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Takagi MA, Rhodes ST, Kim JH, King M, Soukar S, Martin C, Sasaki Cole A, Chan A, Brennan C, Zyzanski S, Kissoondial B, Ragina N. Evaluating Two Educational Interventions for Enhancing COVID-19 Knowledge and Attitudes in a Sample American Indian/Alaska Native Population. Vaccines (Basel) 2024; 12:787. [PMID: 39066425 PMCID: PMC11281502 DOI: 10.3390/vaccines12070787] [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: 06/15/2024] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated existing healthcare disparities among American Indian/Alaska Native (AI/AN) populations rooted in historical traumas and systemic marginalization. METHODS This study conducted at a single Indian Health Service (IHS) clinic in central Michigan evaluates two educational interventions for enhancing COVID-19 knowledge and attitudes in a sample AI/AN population. Utilizing a pre/post-intervention prospective study design, participants received either a video or infographic educational intervention, followed by a survey assessing their COVID-19 knowledge and attitudes. RESULTS The results indicate significant improvements in knowledge and attitudes post-intervention, with both modalities proving effective. However, specific factors such as gender, political affiliation, and place of residence influenced COVID-19 attitudes and knowledge, emphasizing the importance of tailored interventions. CONCLUSIONS Despite limitations, this study highlights the critical role of educational interventions in addressing vaccine hesitancy and promoting health equity within AI/AN communities. Moving forward, comprehensive strategies involving increased Indian Health Service funding, culturally relevant interventions, and policy advocacy are crucial in mitigating healthcare disparities and promoting health equity within AI/AN communities.
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Affiliation(s)
- Maya Asami Takagi
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
- Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Simone T. Rhodes
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Jun Hwan Kim
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Maxwell King
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Stephanie Soukar
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Chad Martin
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Angela Sasaki Cole
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Arlene Chan
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Ciara Brennan
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
| | - Stephen Zyzanski
- Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Barry Kissoondial
- College of Medicine Affiliated Community Clinic, Central Michigan University, Mount Pleasant, MI 48858, USA;
| | - Neli Ragina
- College of Medicine, Central Michigan University, Mount Pleasant, MI 48858, USA; (S.T.R.); (J.H.K.); (M.K.); (S.S.); (C.M.); (A.S.C.); (A.C.); (C.B.); (N.R.)
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2
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Gianella S, Anderson C, Chaillon A, Wells A, Porrachia M, Caballero G, Vargas M, Lonergan J, Woodworth B, Gaitan N, Rawlings SA, Muttera L, Harkness L, Little SJ, May S, Smith D. Impact of influenza and pneumococcal vaccines on HIV persistence and immune dynamics during suppressive antiretroviral therapy. AIDS 2024; 38:1131-1140. [PMID: 38526550 PMCID: PMC11141237 DOI: 10.1097/qad.0000000000003882] [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] [Indexed: 03/26/2024]
Abstract
OBJECTIVE We sought to determine if standard influenza and pneumococcal vaccines can be used to stimulate HIV reservoirs during antiretroviral therapy (ART). DESIGN A prospective, randomized, double-blinded, placebo-controlled, crossover trial of two clinically recommended vaccines (influenza and pneumococcal). METHODS Persons with HIV on ART ( N = 54) were enrolled in the clinical trial. Blood was collected at baseline and days 2,4,7,14, and 30 postimmunizations. Levels of cellular HIV RNA and HIV DNA were measured by ddPCR. Expression of immunological markers on T cell subsets was measured by flow cytometry. Changes in unspliced cellular HIV RNA from baseline to day 7 postinjection between each vaccine and placebo was the primary outcome. RESULTS Forty-seven participants completed at least one cycle and there were no serious adverse events related to the intervention. We observed no significant differences in the change in cellular HIV RNA after either vaccine compared with placebo at any timepoint. In secondary analyses, we observed a transient increase in total HIV DNA levels after influenza vaccine, as well as increased T cell activation and exhaustion on CD4 + T cells after pneumococcal vaccine. CONCLUSION Clinically recommended vaccines were well tolerated but did not appear to stimulate the immune system strongly enough to elicit significantly noticeable HIV RNA transcription during ART.Clinicaltrials.gov identifier: NCT02707692.
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Affiliation(s)
- Sara Gianella
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Christy Anderson
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Antoine Chaillon
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Alan Wells
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Magali Porrachia
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Gemma Caballero
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Milenka Vargas
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Joseph Lonergan
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Brendon Woodworth
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Noah Gaitan
- Department of Medicine, University of California San Diego, La Jolla, CA
| | | | - Leticia Muttera
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Liliana Harkness
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Susan J. Little
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Susanne May
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Davey Smith
- Department of Medicine, University of California San Diego, La Jolla, CA
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3
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Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following influenza and COVID-19 vaccination. Biol Sex Differ 2024; 15:50. [PMID: 38890702 PMCID: PMC11184791 DOI: 10.1186/s13293-024-00625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/06/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. In a predominately young adult female population of healthcare workers, we sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. METHODS This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the mandatory annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination for bivalent COVID-19 and influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. RESULTS Females were more likely to report local AEs after either influenza (OR = 2.28, p = 0.001) or COVID-19 (OR = 2.57, p = 0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after either influenza (OR = 1.18, p = 0.552) or COVID-19 (OR = 0.96, p = 0.907) vaccination. Hormonal birth control use did not impact the rates of reported AEs following influenza vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. CONCLUSIONS Our findings highlight the need for sex- and gender-inclusive policies to inform more effective mandatory occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers, a predominately female population, and to more fully characterize the post-vaccination behavioral differences between men and women.
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Affiliation(s)
- Anna Yin
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nadia Wang
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patrick J Shea
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Erica N Rosser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Helen Kuo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janna R Shapiro
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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4
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Tadount F, Kiely M, Assi A, Rafferty E, Sadarangani M, MacDonald SE, Quach C. Sex Differences in the Immunogenicity and Efficacy of Seasonal Influenza Vaccines: A Meta-analysis of Randomized Controlled Trials. Open Forum Infect Dis 2024; 11:ofae222. [PMID: 38737434 PMCID: PMC11088355 DOI: 10.1093/ofid/ofae222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024] Open
Abstract
Background Sex impacts individuals' response to vaccination. However, most vaccine studies do not report these differences disaggregated by sex. The aim of this study was to assess sex differences in the immunogenicity and efficacy of influenza vaccine. Methods We performed a meta-analysis using phase 3 randomized controlled trial data conducted between 2010 and 2018. Using hemagglutination inhibition antibody titers for each strain, differences in geometric mean ratios (GMRs) were calculated by sex. Risk ratios (RRs) comparing seroconversion proportions were pooled for females and males using random-effects models. Vaccine efficacy (VE) was assessed. Data were analyzed by age group (18-64 vs ≥65 years). Results A total of 33 092 healthy adults from 19 studies were included for immunogenicity analysis, and 6740 from 1 study for VE. Whereas no sex differences in immunogenicity were found in adults <65 years old, older females had a significantly greater chance to seroconvert compared to older males for all strains: RRH1N1 = 1.17 [95% confidence interval {CI}, 1.12-1.23]; RRH3N2 = 1.09 [95% CI, 1.05-1.14]; RRVictoria = 1.23 [95% CI, 1.14-1.31]; RRYamagata = 1.22 [95% CI, 1.14-1.30]. GMRs were also higher in older females for all strains compared to older males. VE in preventing laboratory-confirmed influenza was higher in older females compared to older males with VEs of 27.32% (95% CI, 1.15%-46.56%) and 6.06% (95% CI, -37.68% to 35.90%), respectively. Conclusions Our results suggest a higher immunogenicity and VE in females compared to males in older adults. These differences in immunogenicity and VE support the disaggregation of vaccine data by sex in clinical trials and observational studies. Clinical Trials Registration CRD42018112260.
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Affiliation(s)
- Fazia Tadount
- Sainte-Justine Hospital Health and Research Center, Montreal, Canada
- Département de Microbiologie, infectiologie et immunologie, Faculté de médecine, Université de Montréal, Montreal, Canada
| | - Marilou Kiely
- Département de Microbiologie, infectiologie et immunologie, Faculté de médecine, Université de Montréal, Montreal, Canada
- Institut national de santé publique du Québec, Québec, Canada
| | - Ali Assi
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Canada
| | - Ellen Rafferty
- Faculty of Nursing and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Shannon E MacDonald
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Canada
| | - Caroline Quach
- Sainte-Justine Hospital Health and Research Center, Montreal, Canada
- Département de Microbiologie, infectiologie et immunologie, Faculté de médecine, Université de Montréal, Montreal, Canada
- Département de Pédiaterie, Faculté de médecine, Université de Montréal, Montreal, Canada
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5
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Szőllősi GJ, Pataki J, Virágh A, Bányai G, Boruzs K, Bíró K, Dombrádi V. Influenza Vaccination Coverage among People with Self-Reported Cardiovascular Diseases-Findings from the Hungarian Implementation of the European Health Interview Survey. Vaccines (Basel) 2024; 12:360. [PMID: 38675742 PMCID: PMC11054540 DOI: 10.3390/vaccines12040360] [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: 02/27/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Worldwide, cardiovascular diseases are the leading cause of mortality. This has significant implications for public health. Influenza, a common infectious disease, poses an increased risk for individuals with chronic conditions, such as cardiovascular diseases. However, little is known about influenza vaccination coverage in this group. This study utilized data from the Hungarian implementation of the European Health Interview Survey to assess influenza vaccination coverage and its determinants among cardiovascular respondents from 2009 to 2019. The findings reveal a downward trend in the vaccination rates over the years (from 24% to 21%), despite the availability of free vaccination in Hungary for this high-risk population. The main factors influencing low influenza vaccine uptake were identified, as follows: young age, a lower level of education, good self-perceived health status, smoking, a lower frequency of medical visits, and not suffering from respiratory diseases. Addressing these disparities necessitates targeted vaccination strategies supported by enhanced education, better access to healthcare services, and the promotion of preventive healthcare measures. Improving vaccination coverage among patients with cardiovascular diseases is imperative for reducing influenza-related morbidity and mortality. This highlights the importance of comprehensive public health interventions and healthcare provider engagement in promoting vaccination among groups at increased risk.
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Affiliation(s)
- Gergő József Szőllősi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary
| | - Jenifer Pataki
- Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (J.P.); (A.V.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Anett Virágh
- Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary; (J.P.); (A.V.)
| | - Gábor Bányai
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Klára Boruzs
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Klára Bíró
- Institute of Health Economics and Management, Faculty of Economics and Business, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (K.B.); (K.B.)
| | - Viktor Dombrádi
- Patient Safety Department, Health Services Management Training Centre, Faculty of Health and Public Administration, Semmelweis University, 1085 Budapest, Hungary;
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6
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Cunningham-Erves J, George W, Sanderson M, Stewart E, Jin SW, Davis J, Brandt HM. Predictors of seasonal influenza and COVID-19 vaccination coverage among adults in Tennessee during the COVID-19 pandemic. Front Public Health 2024; 12:1321173. [PMID: 38500722 PMCID: PMC10945017 DOI: 10.3389/fpubh.2024.1321173] [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: 10/13/2023] [Accepted: 02/06/2024] [Indexed: 03/20/2024] Open
Abstract
Background The COVID-19 pandemic has convoluted hesitancy toward vaccines, including the seasonal influenza (flu) vaccine. Because of COVID-19, the flu season has become more complicated; therefore, it is important to understand all the factors influencing the uptake of these vaccines to inform intervention targets. This article assesses factors related to the uptake of influenza and COVID-19 vaccines among adults in Tennessee. Methods A cross-sectional, secondary data analysis of 1,400 adults was conducted in Tennessee. The adult sample came from two data sources: Data source 1 completed a baseline survey from January to March 2022, and data source 2 was completed from May to August 2022. Data on vaccine attitudes, facilitators and barriers, and communication needs were collected via random digit dial by Scientific Telephone Samples (STS). Two multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to predict sociodemographic and overall vaccine-related factors associated with receipt or non-receipt (referent) of COVID-19 and influenza vaccines. Results Approximately 78% of the adult sample had received the COVID-19 vaccination. A significant positive association for COVID-19 vaccine uptake was seen among those who were older (aged 50-65) (aOR = 1.9; 95% CI: 1.2-3.2), Black (aOR = 2.0; 95% CI:1.3-2.8), and had a college education and higher (aOR = 2.3; 95% CI: 1.5-3.6). However, there was a significant negative association for persons reporting they were extremely religious (aOR = 0.5; 95% CI:0.3-0.9). Over 56% of the adult sample had received the influenza vaccination this season. Those who had a higher annual household income ($80,000+) (aOR = 1.9; 95% CI: 1.3-2.6) and had health insurance (aOR = 2.6; 95% CI: 1.4-4.8) had a significant positive association with influenza vaccine receipt. However, those who were employed part-time or were unemployed had a significant negative association for influenza vaccine receipt (aOR = 0.7; 95% CI: 0.5-0.9). Both COVID-19 and influenza vaccine receipt had strongly significant positive trends with increasing belief in effectiveness and trust (p < 0.0001) and strongly significant negative trends with higher levels of overall vaccine hesitancy (p < 0.0001). Conclusion Strategies to increase COVID-19 and influenza vaccination should be age-specific, focus on increasing geographical and financial access, and offer tailored messages to address concerns about these vaccines.
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Affiliation(s)
- J Cunningham-Erves
- Department of Internal Medicine, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - W George
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States
| | - M Sanderson
- Department of Family and Community Medicine, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - E Stewart
- Department of Internal Medicine, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - S W Jin
- School of Social Work, The University of Memphis, Memphis, TN, United States
| | - J Davis
- Department of Biochemistry and Cancer Biology, School of Medicine, Meharry Medical College, Nashville, TN, United States
| | - H M Brandt
- St. Jude Children's Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN, United States
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Sampson OL, Jay C, Adland E, Csala A, Lim N, Ebbrecht SM, Gilligan LC, Taylor AE, George SS, Longet S, Jones LC, Barnes E, Frater J, Klenerman P, Dunachie S, Carrol M, Hawley J, Arlt W, Groll A, Goulder P. Gonadal androgens are associated with decreased type I interferon production by plasmacytoid dendritic cells and increased IgG titres to BNT162b2 following co-vaccination with live attenuated influenza vaccine in adolescents. Front Immunol 2024; 15:1329805. [PMID: 38481993 PMCID: PMC10933029 DOI: 10.3389/fimmu.2024.1329805] [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: 10/30/2023] [Accepted: 02/13/2024] [Indexed: 04/09/2024] Open
Abstract
mRNA vaccine technologies introduced following the SARS-CoV-2 pandemic have highlighted the need to better understand the interaction of adjuvants and the early innate immune response. Type I interferon (IFN-I) is an integral part of this early innate response that primes several components of the adaptive immune response. Women are widely reported to respond better than men to tri- and quadrivalent influenza vaccines. Plasmacytoid dendritic cells (pDCs) are the primary cell type responsible for IFN-I production, and female pDCs produce more IFN-I than male pDCs since the upstream pattern recognition receptor Toll-like receptor 7 (TLR7) is encoded by X chromosome and is biallelically expressed by up to 30% of female immune cells. Additionally, the TLR7 promoter contains several putative androgen response elements, and androgens have been reported to suppress pDC IFN-I in vitro. Unexpectedly, therefore, we recently observed that male adolescents mount stronger antibody responses to the Pfizer BNT162b2 mRNA vaccine than female adolescents after controlling for natural SARS-CoV-2 infection. We here examined pDC behaviour in this same cohort to determine the impact of IFN-I on anti-spike and anti-receptor-binding domain IgG titres to BNT162b2. Through flow cytometry and least absolute shrinkage and selection operator (LASSO) modelling, we determined that serum-free testosterone was associated with reduced pDC IFN-I, but contrary to the well-described immunosuppressive role for androgens, the most bioactive androgen dihydrotestosterone was associated with increased IgG titres to BNT162b2. Also unexpectedly, we observed that co-vaccination with live attenuated influenza vaccine boosted the magnitude of IgG responses to BNT162b2. Together, these data support a model where systemic IFN-I increases vaccine-mediated immune responses, yet for vaccines with intracellular stages, modulation of the local IFN-I response may alter antigen longevity and consequently improve vaccine-driven immunity.
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Affiliation(s)
- Oliver L. Sampson
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Cecilia Jay
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Emily Adland
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Anna Csala
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Nicholas Lim
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Stella M. Ebbrecht
- Department of Statistics, Technical University of Dortmund, Dortmund, Germany
| | - Lorna C. Gilligan
- Steroid Metabolome Analysis Core, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Angela E. Taylor
- Steroid Metabolome Analysis Core, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Sherley Sherafin George
- Biochemistry Department, Clinical Science Building, Wythenshawe Hospital, Manchester, United Kingdom
| | - Stephanie Longet
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Lucy C. Jones
- Department of Microbiology, Division of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
| | - Ellie Barnes
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - John Frater
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Susie Dunachie
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Miles Carrol
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - James Hawley
- Biochemistry Department, Clinical Science Building, Wythenshawe Hospital, Manchester, United Kingdom
| | - Wiebke Arlt
- Steroid Metabolome Analysis Core, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Medical Research Council London Institute of Medical Sciences (MRC LMS), Imperial College London, London, United Kingdom
| | - Andreas Groll
- Department of Statistics, Technical University of Dortmund, Dortmund, Germany
| | - Philip Goulder
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
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8
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Gan J, Zhang H, Wu J, Liu Y, Liu P, Cheng R, Tang X, Yang L, Luo W, Li W. Effect of inactivated vaccine boosters against severe and critical COVID-19 during the Omicron BA.5 wave: A retrospective analysis of hospitalized patients in China. J Med Virol 2024; 96:e29402. [PMID: 38380744 DOI: 10.1002/jmv.29402] [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: 08/08/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024]
Abstract
Few real-world analyses of the ability of vaccines to protect against severe COVID-19 have been published. In this real-world study, we compared the prevalence of severe or critical COVID-19 between patients at our hospital who were not vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or who had been vaccinated partial, full, or booster course with the CoronaVac, containing inactivated virus propagated in Vero cells. Data from electronic health records were retrospectively analyzed for 4090 inpatients with COVID-19 who were treated at West China Hospital, Chengdu between December 6, 2022 and February 14, 2023. Clinicodemographic characteristics and COVID-19 severity were compared among patients who had been vaccinated 0, 1, 2 or more times with inactivated vaccine CoronaVac. To evaluate vaccine effectiveness over time, we plotted Kaplan-Meier curves with the percentage of patients with the outcome of severe or critical COVID-19 from the time of their last vaccine dose according to vaccination status. Ordinal logistic regression was used to assess associations between vaccination status and COVID-19 severity. Cox regression was used to identify risk factors for severe or critical COVID-19. Among the 4090 patients, 171 had been vaccinated partial and 423 twice with the full CoronaVac regimens, while 905 had been vaccinated three times (boosted). The prevalence of severe or critical COVID-19 among patients was 11 percentage points lower among those vaccinated (40%) at least twice than among those unvaccinated (51%) (p<0.001), while it was 10% points lower among those who had received a booster (41%) than among those unvaccinated (51%) (p<0.001). Protection against severe or critical COVID-19 due to vaccination was significantly weakened by being older than 65 years, being male, or having diabetes, chronic heart disease, autoimmune disease, or chronic lung disease. Completing a full course of immunization with inactivated vaccine CoronaVac against SARS-CoV-2 can reduce the risk of severe or critical COVID-19 due to the Omicron BA.5 subvariant.
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Affiliation(s)
- Jiadi Gan
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Huohuo Zhang
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jiaxuan Wu
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yi Liu
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | | | - Ruixin Cheng
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiumei Tang
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University/Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Linhui Yang
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wenxin Luo
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Center of Precision Medicine, The Research Units of West China, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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9
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Yin A, Wang N, Shea PJ, Rosser EN, Kuo H, Shapiro JR, Fenstermacher KZJ, Pekosz A, Rothman RE, Klein SL, Morgan R. Sex and gender differences in adverse events following receipt of influenza and COVID-19 vaccination among healthcare workers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301440. [PMID: 38318206 PMCID: PMC10843156 DOI: 10.1101/2024.01.17.24301440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Introduction Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. We sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of vaccine outcomes, which remains poorly characterized. Methods This cohort study enrolled Johns Hopkins Health System healthcare workers (HCWs) who were recruited from the annual fall 2019-2022 influenza vaccine and the fall 2022 COVID-19 bivalent vaccine campaigns. Vaccine recipients were enrolled the day of vaccination and AE surveys were administered two days post-vaccination (DPV) for bivalent COVID-19 and Influenza vaccine recipients. Data were collected regarding the presence of a series of solicited local and systemic AEs. Open-ended answers about participants' experiences with AEs also were collected for the COVID-19 vaccine recipients. Results Females were more likely to report local AEs after influenza (OR=2.28, p=0.001) or COVID-19 (OR=2.57, p=0.008) vaccination compared to males, regardless of age or race. Males and females had comparable probabilities of reporting systemic AEs after influenza (OR=1.18, p=0.552) or COVID-19 (OR=0.96, p=0.907) vaccination. Exogenous hormones from birth control use did not impact the rates of reported AEs following COVID-19 vaccination among reproductive-aged female HCWs. Women reported more interruptions in their daily routine following COVID-19 vaccination than men and were more likely to seek out self-treatment. More women than men scheduled their COVID-19 vaccination before their days off in anticipation of AEs. Conclusions Our findings highlight the need for sex- and gender-inclusive policies to inform more effective occupational health vaccination strategies. Further research is needed to evaluate the potential disruption of AEs on occupational responsibilities following mandated vaccination for healthcare workers and to more fully characterize the post-vaccination behavioral differences between men and women. KEY MESSAGE What is already known on this topic: ⇒ Among diversely aged adults 18-64 years, females report more AEs to vaccines, including the influenza and COVID-19 vaccines, than males.⇒ Vaccine AEs play a role in shaping vaccine hesitancy and uptake.⇒ Vaccine uptake related to influenza and COVID-19 are higher among men than women.⇒ Research that addresses both the sex and gender disparities of vaccine outcomes and behaviors is lacking.What this study adds: ⇒ This prospective active reporting study uses both quantitative and qualitative survey data to examine sex and gender differences in AEs following influenza or COVID-19 vaccination among a cohort of reproductive-aged healthcare workers.How this study might affect research, practice, or policy: ⇒ Sex and gender differences in AEs and perceptions relating to vaccination should drive the development of more equitable and effective vaccine strategies and policies in occupational health settings.
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10
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Butt IN, van Eeden C, Kovacs Burns K, Saxinger L, Clifford A, Redmond D, Cohen Tervaert JW, Yacyshyn E. Understanding COVID-19 vaccine hesitancy in vasculitis patients. Front Public Health 2023; 11:1301492. [PMID: 38111485 PMCID: PMC10726054 DOI: 10.3389/fpubh.2023.1301492] [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: 09/25/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Objective To identify the factors that impact COVID-19 vaccine decision-making in vaccine-hesitant vasculitis patients, and compare their perceptions with other rheumatology patients, given existence of data suggesting rheumatology patients may have disease-specific factors that influence their COVID-19 vaccine decision-making. Methods This cross-sectional study surveyed adult rheumatology patients from the Kaye Edmonton Clinic Rheumatology Clinic, in Canada, between June and August 2021, using an anonymous online questionnaire. Survey responses were analyzed for statistical differences using chi-square analysis. Results The COVID-19 Vaccine Perceptions Survey had a response rate of 70.9%. Of the total 231 respondents, 103 patients were diagnosed with vasculitis. At the time of the survey, 10.6% of vasculitis patients refused to receive a COVID-19 vaccine compared to 6.3% for other rheumatology patients. Compared to other rheumatology patients, vaccine-hesitant vasculitis patients were significantly more concerned about almost every aspect of available COVID-19 vaccines [e.g., safety (p < 0.001), components (p < 0.001)], and feared that they could contract SARS-CoV-2 from a vaccine (p < 0.001). These vaccine-hesitant patients were also significantly less pleased with the government's pandemic response, less confident in healthcare team-provided information (p < 0.001), and more likely to report that healthcare providers had no role in their COVID-19 vaccine decision-making (p < 0.001). Conclusion Vaccine-hesitant vasculitis patients may have multiple considerations influencing COVID-19 vaccine hesitancy, including vaccine and disease-specific concerns, along with unfavorable perceptions of the healthcare system (government and healthcare providers). Healthcare providers can address some of these concerns by initiating patient-centered discussions around immunizations to help support educated decision-making.
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Affiliation(s)
| | | | | | | | | | | | | | - Elaine Yacyshyn
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
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11
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Kiely M, Tadount F, Lo E, Sadarangani M, Wei SQ, Rafferty E, Quach C, MacDonald SE. Sex differences in adverse events following seasonal influenza vaccines: a meta-analysis of randomised controlled trials. J Epidemiol Community Health 2023; 77:791-801. [PMID: 37734937 PMCID: PMC10646905 DOI: 10.1136/jech-2023-220781] [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: 04/26/2023] [Accepted: 07/20/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Despite being a vaccine-preventable disease, influenza remains a major public health threat with vaccine safety concerns reducing vaccine acceptability. Immune responses to vaccines and adverse events may differ between males and females, but most studies do not report results by sex. Using data from clinical trials, we explored sex differences in adverse events following seasonal influenza vaccines. METHODS We obtained data for phase III randomised controlled trials identified through a systematic review and clinical trials registries, and performed a two-stage meta-analysis. Risk ratios (RR) and 95% confidence intervals (95% CI) comparing solicited reactions in females versus males were pooled using the Mantel-Haenszel method and a random-effects model. We used the ROBINS-I tool to assess risk of bias and the I2 statistic for heterogeneity. Main analysis was stratified by age: 18-64 years and ≥65 years. RESULTS The dataset for this analysis included 34 343 adults from 18 studies (12 with individual-level data and 6 with aggregate data). There was a higher risk of injection site reactions in females compared with males for both younger and older participants, with RRs of 1.29 (95% CI 1.21 to 1.37) and 1.43 (95% CI 1.28 to 1.60), respectively. Higher risk in females was also observed for systemic reactions, with RRs of 1.25 (95% CI 1.20 to 1.31) and 1.27 (95% CI 1.20 to 1.34) for younger and older participants, respectively. We also observed elevated risks of severe reactions in females, with a higher RR in younger versus older participants for systemic reactions (RRs 2.12 and 1.48, p=0.03, I2=79.7%). RRs were not found to vary between quadrivalent and trivalent vaccines. CONCLUSION This meta-analysis suggested a higher risk of solicited reactions following influenza vaccines for females compared with males, irrespective of age and vaccine type. Transparent communication of this risk could increase the trust in vaccines and limit vaccine hesitancy. Future studies should report results stratified by sex and explore the role of gender in the occurrence of adverse events.
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Affiliation(s)
- Marilou Kiely
- Department of Microbiology, Infectiology, immunology & Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Fazia Tadount
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Ernest Lo
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Quebec, Quebec, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University if British Columbia, Vancouver, British Columbia, Canada
| | - Shu Qin Wei
- Institut national de santé publique du Québec, Quebec, Quebec, Canada
| | | | - Caroline Quach
- Department of Microbiology, Infectiology, immunology & Pediatrics, University of Montreal, Montreal, Quebec, Canada
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12
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Slingerland P, van Hunsel FPAM, Lieber T, van Balveren L, Duijster JW. The Effect of Sex on the Incidence, Latency, Duration and Perceived Burden of Adverse Events Following Seasonal Influenza Vaccination in the Netherlands. Drug Saf 2023; 46:1323-1334. [PMID: 37882905 DOI: 10.1007/s40264-023-01356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION The annual reformulation of the seasonal influenza vaccine results in fluctuating frequencies and severity of adverse effects following immunization (AEFIs), which stresses the importance of pharmacovigilance. Also, sex-related factors are known to influence the development of AEFIs. This study aims to describe the difference in incidence and course (i.e., time-to-onset, time-to-recovery, and perceived burden) of AEFIs between males and females after seasonal influenza vaccination. METHODS We assessed data from cohort event monitoring studies, which were performed over nine consecutive years (2013-2021), each covering several months during the seasonal influenza campaign in the Netherlands. Participants reported information about AEFIs over a 30-day period in three questionnaires. The effect of sex, age, body mass index, study year, and comorbidities on the incidence of any AEFI, local reactions, fever and the five most reported AEFIs was analyzed using logistic regression. The difference in time-to-onset, time-to-recovery, and perceived burden between males and females was analyzed by the Kruskal-Wallis test. RESULTS The cohort included 7789 participants (53.0% females). Females had around 2.5-fold (p < 0.001) higher odds of developing any AEFI compared with males. Some study years and comorbidities were positively associated with AEFI incidence, whereas age was negatively associated. An AEFI had a significant shorter time-to-onset, a longer time-to-recovery, and a higher perceived burden in females compared to males. CONCLUSION Overall, the results confirm that females experience AEFIs more often than males. Additionally, this study shows that the course of AEFIs only partially differs between the sexes.
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Affiliation(s)
- P Slingerland
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
| | - Florence P A M van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands.
| | - T Lieber
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
| | - L van Balveren
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
| | - J W Duijster
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
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13
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Murished GM, Dandachi I, Aljabr W. Side effects of COVID-19 vaccines in the middle eastern population. Front Immunol 2023; 14:1270187. [PMID: 38022593 PMCID: PMC10654979 DOI: 10.3389/fimmu.2023.1270187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.
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Affiliation(s)
| | | | - Waleed Aljabr
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
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14
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Sengupta A, Al-Otaibi N, Hinkula J. Sex-Specific Immune Responses to Seasonal Influenza Vaccination in Diabetic Individuals: Implications for Vaccine Efficacy. J Immunol Res 2023; 2023:3111351. [PMID: 37881338 PMCID: PMC10597737 DOI: 10.1155/2023/3111351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 10/27/2023] Open
Abstract
Seasonal influenza vaccination has different implications on the immune response depending on the comorbidities. Diabetes is one such critical disease that increases the patient's susceptibility to influenza and suppresses vaccine efficacy and immunity. The sex of the individuals also plays a definitive role in the immune responses to both the vaccine and the infection. This study aims to understand the efficacy of the seasonal vaccine against influenza in diabetic groups and undergoing immune mechanisms in different sexes (females and males). In this study, we are reporting about a switching of the immune response of the infected and vaccinated diabetic females towards stronger Th1/Th17 responses with suppressed humoral immunity. They show increased cDC1, enhanced proinflammatory activities within T cells, CD8T activation, Th17 proliferation, and the majority of IgG2 antibody subtypes with reduced neutralization potential. Males with diabetes exhibit enhanced humoral Th2-immunity than the nondiabetic group. They exhibit higher cDC2, and DEC205 levels within them with an increase in plasma B lymphocytes, higher IgG1 subtypes in plasma cells, and influenza-hemagglutinin-specific IgG titer with stronger virus neutralization potential. Males with diabetes recovered better than the females as observed from the changes in their body weight. This study highlights the critical immune mechanisms and sex-specific swapping of their preferred immune response pathways against influenza after vaccination during diabetes. We propose a need for a sex-specific customized vaccine regimen to be implemented against influenza for individuals having diabetes to exploit the manifested strength and weakness in their protective immunity.
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Affiliation(s)
- Anirban Sengupta
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping 58185, Sweden
| | - Noha Al-Otaibi
- King Abdulaziz City for Science and Technology (KACST), Riyad 11442, Saudi Arabia
| | - Jorma Hinkula
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping 58185, Sweden
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15
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Werner F, Zeschick N, Kühlein T, Steininger P, Überla K, Kaiser I, Sebastião M, Hueber S, Warkentin L. Patient-reported reactogenicity and safety of COVID-19 vaccinations vs. comparator vaccinations: a comparative observational cohort study. BMC Med 2023; 21:358. [PMID: 37726711 PMCID: PMC10510262 DOI: 10.1186/s12916-023-03064-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND In the course of the SARS-CoV-2 pandemic, multiple vaccines were developed. Little was known about reactogenicity and safety in comparison to established vaccines, e.g. influenza, pneumococcus, or herpes zoster. Therefore, the present study aimed to compare self-reported side effects in persons vaccinated against SARS-CoV-2 with the incidence of side effects in persons receiving one of the established vaccines. METHODS A longitudinal observational study was conducted over a total of 124 days using web-based surveys. Persons receiving either a vaccination against SARS-CoV-2 or one of the established vaccines (comparator group) were included. In the first questionnaire (short-term survey), 2 weeks after vaccination, mainly local and systemic complaints were evaluated. The long-term survey (42 days after vaccination) and follow-up survey (124 weeks after vaccination) focused on medical consultations for any reason. Multivariate analyses were conducted to determine the influence of the vaccine type (SARS-CoV-2 vs. comparator) and demographic factors. RESULTS In total, data from 16,636 participants were included. Self-reported reactogenicity was lowest in the comparator group (53.2%) and highest in the ChAdOx1 group (85.3%). Local reactions were reported most frequently after mRNA-1273 (73.9%) and systemic reactions mainly after vector-based vaccines (79.8%). Almost all SARS-CoV-2 vaccines showed increased odds of reporting local or systemic reactions. Approximately equal proportions of participants reported medical consultations. None in the comparator group suspected a link to vaccination, while this was true for just over one in 10 in the mRNA-1273 group. The multivariate analysis showed that people with SARS-CoV-2 vaccination were not more likely to report medical consultations; patients who had received a regimen with at least one ChAdOx1 were even less likely to report medical consultations. Younger age, female gender and higher comorbidity were mostly associated with higher odds of medical consultations. CONCLUSION The rate of adverse reactions after established vaccinations was roughly comparable to previous studies. Two weeks after vaccination, participants in the SARS-CoV-2 vaccination group reported more local and systemic local reactions than participants in the comparator group. In the further course, however, there were no higher odds of medical consultations in either of the two groups. Thus, altogether, we assume comparable safety. TRIAL REGISTRATION DRKS-ID DRKS00025881 and DRKS-ID DRKS00025373.
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Affiliation(s)
- Felix Werner
- Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Universitätsstraße 29, Erlangen, 91054, Germany.
| | - Nikoletta Zeschick
- Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Universitätsstraße 29, Erlangen, 91054, Germany
| | - Thomas Kühlein
- Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Universitätsstraße 29, Erlangen, 91054, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Schloßgarten 4, Erlangen, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Schloßgarten 4, Erlangen, Germany
| | - Isabelle Kaiser
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstraße 6, Erlangen, Germany
| | - Maria Sebastião
- Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Universitätsstraße 29, Erlangen, 91054, Germany
| | - Susann Hueber
- Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Universitätsstraße 29, Erlangen, 91054, Germany
| | - Lisette Warkentin
- Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Uniklinikum Erlangen, Universitätsstraße 29, Erlangen, 91054, Germany
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16
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Shapiro JR, Seddu K, Park HS, Lee JS, Creisher PS, Yin A, Shea P, Kuo H, Li H, Abrams E, Leng SX, Morgan R, Klein SL. The intersection of biological sex and gender in adverse events following seasonal influenza vaccination in older adults. Immun Ageing 2023; 20:43. [PMID: 37644610 PMCID: PMC10463383 DOI: 10.1186/s12979-023-00367-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/22/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Women/females report more adverse events (AE) following immunization than men/males for many vaccines, including the influenza and COVID-19 vaccines. This discrepancy is often dismissed as a reporting bias, yet the relative contributions of biological sex and gender are poorly understood. We investigated the roles of sex and gender in the rate of AE following administration of the high-dose seasonal influenza vaccine to older adults (≥ 75 years) using an AE questionnaire administered 5-8 days post-vaccination. Participant sex (male or female) was determined by self-report and a gender score questionnaire was used to assign participants to one of four gender categories (feminine, masculine, androgynous, or undifferentiated). Sex steroid hormones and inflammatory cytokines were measured in plasma samples collected prior to vaccination to generate hypotheses as to the biological mechanism underpinning the AE reported. RESULTS A total of 423 vaccines were administered to 173 participants over four influenza seasons (2019-22) and gender data were available for 339 of these vaccinations (2020-22). At least one AE was reported following 105 vaccinations (25%), by 23 males and 82 females. The majority of AE occurred at the site of injection, were mild, and transient. The odds of experiencing an AE were 3-fold greater in females than males and decreased with age to a greater extent in females than males. The effects of gender, however, were not statistically significant, supporting a central role of biological sex in the occurrence of AE. In males, estradiol was significantly associated with IL-6 and with the probability of experiencing an AE. Both associations were absent in females, suggesting a sex-specific effect of estradiol on the occurrence of AE that supports the finding of a biological sex difference. CONCLUSIONS These data support a larger role for biological sex than for gender in the occurrence of AE following influenza vaccination in older adults and provide an initial investigation of hormonal mechanisms that may mediate this sex difference. This study highlights the complexities of measuring gender and the importance of assessing AE separately for males and females to better understand how vaccination strategies can be tailored to different subsets of the population.
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Affiliation(s)
- Janna R Shapiro
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Kumba Seddu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - John S Lee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Patrick S Creisher
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Anna Yin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Patrick Shea
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Helen Kuo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Huifen Li
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Engle Abrams
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean X Leng
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Domnich A, Amicizia D, Lai PL, Ogliastro M, Piedrahita-Tovar M, Orsi A, Icardi G, Panatto D. Three seasons of enhanced safety surveillance of a cell culture-based quadrivalent influenza vaccine. Hum Vaccin Immunother 2023; 19:2261689. [PMID: 37787067 PMCID: PMC10549188 DOI: 10.1080/21645515.2023.2261689] [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: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
The objective of this paper is to summarize annual enhanced safety surveillance activity across three seasons (2019/20-2021/22) for cell culture-based quadrivalent influenza vaccine (QIVc; Flucelvax® Tetra) in all age groups. This activity was conducted in primary care setting in Genoa (Italy) during the seasons 2019/20, 2020/21 and 2021/22. All adverse events registered within the first seven days following immunization were analyzed by season, type, age group and seriousness. Over three seasons, 3,603 QIVc exposures were recorded within the enhanced passive safety surveillance activity. No safety signals were identified. The overall reporting rates of individual case safety reports for the seasons 2019/20, 2020/21 and 2021/22 were 1.75%, 0.48% and 0.40%, respectively. The average number of adverse events per individual case safety report was similar (range 3.3-3.8 adverse events per case report) across the three seasons. Most adverse events were reactogenic in nature. The rate of adverse events was similarly low in all age groups. Enhanced passive safety surveillance activity is a feasible approach for the post-marketing monitoring of seasonal influenza vaccines. Within its limitations, results of this study support the favorable safety profile of QIVc. These safety data could further bolster public trust in influenza vaccines with the goal to increase vaccination uptake in all target groups.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | - Andrea Orsi
- Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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18
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Wunderlich B, Laskow T, Li H, Zhang L, Abrams E, Tian J, Yu J, Chen Y, Tavenier J, Huang Y, Talaat K, Bream JH, Xue QL, Pawelec G, Leng SX. Interseason waning of vaccine-induced hemagglutination inhibition antibody titers and contributing factors to pre-existing humoral immunity against influenza in community-dwelling older adults 75 years and older. Immun Ageing 2023; 20:38. [PMID: 37525151 PMCID: PMC10388475 DOI: 10.1186/s12979-023-00362-8] [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: 12/14/2022] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Seasonal influenza causes significant morbidity and mortality with a disproportionately high disease burden in older adults. Strain-specific hemagglutination-inhibition (HAI) antibody titer is a well-established measure of humoral immunity against influenza and pre-vaccination HAI titer is a valuable indicator of pre-existing humoral immunity at the beginning of each influenza season in highly vaccinated older adults. While vaccine-induced HAI antibody titers are known to wane over time, accurate assessment of their interseason waning has been challenging. This is because pre-vaccination HAI titers are routinely measured using current season vaccine strain antigens instead of the prior season vaccines with which individuals were immunized; as such, they do not accurately represent residual antibody titers from prior season vaccination. This study took advantage of available pre-vaccination HAI titers measured using both current and prior season vaccine strain antigens in a longitudinal influenza immunization study with participants enrolled for multiple consecutive influenza seasons from 2014 through 2017. Influenza A virus (IAV) H3N2 and influenza B virus (IBV) strains in the vaccine formula changed in 2015 and again in 2016 season. IAV H1N1 vaccine strain remained the same from 2014 through 2016 seasons, but changed in 2017. We also investigated factors contributing to pre-existing humoral immunity. RESULTS Interseason waning of HAI titers was evident, but rates of waning varied among vaccine strains and study seasons, from 18% (p = .43) to 61% (p < .01). Rates of waning were noticeably greater when pre-vaccination HAI titers were measured by the routine approach, i.e., using current season vaccine strain antigens, from 33% (p = .12) to 83% (p < .01), adjusting for age at prior study season, sex, race, and education. This was largely because the routinely measured pre-vaccination HAI titers underrepresented residual HAI titers from prior season vaccinations. Moreover, interseason antibody waning and prior season post-vaccination HAI titers had significant and independent associations with pre-vaccination HAI titers. CONCLUSIONS The routinely measured pre-vaccination HAI titer overestimates interseason HAI antibody waning as it underestimates residual antibody titers from prior season vaccination when virus strains in the vaccine formula change. Moreover, interseason antibody waning and prior season post-vaccination HAI titers independently contribute to pre-existing humoral immunity in this highly vaccinated, community-dwelling older adult population.
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Affiliation(s)
- Bettina Wunderlich
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Laskow
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins Center On Aging and Immune Remodeling, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, JHAAC Room 1A.38A, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA
| | - Huifen Li
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins Center On Aging and Immune Remodeling, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, JHAAC Room 1A.38A, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA
| | - Li Zhang
- Department of Geriatrics, The First People's Hospital of Yunnan Province, Kunming, China
| | - Engle Abrams
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins Center On Aging and Immune Remodeling, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, JHAAC Room 1A.38A, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA
| | - Jing Tian
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jun Yu
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins Center On Aging and Immune Remodeling, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, JHAAC Room 1A.38A, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA
| | - Yiyin Chen
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins Center On Aging and Immune Remodeling, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, JHAAC Room 1A.38A, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA
| | - Juliette Tavenier
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | | | - Kawsar Talaat
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jay H Bream
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Immunology Training Program, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Qian-Li Xue
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Graham Pawelec
- Department of Immunology, University of Tübingen, Tübingen, Germany
- Health Sciences North Research Institute, Sudbury, ON, Canada
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins Center On Aging and Immune Remodeling, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, JHAAC Room 1A.38A, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA.
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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19
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Jaber MA, Abdelmagied M, El-Ameen EM, Afrashtehfar KI. COVID-19 Vaccine Acceptance among Ajman Undergraduate Dental Students: A Cross-Sectional Study. Int J Dent 2023; 2023:3511960. [PMID: 37284300 PMCID: PMC10241569 DOI: 10.1155/2023/3511960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/03/2023] [Accepted: 05/03/2023] [Indexed: 06/08/2023] Open
Abstract
Background Achieving widespread coronavirus disease 2019 (COVID-19) vaccination is crucial in controlling the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This cross-sectional study aimed to identify factors associated with the willingness of dental medicine students to receive the COVID-19 vaccine. Objectives The study sought to assess the knowledge, attitudes, and behaviors of undergraduate dental students toward COVID-19 vaccines and to identify determinants, motivators, and barriers to vaccine uptake and booster receipt. Methods A web-based survey was distributed to all 882 undergraduate dental surgery students in January 2022, and 70.7% of the students responded. The survey used χ2 tests and logistic regression analysis to examine the association among the variables. The significance level was set at α = 0.05. Results Most participants (72.4%) reported having adequate knowledge of COVID-19. The vaccine acceptance rate was higher among male and older trainees, with no significant difference compared to women and younger trainees with no significant difference (p = 0.849). Acceptance of the vaccine varied according to study level (5-year program), ranging from 44.8% to 73.0%, in the following order 4th > 1st > 3rd > 5th > 2nd year. Social media (76.8%), government websites (66.5%), and family and friends (57.2%) were the main sources of COVID-19-related information. Among hesitant and unwilling participants, the main concerns were side effects (34.0%) and lack of understanding about the vaccine's mechanism (67.3%). Conclusions Ajman dental students had moderate knowledge of COVID-19 and obtained information mainly from social media, government websites, and family and friends. Age, sex, and study year influenced vaccine acceptance. The main reasons for refusal were lack of knowledge, fear of side effects, and complications. Education campaigns are needed to increase vaccine acceptance among dental students.
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Affiliation(s)
- M. A. Jaber
- Clinical Sciences Department, College of Dentistry, Ajman University, P.O. Box 346, Ajman City, UAE
| | - M. Abdelmagied
- Clinical Sciences Department, College of Dentistry, Ajman University, P.O. Box 346, Ajman City, UAE
| | - E. M. El-Ameen
- College of Medicine, Ajman University, P.O. Box 346, Ajman City, UAE
| | - K. I. Afrashtehfar
- Clinical Sciences Department, College of Dentistry, Ajman University, P.O. Box 346, Ajman City, UAE
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Bern 3010, Switzerland
- Artificial Intelligence Research Center (AIRC), Ajman University, P.O. Box 346, Ajman City, UAE
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20
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Basri AH, Roga AU, Basri M, Tresno I, Lerik MCD. Manifestations of adverse events post Sinovac vaccine immunization at Wirasakti Hospital, Kupang. J Public Health Afr 2023; 14:1963. [PMID: 37347068 PMCID: PMC10280241 DOI: 10.4081/jphia.2023.1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/03/2022] [Indexed: 06/23/2023] Open
Abstract
Background Since it was first discovered, COVID-19 has spread worldwide and has been declared a pandemic by the World Health Organization. One of the various efforts made to prevent the spread of COVID-19 is the development of the COVID-19 vaccine. One of the vaccines developed and used by the Indonesian government is the Sinovac vaccine. However, like vaccines in general, there are always vaccine safety problems which are better known as adverse events following immunization (AEFI). Objective The purpose of this study is to determine the AEFI manifestations that occurred in Sinovac vaccination participants at Wirasakti Hospital, Kupang. Methods The sample included 51 people, who later became known as research subjects. The criteria for vaccine recipients and instructions for recording AEFI refer to the technical guidelines issued by the Ministry of Health, namely the Decree of the Director General of Disease Prevention and Control number HK.02.02/4/1/2021 regarding technical instructions for implementation of vaccination in the context of combating pandemic COVID-19. Results The results showed that out of 198 vaccination participants, 15 of them had AEFI and those who had AEFI were women. The AEFI manifestations that occur are dizziness, palpitations, shortness of breath, cramps in the hands, and trembling hands. All AEFI that occurred are non-serious in nature. Conclusion Sinovac vaccine is relatively safe to use because only a small proportion of respondents (29.4%) have AEFI.
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Affiliation(s)
- Aries Hasan Basri
- Wirasakti Hospital Kupang, Kupang, East Nusa Tenggara
- Faculty of Public Health, Nusa Cendana University, Kupang, East Nusa Tenggara
| | - Anderias Umbu Roga
- Faculty of Public Health, Nusa Cendana University, Kupang, East Nusa Tenggara
| | - Muntasir Basri
- Faculty of Public Health, Nusa Cendana University, Kupang, East Nusa Tenggara
| | - Idawati Tresno
- Faculty of Medicine, Nusa Cendana University, Kupang, East Nusa Tenggara, Indonesia
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21
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Fairweather D, Beetler DJ, Musigk N, Heidecker B, Lyle MA, Cooper LT, Bruno KA. Sex and gender differences in myocarditis and dilated cardiomyopathy: An update. Front Cardiovasc Med 2023; 10:1129348. [PMID: 36937911 PMCID: PMC10017519 DOI: 10.3389/fcvm.2023.1129348] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
In the past decade there has been a growing interest in understanding sex and gender differences in myocarditis and dilated cardiomyopathy (DCM), and the purpose of this review is to provide an update on this topic including epidemiology, pathogenesis and clinical presentation, diagnosis and management. Recently, many clinical studies have been conducted examining sex differences in myocarditis. Studies consistently report that myocarditis occurs more often in men than women with a sex ratio ranging from 1:2-4 female to male. Studies reveal that DCM also has a sex ratio of around 1:3 women to men and this is also true for familial/genetic forms of DCM. Animal models have demonstrated that DCM develops after myocarditis in susceptible mouse strains and evidence exists for this progress clinically as well. A consistent finding is that myocarditis occurs primarily in men under 50 years of age, but in women after age 50 or post-menopause. In contrast, DCM typically occurs after age 50, although the age that post-myocarditis DCM occurs has not been investigated. In a small study, more men with myocarditis presented with symptoms of chest pain while women presented with dyspnea. Men with myocarditis have been found to have higher levels of heart failure biomarkers soluble ST2, creatine kinase, myoglobin and T helper 17-associated cytokines while women develop a better regulatory immune response. Studies of the pathogenesis of disease have found that Toll-like receptor (TLR)2 and TLR4 signaling pathways play a central role in increasing inflammation during myocarditis and in promoting remodeling and fibrosis that leads to DCM, and all of these pathways are elevated in males. Management of myocarditis follows heart failure guidelines and there are currently no disease-specific therapies. Research on standard heart failure medications reveal important sex differences. Overall, many advances in our understanding of the effect of biologic sex on myocarditis and DCM have occurred over the past decade, but many gaps in our understanding remain. A better understanding of sex and gender effects are needed to develop disease-targeted and individualized medicine approaches in the future.
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Affiliation(s)
- DeLisa Fairweather
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
- Department of Environmental Health Sciences and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Danielle J. Beetler
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, FL, United States
| | - Nicolas Musigk
- Department of Cardiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bettina Heidecker
- Department of Cardiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Melissa A. Lyle
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Leslie T. Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Katelyn A. Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States
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22
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Shapiro JR, Seddu K, Park HS, Lee JS, Creisher PS, Yin A, Shea P, Kuo H, Li H, Abrams E, Leng SX, Morgan R, Klein SL. The intersection of biological sex and gender in adverse events following seasonal influenza vaccination in older adults. RESEARCH SQUARE 2023:rs.3.rs-2557775. [PMID: 36798418 PMCID: PMC9934749 DOI: 10.21203/rs.3.rs-2557775/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background Women/females report more adverse events (AE) following immunization than men/males for many vaccines, including the influenza and COVID-19 vaccines. This discrepancy is often dismissed as a reporting bias, yet the relative contributions of biological sex and gender are poorly understood. We investigated the roles of sex and gender in the rate of AE following administration of the high-dose seasonal influenza vaccine to older adults (≥ 75 years) using an AE questionnaire administered 5-8 days post-vaccination. Participant sex (male or female) was determined by self-report and a gender score questionnaire was used to assign participants to one of four gender categories (feminine, masculine, androgynous, or undifferentiated). Sex steroid hormones and inflammatory cytokines were measured in plasma samples collected prior to vaccination to elucidate a possible biological mechanism for the AE reported. Results A total of 423 vaccines were administered to 173 participants over four influenza seasons (2019-22) and gender data were available for 339 of these vaccinations (2020-22). At least one AE was reported following 105 vaccinations (25%), by 23 males and 82 females. The majority of AE occurred at the site of injection, were mild, and transient. The odds of experiencing an AE were 3-fold greater in females than males and decreased with age to a greater extent in females than males. The effects of gender, however, were not statistically significant, supporting a central role of biological sex in the occurrence of AE. In males, estradiol was significantly associated with IL-6 and with the probability of experiencing an AE. Both associations were absent in females, suggesting a sex-specific effect of estradiol on the occurrence of AE that supports the finding of a biological sex difference. Conclusions These data support a larger role for biological sex than for gender in the occurrence of AE following influenza vaccination in older adults and provide an initial investigation of hormonal mechanisms that may mediate this sex difference. This study highlights the complexities of measuring gender and the importance of assessing AE separately for males and females to better understand how vaccination strategies can be tailored to different subsets of the population.
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Affiliation(s)
| | - Kumba Seddu
- Johns Hopkins Bloomberg School of Public Health
| | | | - John S Lee
- Johns Hopkins Bloomberg School of Public Health
| | | | - Anna Yin
- Johns Hopkins Bloomberg School of Public Health
| | | | - Helen Kuo
- Johns Hopkins Bloomberg School of Public Health
| | - Huifen Li
- Johns Hopkins University School of Medicine
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23
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Creisher PS, Seddu K, Mueller AL, Klein SL. Biological Sex and Pregnancy Affect Influenza Pathogenesis and Vaccination. Curr Top Microbiol Immunol 2023; 441:111-137. [PMID: 37695427 DOI: 10.1007/978-3-031-35139-6_5] [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: 09/12/2023]
Abstract
Males and females differ in the outcome of influenza A virus (IAV) infections, which depends significantly on age. During seasonal influenza epidemics, young children (< 5 years of age) and aged adults (65+ years of age) are at greatest risk for severe disease, and among these age groups, males tend to suffer a worse outcome from IAV infection than females. Following infection with pandemic strains of IAVs, females of reproductive ages (i.e., 15-49 years of age) experience a worse outcome than their male counterparts. Although females of reproductive ages experience worse outcomes from IAV infection, females typically have greater immune responses to influenza vaccination as compared with males. Among females of reproductive ages, pregnancy is one factor linked to an increased risk of severe outcome of influenza. Small animal models of influenza virus infection and vaccination illustrate that immune responses and repair of damaged tissue following IAV infection also differ between the sexes and impact the outcome of infection. There is growing evidence that sex steroid hormones, including estrogens, progesterone, and testosterone, directly impact immune responses during IAV infection and vaccination. Greater consideration of the combined effects of sex and age as biological variables in epidemiological, clinical, and animal studies of influenza pathogenesis is needed.
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Affiliation(s)
- Patrick S Creisher
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, United States
| | - Kumba Seddu
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, United States
| | - Alice L Mueller
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, United States
| | - Sabra L Klein
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, United States.
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24
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St Clair LA, Chaulagain S, Klein SL, Benn CS, Flanagan KL. Sex-Differential and Non-specific Effects of Vaccines Over the Life Course. Curr Top Microbiol Immunol 2023; 441:225-251. [PMID: 37695431 PMCID: PMC10917449 DOI: 10.1007/978-3-031-35139-6_9] [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] [Indexed: 09/12/2023]
Abstract
Biological sex and age have profound effects on immune responses throughout the lifespan and impact vaccine acceptance, responses, and outcomes. Mounting evidence from epidemiological, clinical, and animal model studies show that males and females respond differentially to vaccination throughout the lifespan. Within age groups, females tend to produce greater vaccine-induced immune responses than males, with sex differences apparent across all age groups, but are most pronounced among reproductive aged individuals. Females report more adverse effects following vaccination than males. Females, especially among children under 5 years of age, also experience more non-specific effects of vaccination. Despite these known sex- and age-specific differences in vaccine-induced immune responses and outcomes, sex and age are often ignored in vaccine research. Herein, we review the known sex differences in the immunogenicity, effectiveness, reactogenicity, and non-specific effects of vaccination over the lifespan. Ways in which these data can be leveraged to improve vaccine research are described.
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Affiliation(s)
- Laura A St Clair
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabal Chaulagain
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christine Stabell Benn
- Institute of Clinical Research and Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark
| | - Katie L Flanagan
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, TAS, Australia.
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25
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Vijayasingham L, Heidari S, Munro J, Omer S, MacDonald N. Resolving sex and gender bias in COVID-19 vaccines R&D and beyond. Hum Vaccin Immunother 2022; 18:2035142. [PMID: 35143380 PMCID: PMC9009935 DOI: 10.1080/21645515.2022.2035142] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The influence of sex and gender in immune response and vaccine outcomes is established in many disease areas, including in COVID-19. Yet, there are notable gaps in the consideration of sex and gender in the analysis and reporting of COVID-19 vaccines clinical trial data. The push for stronger sex and gender integration in vaccines science should be championed by all researchers and stakeholders across the R&D and access ecosystem - not just gender experts. This requires joint action on the tactical framing of customized value propositions (based on stakeholder motivations), the stronger enforcement of existing regulation, tools, and commitments, and aligning the overall agenda to parallel calls on intersectionality, equity diversity and inclusion.
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Affiliation(s)
- Lavanya Vijayasingham
- Gender and Health Hub, United Nations University- International Institute for Global Health, Kuala Lumpur, Malaysia
- CONTACT Lavanya Vijayasingham Gender and Health Hub, United Nations University- International Institute for Global Health, UKM Medical Centre, Jalan Yaacob Latif, 56000 Kuala Lumpur, Malaysia
| | - Shirin Heidari
- GENDRO, Geneva, Switzerland
- Global Health Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Jean Munro
- Gender Equality, GAVI Vaccine Alliance, Geneva, Switzerland
| | - Saad Omer
- Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Noni MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
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26
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Riad A, Alsaad SS, Almurikhi AA, Alzahrani FA, Alghamdi AM, Alzaid EH, Klugar M. Side Effects of COVID-19 Vaccines Primer Doses: Experience of Saudi Healthcare Workers Participating in CoVaST-SA. Vaccines (Basel) 2022; 10:2137. [PMID: 36560547 PMCID: PMC9788140 DOI: 10.3390/vaccines10122137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Side effects emerging after COVID-19 vaccines may adversely impact public confidence in vaccines. Therefore, this study was designed to explore the short-term side effects of COVID-19 vaccines as a part of the COVID-19 Vaccines Safety Tracking (CoVaST) study. METHODS A cross-sectional survey-based study was carried out to collect data from healthcare workers (HCWs) in Saudi Arabia. The study was initiated between June and December 2021. A validated questionnaire was used in this study consisting of four categories, including demographic characteristics and medical anamnesis of the participants, COVID-19-associated anamnesis, and side effects of vaccine uptake. RESULTS The study included 1039 participants, of which 70.2% were females, and their median age was 34. About 82.9% and 52.3% of the participants reported a minimum of both one local and systemic side effect, respectively. Females, young participants (≤34 years old), and non-obese participants had more potential to disclose post-vaccination side effects than their counterparts. Heterologous schedules and viral vector-based vaccines were linked with a greater rate of systemic side effects, whereas homologous vaccination schedules and mRNA-based vaccines were linked with a greater rate of local side effects. CONCLUSION Future studies on COVID-19 vaccines should focus on the role of BMI, previous infection, and vaccination schedule in terms of vaccine safety and reactogenicity.
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Affiliation(s)
- Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
| | - Safa S. Alsaad
- Department of Family Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Ali A. Almurikhi
- Department of Family Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Fayez A. Alzahrani
- Department of Family Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Ali M. Alghamdi
- Department of Infectious Diseases, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Esra H. Alzaid
- Department of Family Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
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Szőllősi GJ, Minh NC, Pataki J, Santoso CM, Nagy AC, Kardos L. Influenza Vaccination Coverage and Its Predictors among Self-Reported Diabetic Patients-Findings from the Hungarian Implementation of the European Health Interview Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16289. [PMID: 36498357 PMCID: PMC9736192 DOI: 10.3390/ijerph192316289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/27/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
In high-risk populations, such as the elderly or those with serious medical issues, for instance, people with cardiovascular diseases or diabetes, influenza can have devastating effects because it might contribute to severe complications or even death. This makes vaccination against influenza an essential component of public health. The primary objective of our research was to identify the characteristics that influenced whether an individual chose to become vaccinated against influenza, with an emphasis on whether they reported having diabetes. The data were obtained from the Hungarian implementation of the European Health Interview Surveys, which were conducted in 2009, 2014, and 2019. The total sample size was 15,874 people. To determine the variables that were related to vaccination, a multivariate logistic regression analysis that included interactions was performed. The overall vaccination coverage was 13% in 2009 and 12% in 2014 and 2019 among non-diabetic respondents; the coverage was 26% in 2009, 28% in 2014, and 25% in 2019 among diabetic respondents. Despite vaccination coverage in both groups being below the optimal level of 75%, we were able to identify factors influencing vaccination coverage. Among diabetic respondents, younger age, lower education level, sex, and co-morbidities were factors that influenced vaccination status. It is important for authorities managing healthcare and medical practitioners to be aware of the potential effects that influenza can have on diabetic patients; therefore, more efforts need to be made to increase the number of diabetic people receiving a vaccination against influenza.
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Mordant FL, Price OH, Rudraraju R, Slavin MA, Marshall C, Worth LJ, Peck H, Barr IG, Sullivan SG, Subbarao K. Antibody titres elicited by the 2018 seasonal inactivated influenza vaccine decline by 3 months post-vaccination but persist for at least 6 months. Influenza Other Respir Viruses 2022; 17:e13072. [PMID: 36451293 PMCID: PMC9835415 DOI: 10.1111/irv.13072] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In Australia, seasonal inactivated influenza vaccine is typically offered in April. However, the onset, peak and end of a typical influenza season vary, and optimal timing for vaccination remains unclear. Here, we investigated vaccine-induced antibody response kinetics over 6 months in different age groups. METHODS We conducted a prospective serosurvey among 71 adults aged 18-50 years, 15 community-dwelling ('healthy') and 16 aged-care facility resident ('frail') older adults aged ≥65 years who received the 2018 southern hemisphere vaccines. Sera were collected at baseline, and 1, 2, 4, and 6 months post-vaccination. Antibody titres were measured by haemagglutination inhibition or microneutralisation assays. Geometric mean titres were estimated using random effects regression modelling and superimposed on 2014-2018 influenza season epidemic curves. RESULTS Antibody titres peaked 1.2-1.3 months post-vaccination for all viruses, declined by 3 months post-vaccination but, notably, persisted above baseline after 6 months in all age groups by 1.3- to 1.5-fold against A(H1N1)pdm09, 1.7- to 2-fold against A(H3N2), 1.7- to 2.1-fold against B/Yamagata and 1.8-fold against B/Victoria. Antibody kinetics were similar among different age groups. Antibody responses were poor against cell-culture grown compared to egg-grown viruses. CONCLUSIONS These results suggest subtype-specific antibody-mediated protection persists for at least 6 months, which corresponds to the duration of a typical influenza season.
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Affiliation(s)
- Francesca L. Mordant
- Department of Microbiology and ImmunologyUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Olivia H. Price
- World Health Organization Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Rajeev Rudraraju
- Department of Microbiology and ImmunologyUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Monica A. Slavin
- Department of Infectious Diseases and Infection PreventionPeter MacCallum Cancer CentreMelbourneAustralia,National Centre for Infections in Cancer (NCIC), Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneAustralia,Immunocompromised Host Infection ServiceRoyal Melbourne HospitalMelbourneAustralia,Department of Infectious DiseasesUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Caroline Marshall
- Department of Infectious DiseasesUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Infection Prevention and Surveillance ServiceMelbourne HealthMelbourneAustralia
| | - Leon J. Worth
- Department of Infectious Diseases and Infection PreventionPeter MacCallum Cancer CentreMelbourneAustralia,National Centre for Infections in Cancer (NCIC), Sir Peter MacCallum Department of OncologyUniversity of MelbourneMelbourneAustralia,Victorian Healthcare Associated Infection Surveillance System (VICNISS)Royal Melbourne Hospital at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Heidi Peck
- World Health Organization Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Ian G. Barr
- Department of Microbiology and ImmunologyUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,World Health Organization Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Sheena G. Sullivan
- World Health Organization Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,Department of Infectious DiseasesUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | - Kanta Subbarao
- Department of Microbiology and ImmunologyUniversity of Melbourne at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia,World Health Organization Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
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Distinct immunological and molecular signatures underpinning influenza vaccine responsiveness in the elderly. Nat Commun 2022; 13:6894. [PMID: 36371426 PMCID: PMC9653450 DOI: 10.1038/s41467-022-34487-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
Seasonal influenza outbreaks, especially in high-risk groups such as the elderly, represent an important public health problem. Prevailing inadequate efficacy of seasonal vaccines is a crucial bottleneck. Understanding the immunological and molecular mechanisms underpinning differential influenza vaccine responsiveness is essential to improve vaccination strategies. Here we show comprehensive characterization of the immune response of randomly selected elderly participants (≥ 65 years), immunized with the adjuvanted influenza vaccine Fluad. In-depth analyses by serology, multi-parametric flow cytometry, multiplex and transcriptome analysis, coupled to bioinformatics and mathematical modelling, reveal distinguishing immunological and molecular features between responders and non-responders defined by vaccine-induced seroconversion. Non-responders are specifically characterized by multiple suppressive immune mechanisms. The generated comprehensive high dimensional dataset enables the identification of putative mechanisms and nodes responsible for vaccine non-responsiveness independently of confounding age-related effects, with the potential to facilitate development of tailored vaccination strategies for the elderly.
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Forst CV, Chung M, Hockman M, Lashua L, Adney E, Hickey A, Carlock M, Ross T, Ghedin E, Gresham D. Vaccination History, Body Mass Index, Age, and Baseline Gene Expression Predict Influenza Vaccination Outcomes. Viruses 2022; 14:2446. [PMID: 36366544 PMCID: PMC9697051 DOI: 10.3390/v14112446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Seasonal influenza is a primary public health burden in the USA and globally. Annual vaccination programs are designed on the basis of circulating influenza viral strains. However, the effectiveness of the seasonal influenza vaccine is highly variable between seasons and among individuals. A number of factors are known to influence vaccination effectiveness including age, sex, and comorbidities. Here, we sought to determine whether whole blood gene expression profiling prior to vaccination is informative about pre-existing immunological status and the immunological response to vaccine. We performed whole transcriptome analysis using RNA sequencing (RNAseq) of whole blood samples obtained prior to vaccination from 275 participants enrolled in an annual influenza vaccine trial. Serological status prior to vaccination and 28 days following vaccination was assessed using the hemagglutination inhibition assay (HAI) to define baseline immune status and the response to vaccination. We find evidence that genes with immunological functions are increased in expression in individuals with higher pre-existing immunity and in those individuals who mount a greater response to vaccination. Using a random forest model, we find that this set of genes can be used to predict vaccine response with a performance similar to a model that incorporates physiological and prior vaccination status alone. A model using both gene expression and physiological factors has the greatest predictive power demonstrating the potential utility of molecular profiling for enhancing prediction of vaccine response. Moreover, expression of genes that are associated with enhanced vaccination response may point to additional biological pathways that contribute to mounting a robust immunological response to the seasonal influenza vaccine.
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Affiliation(s)
- Christian V. Forst
- Department of Genetics and Genomic Sciences, Department of Microbiology, Icahn School of Medicine at Mt Sinai, One Gustave L. Levy Place, Box 1498, New York, NY 10029-6574, USA
| | - Matthew Chung
- Systems Genomics Section, Laboratory of Parasitic Diseases, NIAID, NIH, Bethesda, MD 20894, USA
| | - Megan Hockman
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
| | - Lauren Lashua
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
| | - Emily Adney
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
| | - Angela Hickey
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
| | - Michael Carlock
- Center for Vaccines and Immunology, University of Georgia, Athens, GA 30602, USA
- Department of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
| | - Ted Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA 30602, USA
- Department of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
| | - Elodie Ghedin
- Systems Genomics Section, Laboratory of Parasitic Diseases, NIAID, NIH, Bethesda, MD 20894, USA
| | - David Gresham
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
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Kouthouridis S, Robson E, Hartung A, Raha S, Zhang B. Se(XY) matters: the importance of incorporating sex in microphysiological models. Trends Biotechnol 2022; 40:1284-1298. [PMID: 35597689 DOI: 10.1016/j.tibtech.2022.04.005] [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: 01/13/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 01/21/2023]
Abstract
The development of microphysiological models is currently at the forefront of preclinical research. Although these 3D tissue models are being developed to mimic physiological organ function and diseases, which are often sexually dimorphic, sex is usually neglected as a biological variable. For decades, national research agencies have required government-funded clinical trials to include both male and female participants as a means of eliminating male bias. However, this is not the case in preclinical trials, which have been shown to favor male rodents in animal studies and male cell types in in vitro studies. In this Opinion, we highlight the importance of considering sex as a biological variable and outline five approaches for incorporating sex-specific features into current microphysiological models.
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Affiliation(s)
- Sonya Kouthouridis
- Department of Chemical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Eleanor Robson
- Department of Chemical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Alicia Hartung
- Department of Chemical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada; School of Biomedical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Sandeep Raha
- Department of Pediatrics, McMaster University, Hamilton, ON, L8S 4L8, Canada; Graduate Program in Medical Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada.
| | - Boyang Zhang
- Department of Chemical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada; School of Biomedical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada.
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Nassar MK, Salem KM, Elgamal M, Abdel-Gawad SM, Tharwat S. COVID-19 Vaccination Trends and Side Effects among Egyptian Hemodialysis Patients: A Multicenter Survey Study. Vaccines (Basel) 2022; 10:vaccines10101771. [PMID: 36298635 PMCID: PMC9611711 DOI: 10.3390/vaccines10101771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 01/24/2023] Open
Abstract
(1) Background: Vaccination may be a key intervention to prevent infection in chronic hemodialysis (CHD) patients. This study aimed to determine the COVID-19 vaccination status in Egyptian CHD patients and to analyze the safety and detailed side effect profile of the COVID-19 vaccine among these patients. (2) Methods: This survey-based study was conducted on 670 end-stage renal disease (ESRD) patients on CHD from 3 December 2021 to 5 February 2022. Subjects were asked about sociodemographic characteristics, clinical and therapeutic data, in addition to their COVID-19 vaccination status. If the subject had been vaccinated, we inquired about the type of vaccine and the side effects that occurred within a few days after administration of the first and second dose of the COVID-19 vaccine. Additionally, subjects were asked about the onset of side effects (days from vaccination), timing of maximum symptoms, intensity of symptoms and their effect on activity and need for medical attention. (3) Results: The study included 670 CHD patients with a mean age of 50.79 years; 58.1% were females. The vast majority (614; 91.6%) of the studied patients received two doses of the vaccine. Side effects were more commonly reported after the first dose than the second dose. The main side effects reported were generalized weakness/fatigue (56%), headache (43.8%) and fever (40.4%), and sore arm/pain was also reported (29.3%). Adverse events mostly occurred within one day after vaccination and the maximum symptoms usually happened on the second day. The median duration of symptoms was 3 days with a maximum duration up to 5 days. The univariate logistic regression analysis showed that male gender (OR 1.848; (95% CI, 1.242−2.749), p = 0.002), age (OR 0.981; (95% CI, 0.969−0.993), p = 0.003), smoking (OR 6.067; (95% CI, 3.514−10.475), p < 0.001), duration since starting HD (OR 0.998; (95% CI, 0.998−0.999), p < 0.001), associated comorbidities (OR 2.202; (95% CI, 1.478−3.281), p < 0.001) and prior COVID-19 infection (OR 3.318; (95% CI, 1.952−5.642), p < 0.001) were the main determinants of adverse events related to COVID-19 vaccination. (4) Conclusions: our preliminary findings support the favorable short-term safety profile of the COVID-19 vaccine among CHD patients, and hence can reassure both clinicians and patients, as well as further promote COVID-19 vaccine administration among these patients.
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Affiliation(s)
- Mohammed Kamal Nassar
- Mansoura Nephrology & Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
| | - Karem Mohamed Salem
- Nephrology & Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum 63511, Egypt
| | - Mohamed Elgamal
- Chest Department, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
| | - Sara M. Abdel-Gawad
- Mansoura Nephrology and Dialysis Unit (MNDU), Mansoura University, Mansoura 35511, Egypt
| | - Samar Tharwat
- Rheumatology & Immunology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
- Correspondence: ; Tel.: +20-010-9178-4143
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Collatuzzo G, Visci G, Violante FS, Porru S, Spiteri G, Monaco MGL, Larese Fillon F, Negro C, Janke C, Castelletti N, De Palma G, Sansone E, Mates D, Teodorescu S, Fabiánová E, Bérešová J, Vimercati L, Tafuri S, Abedini M, Ditano G, Asafo SS, Boffetta P. Determinants of anti-S immune response at 6 months after COVID-19 vaccination in a multicentric European cohort of healthcare workers – ORCHESTRA project. Front Immunol 2022; 13:986085. [PMID: 36248889 PMCID: PMC9559243 DOI: 10.3389/fimmu.2022.986085] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe duration of immune response to COVID-19 vaccination is of major interest. Our aim was to analyze the determinants of anti-SARS-CoV-2 IgG titer at 6 months after 2-dose vaccination in an international cohort of vaccinated healthcare workers (HCWs).MethodsWe analyzed data on levels of anti-SARS-CoV-2 Spike antibodies and sociodemographic and clinical characteristics of 6,327 vaccinated HCWs from 8 centers from Germany, Italy, Romania and Slovakia. Time between 1st dose and serology ranged 150-210 days. Serological levels were log-transformed to account for the skewness of the distribution and normalized by dividing them by center-specific standard errors, obtaining standardized values. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of 1 standard deviation of log antibody level and corresponding 95% confidence interval (CI), and finally combined them in random-effects meta-analyses.ResultsA 6-month serological response was detected in 99.6% of HCWs. Female sex (RR 1.10, 95%CI 1.00-1.21), past infection (RR 2.26, 95%CI 1.73-2.95) and two vaccine doses (RR 1.50, 95%CI 1.22-1.84) predicted higher IgG titer, contrary to interval since last dose (RR for 10-day increase 0.94, 95%CI 0.91-0.97) and age (RR for 10-year increase 0.87, 95%CI 0.83-0.92). M-RNA-based vaccines (p<0.001) and heterologous vaccination (RR 2.46, 95%CI 1.87-3.24, one cohort) were associated with increased antibody levels.ConclusionsFemale gender, young age, past infection, two vaccine doses, and m-RNA and heterologous vaccination predicted higher antibody level at 6 months. These results corroborate previous findings and offer valuable data for comparison with trends observed with longer follow-ups.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Gianluca Spiteri
- Clinical Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy
| | | | | | - Corrado Negro
- Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University (LMU) Klinikum, Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University (LMU) Klinikum, Munich, Germany
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - Jana Bérešová
- Epidemiology Department, Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Shuffield S. Asafo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States
- *Correspondence: Paolo Boffetta,
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Sarfraz A, Sarfraz Z, Sarfraz M, Nadeem Z, Felix M, Cherrez-Ojeda I. Menstrual irregularities following COVID-19 vaccination: A global cross-sectional survey. Ann Med Surg (Lond) 2022; 81:104220. [PMID: 35957648 PMCID: PMC9356761 DOI: 10.1016/j.amsu.2022.104220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Azza Sarfraz
- The Aga Khan University, Karachi, Pakistan
- Corresponding author. Department of Pediatrics and Child Health, Faculty Office Building, Aga Khan University, P.O. Box: 3500, Stadium Road, Karachi, 74800, Pakistan.
| | - Zouina Sarfraz
- Fatima Jinnah Medical University, Lahore, Pakistan
- Corresponding author. Fatima Jinnah Medical University, Queen's Road, Mozang Chungi, Lahore, Punjab, 54000, Pakistan.
| | | | | | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
| | - Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador
- Respiralab, Respiralab Research Group, Guayaquil, Ecuador
- Corresponding author. Universidad Espíritu Santo, Km. 2Vía La Puntilla, Samborondón, 0901, Ecuador.
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Active Safety Surveillance of Four Types of COVID-19 Vaccines: A National Study from Jordan. Clin Drug Investig 2022; 42:813-827. [PMID: 35999428 PMCID: PMC9398044 DOI: 10.1007/s40261-022-01191-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 12/23/2022]
Abstract
Background Although the Pfizer-BioNTech (BNT162b2), Oxford-AstraZeneca (ChAdOx1 nCoV-19), Sinopharm (BBIBP-CorV), and Sputnik V coronavirus disease 2019 (COVID-19) vaccines have been granted emergency approval in many nations, their safety has never been studied and compared in one community-based study. This study aimed to investigate and compare the incidence, nature, severity, and predictors of adverse events following immunization (AEFIs) with COVID-19 vaccines. Method This was a prospective observational study conducted in Jordan between 1 January and 21 September 2021. A team of pharmacists and nurses (n = 407) collected the local and systemic AEFIs of four COVID-19 vaccines by prospectively contacting participants registered in the national vaccination program platform. A red-flag technology was inserted to classify and track rare and serious AEFIs. Results This study included 658,428 participants who were vaccinated with 1,032,430 doses; 610,591, 279,606, 140,843, and 1390 participants received the first and second doses of the BNT162b2, BBIBP-CorV, ChAdOx1 nCoV-19, and Sputnik V vaccines, respectively. The overall incidence of AEFIs was 28.8%, and the overall rates of systemic, local, and immediate hypersensitivity AEFIs were 22.2%, 18.8%, and 0.5%, respectively. The highest proportions of immediate hypersensitivity AEFIs and systemic AEFIs were reported after administration of the Sputnik V vaccine and ChAdOx1 nCoV-19 first dose, respectively. The most severe AEFIs were reported after ChAdOx1 nCoV-19 first dose and BNT162b2 second dose. The hospitalization and mortality rates after vaccination were 20 in 10,000 and 1 in 10,000, respectively. Based on red-flag tracking, the top three outcome events were lymphadenopathy (157.9/100,000), anxiety disorders (136.6/100,000), and lower respiratory tract infection (100.9/100,000), with Guillain-Barré syndrome (1.8/100,000), vasculitis (3.0/100,000), and myopericarditis (4.8/100,000) being the least common. Conclusion The incidence rates of local, systemic, and immediate hypersensitivity AEFIs of four COVID-19 vaccines occur frequently. High incidence rates of rare and serious AEFIs were reported in this study. Younger participants, females, those who had previously had COVID-19, and smokers were more likely to encounter AEFIs. Supplementary Information The online version contains supplementary material available at 10.1007/s40261-022-01191-1.
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Attitudes toward Receiving COVID-19 Booster Dose in the Middle East and North Africa (MENA) Region: A Cross-Sectional Study of 3041 Fully Vaccinated Participants. Vaccines (Basel) 2022; 10:vaccines10081270. [PMID: 36016158 PMCID: PMC9414713 DOI: 10.3390/vaccines10081270] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 01/14/2023] Open
Abstract
COVID-19 vaccines are crucial to control the pandemic and avoid COVID-19 severe infections. The rapid evolution of COVID-19 variants such as B.1.1.529 is alarming, especially with the gradual decrease in serum antibody levels in vaccinated individuals. Middle Eastern countries were less likely to accept the initial doses of vaccines. This study was directed to determine COVID-19 vaccine booster acceptance and its associated factors in the general population in the MENA region to attain public herd immunity. We conducted an online survey in five countries (Egypt, Iraq, Palestine, Saudi Arabia, and Sudan) in November and December 2021. The questionnaire included self-reported information about the vaccine type, side effects, fear level, and several demographic factors. Kruskal−Wallis ANOVA was used to associate the fear level with the type of COVID-19 vaccine. Logistic regression was performed to confirm the results and reported as odds ratios (ORs) and 95% confidence intervals. The final analysis included 3041 fully vaccinated participants. Overall, 60.2% of the respondents reported willingness to receive the COVID-19 booster dose, while 20.4% were hesitant. Safety uncertainties and opinions that the booster dose is not necessary were the primary reasons for refusing the booster dose. The willingness to receive the booster dose was in a triangular relationship with the side effects of first and second doses and the fear (p < 0.0001). Females, individuals with normal body mass index, history of COVID-19 infection, and influenza-unvaccinated individuals were significantly associated with declining the booster dose. Higher fear levels were observed in females, rural citizens, and chronic and immunosuppressed patients. Our results suggest that vaccine hesitancy and fear in several highlighted groups continue to be challenges for healthcare providers, necessitating public health intervention, prioritizing the need for targeted awareness campaigns, and facilitating the spread of evidence-based scientific communication.
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Correlation between Adverse Events and Antibody Titers among Healthcare Workers Vaccinated with BNT162b2 mRNA COVID-19 Vaccine. Vaccines (Basel) 2022; 10:vaccines10081220. [PMID: 36016109 PMCID: PMC9412348 DOI: 10.3390/vaccines10081220] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/20/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives: The BNT162b2 mRNA COVID-19 vaccine has been found to be highly effective in preventing COVID-19 but is associated with increased reactogenicity. We aimed to examine the correlation between immunogenicity and reactogenicity of the BNT162b2 vaccine. Methods: Subjects without prior SARS-CoV-2 infection that participated in active surveillance after being vaccinated with the BNT162b2 vaccine were included. Study participants reported adverse drug reactions (ADRs) through questionnaires administered by text message after receiving each dose of the vaccine. A reactogenicity score was developed based on the type and duration of ADRs. In addition, anti-receptor binding domain (RBD) levels and neutralization assays were performed 7−21 and 7−38 days after the first and second vaccine doses, respectively. Associations between ADRs and antibody levels were assessed by Spearman correlations. Multivariable logistic regression analyses were used to identify factors associated with ADRs. Results: A total of 831 health care workers were included. The mean age was 46.5 years (SD = 11.8) and 75.5% were females. 83.4% and 83.3% had at least one local ADR after the first and second doses, respectively. 33% and 83.2% had at least one systemic ADR after the first and second doses, respectively. Multivariate logistic regression analysis found a significant correlation between ADR score and anti-RBD-IgG titers (r = 0.366; p < 0.0001) after adjustment for age, gender, and days after the second vaccination. High anti-RBD-IgG levels, being younger than 55 and being female, were all correlated with increased rates of ADRs. Conclusion: BNT162b2 mRNA COVID-19 vaccine reactogenicity appears to be correlated with higher post-vaccination antibody levels and is independently associated with younger age and female gender.
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Szőllősi GJ, Minh NC, Santoso CMA, Zsuga J, Nagy AC, Kardos L. An Exploratory Assessment of Factors with Which Influenza Vaccine Uptake Is Associated in Hungarian Adults 65 Years Old and Older: Findings from European Health Interview Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127545. [PMID: 35742792 PMCID: PMC9224319 DOI: 10.3390/ijerph19127545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023]
Abstract
Influenza vaccination is an imperative public health task for elderly people due to a higher risk of developing more severe complications. The main aim of our study was to determine the influencing factors of being vaccinated against influenza among subjects aged 65 and above. Data were from the Hungarian implementations of the European Health Interview Survey 2009, 2014 and 2019 studies with a final sample size of 3355. A multivariate logistic regression model with interactions was used to identify the possible factors associated with vaccination. Approximately 32% of the participants were vaccinated for the most recent influenza season. The most important factors were identified that contributed to influenza vaccination among individuals, which were the following: educational attainment, having a partner, the annual frequency of specialist and doctor visits, and having comorbidities. Respondents who thought that they could do a lot for their health had higher odds of being immunized. Being obese seemed to be a risk factor. According to our findings, the current influenza vaccination coverage was considered as low in Hungary; hence, the implementation of minor reformulations in the field of health policy is suggested.
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Affiliation(s)
- Gergő József Szőllősi
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
- Correspondence:
| | - Nguyen Chau Minh
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
| | - Cornelia Melinda Adi Santoso
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
| | - Judit Zsuga
- Department of Habilitational Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary;
| | - Attila Csaba Nagy
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary; (N.C.M.); (C.M.A.S.); (A.C.N.)
| | - László Kardos
- Department of Biostatistics and Bioinformatics, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary;
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Ohm M, Boef AGC, Stoof SP, van Ravenhorst MB, van der Klis FRM, Berbers GAM, Knol MJ. Sex-Related Differences in the Immune Response to Meningococcal Vaccinations During Adolescence. Front Public Health 2022; 10:871670. [PMID: 35602158 PMCID: PMC9120633 DOI: 10.3389/fpubh.2022.871670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Immune responses to pediatric vaccinations have been reported to differ according to sex. Such sex-differential responses may become more pronounced during adolescence due to hormonal differences. We investigated whether the vaccine response following primary vaccination against meningococcal serogroup A (MenA), MenW and MenY and booster vaccination against MenC differed between girls and boys using data from two clinical studies. Methods Children aged 10, 12, and 15 years, who had been primed with MenC vaccination between 14 months and 6 years of age, received a booster MenC vaccination or MenACWY vaccination. Polysaccharide-specific IgG concentrations and functional antibody titers [determined with the serum bactericidal antibody (SBA) assay] were measured at baseline, 1 month, 1 year, and 3 years (only MenC group) after vaccination. We calculated geometric mean concentrations and titers (GMC and GMT) ratios for girls vs. boys adjusted for age group. Additionally, we compared the proportion protected individuals between girls and boys at all timepoints. Results This study included 342 girls and 327 boys from two clinical trials. While MenAWY antibody levels did not differ consistently 1 month after vaccination, all GMC- and GMT-ratios were in favor of girls 1 year after vaccination [range: 1.31 (1.02–1.70) for MenA IgG to 1.54 (1.10–2.16) for MenW IgG]. Overall, MenC antibody levels were slightly higher in girls at all postvaccination timepoints (GMC- and GMT-ratios: 1.16/1.17 at 1 month, 1.16/1.22 at 1 year and 1.12/1.15 3 years postvaccination). Higher MenC antibody levels were observed in 12- and 15-year-old girls compared to boys of the same age, whereas 10-year-old boys and girls had similar antibody levels. The percentage of participants protected (SBA titer ≥ 8) was very high (95–100%) at all timepoints, and did not differ significantly between boys and girls. Conclusion Antibody responses were higher in girls than in boys for all serogroups at most timepoints after primary MenAWY vaccination and booster MenC vaccination. The differences in average titers were however small and the percentage participants with protective titers was very high for both sexes.
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Age and sex associations of SARS-CoV-2 antibody responses post BNT162b2 vaccination in healthcare workers: A mixed effects model across two vaccination periods. PLoS One 2022; 17:e0266958. [PMID: 35486622 PMCID: PMC9053797 DOI: 10.1371/journal.pone.0266958] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/30/2022] [Indexed: 12/27/2022] Open
Abstract
This study aimed to examine the associations with epidemiological, behavioral and clinical parameters of IgG antibody responses against the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after immunization with two doses of the BNT162b2 vaccine in a cohort of healthcare workers (HCWs, n = 439) in Greece. We used a mixed effects model to investigate the potential associations of antibody levels one and three months after vaccination and examined by bootstrapping t-tests the putative effects of gender and age for each period. We also employed exact tests of independence in R × C contingency tables to explore associations between behavioral and gender variables with vaccinations side effects. We found significant differences between males and females as well as between subjects in the youngest (21–30 years) and the older age groups in both study periods. We also detected a decrease in titers with age and time. Males had steeper elimination rates across the age span in both periods, in contrast to females who exhibited a softer elimination titer rate with age in the first period and almost constant titers in the second. Concerning side effects, we found a significant association between pain at the injection site and female sex. Hence, our real-world data analyses revealed potentially important clues into the associations of antibody responses to SARS-CoV-2 spike. We discuss the importance of these findings in view of current mass vaccination perspectives and provide useful clues for the design and optimal timing of booster doses for COVID-19.
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Skowronski DM, Setayeshgar S, Zou M, Prystajecky N, Tyson JR, Galanis E, Naus M, Patrick DM, Sbihi H, El Adam S, Henry B, Hoang LMN, Sadarangani M, Jassem AN, Krajden M. Single-dose mRNA Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Including Alpha and Gamma Variants: A Test-negative Design in Adults 70 Years and Older in British Columbia, Canada. Clin Infect Dis 2022; 74:1158-1165. [PMID: 34244723 PMCID: PMC8406884 DOI: 10.1093/cid/ciab616] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Randomized-controlled trials of messenger RNA (mRNA) vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) included relatively few elderly participants. We assess single-dose mRNA vaccine effectiveness (VE) in adults ≥ 70 years old in British Columbia, Canada, where second doses were deferred by up to 16 weeks and where a spring 2021 wave uniquely included codominant circulation of Alpha (B.1.1.7) and Gamma (P.1) variants of concern (VOC). METHODS Analyses included community-dwelling adults ≥ 70 years old with specimen collection between 4 April (epidemiological week 14) and 1 May (week 17) 2021. Adjusted VE was estimated by test-negative design. Cases were reverse-transcription polymerase chain reaction (RT-PCR) test-positive for SARS-CoV-2, and controls were test-negative. Vaccine status was defined by receipt of a single-dose ≥ 21 days before specimen collection, but a range of intervals was assessed. Variant-specific VE was estimated against viruses genetically characterized as Alpha, Gamma or non-VOC lineages. RESULTS VE analyses included 16 993 specimens: 1226 (7%) test-positive cases and 15 767 test-negative controls. Of 1131 (92%) genetically characterized viruses, 509 (45%), 314 (28%), and 276 (24%) were Alpha, Gamma, and non-VOC lineages, respectively. At 0-13 days postvaccination, VE was negligible at 14% (95% confidence interval [CI], 0-26) but increased from 43% (95% CI, 30-53) at 14-20 days to 75% (95% CI, 63-83) at 35-41 days postvaccination. VE at ≥ 21 days postvaccination was 65% (95% CI, 58-71) overall: 72% (95% CI, 58-81), 67% (95% CI, 57-75), and 61% (95% CI, 45-72) for non-VOC, Alpha, and Gamma variants, respectively. CONCLUSIONS A single dose of mRNA vaccine reduced the risk of SARS-CoV-2 by about two-thirds in adults ≥ 70 years old, with protection only minimally reduced against Alpha and Gamma variants.
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Affiliation(s)
- Danuta M Skowronski
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Solmaz Setayeshgar
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Macy Zou
- BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Natalie Prystajecky
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - John R Tyson
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Eleni Galanis
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Monika Naus
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - David M Patrick
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
- BC Centre for Disease Control, Data and Analytics Services, Vancouver, British Columbia, Canada
| | - Shiraz El Adam
- BC Centre for Disease Control, Communicable Diseases and Immunization Services, Vancouver, British Columbia, Canada
| | - Bonnie Henry
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
- Office of the Provincial Health Officer, Ministry of Health, Victoria, British Columbia, Canada
| | - Linda M N Hoang
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- BC Children's Hospital Research Institute, Vaccine Evaluation Center, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pediatrics, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
| | - Mel Krajden
- BC Centre for Disease Control, Public Health Laboratory, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, British Columbia, Canada
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Nachtigall I, Bonsignore M, Hohenstein S, Bollmann A, Günther R, Kodde C, Englisch M, Ahmad-Nejad P, Schröder A, Glenz C, Kuhlen R, Thürmann P, Meier-Hellmann A. Effect of gender, age and vaccine on reactogenicity and incapacity to work after COVID-19 vaccination: a survey among health care workers. BMC Infect Dis 2022; 22:291. [PMID: 35346089 PMCID: PMC8960217 DOI: 10.1186/s12879-022-07284-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/15/2022] [Indexed: 01/14/2023] Open
Abstract
Abstract
Background
The aim of our study was to assess the impact the impact of gender and age on reactogenicity to three COVID-19 vaccine products: Biontech/Pfizer (BNT162b2), Moderna (mRNA-1273) and AstraZeneca (ChAdOx). Additional analyses focused on the reduction in working capacity after vaccination and the influence of the time of day when vaccines were administered.
Methods
We conducted a survey on COVID-19 vaccinations and eventual reactions among 73,000 employees of 89 hospitals of the Helios Group. On May 19th, 2021 all employees received an email, inviting all employees who received at least 1 dose of a COVID-19 to participate using an attached link. Additionally, the invitation was posted in the group’s intranet page. Participation was voluntary and non-traceable. The survey was closed on June 21st, 2021.
Results
8375 participants reported on 16,727 vaccinations. Reactogenicity was reported after 74.6% of COVID-19 vaccinations. After 23.0% vaccinations the capacity to work was affected. ChAdOx induced impairing reactogenicity mainly after the prime vaccination (70.5%), while mRNA-1273 led to more pronounced reactions after the second dose (71.6%). Heterologous prime-booster vaccinations with ChAdOx followed by either mRNA-1273 or BNT162b2 were associated with the highest risk for impairment (81.4%). Multivariable analyses identified the factors older age, male gender and vaccine BNT162b as independently associated with lower odds ratio for both, impairing reactogenicity and incapacity to work. In the comparison of vaccine schedules, the heterologous combination ChAdOx + BNT162b or mRNA-1273 was associated with the highest and the homologue prime-booster vaccination with BNT162b with the lowest odds ratios. The time of vaccination had no significant influence.
Conclusions
Around 75% of the COVID-19 vaccinations led to reactogenicity and nearly 25% of them led to one or more days of work loss. Major risk factors were female gender, younger age and the administration of a vaccine other than BNT162b2. When vaccinating a large part of a workforce against COVID-19, especially in professions with a higher proportion of young and women such as health care, employers and employees must be prepared for a noticeable amount of absenteeism. Assuming vaccine effectiveness to be equivalent across the vaccine combinations, to minimize reactogenicity, employees at risk should receive a homologous prime-booster immunisation with BNT162b2.
Trial registration: The study was approved by the Ethic Committee of the Aerztekammer Berlin on May 27th, 2021 (Eth-37/21) and registered in the German Clinical Trials Register (DRKS 00025745). The study was supported by the Helios research grant HCRI-ID 2021-0272.
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Recio-Román A, Recio-Menéndez M, Román-González MV. Political Populism, Institutional Distrust and Vaccination Uptake: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063265. [PMID: 35328952 PMCID: PMC8955402 DOI: 10.3390/ijerph19063265] [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] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
Politics is ubiquitous in public health, but vaccines had never been weaponized to instill distrust to gain political advantage. In pandemic and post-pandemic scenarios, populist political parties could use vaccine-related issues to generate distrust in evidence-based knowledge. Therefore, some questions arise. What impact could populist political parties impinge on vaccination uptake rates through sowing political discontent? What could the medical institutions do to avoid the adverse effects that these political strategies could infringe? For answering these research questions, we first hypothesized that vaccine uptake was negatively associated with distrust in the institutions. Furthermore, we analyzed whether populism mediates this relationship. In doing so, we hypothesized a positive association between distrust and populism, because populists, mainly fueled by politically discontent citizens, offer hope of a better future, blaming their misfortune on the actions of the elite. Additionally, we hypothesized that those citizens with a higher level of political dissatisfaction, following the claims of the populist political parties, will have lower vaccine uptake results, because they will be discouraged from making the efforts to counter the pandemic. Based on a survey carried out by the European Commission that covered 27 E.U. + U.K. countries (totaling 27,524 respondents), this paper proves that an individual’s political discontent fully mediates the relationship between distrust in institutions and vaccine uptake. Targeting the vaccine-hesitant population is quite convenient for populists because they only need to convince a minority of citizens not to be vaccinated to achieve their destabilizing goals. New outbreaks will appear if the minimum herd immunity coverage is not reached, reinforcing a vicious circle of distrust in elites, in consequence. For tackling this matter, recommendations are given to institutional managers from a social marketing standpoint.
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Kuo H, Shapiro JR, Dhakal S, Morgan R, Fink AL, Liu H, Westerbeck JW, Sylvia KE, Park HS, Ursin RL, Shea P, Shaw-Saliba K, Fenstermacher K, Rothman R, Pekosz A, Klein SL. Sex-specific effects of age and body mass index on antibody responses to seasonal influenza vaccines in healthcare workers. Vaccine 2022; 40:1634-1642. [PMID: 33678455 PMCID: PMC8417149 DOI: 10.1016/j.vaccine.2021.02.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/15/2021] [Accepted: 02/19/2021] [Indexed: 12/15/2022]
Abstract
Healthcare institutions with mandatory influenza vaccination policies have over 90% vaccination rates among healthcare workers (HCWs) resulting in a population that has received the influenza vaccine in many, consecutive years. This study explored the impact of sex and other host factors in pre- and post-vaccination neutralizing antibody (nAb) titers and seroconversion against the H1N1 and H3N2 influenza A viruses (IAVs) among HCWs enrolled into a cross-sectional serosurvey during the annual Johns Hopkins Hospital employee vaccination campaign in the 2017-18 and 2018-19 seasons. The study enrolled 111 participants (male = 38, female = 73) in 2017-18 and 163 (male = 44, female = 119) in 2018-19. Serum samples were collected immediately prior to vaccination and approximately 28 days later and nAb titers to vaccine strains determined. An intersectional approach was used to disaggregate the combined effects of sex with age and body mass index (BMI) in the nAb response. Differences between the pre- or post-vaccination geometric mean nAb titers between male and female HCWs were not observed. Male HCWs were 2.86 times more likely to seroconvert compared to female HCWs in 2017-2018, but the same trend was not observed in the following year. When data were disaggregated by age and sex, older female HCWs had higher H1N1 pre- and post-vaccination nAb titers compared to male HCWs in the same age group for both vaccination campaign seasons. In both years, the decline in H3N2 pre-vaccination titers with increasing BMI was greater in female than male HCW. The sex-specific effects of age and BMI on nAb responses to seasonal influenza vaccines require greater consideration.
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Affiliation(s)
- Helen Kuo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Janna R Shapiro
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Santosh Dhakal
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ashley L Fink
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Hsuan Liu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jason W Westerbeck
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kristyn E Sylvia
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Han-Sol Park
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Rebecca L Ursin
- Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Patrick Shea
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Katherine Fenstermacher
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Sabra L Klein
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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Bohn-Goldbaum E, Cross T, Leeb A, Peters I, Booy R, Edwards KM. Adverse events following influenza immunization: understanding the role of age and sex interactions. Expert Rev Vaccines 2022; 21:415-422. [PMID: 34937488 DOI: 10.1080/14760584.2022.2021075] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Reduction of adverse events following immunization (AEFI) could improve vaccine uptake. Evidence suggests sex and age affect AEFI rates but, with limited understanding of their interaction, groups at higher risk for adverse reaction cannot be identified. RESEARCH DESIGN AND METHODS Using deidentified data (n = 308,481) from Australians receiving influenza vaccinations in the 2020 calendar year, we analyzed the effects of independent predictors (i.e. age and sex), on experiencing an AEFI using logistic regression generalized additive modeling to capture any nonlinear relationships and adjusting for vaccine brand and concomitant vaccination. RESULTS The overall reaction rate was 5.5%. Modeling revealed significant effects of age (p < 0.001), sex (p < 0.001), and age × sex (p < 0.001). Females were more likely than males to experience AEFIs between 7.5 and 87.5 years of age and exhibited peak odds at about 53 years, while peak odds for males occurred in infancy. CONCLUSION The results suggest there is a need for targeting AEFI reduction in females, particularly in 30-70-year-olds, to improve the vaccination experience. The results further suggest that reducing concomitant vaccination and choosing less reactogenic vaccine brands could reduce risk of AEFI, however, retaining concomitant vaccination may optimize vaccine uptake.
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Affiliation(s)
- Erika Bohn-Goldbaum
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Troy Cross
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Alan Leeb
- Illawarra Medical Centre, Ballajura, Western Australia, Australia.,SmartVax, Perth, Western Australia, Australia
| | - Ian Peters
- SmartVax, Perth, Western Australia, Australia.,Datavation, Perth, Western Australia, Australia
| | - Robert Booy
- The Children's Hospital at Westmead, The University of Sydney, Sydney Medical School, Sydney, Australia
| | - Kate M Edwards
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Öztürk BÖ, Akdemir İ, Azap A, Çelik G, Bavbek S, Mungan D. Anaphylaxis is rare due to CoronaVac in a population of healthcare workers. Asia Pac Allergy 2022; 12:e35. [DOI: 10.5415/apallergy.2022.12.e35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Betül Özdel Öztürk
- Division of Allergy and Immunology, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - İrem Akdemir
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Gülfem Çelik
- Division of Allergy and Immunology, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Sevim Bavbek
- Division of Allergy and Immunology, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Dilşad Mungan
- Division of Allergy and Immunology, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
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Papadopoli R, De Sarro C, Palleria C, Gallelli L, Pileggi C, De Sarro G. Serological Response to SARS-CoV-2 Messenger RNA Vaccine: Real-World Evidence from Italian Adult Population. Vaccines (Basel) 2021; 9:1494. [PMID: 34960240 PMCID: PMC8705669 DOI: 10.3390/vaccines9121494] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study aims to investigate the extent of the BNT162b2 mRNA vaccine-induced antibodies against SARS-CoV-2 in a large cohort of Italian subjects belonging to the early vaccinated cohort in Italy. METHODS A prospective study was conducted between December 2020 and May 2021. Three blood samples were collected for each participant: one at the time of the first vaccine dose (T0), one at the time of the second vaccine dose, (T1) and the third 30 days after this last dose (T2). RESULTS We enrolled 2591 fully vaccinated subjects; 16.5% were frail subjects, and 9.8% were over 80 years old. Overall, 98.1% of subjects were seropositive when tested at T2, and 76.3% developed an anti-S IgG titer ≥4160 AU/mL, which is adequate to develop viral neutralizing antibodies. Seronegative subjects at T1 were more likely to remain seronegative at T2 or to develop a low-intermediate anti-S IgG titer (51-4159 AU/mL). CONCLUSIONS In summary, vaccination leads to detectable anti-S IgG titer in nearly all vaccine recipients. Stratification of the seroconversion level could be useful to promptly identify high-risk groups who may not develop a viral neutralizing response, even in the presence of seroconversion, and therefore may remain at higher risk of infection, despite vaccination.
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Affiliation(s)
| | | | | | | | - Claudia Pileggi
- Department of Health Sciences, Campus “Salvatore Venuta”, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (R.P.); (C.D.S.); (C.P.); (L.G.); (G.D.S.)
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Agrawal S, Makuch S, Lachowicz G, Dróżdż M, Dudek K, Mazur G. How Sociodemographic Factors Impact the Utilization of Recommended Clinical Preventive Screening Services in Poland: A Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13225. [PMID: 34948831 PMCID: PMC8701877 DOI: 10.3390/ijerph182413225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/30/2021] [Accepted: 12/13/2021] [Indexed: 12/03/2022]
Abstract
Cardiovascular disease (CVD) and cancer are the most frequent causes of mortality in Poland. To date, no study in Poland has attempted to analyze the impact of sociodemographic factors on the utilization of all recommended preventive services for these diseases. To address this challenge, a nationwide cross-sectional study was conducted. One thousand adults aged 18 years or older were interviewed using computer-assisted telephone surveys conducted via random selection. A representative population was obtained in accordance with existing demographics per voivodeship in Poland. We assessed whether factors such as age, gender, body mass index (BMI), net income, household size, place of residence, and education impacted the odds ratio of utilizing recommended preventive services for CVD and cancer. We determined that elderly patients receive influenza vaccination, measure blood pressure, PSA concentration, glucose and lipid profiles, and undergo colonoscopy and mammography more often than younger counterparts. Men were more often influenza vaccinated (OR = 1.56, 95% CI: 1.07-2.27) than women, while women measured blood glucose more often than men (OR = 0.62, 95% CI: 0.42-0.93). Furthermore, net income < 2000 PLN, BMI < 24 kg/m2 and at least secondary education level were found to be crucial predictors of undergoing mammography (OR = 2.16; 95% CI: 1.26-3.72), cervical smear tests (OR = 1.99, 95% CI: 1.24-3.17), and lipid measurements (OR = 1.76, 95% CI: 1.07-2.91), respectively. Educating people and financial support seem to play a crucial role in implementing novel campaigns and preventive programs in Poland. Addressing each significant factor may be of paramount importance in improving the receipt of preventive services and warranting greater preventive care coverage in the Polish population.
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Affiliation(s)
- Siddarth Agrawal
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wrocław, Poland; (G.L.); (G.M.)
| | - Sebastian Makuch
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, St. K. Marcinkowskiego 1, 50-368 Wrocław, Poland;
| | - Gabriella Lachowicz
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wrocław, Poland; (G.L.); (G.M.)
| | - Mateusz Dróżdż
- Faculty of Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 5, 50-345 Wrocław, Poland;
| | - Krzysztof Dudek
- Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, St. I. Łukasiewicza 5, 50-371 Wrocław, Poland;
| | - Grzegorz Mazur
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wrocław, Poland; (G.L.); (G.M.)
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A Text Mining-Based Survey of Pre-Impressions of Medical Staff toward COVID-19 Vaccination in a Designated Medical Institution for Class II Infectious Diseases. Vaccines (Basel) 2021; 9:vaccines9111282. [PMID: 34835212 PMCID: PMC8623688 DOI: 10.3390/vaccines9111282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 12/14/2022] Open
Abstract
The present study investigated the pre-impressions of medical staff toward coronavirus disease 2019 (COVID-19) vaccination in a designated medical institution for class II infectious diseases in Sakaide, Japan using a text mining analysis. A total of 387 medical staff were surveyed on their pre-vaccination impressions toward the COVID-19 vaccine using an open-ended questionnaire from March 1st to 7th (the first survey) and from March 22nd to 28th (the second survey) at Sakaide City Hospital, Sakaide, Japan. A total of 296 people answered the question for the first time and 234 people answered for the second time among the 387 people. The vaccination rate was slightly lower for the younger generation than for the older generation. Before the first vaccination, the younger generation expressed concerns about side effects as well as a negative impact on pregnancy. However, before the second vaccination, there were fewer concerns regarding side effects and words of reassurance were also noted. Nurses expressed more opinions about side effects in both the first and second vaccinations than other medical staff. Concerns regarding side effects among medical staff decreased with the progression of COVID-19 vaccination. These data may provide useful information about the promotion of COVID-19 vaccination to the public, particularly in the young generation and women.
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Riad A, Pokorná A, Klugarová J, Antalová N, Kantorová L, Koščík M, Klugar M. Side Effects of mRNA-Based COVID-19 Vaccines among Young Adults (18-30 Years Old): An Independent Post-Marketing Study. Pharmaceuticals (Basel) 2021; 14:1049. [PMID: 34681273 PMCID: PMC8696621 DOI: 10.3390/ph14101049] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/09/2023] Open
Abstract
Young adults had been widely perceived as a low-risk group for COVID-19 severity; therefore, they were deprioritised within the mass vaccination strategies as their prognosis of COVID-19 infection is relatively more favourable than older age groups. On the other hand, vaccination of this demographic group is indispensable to achieve herd immunity. A cross-sectional survey-based study was used to evaluate the side effects of mRNA-based COVID-19 vaccines among university students in the Czech Republic. The validated questionnaire was delivered in a digital form, and it consisted of demographic data; COVID-19 vaccine-related anamnesis; and local, systemic, orofacial, and skin-related side effects' prevalence, onset, and duration. Out of the 539 included participants, 70.1% were females and 45.8% were <23 years old. The vast majority (95.2%) reported at least one side effect. The most common side effect was injection site pain (91.8%), followed by fatigue (62.5%), headache (36.4%), and muscle pain (34.9%). The majority of local side effects occurred after both doses (74.4%), while most systemic side effects occurred after the second dose only (56.2%). Most local (94.2%) and systemic (93.3%) side effects resolved within three days after vaccination. Females participants' adjusted odds ratio (AOR) showed they were 2.566 (CI 95%: 1.103-5.970) times more likely to experience post-vaccination side effects, and the participants who received two doses reported an increased AOR of 1.896 (0.708-5.077) for experiencing side effects. The results of this study imply that mRNA-based COVID-19 vaccines are highly probably safe for young adults, and further studies are required to investigate the role of medical anamnesis, prior COVID-19 infection, and gender in side effects incidence.
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Affiliation(s)
- Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (L.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (N.A.); (M.K.)
| | - Andrea Pokorná
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (L.K.); (M.K.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Jitka Klugarová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (L.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (N.A.); (M.K.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Natália Antalová
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (N.A.); (M.K.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Lucia Kantorová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (L.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (N.A.); (M.K.)
| | - Michal Koščík
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (N.A.); (M.K.)
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (A.P.); (J.K.); (L.K.); (M.K.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (N.A.); (M.K.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
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