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Serhan M, Psihogios A, Kabir N, Bota AB, Mithani SS, Smith DP, Zhu DT, Greyson D, Wilson S, Fell D, Top KA, Bettinger JA, Wilson K. A scoping review of active, participant centred, digital adverse events following immunization (AEFI) surveillance of WHO approved COVID-19 vaccines: A Canadian immunization Research Network study. Hum Vaccin Immunother 2024; 20:2293550. [PMID: 38374618 PMCID: PMC10880498 DOI: 10.1080/21645515.2023.2293550] [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: 07/21/2023] [Accepted: 12/08/2023] [Indexed: 02/21/2024] Open
Abstract
This scoping review examines the role of digital solutions in active, participant-centered surveillance of adverse events following initial release of COVID-19 vaccines. The goals of this paper were to examine the existing literature surrounding digital solutions and technology used for active, participant centered, AEFI surveillance of novel COVID-19 vaccines approved by WHO. This paper also aimed to identify gaps in literature surrounding digital, active, participant centered AEFI surveillance systems and to identify and describe the core components of active, participant centered, digital surveillance systems being used for post-market AEFI surveillance of WHO approved COVID-19 vaccines, with a focus on the digital solutions and technology being used, the type of AEFI detected, and the populations under surveillance. The findings highlight the need for customized surveillance systems based on local contexts and the lessons learned to improve future vaccine monitoring and pandemic preparedness.
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Affiliation(s)
- Mohamed Serhan
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Athanasios Psihogios
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Nooh Kabir
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - A. Brianne Bota
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Salima S. Mithani
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - David P. Smith
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - David T. Zhu
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Sarah Wilson
- Health Protection, Public Health Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Populations & Public Health Research Program, ICES, Toronto, ON, Canada
| | - Deshayne Fell
- Department of Pediatrics, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Karina A. Top
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Departments of Pediatrics and Community Health & Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Julie A. Bettinger
- Vaccine Evaluation Center, Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Kumanan Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Canada
- O’Neill Institute for National and Global Health Law, Georgetown University
- Bruyère Research Institute, Ottawa, Canada
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Janekrongtham C, Salazar M, Doung-ngern P. Sex Differences in Serious Adverse Events Reported Following Booster Doses of COVID-19 Vaccination in Thailand: A Countrywide Nested Unmatched Case-Control Study. Vaccines (Basel) 2023; 11:1772. [PMID: 38140176 PMCID: PMC10747632 DOI: 10.3390/vaccines11121772] [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: 09/11/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 12/24/2023] Open
Abstract
A booster dose of a COVID-19 vaccine has been proven effective in restoring vaccine effectiveness and is currently recommended for use in some populations at risk of severe COVID-19 infection. Since sex differences in adverse events are significant in response to the vaccines, the safety of booster selection must be studied to avoid serious adverse events (SAE), such as life-threatening diseases. First, this study aimed to identify sex differences in SAE incidences using a prospective cohort design. Second, a nested unmatched case-control study was used to identify factors associated with reported SAE within 30 days after the booster shot. Multivariable logistic regression indicated the adjusted odds ratio by accounting for host and vaccine variables, thus, policy effects. The findings confirmed that SAE was rare and that age-sex-dominated disease classifications differed. Specific to SAE following the booster dose, we found that females aged 12-40 had a higher risk of being reported with SAE than males of the same age, while males over 50 had a higher risk than females. Other risk factors identified were the presence of metabolic syndrome and the use of certain vaccine brands. Mechanisms could be explained by individual host responses rather than the vaccines' direct effect. Therefore, SAE could be preventable by age-sex-specific vaccine selection, post-vaccination precautions, and early symptom detection. Future vaccine development should aim to limit host-specific reactogenicity for safety concerns.
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Affiliation(s)
- Chawisar Janekrongtham
- Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health, 88/21 Tiwanon Rd., Nonthaburi 11000, Thailand
| | - Mariano Salazar
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset Tomtebodavägen 18 A, Plan 3, 17165 Stockholm, Sweden;
| | - Pawinee Doung-ngern
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, 88/21 Tiwanon Rd., Nonthaburi 11000, Thailand;
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Yamin D, Yechezkel M, Arbel R, Beckenstein T, Sergienko R, Duskin-Bitan H, Yaron S, Peretz A, Netzer D, Shmueli E. Safety of monovalent and bivalent BNT162b2 mRNA COVID-19 vaccine boosters in at-risk populations in Israel: a large-scale, retrospective, self-controlled case series study. THE LANCET. INFECTIOUS DISEASES 2023; 23:1130-1142. [PMID: 37352878 DOI: 10.1016/s1473-3099(23)00207-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/09/2023] [Accepted: 03/21/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND COVID-19 continues to be a major health threat, particularly among at-risk groups, including individuals aged 60 years or older and people with particular medical conditions. Nevertheless, the absence of sufficient vaccine safety information is one of the key contributors to vaccine refusal. We aimed to assess the short-term safety profile of the BNT162b2 mRNA COVID-19 vaccine booster doses. METHODS In this self-controlled case series study, we used a database of members of the largest health-care organisation in Israel. We analysed the medical records of individuals at risk of COVID-19 complications who had received two doses of the monovalent BNT162b2 mRNA COVID-19 vaccine (tozinameran, Pfizer-BioNTech) as their primary course of vaccination and then also received BNT162b2 mRNA COVID-19 vaccine boosters between July 30, 2021, and Nov 28, 2022, as a monovalent first or second booster, or as a bivalent first, second, or third booster, or a combination of these. We included individuals who had active membership of the health-care organisation and who were alive (excluding COVID-19 deaths) throughout the entire study period. We excluded individuals who, during the study period, were either not active Clalit Health Services members or died of non-COVID-19 causes, and those who were infected with COVID-19 during the 7-day period after vaccination. Individuals' at-risk status was assessed on the day before the baseline period started. The primary outcome was non-COVID-19 hospitalisation for 29 adverse events that might be associated with vaccination. For each adverse event, we compared the risk difference of hospitalisation during a 28-day pre-vaccination baseline period versus during a 28-day post-vaccination period, using a non-parametric percentile bootstrap method. FINDINGS Of the 3 574 243 members of the health-care organisation, 1 073 110 received a first monovalent booster, 394 251 received a second monovalent booster, and 123 084 received a bivalent first, second, or third booster. Overall, we found no indication of an elevated risk of non-COVID-19 hospitalisation following administration of any of the booster vaccines (risk difference in events per 100 000 individuals: first monovalent booster -37·1 [95% CI -49·8 to -24·2]; second monovalent booster -37·8 [-62·2 to -13·2]; and bivalent booster -18·7 [-53·6 to 15·4]). Except for extremely rare elevated risks after the first monovalent booster-of myocarditis (risk difference 0·7 events per 100 000 individuals [95% CI 0·3-1·3]), seizures (2·2 [0·4-4·1]), and thrombocytopenia (2·6 [0·7-4·7])-we found no safety signals in other adverse events, including ischaemic stroke. INTERPRETATION This study provides the necessary vaccine safety assurances for at-risk populations to receive timed roll-out booster vaccinations. These assurances could reduce vaccine hesitancy and increase the number of at-risk individuals who opt to become vaccinated, and thereby prevent the severe outcomes associated with COVID-19. FUNDING Israel Science Foundation and Israel Precision Medicine Partnership programme.
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Affiliation(s)
- Dan Yamin
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel; Centre for Combatting Pandemics, Tel Aviv University, Tel Aviv, Israel.
| | - Matan Yechezkel
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Arbel
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel; Maximizing Health Outcomes Research Lab, Sapir College, Sderot, Israel
| | - Tanya Beckenstein
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
| | - Ruslan Sergienko
- Department of Health Policy and Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Hadar Duskin-Bitan
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; Institute of Endocrinology, Rabin Medical Centre, Petach Tikva, Israel
| | - Shlomit Yaron
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
| | - Alon Peretz
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel; School of Public Health, University of Haifa, Haifa, Israel
| | - Doron Netzer
- Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel
| | - Erez Shmueli
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel; MIT Media Lab, Cambridge, MA, USA
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Hasasneh A, Hijazi H, Talib MA, Afadar Y, Nassif AB, Nasir Q. Wearable Devices and Explainable Unsupervised Learning for COVID-19 Detection and Monitoring. Diagnostics (Basel) 2023; 13:3071. [PMID: 37835814 PMCID: PMC10572947 DOI: 10.3390/diagnostics13193071] [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: 07/24/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Despite the declining COVID-19 cases, global healthcare systems still face significant challenges due to ongoing infections, especially among fully vaccinated individuals, including adolescents and young adults (AYA). To tackle this issue, cost-effective alternatives utilizing technologies like Artificial Intelligence (AI) and wearable devices have emerged for disease screening, diagnosis, and monitoring. However, many AI solutions in this context heavily rely on supervised learning techniques, which pose challenges such as human labeling reliability and time-consuming data annotation. In this study, we propose an innovative unsupervised framework that leverages smartwatch data to detect and monitor COVID-19 infections. We utilize longitudinal data, including heart rate (HR), heart rate variability (HRV), and physical activity measured via step count, collected through the continuous monitoring of volunteers. Our goal is to offer effective and affordable solutions for COVID-19 detection and monitoring. Our unsupervised framework employs interpretable clusters of normal and abnormal measures, facilitating disease progression detection. Additionally, we enhance result interpretation by leveraging the language model Davinci GPT-3 to gain deeper insights into the underlying data patterns and relationships. Our results demonstrate the effectiveness of unsupervised learning, achieving a Silhouette score of 0.55. Furthermore, validation using supervised learning techniques yields high accuracy (0.884 ± 0.005), precision (0.80 ± 0.112), and recall (0.817 ± 0.037). These promising findings indicate the potential of unsupervised techniques for identifying inflammatory markers, contributing to the development of efficient and reliable COVID-19 detection and monitoring methods. Our study shows the capabilities of AI and wearables, reflecting the pursuit of low-cost, accessible solutions for addressing health challenges related to inflammatory diseases, thereby opening new avenues for scalable and widely applicable health monitoring solutions.
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Affiliation(s)
- Ahmad Hasasneh
- Department of Natural, Engineering, and Technology Sciences, Faculty of Graduate Studies, Arab American University, Ramallah P-600-699, Palestine;
| | - Haytham Hijazi
- Department of Informatics Engineering, CISUC-Centre for Informatics and Systems of the University of Coimbra, University of Coimbra, 3030-790 Coimbra, Portugal
- Intelligent Systems Department, Palestine Ahliya University, Bethlehem P-150-199, Palestine
| | - Manar Abu Talib
- College of Computing and Informatics, University of Sharjah, Sharjah 27272, United Arab Emirates; (M.A.T.); (Y.A.); (A.B.N.); (Q.N.)
| | - Yaman Afadar
- College of Computing and Informatics, University of Sharjah, Sharjah 27272, United Arab Emirates; (M.A.T.); (Y.A.); (A.B.N.); (Q.N.)
| | - Ali Bou Nassif
- College of Computing and Informatics, University of Sharjah, Sharjah 27272, United Arab Emirates; (M.A.T.); (Y.A.); (A.B.N.); (Q.N.)
| | - Qassim Nasir
- College of Computing and Informatics, University of Sharjah, Sharjah 27272, United Arab Emirates; (M.A.T.); (Y.A.); (A.B.N.); (Q.N.)
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Tatsi EB, Filippatos F, Dellis C, Dourdouna MM, Syriopoulou V, Michos A. Kinetics of SARS-CoV-2 Spike Antibodies after the Second and Third Dose of the BNT162b2 COVID-19 Vaccine and Association with Epidemiological Characteristics and Breakthrough Infection in a Cohort Study of Healthcare Workers. Microorganisms 2023; 11:2010. [PMID: 37630570 PMCID: PMC10458561 DOI: 10.3390/microorganisms11082010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
To prospectively study the kinetics of immune responses after immunization with the BNT162b2 mRNA COVID-19 vaccine and their association with epidemiological parameters and breakthrough infection (BI), we measured total (TAbs-WT) and neutralizing antibodies against wild-type (NAbs-WT) and Omicron (NAbs-O) SARS-CoV-2 spike proteins in healthcare workers (HCWs) after the second (4 and 8 months) and third dose (1 and 8 months). Vaccinated HCWs (n = 486), with a median age (IQR) of 49 years (38-56), were included in this prospective cohort study. BI was observed 4 and 8 months after the second dose in 8/486 (1.6%) and 15/486 (3.1%) HCWs, respectively, and 1 and 8 months after the third dose in 17/486 (3.5%) and 152/486 (31.3%) HCWs, respectively. A comparison of immune responses 1 month after the third dose in vaccinated HCWs without a BI or with a BI in the next 7 months did not detect any statistically significant differences in the TAbs-WT (median (IQR): 16,611.0 (13,011.0) U/mL vs. 17,572.5 (14,501.0) U/mL, p = 0.529) and NAbs-WT (median (IQR): 96.5% (1.7) vs. 96.7% (1.9), p = 0.555). After infection, HCWs with a BI had significantly increased TAbs-WT levels at all time points compared to healthy HCWs. The findings of the present study indicate that antibody levels after three doses of the BNT162b2 vaccine are not directly associated with the possibility of a BI.
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Affiliation(s)
- Elizabeth-Barbara Tatsi
- Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, ‘Aghia Sophia’ Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.-B.T.); (V.S.)
- University Research Institute of Maternal and Child Health and Precision Medicine, 11527 Athens, Greece
| | - Filippos Filippatos
- Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, ‘Aghia Sophia’ Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.-B.T.); (V.S.)
| | - Charilaos Dellis
- Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, ‘Aghia Sophia’ Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.-B.T.); (V.S.)
| | - Maria-Myrto Dourdouna
- Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, ‘Aghia Sophia’ Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.-B.T.); (V.S.)
| | - Vasiliki Syriopoulou
- Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, ‘Aghia Sophia’ Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.-B.T.); (V.S.)
| | - Athanasios Michos
- Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, ‘Aghia Sophia’ Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.-B.T.); (V.S.)
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Mofaz M, Yechezkel M, Einat H, Kronfeld-Schor N, Yamin D, Shmueli E. Real-time sensing of war's effects on wellbeing with smartphones and smartwatches. COMMUNICATIONS MEDICINE 2023; 3:55. [PMID: 37069232 PMCID: PMC10109229 DOI: 10.1038/s43856-023-00284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/31/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Modern wars have a catastrophic effect on the wellbeing of civilians. However, the nature of this effect remains unclear, with most insights gleaned from subjective, retrospective studies. METHODS We prospectively monitored 954 Israelis (>40 years) from two weeks before the May 2021 Israel-Gaza war until four weeks after the ceasefire using smartwatches and a dedicated mobile application with daily questionnaires on wellbeing. This war severely affected civilians on both sides, where over 4300 rockets and missiles were launched towards Israeli cities, and 1500 aerial, land, and sea strikes were launched towards 16,500 targets in the Gaza Strip. RESULTS We identify considerable changes in all the examined wellbeing indicators during missile attacks and throughout the war, including spikes in heart rate levels, excessive screen-on time, and a reduction in sleep duration and quality. These changes, however, fade shortly after the war, with all affected measures returning to baseline in nearly all the participants. Greater changes are observed in individuals living closer to the battlefield, women, and younger individuals. CONCLUSIONS The demonstrated ability to monitor objective and subjective wellbeing indicators during crises in real-time is pivotal for the early detection of and prompt assistance to populations in need.
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Affiliation(s)
- Merav Mofaz
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Matan Yechezkel
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
| | - Haim Einat
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel-Aviv, Israel
| | - Noga Kronfeld-Schor
- School of Zoology and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Dan Yamin
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel
- Center for Combating Pandemics, Tel-Aviv University, Tel-Aviv, Israel
| | - Erez Shmueli
- Department of Industrial Engineering, Tel-Aviv University, Tel-Aviv, Israel.
- MIT Media Lab, Cambridge, MA, USA.
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Schuurmans MM, Muszynski M, Li X, Marcinkevičs R, Zimmerli L, Monserrat Lopez D, Michel B, Weiss J, Hage R, Roeder M, Vogt JE, Brunschwiler T. Multimodal Remote Home Monitoring of Lung Transplant Recipients during COVID-19 Vaccinations: Usability Pilot Study of the COVIDA Desk Incorporating Wearable Devices. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59030617. [PMID: 36984618 PMCID: PMC10051543 DOI: 10.3390/medicina59030617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
Background and Objectives: Remote patient monitoring (RPM) of vital signs and symptoms for lung transplant recipients (LTRs) has become increasingly relevant in many situations. Nevertheless, RPM research integrating multisensory home monitoring in LTRs is scarce. We developed a novel multisensory home monitoring device and tested it in the context of COVID-19 vaccinations. We hypothesize that multisensory RPM and smartphone-based questionnaire feedback on signs and symptoms will be well accepted among LTRs. To assess the usability and acceptability of a remote monitoring system consisting of wearable devices, including home spirometry and a smartphone-based questionnaire application for symptom and vital sign monitoring using wearable devices, during the first and second SARS-CoV-2 vaccination. Materials and Methods: Observational usability pilot study for six weeks of home monitoring with the COVIDA Desk for LTRs. During the first week after the vaccination, intensive monitoring was performed by recording data on physical activity, spirometry, temperature, pulse oximetry and self-reported symptoms, signs and additional measurements. During the subsequent days, the number of monitoring assessments was reduced. LTRs reported on their perceptions of the usability of the monitoring device through a purpose-designed questionnaire. Results: Ten LTRs planning to receive the first COVID-19 vaccinations were recruited. For the intensive monitoring study phase, LTRs recorded symptoms, signs and additional measurements. The most frequent adverse events reported were local pain, fatigue, sleep disturbance and headache. The duration of these symptoms was 5-8 days post-vaccination. Adherence to the main monitoring devices was high. LTRs rated usability as high. The majority were willing to continue monitoring. Conclusions: The COVIDA Desk showed favorable technical performance and was well accepted by the LTRs during the vaccination phase of the pandemic. The feasibility of the RPM system deployment was proven by the rapid recruitment uptake, technical performance (i.e., low number of errors), favorable user experience questionnaires and detailed individual user feedback.
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Affiliation(s)
- Macé M Schuurmans
- Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | | | - Xiang Li
- Department of Mathematics, ETH Zurich, 8092 Zurich, Switzerland
- Department of Computer Science, ETH Zurich, 8092 Zurich, Switzerland
| | | | | | - Diego Monserrat Lopez
- IBM Research Europe, 8803 Rüschlikon, Switzerland
- Department of Biosystems Science and Engineering, ETH Zurich, 4058 Basel, Switzerland
| | - Bruno Michel
- IBM Research Europe, 8803 Rüschlikon, Switzerland
| | - Jonas Weiss
- IBM Research Europe, 8803 Rüschlikon, Switzerland
| | - René Hage
- Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Maurice Roeder
- Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Julia E Vogt
- Department of Computer Science, ETH Zurich, 8092 Zurich, Switzerland
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Lee DY, Kang DY, Kim E, Lee SJ, Baek JH, Lee JS, Park MY, Im JH. Adverse events of a third dose of BNT162b2 mRNA COVID-19 vaccine among Korean healthcare workers. Medicine (Baltimore) 2023; 102:e33236. [PMID: 36930126 PMCID: PMC10018524 DOI: 10.1097/md.0000000000033236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
Due to the urgency of controlling the coronavirus disease 2019 pandemic, coronavirus disease 2019 messenger ribonucleic acid (mRNA) vaccines have been expeditiously approved and introduced in several countries without sufficient evaluation for adverse events. We analyzed adverse events among Korean healthcare workers who received all 3 doses of the BNT162b2 mRNA vaccine. This survey was conducted among hospital workers of Inha University Hospital who had received the BNT162b2 mRNA vaccine for their first, second, third rounds, and using a diary card. The surveyed adverse events included local (redness, edema, and injection site pain) and systemic (fever, fatigue, headache, chill, myalgia, arthralgia, vomiting, diarrhea, pruritis, and urticaria) side effects and were divided into 5 grades (Grade 0 = none - Grade 4 = critical). Based on adverse events reported at least once after any of the 3 doses, the most common systemic adverse reactions were chills and headache (respectively, 62.6%, 62.4%), followed by myalgia (55.3%), arthralgia (53.4%), fatigue (51.6%), pruritus (38.1%), and fever (36.5%). The frequency and duration of adverse events were significantly greater in women (P < .05) than men. Except for redness, pruritus, urticaria, and most adverse reactions had a higher rate of occurrence after the third dose in subjects who also had reactions with the second dose. However, grade 4 adverse events did occur with the third dose in some patients, even if there were no side effects with the first and second doses. Adverse events experienced with the first and second doses of the BNT162b2 mRNA vaccine in Korean healthcare workers increased the incidence of adverse events at the time of the third dose. On the other hand, grade 4 adverse events could still occur with the third dose even though there were no side effects with the first and second doses.
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Affiliation(s)
- Dong Yeop Lee
- Department of Preventive Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Dong Yoon Kang
- Department of Preventive Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Eunjung Kim
- Infection Control Unit, Inha University Hospital, Incheon, Korea
| | - Se-joo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Ji Hyeon Baek
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jin-Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Mi Youn Park
- Department of Nursing, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jae Hyoung Im
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
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Yechezkel M, Mofaz M, Painsky A, Patalon T, Gazit S, Shmueli E, Yamin D. Safety of the fourth COVID-19 BNT162b2 mRNA (second booster) vaccine: a prospective and retrospective cohort study. THE LANCET. RESPIRATORY MEDICINE 2023; 11:139-150. [PMID: 36410364 PMCID: PMC9889528 DOI: 10.1016/s2213-2600(22)00407-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The effectiveness of the second BNT162b2 (Pfizer-BioNTech) mRNA COVID-19 booster vaccine dose (ie, fourth inoculation) is well established, but its safety has yet to be fully understood. The absence of sufficient vaccine safety information is one of the key contributors to vaccine hesitancy. In this study, we aimed to evaluate the safety profile of the second BNT162b2 mRNA COVID-19 booster vaccine using data from a retrospective cohort and a prospective cohort. METHODS To evaluate the safety profile of the second booster vaccine, we analysed its short-term effects and compared them to those of the first booster by using data from, first, a retrospective cohort of 250 000 random members of the second-largest health-care organisation in Israel (Maccabi Healthcare Services) and, second, a prospective cohort (the PerMed study) of 4698 participants from all across Israel. Individuals who were aged 18 years or older who received the second BNT162b2 mRNA COVID-19 vaccine booster during the vaccination campaign, from Dec 30, 2021, to July 22, 2022, were eligible for inclusion in the retrospective cohort analysis. To be included in the PerMed study, participants needed to be 18 years or older, members of Maccabi Healthcare Services at the time of enrolment, using their own smartphone, and be able to give informed consent by themselves. Participants from the prospective cohort received smartwatches, downloaded a dedicated mobile application, and granted access to their medical records. The smartwatches continuously monitored several physiological measures, including heart rate. For analysis of the prospective cohort data, we used the Kruskal-Wallis test to compare heart rate levels observed before and after vaccination. The mobile application collected daily self-reported questionnaires on local and systemic reactions. Medical records of the retrospective cohort were accessed to examine the occurrence of 25 potential adverse events, and we evaluated the risk differences between 42 days in the periods before and after vaccination in a pairwise method using non-parametric percentile bootstrap. FINDINGS The retrospective cohort included 94 169 participants who received the first booster and 17 814 who received the second booster. Comparing the 42 days before and after vaccination, the second booster was not associated with any of the 25 adverse events investigated, including myocardial infarction (risk difference, 2·25 events per 10 000 individuals [95% CI -3·93 to 8·98]) and Bell's Palsy (-1·68 events [-5·61 to 2·25]). None of the individuals was diagnosed with myocarditis or pericarditis following vaccination with the second booster. The prospective cohort included 1785 participants who received the first booster and 699 who received the second booster. We found no significant differences after inoculation with the first booster compared with the second booster (heart rate: day 2 [p=0·3], day 6 [p=0·89]; extent of self-reported reactions [p=0·06]). We found a significant increase in mean heart rate relative to that observed during the week before vaccination (baseline) levels during the first 3 days following the second booster (p<0·0001), peaking on day 2 (mean difference of 1·61 bpm [1·07 to 2·16] compared with baseline). Mean heart rate values returned to baseline levels by day 6 (-0·055 bpm [-0·56 to 0·45] compared with baseline). INTERPRETATION Both our retrospective and prospective analyses support the safety of the second booster, with our findings reflecting physicians' diagnoses, patients' objective physiological measures, and patients' subjective reactions. We believe this study provides safety assurances to the global population who are eligible to receive an additional COVID-19 booster inoculation. These assurances can help increase the number of high-risk individuals who opt to receive this booster vaccine and thereby prevent severe outcomes associated with COVID-19. FUNDING European Research Council (ERC).
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Affiliation(s)
- Matan Yechezkel
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Merav Mofaz
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Amichai Painsky
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Tal Patalon
- Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Erez Shmueli
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel,Media Lab, MIT, Cambridge, MA, USA
| | - Dan Yamin
- Department of Industrial Engineering, Tel Aviv University, Tel Aviv, Israel; Center for Combatting Pandemics, Tel Aviv University, Tel Aviv, Israel.
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10
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Tanaka H, Mukai J, Kushibiki K, Mizushima S, Maeda K, Fujimoto Y, Sawada R, Oda M, Okuda H, Yamaki M, Hashiguchi S, Kawai I, Kawaguchi I, Masuda N, Matsushita H. Effect of the third dose of BNT162b2 COVID-19 mRNA vaccine on anti-SARS-CoV-2 antibody levels in healthcare workers. Vaccine 2023; 41:365-371. [PMID: 36460533 PMCID: PMC9684125 DOI: 10.1016/j.vaccine.2022.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Administration of three doses of Pfizer-BioNTech BNT162b2 COVID-19 mRNA vaccine was completed in Japan in the spring of 2022. This study aimed to evaluate the antibody responses, and kinetics of three doses of vaccine in healthcare workers (HCWs). PATIENTS AND METHODS We conducted a longitudinal cohort study with HCWs, who had no history of COVID-19 or serologic evidence of SARS-CoV-2 infection, from a single hospital. Immunoglobulin G (IgG) titers of anti-SARS-CoV-2 spike protein (SP) and nucleocapsid protein (NP) titers were measured using an automated chemiluminescent enzyme immunoassay system. RESULTS A total of 636 HCWs participated in the study. The anti-SP IgG titers decreased slowly after the second dose of the BNT162b2 vaccine in all participants, and robust antibody response was observed after the third dose of the vaccine. The peak anti-SP IgG titer after the third dose was approximately 4.1-fold higher than that after the first and second doses, and the rate of decrease in the anti-SP IgG titer after the third dose was significantly more gradual, than that after the second dose. After the second dose of vaccine, the antibody response was weaker in older participants than in younger participants, and in males than in females respectively, whereas the response to the third dose of vaccine did not differ significantly by sex or age. Adverse events following immunization were generally mild to moderate. CONCLUSION The third dose of the BNT162b2 vaccine induced a significant and sustained increase in anti-SP IgG titers, and was generally safe and well-tolerated.
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Affiliation(s)
- Hidenori Tanaka
- Department of Respiratory Medicine, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Junji Mukai
- Department of Pharmacy, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Kenichi Kushibiki
- General Affairs Division, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Sayuri Mizushima
- Department of Clinical Laboratory, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Kyoko Maeda
- Department of Clinical Laboratory, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Yuko Fujimoto
- Department of Clinical Laboratory, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Ryugo Sawada
- Department of Surgery, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan,Infection Control Room, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Manabu Oda
- Infection Control Room, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Hiroshi Okuda
- Department of Pharmacy, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Mayumi Yamaki
- Medical Affairs Division, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Shin Hashiguchi
- Clinical Research Center, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Ichiro Kawai
- Clinical Research Center, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Izumi Kawaguchi
- Department of Nursing, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
| | - Noriyuki Masuda
- Department of Respiratory Medicine, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan; Clinical Research Center, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan.
| | - Haruhiko Matsushita
- Department of Respiratory Medicine, Izumi City General Hospital, 4-5-1 Wakecho, Izumi, Osaka 594-0073, Japan
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11
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Raw RK, Rees J, Chadwick DR. Increased adverse events following third dose of BNT162b2/Pfizer vaccine in those with previous COVID-19, but not with concurrent influenza vaccine. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001053. [PMID: 36963011 PMCID: PMC10021629 DOI: 10.1371/journal.pgph.0001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/23/2023] [Indexed: 02/19/2023]
Abstract
Prior studies suggest that adverse events (AEs) following doses one and two of BNT162b2/Pfizer vaccine are worse in those with a prior history of COVID-19. To establish whether this outcome applies to a third/booster dose, we conducted a survey with 534 healthcare workers (HCW) in Northeast England, who reported AEs following all three doses of BNT162b2/Pfizer vaccine. We also explored AEs associated with concurrent seasonal influenza immunisation, in a subset of 492 HCWs. For all doses of BNT162b2/Pfizer vaccine there was a cluster of systemic AEs that were consistently worse in HCWs with a prior history of COVID-19. AEs were no worse in HCWs who received their third/booster dose within 7 days of the influenza jab, rather than further apart. Gender and the presence of ongoing COVID-19 symptoms (OCS) had no effect on AEs associated with COVID-19 or influenza vaccination, though younger HCWs experienced more AEs overall. Our findings have implications for vaccine hesitancy and immunisation protocols.
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Affiliation(s)
- Rachael K Raw
- School of Medicine and Health, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jon Rees
- The School of Psychology, University of Sunderland, Sunderland, United Kingdom
| | - David R Chadwick
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, United Kingdom
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12
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Kwon CY, Lee B. Impact of COVID-19 Vaccination on Heart Rate Variability: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10122095. [PMID: 36560505 PMCID: PMC9787739 DOI: 10.3390/vaccines10122095] [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: 11/15/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Establishing and disseminating evidence-based safety information could potentially facilitate beneficial choices in coronavirus disease (COVID-19) vaccinations. This systematic review investigated the potential impact of COVID-19 vaccinations on human heart rate variability (HRV) parameters through comprehensive searches of four electronic medical databases. Five observational studies reporting HRV parameters of individuals vaccinated against COVID-19 and published up to 29 July 2022 were included in this review. Among them, four studies reported the square root of the mean squared differences of successive NN intervals (RMSSD) as their outcome, and the remaining study reported an HRV-based stress indicator. These studies reported short-term changes and rapid recovery in HRV parameters within up to 3 days after COVID-19 vaccination. Some studies showed that the impact of COVID-19 vaccinations on RMSSD was greater in women than men, and in the younger group than in the older group. The methodological quality of the included studies was not optimal; the review revealed short-term changes in HRV parameters, particularly RMSSD, following COVID-19 vaccination. However, as the included studies did not report important parameters besides RMSSD, the limitation exists that the postvaccination long-term HRV stability was not reported.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, 52-57, Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
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13
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Torres M, Corona M, Rodríguez-Mora S, Casado-Fernández G, Zurdo-Castronuño A, Mateos E, Ramos-Martín F, Sánchez-Menéndez C, Murciano-Antón MA, García-Pérez J, Alcamí J, Pérez-Olmeda M, Coiras M, López-Jiménez J, García-Gutiérrez V. Strong Humoral but Not Cellular Immune Responses against SARS-CoV-2 in Individuals with Oncohematological Disease Who Were Treated with Rituximab before Receiving a Vaccine Booster. Cancers (Basel) 2022; 14:5537. [PMID: 36428631 PMCID: PMC9688562 DOI: 10.3390/cancers14225537] [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: 09/24/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/12/2022] Open
Abstract
The humoral immune response developed after receiving the full vaccination schedule against COVID-19 is impaired in individuals who received anti-CD20 therapy 6-9 months before vaccination. However, there is little information about the cellular immune responses elicited in these individuals. In this study, we analyzed the humoral and cellular immune responses in 18 individuals with hematological disease who received the last dose of rituximab 13.8 months (IQR 9.4-19) before the booster dose. One month after receiving the booster dose, the seroconversion rate in the rituximab-treated cohort increased from 83.3% to 88.9% and titers of specific IgGs against SARS-CoV-2 increased 1.53-fold (p = 0.0098), while the levels of neutralizing antibodies increased 3.03-fold (p = 0.0381). However, the cytotoxic activity of peripheral blood mononuclear cells (PBMCs) from rituximab-treated individuals remained unchanged, and both antibody-dependent cellular cytotoxicity (ADCC) and direct cellular cytotoxicity (CDD) were reduced 1.7-fold (p = 0.0047) and 2.0-fold (p = 0.0086), respectively, in comparison with healthy donors. Breakthrough infections rate was higher in our cohort of rituximab-treated individuals (33.33%), although most of the infected patients (83.4%) developed a mild form of COVID-19. In conclusion, our findings confirm a benefit in the humoral, but not in the cellular, immune response in rituximab-treated individuals after receiving a booster dose of an mRNA-based vaccine against COVID-19.
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Affiliation(s)
- Montserrat Torres
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Magdalena Corona
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
- Faculty of Sciences, Universidad de Alcalá, 28871 Alcalá de Henares, Spain
| | - Sara Rodríguez-Mora
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Guiomar Casado-Fernández
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Faculty of Sciences, Universidad de Alcalá, 28871 Alcalá de Henares, Spain
| | - Alejandro Zurdo-Castronuño
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Elena Mateos
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Fernando Ramos-Martín
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Clara Sánchez-Menéndez
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | | | - Javier García-Pérez
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- AIDS Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - José Alcamí
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- AIDS Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Mayte Pérez-Olmeda
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Serology Service, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mayte Coiras
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, 28220 Majadahonda, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28220 Majadahonda, Spain
| | - Javier López-Jiménez
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Valentín García-Gutiérrez
- Hematology and Hemotherapy Service, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
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Higher sensitivity monitoring of reactions to COVID-19 vaccination using smartwatches. NPJ Digit Med 2022; 5:140. [PMID: 36085312 PMCID: PMC9461410 DOI: 10.1038/s41746-022-00683-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/23/2022] [Indexed: 11/08/2022] Open
Abstract
More than 12 billion COVID-19 vaccination shots have been administered as of August 2022, but information from active surveillance about vaccine safety is limited. Surveillance is generally based on self-reporting, making the monitoring process subjective. We study participants in Israel who received their second or third Pfizer BioNTech COVID-19 vaccination. All participants wore a Garmin Vivosmart 4 smartwatch and completed a daily questionnaire via smartphone. We compare post-vaccination smartwatch heart rate data and a Garmin-computed stress measure based on heart rate variability with data from the patient questionnaires. Using a mixed effects panel regression to remove participant-level fixed and random effects, we identify considerable changes in smartwatch measures in the 72 h post-vaccination even among participants who reported no side effects in the questionnaire. Wearable devices were more sensitive than questionnaires in determining when participants returned to baseline levels. We conclude that wearable devices can detect physiological responses following vaccination that may not be captured by patient self-reporting. More broadly, the ubiquity of smartwatches provides an opportunity to gather improved data on patient health, including active surveillance of vaccine safety.
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