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Angeletti PM, Marchi S, Trombetta CM, Altobelli E. Flu vaccine administration in the period before SARS-CoV-2 infection and its outcomes: An umbrella review. Prev Med Rep 2024; 38:102575. [PMID: 38283956 PMCID: PMC10820254 DOI: 10.1016/j.pmedr.2023.102575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024] Open
Abstract
Objective The potential association between influenza vaccination and SARS-CoV-2 infection and related outcomes is still controversial. The aim of this umbrella review is to represent the impact of previous influenza vaccination and COVID-19 outcomes using evidence currently available in literature. Methods A literature search of MEDLINE, EMBASE, Scopus, Web of Science and Cochrane Library was conducted. The paper selection was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method by two-blinded authors. The quality of meta-analyses was assessed using the AMSTAR 2 scale (A MeaSurement Tool to Assess systematic Reviews). The outcomes investigated were SARS-CoV-2 infection after influenza vaccination, hospitalization, intensive care unit admission, mechanical ventilation and mortality. Results The literature research identified 7 ecological studies and 6 meta-analyses. All the ecological studies show a negative relationship between influenza vaccination and COVID-19. The meta-analyses suggest a protective action of influenza vaccination against SARS-CoV-2 infection. Regarding the outcomes evaluated, only two studies reported a statistically significant reduction of 12% and of 17% in hospitalization and intensive care unit admission, respectively. Regarding mechanical ventilation, three studies showed a risk reduction of 31%, 27% and 28%. A substantial reduction of mortality risk was also observed in one study. Conclusions These results suggest that influenza vaccination could be associated with reduced susceptibility to SARS-CoV-2 infection, mechanical ventilation and mortality. Our findings highlighted how the administration of flu vaccine in subjects at risk could lead to a reduction in mortality, particularly in the over 65y.
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Affiliation(s)
- Paolo Matteo Angeletti
- Department of Life, Health and Environmental Sciences, Section of Epidemiology and Biostatistics Unit, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100 L'Aquila, Coppito (AQ), Italy
- Cardiovascular Department, UO of Cardiac Anesthesia of the IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | | | - Emma Altobelli
- Department of Life, Health and Environmental Sciences, Section of Epidemiology and Biostatistics Unit, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100 L'Aquila, Coppito (AQ), Italy
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2
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Pontiroli AE, Scovenna F, Carlini V, Tagliabue E, Martin-Delgado J, Sala LL, Tanzi E, Zanoni I. Vaccination against influenza viruses reduces infection, not hospitalization or death, from respiratory COVID-19: A systematic review and meta-analysis. J Med Virol 2024; 96:e29343. [PMID: 38163281 PMCID: PMC10924223 DOI: 10.1002/jmv.29343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and has brought a huge burden in terms of human lives. Strict social distance and influenza vaccination have been recommended to avoid co-infections between influenza viruses and SARS-CoV-2. Scattered reports suggested a protective effect of influenza vaccine on COVID-19 development and severity. We analyzed 51 studies on the capacity of influenza vaccination to affect infection with SARS-CoV-2, hospitalization, admission to Intensive Care Units (ICU), and mortality. All subjects taken into consideration did not receive any anti-SARS-CoV-2 vaccine, although their status with respect to previous infections with SARS-CoV-2 is not known. Comparison between vaccinated and not-vaccinated subjects for each of the four endpoints was expressed as odds ratio (OR), with 95% confidence intervals (CIs); all analyses were performed by DerSimonian and Laird model, and Hartung-Knapp model when studies were less than 10. In a total of 61 029 936 subjects from 33 studies, influenza vaccination reduced frequency of SARS-CoV-2 infection [OR plus 95% CI = 0.70 (0.65-0.77)]. The effect was significant in all studies together, in health care workers and in the general population; distance from influenza vaccination and the type of vaccine were also of importance. In 98 174 subjects from 11 studies, frequency of ICU admission was reduced with influenza vaccination [OR (95% CI) = 0.71 (0.54-0.94)]; the effect was significant in all studies together, in pregnant women and in hospitalized subjects. In contrast, in 4 737 328 subjects from 14 studies hospitalization was not modified [OR (95% CI) = 1.05 (0.82-1.35)], and in 4 139 660 subjects from 19 studies, mortality was not modified [OR (95% CI) = 0.76 (0.26-2.20)]. Our study emphasizes the importance of influenza vaccination in the protection against SARS-CoV-2 infection.
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Affiliation(s)
- Antonio E. Pontiroli
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Francesco Scovenna
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Valentina Carlini
- IRCCS MultiMedica, Laboratory of Cardiovascular and Dysmetabolic Disease, 20138 Milan, Italy
| | - Elena Tagliabue
- IRCCS MultiMedica, Value-Based Healthcare Unit, 20099 Milan, Italy
| | - Jimmy Martin-Delgado
- Hospital Luis Vernaza, Junta de Beneficiencia de Guayaquil 090603, Ecuador
- Instituto de Investigacion e Innovacion en Salud Integral, Universidad Catolica de Santiago de Guayaquil, Guayaquil 090603, Ecuador
| | - Lucia La Sala
- IRCCS MultiMedica, Laboratory of Cardiovascular and Dysmetabolic Disease, 20138 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Ivan Zanoni
- Harvard Medical School, Boston Children’s Hospital, Division of Immunology and Division of Gastroenterology, Boston, MA 02115, USA
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Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Ruiz-Galiana J, Cantón R, De Lucas Ramos P, García-Botella A, García-Lledó A, Hernández-Sampelayo T, Gómez-Pavón J, González Del Castillo J, Martín-Delgado MC, Bouza E. Insights for COVID-19 in 2023. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023. [PMID: 36510683 DOI: 10.3701/req/059.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Predictions for a near end of the pandemic by the World Health Organization should be interpreted with caution. Current evidence indicates that the efficacy of a fourth dose of classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection in its predominant variant (Omicron). However, its efficacy is high against severe symptomatic infection, hospitalization and death. The new vaccines being introduced are bivalent and active against the Omicron variants. Potential new vaccines to be introduced in the coming year include a vaccine based on a recombinant protein that emulates the receptor binding domain of the Spike protein under development by the Spanish company Hipra, as well as vaccines for nasal or oral administration. Available information suggests that vaccines against COVID-19 can be administered in association with influenza vaccination without particular complications. New drugs against COVID-19, both antiviral and anti-inflammatory, are under investigation, but this does not seem to be the case with monoclonal antibodies. The indication to use masks in some circumstances will be maintained next year in view of the accumulation of scientific data on their efficacy. Finally, the long COVID or Post-COVID syndrome may continue to affect a very high proportion of patients who have had the disease, requiring combined diagnostic and therapeutic resources.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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4
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Kim J, Yoo D, Hong K, Chun BC. Health behaviors and the risk of COVID-19 incidence: A Bayesian hierarchical spatial analysis. J Infect Public Health 2023; 16:190-195. [PMID: 36580692 PMCID: PMC9773785 DOI: 10.1016/j.jiph.2022.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Effective infection control measures, based on a sound understanding of geographical community-specific health behavioral characteristics, should be implemented from the early stage of disease transmission. However, few studies have explored health behaviors as a possible contributor to COVID-19 infection in the spatial context. We investigated health behaviors as potential factors of COVID-19 incidence in the early phase of transmission in the spatial context. METHODS We extracted COVID-19 cumulative case data as of February 25, 2021-one day prior to nationwide COVID-19 vaccination commencement-regarding health behaviors and covariates, including health condition and socio-economic factors, at the municipal level from publicly available datasets. The spatial autocorrelation of incidence was analyzed using Global Moran's I statistics. The associations between health behaviors and COVID-19 incidence were examined using Besag-York-Mollie models to deal with spatial autocorrelation of residuals. RESULTS The COVID-19 incidence had positive spatial autocorrelation across South Korea (I = 0.584, p = 0.001). The results suggest that individuals vaccinated against influenza in the preceding year had a negative association with COVID-19 incidence (relative risk=0.913, 95 % Credible Interval=0.838-0.997), even after adjusting for covariates. CONCLUSIONS Our ecological study suggests an association between COVID-19 infection and health behaviors, especially influenza vaccination, in the early stage of COVID-19 transmission at the municipal level.
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Affiliation(s)
- Jeehyun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea
| | - Daesung Yoo
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,Animal and Plant Quarantine Agency, Gimcheon, South Korea
| | - Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea,Correspondence to: Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, South Korea
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5
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Majeed B, David JF, Bragazzi NL, McCarthy Z, Grunnill MD, Heffernan J, Wu J, Woldegerima WA. Mitigating co-circulation of seasonal influenza and COVID-19 pandemic in the presence of vaccination: A mathematical modeling approach. Front Public Health 2023; 10:1086849. [PMID: 36684896 PMCID: PMC9845909 DOI: 10.3389/fpubh.2022.1086849] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023] Open
Abstract
The co-circulation of two respiratory infections with similar symptoms in a population can significantly overburden a healthcare system by slowing the testing and treatment. The persistent emergence of contagious variants of SARS-CoV-2, along with imperfect vaccines and their waning protections, have increased the likelihood of new COVID-19 outbreaks taking place during a typical flu season. Here, we developed a mathematical model for the co-circulation dynamics of COVID-19 and influenza, under different scenarios of influenza vaccine coverage, COVID-19 vaccine booster coverage and efficacy, and testing capacity. We investigated the required minimal and optimal coverage of COVID-19 booster (third) and fourth doses, in conjunction with the influenza vaccine, to avoid the coincidence of infection peaks for both diseases in a single season. We show that the testing delay brought on by the high number of influenza cases impacts the dynamics of influenza and COVID-19 transmission. The earlier the peak of the flu season and the greater the number of infections with flu-like symptoms, the greater the risk of flu transmission, which slows down COVID-19 testing, resulting in the delay of complete isolation of patients with COVID-19 who have not been isolated before the clinical presentation of symptoms and have been continuing their normal daily activities. Furthermore, our simulations stress the importance of vaccine uptake for preventing infection, severe illness, and hospitalization at the individual level and for disease outbreak control at the population level to avoid putting strain on already weak and overwhelmed healthcare systems. As such, ensuring optimal vaccine coverage for COVID-19 and influenza to reduce the burden of these infections is paramount. We showed that by keeping the influenza vaccine coverage about 35% and increasing the coverage of booster or fourth dose of COVID-19 not only reduces the infections with COVID-19 but also can delay its peak time. If the influenza vaccine coverage is increased to 55%, unexpectedly, it increases the peak size of influenza infections slightly, while it reduces the peak size of COVID-19 as well as significantly delays the peaks of both of these diseases. Mask-wearing coupled with a moderate increase in the vaccine uptake may mitigate COVID-19 and prevent an influenza outbreak.
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Affiliation(s)
- Bushra Majeed
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jummy Funke David
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Zack McCarthy
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Martin David Grunnill
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jane Heffernan
- Centre for Disease Modeling, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Modelling Infection and Immunity Lab, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jianhong Wu
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Woldegebriel Assefa Woldegerima
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Taghioff SM, Slavin BR, Mehra S, Holton T, Singh D. The impact of influenza vaccination on surgical outcomes in COVID-19 positive patients: An analysis of 43,580 patients. PLoS One 2023; 18:e0281990. [PMID: 36897891 PMCID: PMC10004617 DOI: 10.1371/journal.pone.0281990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 02/06/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Multiple recent studies suggest a possible protective effect of the influenza vaccine against severe acute respiratory coronavirus 2 (SARS-CoV-2). This effect has yet to be evaluated in surgical patients. This study utilizes a continuously updated federated electronic medical record (EMR) network (TriNetX, Cambridge, MA) to analyze the influence of the influenza vaccine against post-operative complications in SARS-CoV-2-positive patients. METHODS The de-identified records of 73,341,020 patients globally were retrospectively screened. Two balanced cohorts totaling 43,580 surgical patients were assessed from January 2020-January 2021. Cohort One received the influenza vaccine six months-two weeks prior to SARS-CoV-2-positive diagnosis, while Cohort Two did not. Post-operative complications within 30, 60, 90, and 120 days of undergoing surgery were analyzed using common procedural terminology(CPT) codes. Outcomes were propensity score matched for characteristics including age, race, gender, diabetes, obesity, and smoking. RESULTS SARS-CoV-2-positive patients receiving the influenza vaccine experienced significantly decreased risks of sepsis, deep vein thrombosis, dehiscence, acute myocardial infarction, surgical site infections, and death across multiple time points(p<0.05, Bonferroni Correction p = 0.0011). Number needed to vaccinate (NNV) was calculated for all significant and nominally significant findings. CONCLUSION Our analysis examines the potential protective effect of influenza vaccination in SARS-CoV-2-positive surgical patients. Limitations include this study's retrospective nature and reliance on accuracy of medical coding. Future prospective studies are warranted to confirm our findings.
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Affiliation(s)
- Susan M. Taghioff
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Department of Surgery, Luminis Health-Anne Arundel Medical Center, Annapolis, Maryland, United States of America
| | - Benjamin R. Slavin
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Shefali Mehra
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Tripp Holton
- Department of Surgery, Luminis Health-Anne Arundel Medical Center, Annapolis, Maryland, United States of America
| | - Devinder Singh
- Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
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7
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Giner-Soriano M, de Dios V, Ouchi D, Vilaplana-Carnerero C, Monteagudo M, Morros R. Outcomes of COVID-19 Infection in People Previously Vaccinated Against Influenza: Population-Based Cohort Study Using Primary Health Care Electronic Records. JMIR Public Health Surveill 2022; 8:e36712. [PMID: 36265160 PMCID: PMC9662290 DOI: 10.2196/36712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/11/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A possible link between influenza immunization and susceptibility to the complications of COVID-19 infection has been previously suggested owing to a boost in the immunity against SARS-CoV-2. OBJECTIVE This study aimed to investigate whether individuals with COVID-19 could have benefited from vaccination against influenza. We hypothesized that the immunity resulting from the previous influenza vaccination would boost part of the immunity against SARS-CoV-2. METHODS We performed a population-based cohort study including all patients with COVID-19 with registered entries in the primary health care (PHC) electronic records during the first wave of the COVID-19 pandemic (March 1 to June 30, 2020) in Catalonia, Spain. We compared individuals who took an influenza vaccine before being infected with COVID-19, with those who had not taken one. Data were obtained from Information System for Research in Primary Care, capturing PHC information of 5.8 million people from Catalonia. The main outcomes assessed during follow-up were a diagnosis of pneumonia, hospital admission, and mortality. RESULTS We included 309,039 individuals with COVID-19 and compared them on the basis of their influenza immunization status, with 114,181 (36.9%) having been vaccinated at least once and 194,858 (63.1%) having never been vaccinated. In total, 21,721 (19%) vaccinated individuals and 11,000 (5.7%) unvaccinated individuals had at least one of their outcomes assessed. Those vaccinated against influenza at any time (odds ratio [OR] 1.14, 95% CI 1.10-1.19), recently (OR 1.13, 95% CI 1.10-1.18), or recurrently (OR 1.10, 95% CI 1.05-1.15) before being infected with COVID-19 had a higher risk of presenting at least one of the outcomes than did unvaccinated individuals. When we excluded people living in long-term care facilities, the results were similar. CONCLUSIONS We could not establish a protective role of the immunity conferred by the influenza vaccine on the outcomes of COVID-19 infection, as the risk of COVID-19 complications was higher in vaccinated than in unvaccinated individuals. Our results correspond to the first wave of the COVID-19 pandemic, where more complications and mortalities due to COVID-19 had occurred. Despite that, our study adds more evidence for the analysis of a possible link between the quality of immunity and COVID-19 outcomes, particularly in the PHC setting.
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Affiliation(s)
- Maria Giner-Soriano
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Vanessa de Dios
- Department of Clinical Pharmacology, Medicines Area, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Dan Ouchi
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Carles Vilaplana-Carnerero
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Mònica Monteagudo
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Rosa Morros
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Plataforma Spanish Clinical Research Network, Unidad de Investigación Clínica, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Institut Català de la Salut, Barcelona, Spain
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Alòs F, Cánovas Zaldúa Y, Feijóo Rodríguez MV, Del Val Garcia JL, Sánchez-Callejas A, Colomer MÀ. Does Influenza Vaccination Reduce the Risk of Contracting COVID-19? J Clin Med 2022; 11:5297. [PMID: 36142944 PMCID: PMC9504696 DOI: 10.3390/jcm11185297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
The concurrent timing of the COVID-19 pandemic and the seasonal occurrence of influenza, makes it especially important to analyze the possible effect of the influenza vaccine on the risk of contracting COVID-19, or in reducing the complications caused by both diseases, especially in vulnerable populations. There is very little scientific information on the possible protective role of the influenza vaccine against the risk of contracting COVID-19, particularly in groups at high-risk of influenza complications. Reducing the risk of contracting COVID-19 in high-risk patients (those with a higher risk of infection, complications, and death) is essential to improve public well-being and to reduce hospital pressure and the collapse of primary health centers. Apart from overlapping in time, COVID-19 and flu share common aspects of transmission, so that measures to protect against flu might be effective in reducing the risk of contracting COVID-19. In this study, we conclude that the risk of contracting COVID-19 is reduced if patients are vaccinated against flu, but the reduction is small (0.22%) and therefore not clinically important. When this reduction is analysed based on the risk factor suffered by the patient, statistically significant differences have been obtained for patients with cardiovascular problems, diabetics, chronic lung and chronic kidney disease; in all four cases the reduction in the risk of contagion does not reach 1%. It is worth highlighting the behaviour that is completely different from the rest of the data for institutionalized patients. The data for these patients does not suggest a reduction in the risk of contagion for patients vaccinated against the flu, but rather the opposite, a significant increase of 6%. Socioeconomic conditions, as measured by the MEDEA deprivation index, explain increases in the risk of contracting COVID-19, and awareness campaigns should be increased to boost vaccination programs.
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Affiliation(s)
- Francesc Alòs
- Primary Healthcare Center, CAP Passeig de Sant Joan, Gerència Territorial de Barcelona, Institut Català de la Salut, 08010 Barcelona, Spain
- Unitat de Suport a la Recerca Barcelona, Foundation Primary Care Research Institute Jordi Gol i Gurina (IDIAPJGol), 08025 Barcelona, Spain
| | - Yoseba Cánovas Zaldúa
- Primary Healthcare Center, CAP Passeig de Sant Joan, Gerència Territorial de Barcelona, Institut Català de la Salut, 08010 Barcelona, Spain
| | - María Victoria Feijóo Rodríguez
- BASIQ Unitat d’Avaluació, Sistemes d’Informació i Qualitat, Àmbit Barcelona Ciutat, Institut Català de la Salut, 08029 Barcelona, Spain
| | - Jose Luis Del Val Garcia
- Unitat de Suport a la Recerca Barcelona, Foundation Primary Care Research Institute Jordi Gol i Gurina (IDIAPJGol), 08025 Barcelona, Spain
- BASIQ Unitat d’Avaluació, Sistemes d’Informació i Qualitat, Àmbit Barcelona Ciutat, Institut Català de la Salut, 08029 Barcelona, Spain
| | - Andrea Sánchez-Callejas
- BASIQ Unitat d’Avaluació, Sistemes d’Informació i Qualitat, Àmbit Barcelona Ciutat, Institut Català de la Salut, 08029 Barcelona, Spain
| | - Mª Àngels Colomer
- Department of Mathematics ETSEA, University of Lleida, 25198 Lleida, Spain
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Alobwede SM, Kidzeru EB, Katoto PDMC, Lumngwena EN, Cooper S, Goliath R, Jackson A, Wiysonge CS, Shey MS. Influenza Vaccination Uptake and Hesitancy among Healthcare Workers in Early 2021 at the Start of the COVID-19 Vaccine Rollout in Cape Town, South Africa. Vaccines (Basel) 2022; 10:1176. [PMID: 35893825 PMCID: PMC9332543 DOI: 10.3390/vaccines10081176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/09/2022] [Accepted: 07/10/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccination attitudes among healthcare workers (HCWs) predict their level of vaccination uptake and intention to recommend vaccinations to their patients. To our knowledge, no study has been conducted in South Africa to assess hesitancy toward influenza vaccines among HCWs. We adapted a questionnaire developed and validated by Betsch and colleagues and used it to conduct online and face-to-face interviews among HCWs at the start of the COVID-19 vaccine rollout. Multivariate logistic regression was used to assess predictors of influenza vaccine hesitancy. Of 401 participants, 64.5% were women, 49.2% were nurses, and 12.5% were physicians. A total of 54.9% were willing to accept, 20.4% were undecided, and 24.7% intended to refuse influenza vaccination. Participants who were above 25 years of age and physicians were more likely to accept the vaccine. Key predictors of vaccine acceptance were confidence in the effectiveness, consideration of benefits and risks, and willingness to be vaccinated to protect others. Influenza vaccine hesitancy was highest in those who did not trust that influenza vaccines are safe. For future flu seasons, tailored education programs on the safety and effectiveness of flu vaccines targeting younger HCWs, could be vital to improving vaccine uptake.
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Affiliation(s)
- Samuel M. Alobwede
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Clinical Division, Department of Research and Innovation, Partners in Sexual Health, Cape Town 7500, South Africa
| | - Elvis B. Kidzeru
- Centre for Research on Health and Priority Pathologies (CRHPP), Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaounde P.O. Box 13033, Cameroon;
- Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine and Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa
- Division of Radiation Oncology, Department of Radiation Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town 7925, South Africa
| | - Patrick D. M. C. Katoto
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- Centre for General Medicine and Global Health, Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Evelyn N. Lumngwena
- School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa;
- Centre for the Study of Emerging and Re-Emerging Infections (CREMER), Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaounde P.O. Box 13033, Cameroon
| | - Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
- Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Rene Goliath
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
| | - Amanda Jackson
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 7500, South Africa; (P.D.M.C.K.); (S.C.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
- Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban 4091, South Africa
| | - Muki S. Shey
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa; (R.G.); (A.J.)
- Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
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10
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Veronese N, Smith L, Di Gennaro F, Bruyère O, Yang L, Demurtas J, Maggi S, Sabico S, Al-Daghri NM, Barbagallo M, Dominguez LJ, Koyanagi A. Influenza Vaccination and COVID-19 Outcomes in People Older than 50 Years: Data from the Observational Longitudinal SHARE Study. Vaccines (Basel) 2022; 10:vaccines10060899. [PMID: 35746506 PMCID: PMC9229857 DOI: 10.3390/vaccines10060899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023] Open
Abstract
Existing literature on the association between influenza vaccination and COVID-19 infection/outcomes is conflicting. Therefore, we aimed to investigate the association between influenza vaccination and COVID-19 outcomes in a large cohort of adults who participated in the SHARE (Survey of Health, Ageing, and Retirement in Europe). Information regarding influenza vaccination in the previous year, and medical and demographic characteristics, were self-reported. Positivity for COVID-19, symptomatology, and hospitalization were also ascertained using self-reported information. An adjusted logistic regression analysis (including 15 baseline factors or propensity score) was used to assess the association between influenza vaccination and COVID-19 outcomes. A total of 48,408 participants (mean age 67 years; 54.1% females) were included. The prevalence of influenza vaccination was 38.3%. After adjusting for 15 potential confounders, influenza vaccination was significantly associated with a lower risk of positivity for COVID-19 (OR = 0.95; p < 0.0001), symptomatic forms (OR = 0.87; p < 0.0001), and hospitalization for COVID-19 (OR = 0.95; p < 0.0001). The results were similar when using a propensity score approach. In conclusion, influenza vaccination may be beneficial for the prevention of COVID-19, as the present study found that influenza vaccination was associated with a small/moderate lower risk of COVID-19 infection and adverse outcomes.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy; (M.B.); (L.J.D.)
- Correspondence:
| | - Lee Smith
- Center for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PTT, UK;
| | | | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium;
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3E4, Canada;
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jacopo Demurtas
- Primary Care Department, Azienda USL Toscana Sud Est, 52100 Grosseto, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stefania Maggi
- Institute of Neuroscience, National Research Council, 00185 Padova, Italy;
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (S.S.); (N.M.A.-D.)
| | - Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (S.S.); (N.M.A.-D.)
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy; (M.B.); (L.J.D.)
| | - Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy; (M.B.); (L.J.D.)
- Faculty of Medicine, University of Kore, 94100 Enna, Italy
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu/CIBERSAM, ISCIII, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08014 Barcelona, Spain;
- ICREA, 08010 Barcelona, Spain
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11
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Fernández Ibáñez JM, Morales Ballesteros MDC, Fernández Anguita MJ, Galindo Andúgar MÁ, Arias Arias Á, Barberá-Farré JR. Influence of influenza vaccine and comorbidity on the evolution of hospitalized COVID-19 patients⋆. MEDICINA CLÍNICA (ENGLISH EDITION) 2022; 158:603-607. [PMID: 35637933 PMCID: PMC9132981 DOI: 10.1016/j.medcle.2021.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
Background and objective The COVID-19 coronavirus disease outbreak is evolving around the world. Objective: To evaluate the associations between influenza vaccination and other factors and the risk of mortality in hospitalized COVID-19 patients. Materials and methods Retrospective observational study. This study was conducted among hospitalized patients with COVID-19 at Hospital La Mancha Centro between March 5 and 25, 2020. Information on influenza vaccination was extracted from electronic medical records. We used a multivariate logistic regression to explore the association between influenza vaccination and mortality from COVID and other risk factors. Results 410 patients were included. Influenza vaccine had no effect among COVID-19 hospitalized patients [OR: 1.55 (95%CI: 0.96–2.48; p = 0.071)]. Increasing hospital mortality was associated with older age [OR: 1.05 (95% CI 1.02–1.07), per year increase; p < 0.001)], Charlson ≥3 [OR: 1.84 (95%CI: 1.07–3.15, p = 0.027)] and heart failure on admission [OR: 6 (IC95%: 1.6–21.7; p = 0.007)]. Conclusions Influenza vaccine had no effect among COVID-19 hospitalized patients. The risk factors identified were older age, higher comorbidity and heart failure on admission.
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Affiliation(s)
| | | | | | | | - Ángel Arias Arias
- Unidad de Investigación, Hospital General Mancha Centro, Alcázar de San Juan, Spain
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12
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Domenech de Cellès M, Casalegno JS, Lina B, Opatowski L. Estimating the impact of influenza on the epidemiological dynamics of SARS-CoV-2. PeerJ 2021; 9:e12566. [PMID: 34950537 PMCID: PMC8647717 DOI: 10.7717/peerj.12566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
As in past pandemics, co-circulating pathogens may play a role in the epidemiology of coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In particular, experimental evidence indicates that influenza infection can up-regulate the expression of ACE2-the receptor of SARS-CoV-2 in human cells-and facilitate SARS-CoV-2 infection. Here we hypothesized that influenza impacted the epidemiology of SARS-CoV-2 during the early 2020 epidemic of COVID-19 in Europe. To test this hypothesis, we developed a population-based model of SARS-CoV-2 transmission and of COVID-19 mortality, which simultaneously incorporated the impact of non-pharmaceutical control measures and of influenza on the epidemiological dynamics of SARS-CoV-2. Using statistical inference methods based on iterated filtering, we confronted this model with mortality incidence data in four European countries (Belgium, Italy, Norway, and Spain) to systematically test a range of assumptions about the impact of influenza. We found consistent evidence for a 1.8-3.4-fold (uncertainty range across countries: 1.1 to 5.0) average population-level increase in SARS-CoV-2 transmission associated with influenza during the period of co-circulation. These estimates remained robust to a variety of alternative assumptions regarding the epidemiological traits of SARS-CoV-2 and the modeled impact of control measures. Although further confirmatory evidence is required, our results suggest that influenza could facilitate the spread and hamper effective control of SARS-CoV-2. More generally, they highlight the possible role of co-circulating pathogens in the epidemiology of COVID-19.
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Affiliation(s)
| | - Jean-Sebastien Casalegno
- Laboratoire de Virologie des HCL, IAI, CNR des Virus à Transmission Respiratoire (dont la grippe) Hôpital de la Croix-Rousse F-69317 Lyon Cedex 04, France, Lyon, France
- Virpath, Centre International de Recherche en Infectiologie (CIRI), Université de Lyon Inserm U1111, CNRS UMR 5308, ENS de Lyon, UCBL F-69372, Lyon, France
| | - Bruno Lina
- Laboratoire de Virologie des HCL, IAI, CNR des Virus à Transmission Respiratoire (dont la grippe) Hôpital de la Croix-Rousse F-69317 Lyon Cedex 04, France, Lyon, France
- Virpath, Centre International de Recherche en Infectiologie (CIRI), Université de Lyon Inserm U1111, CNRS UMR 5308, ENS de Lyon, UCBL F-69372, Lyon, France
| | - Lulla Opatowski
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-Infective Evasion and Pharma- Coepidemiology Team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Evasion to Antibiotics, Paris, France
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13
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Zeynali Bujani M, Behnampour M, Rahimi N, Safari T, Khazaei Feizabad A, Hossein Sarbazi A, Baniasadi M, Rezaei N, Ansari Moghaddam A. The Effect of Influenza Vaccination on COVID-19 Morbidity, Severity and Mortality: Systematic Review and Meta-Analysis. Malays J Med Sci 2021; 28:20-31. [PMID: 35002487 PMCID: PMC8715887 DOI: 10.21315/mjms2021.28.6.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/20/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is rapidly developing worldwide with a high mortality rate. In this meta-analysis study, the effect of influenza vaccination on the prevention of COVID-19 and its consequences in patients were investigated. The systematic search for this study was performed from November 2019 to 25 November 2020, in the databases of Medline, PubMed, Scopus, Web of Science, Embase, Ebsco, Cochrane and medRxiv. Search terms used included COVID-19, coronavirus, SARS-CoV-2, covid, influenza, flu, grippe and vaccine. The present study examined the association between influenza vaccination and COVID-19 including COVID-19 infection, mortality, hospitalisation and intensive care unit (ICU) admission. Finally, the pooled estimates for different outcomes were calculated by the software for statistics and data science (STATA) version 15 and I2 was used to determine the heterogeneity. By analysing the data of articles, the pooled estimates of these data indicated that influenza vaccination could lower probability of COVID-19 infection up to 24% (OR = 0.77; 95% CI: 0.65, 0.91), of death up to 32% (OR = 0.68; 95% CI: 0.42, 1.11), of the hospitalisation up to 25% (OR = 0.75; 95% CI: 0.46; 1.23) and of admission to ICU up to 29% (OR = 0.71; 95% CI: 0.40, 1.27). Influenza vaccination can help decrease the COVID-19 infection and reduce hospitalisation and the need for ICU and mortality rates.
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Affiliation(s)
- Meysam Zeynali Bujani
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Mohammad Behnampour
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Nima Rahimi
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Tahereh Safari
- Department of Physiology, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | | | - Armaghan Hossein Sarbazi
- Department of Emergency Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Marzieh Baniasadi
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Alireza Ansari Moghaddam
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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14
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King JP, McLean HQ, Belongia EA. Risk of symptomatic severe acute respiratory syndrome coronavirus 2 infection not associated with influenza vaccination in the 2019-2020 season. Influenza Other Respir Viruses 2021; 15:697-700. [PMID: 34169670 PMCID: PMC8447211 DOI: 10.1111/irv.12880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 01/07/2023] Open
Abstract
The association of influenza vaccine and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was assessed by test-negative design using data collected for a study of outpatient COVID-19-like illness with onset dates from June to September 2020. Multivariable logistic regression models examined the association between receipt of 2019-2020 influenza vaccine and PCR-confirmed SARS-CoV-2 with adjustment for potential confounders. Receipt of influenza vaccine during the 2019-2020 influenza season was not associated with increased odds of SARS-CoV-2 infection in adults (aOR 0.83, 95% CI 0.63 to 1.10) or children (aOR 0.92, 95% CI 0.47 to 1.80).
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Affiliation(s)
- Jennifer P. King
- Center for Clinical Epidemiology & Population HealthMarshfield Clinic Research InstituteMarshfieldWisconsinUSA
| | - Huong Q. McLean
- Center for Clinical Epidemiology & Population HealthMarshfield Clinic Research InstituteMarshfieldWisconsinUSA
| | - Edward A. Belongia
- Center for Clinical Epidemiology & Population HealthMarshfield Clinic Research InstituteMarshfieldWisconsinUSA
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15
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Montalti M, Di Valerio Z, Rallo F, Squillace L, Costantino C, Tomasello F, Mauro GL, Stillo M, Perrone P, Resi D, Gori D, Vitale F, Fantini MP. Attitudes toward the SARS-CoV-2 and Influenza Vaccination in the Metropolitan Cities of Bologna and Palermo, Italy. Vaccines (Basel) 2021; 9:vaccines9101200. [PMID: 34696308 PMCID: PMC8538834 DOI: 10.3390/vaccines9101200] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022] Open
Abstract
Vaccine hesitancy (VH) is known to play a relevant role in thwarting the efforts toward reaching satisfactory influenza vaccination coverage, and has caused similar difficulties during the COVID-19 pandemic. This study aims to describe the phenomenon and produce insights on the reasons behind VH. A survey was administered between December 2020 and February 2021 to adults living in the cities of Bologna and Palermo. Of the 443 subjects enrolled, 47.3% were likely to get the influenza vaccination, while 75.6% were willing to receive the COVID-19 vaccination. The most frequent determinants that motivated the willingness to get the COVID-19 vaccine were trust in the safety of vaccines and belief that the vaccine is an effective tool. As for people’s unwillingness to be vaccinated, being exposed to information that produced doubts about the vaccine and lack of trust in a newly developed vaccine were the most frequently involved determinants. Statistically significant positive associations were found between the willingness to be vaccinated and postgraduate education and the propensity towards influenza vaccination. A negative association with being over 40 years old and of female gender was also found. These results might have an impact in better understanding individual reasons behind VH, identifying which categories are more exposed to it and which strategies should be implemented.
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Affiliation(s)
- Marco Montalti
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Zeno Di Valerio
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Flavia Rallo
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
- Correspondence: ; Tel.: +39-051-209-4802
| | - Lorena Squillace
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Francesco Tomasello
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological, and Stomatological Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Michela Stillo
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Paola Perrone
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Davide Resi
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Davide Gori
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Maria Pia Fantini
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
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16
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Influenza vaccine during the 2019-2020 season and COVID-19 risk: A case-control study in Québec. Can Commun Dis Rep 2021; 47:430-434. [PMID: 34737675 DOI: 10.14745/ccdr.v47i10a05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background We carried out a case-control study that examined whether receipt of the inactivated influenza vaccine during the 2019-2020 season impacted on the risk of coronavirus disease 2019 (COVID-19), as there was a concern that the vaccine could be detrimental through viral interference. Methods A total of 920 cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (diagnosed between March and October 2020) and 2,123 uninfected controls were recruited from those who were born in Québec between 1956 and 1976 and who had received diagnostic services at two hospitals (Montréal and Sherbrooke, Québec). After obtaining consent, a questionnaire was administered by phone. Data were analyzed by logistic regression. Results Among healthcare workers, inactivated influenza vaccine received during the previous influenza season was not associated with increased COVID-19 risk (AOR: 0.99, 95% CI: 0.69-1.41). Among participants who were not healthcare workers, influenza vaccination was associated with lower odds of COVID-19 (AOR: 0.73, 95% CI 0.56-0.96). Conclusion We found no evidence that seasonal influenza vaccine increased the risk of developing COVID-19.
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17
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HIV self-testing in Ottawa, Canada used by persons at risk for HIV: The GetaKit study. CANADA COMMUNICABLE DISEASE REPORT = RELEVÉ DES MALADIES TRANSMISSIBLES AU CANADA 2021; 47:435-441. [PMID: 34737676 DOI: 10.14745/ccdr.v47i10a06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background The Public Health Agency of Canada estimates that about 87% of persons living with human immunodeficiency virus (HIV) in Canada have been diagnosed, which is well below the Joint United Nations Programme on HIV/AIDS target to have 95% of HIV-positive persons diagnosed. Research has shown that HIV self-testing may help increase such diagnoses, especially among the populations who are most affected by HIV. The objective of the study was to determine the uptake and diagnosis outcomes associated with free HIV self-testing. Methods We developed the first online mailout free HIV self-testing program in Canada and implemented it in Ottawa. This project ran through the website, www.GetaKit.ca. We intended to recruit 150-400 participants over a 6-12-month period, estimating that this number would yield between 0-1 positive test results (expected positivity rate of 0.08%). Results Between July 20, 2020 and April 1, 2021, 1,268 people accessed the GetaKit website and verified their eligibility. In total, 600 persons were eligible and 405 ordered an HIV kit. Of those who ordered a kit, 399 completed a baseline survey. Overall, 71% of these participants were members of HIV priority groups. For test results, 228 persons reported test results, with one being positive, for a positivity rate of 0.24% overall and 0.44% of reported results. These rates exceed that normally observed in Ottawa. Conclusion Self-testing of HIV can be effectively delivered through a website. Such an intervention will also be used by persons with undiagnosed infections and appears to do so at a rate higher than that observed by other means of testing. Self-testing of HIV may therefore help Canada achieve the United Nations 95-95-95 targets.
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18
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Chiappini E, Parigi S, Galli L, Licari A, Brambilla I, Angela Tosca M, Ciprandi G, Marseglia G. Impact that the COVID-19 pandemic on routine childhood vaccinations and challenges ahead: A narrative review. Acta Paediatr 2021; 110:2529-2535. [PMID: 34028088 PMCID: PMC8222862 DOI: 10.1111/apa.15949] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/23/2022]
Abstract
Aim To document the decline in vaccination coverage in the first months of 2020 as an indirect effect of the COVID‐19 pandemic. Methods We performed a literature review in medical databases. Overall, 143 articles were initially retrieved, out of which 48 were selected and included in the review. Results Our review retrieved similar data in many countries worldwide, and, globally, preliminary data from the first 4 months of 2020 indicate a decline in diphtheria‐tetanus‐pertussis coverage, generally considered the marker of vaccination coverage across countries. World Health Organization recommends maintaining vaccination services, prioritising primary series vaccinations especially for measles‐rubella or poliomyelitis, but it also lets each country decide whether to maintain the immunisation services evaluating the current epidemiology of vaccine‐preventable diseases and the COVID‐19 local transmission scenario. Successively, recovering of vaccinations should be planned. Moreover, during the pandemic, influenza vaccination should be promoted as a central public health measure. Conclusion Future challenges will be to maintain the vaccination programmes, especially in children younger than 2 years old and adolescents, to plan the recovery of vaccinations for subjects who postponed them during the lockdown, and to early identify any vaccine‐preventable disease outbreak.
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Affiliation(s)
- Elena Chiappini
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Sara Parigi
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Luisa Galli
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Amelia Licari
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
| | - Ilaria Brambilla
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
| | | | | | - Gianluigi Marseglia
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
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19
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Massari M, Spila-Alegiani S, Fabiani M, Belleudi V, Trifirò G, Kirchmayer U, Poggi FR, Mancuso P, Menniti-Ippolito F, Gini R, Bartolini C, Leoni O, Ercolanoni M, Da-Re F, Guzzinati S, Luxi N, Riccardo F, Giorgi-Rossi P. Association of Influenza Vaccination and Prognosis in Patients Testing Positive to SARS-CoV-2 Swab Test: A Large-Scale Italian Multi-Database Cohort Study. Vaccines (Basel) 2021; 9:716. [PMID: 34358133 PMCID: PMC8310185 DOI: 10.3390/vaccines9070716] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022] Open
Abstract
To investigate the association of the 2019-2020 influenza vaccine with prognosis of patients positive for SARS-CoV-2A, a large multi-database cohort study was conducted in four Italian regions (i.e., Lazio, Lombardy, Veneto, and Tuscany) and the Reggio Emilia province (Emilia-Romagna). More than 21 million adults were residing in the study area (42% of the population). We included 115,945 COVID-19 cases diagnosed during the first wave of the pandemic (February-May, 2020); 34.6% of these had been vaccinated against influenza. Three outcomes were considered: hospitalization, death, and intensive care unit (ICU) admission/death. The adjusted relative risk (RR) of being hospitalized in the vaccinated group when compared with the non-vaccinated group was 0.87 (95% CI: 0.86-0.88). This reduction in risk was not confirmed for death (RR = 1.04; 95% CI: 1.01-1.06), or for the combined outcome of ICU admission or death. In conclusion, our study, conducted on the vast majority of the population during the first wave of the pandemic in Italy, showed a 13% statistically significant reduction in the risk of hospitalization in some geographical areas and in the younger population. No impact of seasonal influenza vaccination on COVID-19 prognosis in terms of death and death or ICU admission was estimated.
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Affiliation(s)
- Marco Massari
- Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation (CNRVF), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.M.); (F.M.-I.)
| | - Stefania Spila-Alegiani
- Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation (CNRVF), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.M.); (F.M.-I.)
| | - Massimo Fabiani
- Department of Infectious Diseases (DMI), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.F.); (F.R.)
| | - Valeria Belleudi
- Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00147 Rome, Italy; (V.B.); (U.K.); (F.R.P.)
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro 3, 37134 Verona, Italy;
- Italian Society of Pharmacology, Via Giovanni Pascoli 3, 20129 Milan, Italy
| | - Ursula Kirchmayer
- Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00147 Rome, Italy; (V.B.); (U.K.); (F.R.P.)
| | - Francesca Romana Poggi
- Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00147 Rome, Italy; (V.B.); (U.K.); (F.R.P.)
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy; (P.M.); (P.G.-R.)
| | - Francesca Menniti-Ippolito
- Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation (CNRVF), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.M.); (F.M.-I.)
| | - Rosa Gini
- Agenzia Regionale di Sanità della Toscana, Via Pietro Dazzi 1, 50141 Florence, Italy; (R.G.); (C.B.)
| | - Claudia Bartolini
- Agenzia Regionale di Sanità della Toscana, Via Pietro Dazzi 1, 50141 Florence, Italy; (R.G.); (C.B.)
| | - Olivia Leoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Piazza Città di Lombardia 1, 20124 Milan, Italy; (O.L.); (M.E.)
| | - Michele Ercolanoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Piazza Città di Lombardia 1, 20124 Milan, Italy; (O.L.); (M.E.)
| | - Filippo Da-Re
- Regional Directorate of Prevention, Food Safety, Veterinary Public Health, Regione del Veneto, Rio Novo-Dorsoduro 3493, 30123 Venice, Italy;
| | - Stefano Guzzinati
- Azienda Zero, Regione del Veneto, Passaggio Luigi Gaudenzio, 1, 35131 Padova, Italy;
| | - Nicoletta Luxi
- Department BIOMORF, University of Messina, Piazza Pugliatti 1, 98122 Messina, Italy;
| | - Flavia Riccardo
- Department of Infectious Diseases (DMI), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.F.); (F.R.)
| | - Paolo Giorgi-Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy; (P.M.); (P.G.-R.)
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20
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Fernández Ibáñez JM, Morales Ballesteros MDC, Fernández Anguita MJ, Galindo Andúgar MÁ, Arias Arias Á, Barberá-Farré JR. Influence of influenza vaccine and comorbidity on the evolution of hospitalized COVID-19 patients. Med Clin (Barc) 2021; 158:603-607. [PMID: 34304882 PMCID: PMC8206630 DOI: 10.1016/j.medcli.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 12/29/2022]
Abstract
Antecedentes y objetivo El brote de la enfermedad COVID-19 está evolucionando en todo el mundo. El objetivo del estudio es evaluar la asociación entre la vacunación antigripal y el riesgo de mortalidad en pacientes con COVID-19 hospitalizados, así como otros factores de riesgo. Materiales y métodos Estudio observacional retrospectivo. Se realizó entre pacientes hospitalizados con COVID-19 del Hospital La Mancha Centro entre el 5 y el 25 de marzo de 2020. Utilizamos una regresión logística multivariable para explorar la asociación entre la vacunación antigripal y la mortalidad por COVID y otros factores de riesgo. Resultados Se incluyeron 410 pacientes. La vacunación antigripal no tuvo efecto entre los pacientes hospitalizados por COVID-19 (OR: 1,55 [IC 95%; 0,96-2,48; p = 0,071]). El aumento de la mortalidad intrahospitalaria se asoció con edad avanzada (OR: 1,05 [IC 95%; 1,02-1,07]), por cada aumento de año; p < 0,001, Charlson ≥ 3 (OR: 1,84 [IC 95%; 1,07-3,15, p = 0,027]) e insuficiencia cardíaca al ingreso (OR: 6 [IC 95%; 1,6-21,7; p = 0,007]). Conclusiones La vacuna antigripal no tuvo efecto en la evolución de pacientes hospitalizados por COVID-19. Los factores de riesgo identificados fueron la edad avanzada, mayor comorbilidad e insuficiencia cardíaca al ingreso.
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Affiliation(s)
| | | | | | | | - Ángel Arias Arias
- Unidad de Investigación Hospital General Mancha Centro, Alcázar de San Juan, España
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21
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The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Vaccines (Basel) 2021; 9:vaccines9050529. [PMID: 34065294 PMCID: PMC8161076 DOI: 10.3390/vaccines9050529] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022] Open
Abstract
Influenza could circulate in parallel with COVID-19. In the context of COVID-19, some studies observed inverse associations between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, while others did not. We conducted a meta-analysis to assess the association between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, aiming to provide evidence for COVID-19 prevention and vaccination promotion. We searched four databases from inception to 10 March, 2021. Random effects and fixed effects models were used to pool odds ratios (ORs) and adjusted estimates with 95% confidence intervals (CIs). We used funnel plots to evaluate the publication bias, I2 statistics to evaluate the heterogeneity, and conducted subgroup analyses. Sixteen observational studies involving 290,327 participants were included. Influenza vaccination was associated with a lower risk of SARS-CoV-2 infection (pooled adjusted OR: 0.86, 95%CI: 0.81–0.91), while not significantly associated with adverse outcomes (intensive care: adjusted OR 0.63, 95%CI: 0.22–1.81; hospitalization: adjusted OR 0.74, 95%CI: 0.51–1.06; mortality: adjusted OR 0.89, 95%CI: 0.73–1.09). Our findings suggest that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection. It is crucial for policy makers to implement strategies on influenza vaccination, for it may also have benefits for COVID-19 prevention.
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22
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Influenza and pneumococcal vaccinations are not associated to COVID-19 outcomes among patients admitted to a university hospital. Vaccine 2021; 39:3493-3497. [PMID: 34020813 PMCID: PMC8106908 DOI: 10.1016/j.vaccine.2021.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/02/2022]
Abstract
In order to reduce the burden on healthcare systems and to support differential diagnosis with COVID-19, influenza and pneumococcal vaccinations were strongly recommended during the COVID-19 pandemic, especially in vulnerable groups. However, no univocal and conclusive evidence on the relationship between influenza and pneumococcal vaccinations and COVID‐19 outcomes exists. We evaluated the association between such vaccinations, COVID-19 hospitalization, intensive care unit admissions and deaths in a cohort (N = 741) of COVID-19 patients who had access to the emergency room of a large Italian University hospital between March 1, 2020 and June 1, 2020. Results show that influenza and pneumococcal vaccinations did not affect hospitalization, intensive care unit admission and deaths in COVID-19 patients in the overall sample and in those ≥65 years. The same pattern of results was confirmed considering timing of influenza vaccine administration, vaccination type, and number of uptakes in the last five vaccination campaigns. In conclusion, our study does not support an impact of influenza and pneumococcal vaccinations on COVID-19 outcomes.
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23
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Root-Bernstein R. Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths. Vaccines (Basel) 2021; 9:474. [PMID: 34066697 PMCID: PMC8151685 DOI: 10.3390/vaccines9050474] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/01/2021] [Accepted: 05/05/2021] [Indexed: 12/21/2022] Open
Abstract
This study examines the relationship of pneumococcal vaccination rates, influenza, measles-mumps-rubella (MMR) diphtheria-tetanus-pertussis vaccinations (DTP), polio, Haemophilus influenzae type B (Hib), and Bacillus Calmette-Guerin (tuberculosis) vaccination rates to COVID-19 case and death rates for 51 nations that have high rates of COVID-19 testing and for which nearly complete childhood, at-risk adult and elderly pneumococcal vaccination data were available. The study is unique in a large number of nations examined, the range of vaccine controls, in testing effects of combinations of vaccinations, and in examining the relationship of COVID-19 and vaccination rates to invasive pneumococcal disease (IPD). Analysis of Italian regions and the states of the United States were also performed. Significant positive correlations were found between IPD (but not lower respiratory infections) and COVID-19 rates, while significant negative correlations were found between pneumococcal vaccination and COVID-19 rates. Influenza and MMR vaccination rates were negatively correlated with lower respiratory infection (LRI) rates and may synergize with pneumococcal vaccination rates to protect against COVID-19. Pneumococcal and influenza vaccination rates were independent of other vaccination rates. These results suggest that endemic rates of bacterial pneumonias, for which pneumococci are a sentinel, may set regional and national susceptibility to severe COVID-19 disease and death.
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Affiliation(s)
- Robert Root-Bernstein
- Department of Physiology, 567 Wilson Road, Room 1104 Biomedical and Physical Sciences Building, Michigan State University, East Lansing, MI 48824, USA
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24
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Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland. Vaccines (Basel) 2021. [DOI: 10.3390/vaccines9050415
expr 888502299 + 814659637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55–0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.
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25
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Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland. Vaccines (Basel) 2021; 9:415. [PMID: 33919206 PMCID: PMC8143078 DOI: 10.3390/vaccines9050415&set/a 843283251+814136669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55-0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.
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26
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Kowalska M, Niewiadomska E, Barański K, Kaleta-Pilarska A, Brożek G, Zejda JE. Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland. Vaccines (Basel) 2021; 9:415. [PMID: 33919206 PMCID: PMC8143078 DOI: 10.3390/vaccines9050415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55-0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.
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Affiliation(s)
- Małgorzata Kowalska
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Ewa Niewiadomska
- Department of Epidemiology and Biostatistics, School of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland;
| | - Kamil Barański
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Angelina Kaleta-Pilarska
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Grzegorz Brożek
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Jan Eugeniusz Zejda
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
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27
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Zejda JE, Brożek GM, Kowalska M, Barański K, Kaleta-Pilarska A, Nowakowski A, Xia Y, Buszman P. Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Random Sample of Inhabitants of the Katowice Region, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3188. [PMID: 33808716 PMCID: PMC8003539 DOI: 10.3390/ijerph18063188] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022]
Abstract
Lack of knowledge around seroprevalence levels of COVID-19 in Poland was the reason for the implementation of a seroepidemiological study in the Katowice Region (2,100,000 inhabitants). In October-November 2020, a questionnaire examination and measurement of anti-SARS-CoV-2 IgG and IgM antibodies were performed in a random sample of the general population (n = 1167). The objectives of the study were to estimate the prevalence of IgG and IgM antibodies and to assess their host-related correlates. The prevalence of IgG seropositivity was 11.4% (95% CI: 9.5-13.2%) and IgM seropositivity was 4.6% (95% CI: 3.5-5.8%). Diagnosis of COVID-19 was found in 4.8% of subjects. A positive IgG test was statistically significantly associated with age (inverse relationship), a person's contact with a COVID-19 patient, quarantine, and two symptoms in the past: fever and loss of smell/taste. Positive IgG tests were less prevalent in subjects who had diagnoses of arterial hypertension, diabetes, or rheumatologic disorders. IgM test positivity was associated with quarantine and loss of smell/taste only with no effect of chronic diseases found. In Poland, in the period October-November 2020, the prevalence of SARS-CoV-2 infection was larger than earlier estimates obtained in other European countries, probably reflecting the measurements obtained during the "second wave" of the epidemic.
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Affiliation(s)
- Jan E. Zejda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
| | - Grzegorz M. Brożek
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
| | - Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
| | - Kamil Barański
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
| | - Angelina Kaleta-Pilarska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
| | - Artur Nowakowski
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
| | - Yuchen Xia
- State Key Laboratory of Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430072, China;
| | - Paweł Buszman
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (G.M.B.); (M.K.); (K.B.); (A.K.-P.); (A.N.); (P.B.)
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28
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Chen YC, Chow-In Ko P, Lee WC, Lien WC. Ecological fallacy in COVID-19 epidemiological inference: Influenza vaccination rate as an example. J Formos Med Assoc 2021; 120:1655-1656. [PMID: 33781655 PMCID: PMC7972645 DOI: 10.1016/j.jfma.2021.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yi-Chu Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Nursing, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Patrick Chow-In Ko
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wan-Ching Lien
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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29
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Kissling E, Hooiveld M, Brytting M, Vilcu AM, de Lange M, Martínez-Baz I, Sigerson D, Enkirch T, Belhillil S, Meijer A, Castilla J, William N, Carnahan A, Falchi A, Hendriksen J, Casado I, Murray J, Enouf V, Dijkstra F, Marques DFP, Valenciano M. Absence of association between 2019-20 influenza vaccination and COVID-19: Results of the European I-MOVE-COVID-19 primary care project, March-August 2020. Influenza Other Respir Viruses 2021; 15:429-438. [PMID: 33481344 PMCID: PMC8013620 DOI: 10.1111/irv.12839] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019-20 influenza vaccination and COVID-19. METHODS We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European countries, from March to August 2020. Patients presenting with acute respiratory infection were swabbed, with demographic, 2019-20 influenza vaccination and clinical information documented. Using logistic regression, we measured the adjusted odds ratio (aOR), adjusting for study site and age, sex, calendar time, presence of chronic conditions. The main analysis included patients swabbed ≤7 days after onset from the three countries with <15% of missing influenza vaccination. In secondary analyses, we included five countries, using multiple imputation with chained equations to account for missing data. RESULTS We included 257 COVID-19 cases and 1631 controls in the main analysis (three countries). The overall aOR between influenza vaccination and COVID-19 was 0.93 (95% CI: 0.66-1.32). The aOR was 0.92 (95% CI: 0.58-1.46) and 0.92 (95% CI: 0.51-1.67) among those aged 20-59 and ≥60 years, respectively. In secondary analyses, we included 6457 cases and 69 272 controls. The imputed aOR was 0.87 (95% CI: 0.79-0.95) among all ages and any delay between swab and symptom onset. CONCLUSIONS There was no evidence that COVID-19 cases were more likely to be vaccinated against influenza than controls. Influenza vaccination should be encouraged among target groups for vaccination. I-MOVE-COVID-19 will continue documenting influenza vaccination status in 2020-21, in order to learn about effects of recent influenza vaccination.
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Affiliation(s)
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | | | - Sylvie Belhillil
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, Institut Pasteur, UMR 3568 CNRS, University of Paris, Paris, France
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jesus Castilla
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | | | | | - Janneke Hendriksen
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | - Vincent Enouf
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, Institut Pasteur, UMR 3568 CNRS, University of Paris, Paris, France
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Diogo F P Marques
- Epiconcept, Paris, France.,Public Health Scotland, Glasgow, Scotland
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30
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Stefanati A, d’Anchera E, De Motoli F, Savio M, Toffoletto MV, Gabutti G. Value of Immunizations during the COVID-19 Emergency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E778. [PMID: 33477591 PMCID: PMC7831295 DOI: 10.3390/ijerph18020778] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 12/05/2022]
Abstract
Recent estimates by World Health Organization (WHO, Geneva, Switzerland) and United Nations International Children's Emergency Fund (UNICEF) show a significant decline in vaccinal coverage rates in both pediatric and adult populations. The interruption of vaccination services is reported in at least 68 countries, with the involvement of about 80 million children worldwide. The situation is alarming if we consider that already in the period preceding the pandemic, immunization programs slowed down in various areas of the world. For these reasons, there is the risk of overloading health systems, already under pressure from the pandemic emergency, by employing human and economic resources for the management of epidemic outbreaks from vaccine-preventable diseases. The restoration and integration of vaccination services, the immunization of susceptible individuals as well as the adoption of adequate monitoring and surveillance measures are the main activities adopted by different countries to address the current global health emergency.
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Affiliation(s)
- Armando Stefanati
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Erica d’Anchera
- Department of Medical Sciences, Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.d.); (F.D.M.); (M.S.); (M.V.T.)
| | - Francesco De Motoli
- Department of Medical Sciences, Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.d.); (F.D.M.); (M.S.); (M.V.T.)
| | - Marta Savio
- Department of Medical Sciences, Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.d.); (F.D.M.); (M.S.); (M.V.T.)
| | - Maria Vittoria Toffoletto
- Department of Medical Sciences, Postgraduate School of Hygiene and Preventive Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.d.); (F.D.M.); (M.S.); (M.V.T.)
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
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Gatti M, Raschi E, Moretti U, Ardizzoni A, Poluzzi E, Diemberger I. Influenza Vaccination and Myo-Pericarditis in Patients Receiving Immune Checkpoint Inhibitors: Investigating the Likelihood of Interaction through the Vaccine Adverse Event Reporting System and VigiBase. Vaccines (Basel) 2021; 9:vaccines9010019. [PMID: 33406694 PMCID: PMC7823897 DOI: 10.3390/vaccines9010019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 01/13/2023] Open
Abstract
Background: Evidence on whether the influenza vaccine could exacerbate immune-related adverse events, including myopericarditis (MP), in patients treated with immune checkpoint inhibitors (ICIs), is still conflicting. We explored this issue through a global real-world approach. Methods: We queried the Vaccine Adverse Event Reporting System (VAERS) and VigiBase to retrieve cases of MP in which the influenza vaccine and ICIs were recorded as suspect and were concomitantly reported. For the included cases, causality assessment and Drug Interaction Probability Scale (DIPS) algorithms were applied. Results: There were 191 and 399 reports of MP with the influenza vaccine that were retrieved (VAERS and VigiBase, respectively). No case of MP reporting the concomitant use of ICIs and the influenza vaccine was found in VAERS, while three cases of myocarditis were retrieved in VigiBase. All of the cases were unclassifiable for a causality assessment because of the lack of data concerning latency. According to the DIPS, one report was categorized as possible and two as doubtful. Conclusion: The paucity of cases coupled with the doubtful causality assessment make the potential interaction between influenza vaccines and ICIs in cancer patients negligible from clinical and epidemiological standpoints. These findings support the cardiovascular safety of the influenza vaccination, which remains strongly recommended in cancer patients, especially in the current COVID-19 era.
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Affiliation(s)
- Milo Gatti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy; (M.G.); (E.R.); (E.P.)
| | - Emanuel Raschi
- Department of Medical and Surgical Sciences, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy; (M.G.); (E.R.); (E.P.)
| | - Ugo Moretti
- Department of Public Health and Community Medicine, University of Verona, 37134 Verona, Italy;
| | - Andrea Ardizzoni
- Medical Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico S. Orsola-Malpighi, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy;
| | - Elisabetta Poluzzi
- Department of Medical and Surgical Sciences, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy; (M.G.); (E.R.); (E.P.)
| | - Igor Diemberger
- Cardiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-2143-434; Fax: +39-0516-364-216
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Wang X, Kulkarni D, Dozier M, Hartnup K, Paget J, Campbell H, Nair H. Influenza vaccination strategies for 2020-21 in the context of COVID-19. J Glob Health 2020; 10:021102. [PMID: 33312512 PMCID: PMC7719353 DOI: 10.7189/jogh.10.021102] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Influenza vaccination prevents people from influenza-related diseases and thereby mitigates the burden on national health systems when COVID-19 circulates and public health measures controlling respiratory viral infections are relaxed. However, it is challenging to maintain influenza vaccine services as the COVID-19 pandemic has the potential to disrupt vaccination programmes in many countries during the 2020/21 winter. We summarise available recommendations and strategies on influenza vaccination, specifically the changes in the context of the COVID-19 pandemic. METHODS We searched websites and databases of national and international public health agencies (focusing on Europe, North and South America, Australia, New Zealand, and South Africa). We also contacted key influenza immunization focal points and experts in respective countries and organizations including WHO and ECDC. RESULTS Available global and regional guidance emphasises the control of COVID-19 infection in immunisation settings by implementing multiple measures, such as physical distancing, hand hygiene practice, appropriate use of personal protective equipment by health care workers and establishing separate vaccination sessions for medically vulnerable people. The guidance also emphasises using alternative models or settings (eg, outdoor areas and pharmacies) for vaccine delivery, communication strategies and developing registry and catch-up programmes to achieve high coverage. Several novel national strategies have been adopted, such as combining influenza vaccination with other medical visits and setting up outdoor and drive through vaccination clinics. Several Southern Hemisphere countries have increased influenza vaccine coverage substantially for the 2020 influenza season. Most of the countries included in our review have planned a universal or near universal influenza vaccination for health care workers, or have made influenza vaccination for health care workers mandatory. Australia has requested that all workers and visitors in long term care facilities receive influenza vaccine. The UK has planned to expand the influenza programme to provide free influenza vaccine for the first time to all adults 50-64 years of age, people on the shielded patient list and their household members and children in the first year of secondary school. South Africa has additionally prioritised people with hypertension for influenza vaccination. CONCLUSIONS This review of influenza vaccination guidance and strategies should support strategy development on influenza vaccination in the context of COVID-19.
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Affiliation(s)
- Xin Wang
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Durga Kulkarni
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Marshall Dozier
- Information Services, University of Edinburgh, Edinburgh, UK
| | - Karen Hartnup
- Information Services, University of Edinburgh, Edinburgh, UK
| | - John Paget
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
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