sich eine vergleichbare Anzahl an Serokonversionen durch die Impfung. Eine Korrelation zwischen Immunglobulindosierung und Impfantwort sowie Infusionsintervall und Impfantwort ließ sich nicht feststellen. Demgegenüber zeigte jedoch insbesondere die Kombination aus Mycophenolatmofetil (MMF) und Prednisolon eine signifikante Reduktion der spezifischen Antikörpersynthese.
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Fabiani M, Puopolo M, Filia A, Sacco C, Mateo-Urdiales A, Spila Alegiani S, Del Manso M, D’Ancona F, Vescio F, Bressi M, Petrone D, Spuri M, Rota MC, Massari M, Da Cas R, Morciano C, Stefanelli P, Bella A, Tallon M, Proietti V, Siddu A, Battilomo S, Palamara AT, Popoli P, Brusaferro S, Rezza G, Riccardo F, Menniti Ippolito F, Pezzotti P. Effectiveness of an mRNA vaccine booster dose against SARS-CoV-2 infection and severe COVID-19 in persons aged ≥60 years and other high-risk groups during predominant circulation of the delta variant in Italy, 19 July to 12 December 2021. Expert Rev Vaccines 2022; 21:975-982. [PMID: 35389748 PMCID: PMC9115794 DOI: 10.1080/14760584.2022.2064280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/06/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Consolidated information on the effectiveness of COVID-19 booster vaccination in Europe are scarce. RESEARCH DESIGN AND METHODS We assessed the effectiveness of a booster dose of an mRNA vaccine against any SARS-CoV-2 infection (symptomatic or asymptomatic) and severe COVID-19 (hospitalization or death) after over two months from administration among priority target groups (n = 18,524,568) during predominant circulation of the Delta variant in Italy (July-December 2021). RESULTS Vaccine effectiveness (VE) against SARS-CoV-2 infection and, to a lesser extent, against severe COVID-19, among people ≥60 years and other high-risk groups (i.e. healthcare workers, residents in long-term-care facilities, and persons with comorbidities or immunocompromised), peaked in the time-interval 3-13 weeks (VE against infection = 67.2%, 95% confidence interval (CI): 62.5-71.3; VE against severe disease = 89.5%, 95% CI: 86.1-92.0) and then declined, waning 26 weeks after full primary vaccination (VE against infection = 12.2%, 95% CI: -4.7-26.4; VE against severe disease = 65.3%, 95% CI: 50.3-75.8). After 3-10 weeks from the administration of a booster dose, VE against infection and severe disease increased to 76.1% (95% CI: 70.4-80.7) and 93.0% (95% CI: 90.2-95.0), respectively. CONCLUSIONS These results support the ongoing vaccination campaign in Italy, where the administration of a booster dose four months after completion of primary vaccination is recommended.
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Affiliation(s)
- Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Puopolo
- Department of Neuroscience, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fortunato D’Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fenicia Vescio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Bressi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Matteo Spuri
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Massari
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Da Cas
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina Morciano
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Tallon
- Department of Informatics, Istituto Superiore di Sanità, Rome, Italy
| | - Valeria Proietti
- Directorate of Digitalisation, Health Information System and Statistics, Italian Ministry of Health, Rome, Italy
| | - Andrea Siddu
- General Directorate of Health Prevention, Italian Ministry of Health, Rome, Italy
| | - Serena Battilomo
- Directorate of Digitalisation, Health Information System and Statistics, Italian Ministry of Health, Rome, Italy
| | | | - Patrizia Popoli
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giovanni Rezza
- General Directorate of Health Prevention, Italian Ministry of Health, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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