1
|
Camacho-Moll ME, Mata-Tijerina VL, Gutiérrez-Salazar CC, Silva-Ramírez B, Peñuelas-Urquides K, González-Escalante L, Escobedo-Guajardo BL, Cruz-Luna JE, Corrales-Pérez R, Gómez-García S, Bermúdez-de León M. The impact of comorbidity status in COVID-19 vaccines effectiveness before and after SARS-CoV-2 omicron variant in northeastern Mexico: a retrospective multi-hospital study. Front Public Health 2024; 12:1402527. [PMID: 38932780 PMCID: PMC11199416 DOI: 10.3389/fpubh.2024.1402527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction The end of the coronavirus disease 2019 (COVID-19) pandemic has been declared by the World Health Organization on May 5, 2023. Several vaccines were developed, and new data is being published about their effectiveness. However, the clinical trials for the vaccines were performed before the Omicron variant appeared and there are population groups where vaccine effectiveness still needs to be tested. The overarching goal of the present study was to analyze the effects of COVID-19 vaccination before and after the Omicron variant in patients considering comorbidities in a population from Nuevo Leon, Mexico. Methods Epidemiological COVID-19 data from the Mexican Social Security Institute were collected from 67 hospitals located in northeastern Mexico, from July 2020 to May 2023, and a total of 669,393 cases were compiled, 255,819 reported a SARS-CoV-2 positive reverse transcription quantitative polymerase chain reaction (RT-qPCR) test or a positive COVID-19 antigen rapid test. Results Before Omicron (BO, 2020-2021), after 14 days of two doses of COVID-19 vaccine, BNT162b2 and ChAdOx1 vaccines were effective against infection in non-comorbid and all comorbid subgroups, whereas after Omicron (AO, 2022- 2023) there was no significant effectiveness against infection with none of the vaccines. Regarding hospitalization BO, BNT162b2, ChAdOx1, CoronaVac and mRNA-1273 significantly protected non-comorbid patients whereas BNT162b2, ChAdOx1, and mRNA-1273, protected all comorbid subgroups against hospitalization. AO, BNT162b2, ChAdOx1, CoronaVac and mRNA-1273 were effective against hospitalization in non-comorbid patients whereas for most comorbid subgroups BNT162b2, ChAdOx1 and CoronaVac were effective against hospitalization. Non-comorbid patients were protected against death as an outcome of COVID-19 during the BO period with most vaccines whereas a reduction in effectiveness was observed AO with mRNA-1273 vaccines in patients with hypertension, and diabetes mellitus. Discussion BO, COVID-19 vaccines were effective against infection, hospitalization, and death whereas AO, COVID-19 vaccines failed to protect the population from COVID-19 infection. A varying effectiveness against hospitalization and death is observed AO.
Collapse
Affiliation(s)
- Maria Elena Camacho-Moll
- Laboratory of Molecular Biology, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Viviana Leticia Mata-Tijerina
- Laboratory of Immunogenetics, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | | | - Beatriz Silva-Ramírez
- Laboratory of Immunogenetics, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Katia Peñuelas-Urquides
- Laboratory of Molecular Microbiology, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Laura González-Escalante
- Laboratory of Molecular Microbiology, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Brenda Leticia Escobedo-Guajardo
- Laboratory of Molecular Research of Diseases, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Jorge Eleazar Cruz-Luna
- Medical Epidemiological Assistance Coordination of the State of Nuevo Leon, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Roberto Corrales-Pérez
- Medical Epidemiological Assistance Coordination of the State of Nuevo Leon, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Salvador Gómez-García
- Medical Epidemiological Assistance Coordination of the State of Nuevo Leon, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| | - Mario Bermúdez-de León
- Laboratory of Molecular Biology, Northeast Biomedical Research Center, Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico
| |
Collapse
|
2
|
Ezzikouri S, Tajudeen R, Majidi H, Redwane S, Aqillouch S, Abdulaziz M, Aragaw M, Papa Fallah M, Sembuche S, Batcho S, Kabwe P, Gonese E, Laazaazia O, Elmessaoudi-Idrissi M, Meziane N, Ainahi A, Sarih M, Ogwell Ouma AE, Maaroufi A. Seroepidemiological assessment of SARS-CoV-2 vaccine responsiveness and associated factors in the vaccinated community of the Casablanca-Settat Region, Morocco. Sci Rep 2024; 14:7817. [PMID: 38570577 PMCID: PMC10991243 DOI: 10.1038/s41598-024-58498-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
Assessing the prevalence of SARS-CoV-2 IgG positivity through population-based serological surveys is crucial for monitoring COVID-19 vaccination efforts. In this study, we evaluated SARS-CoV-2 IgG positivity within a provincial cohort to understand the magnitude of the humoral response against the SARS-CoV-2 vaccine and to inform evidence-based public health decisions. A community-based cross-sectional seroprevalence study was conducted, involving 10,669 participants who received various vaccines (two doses for BBIBP-CorV/Sinopharm, Covishield vaccine, and Pfizer/BioNTech, and one dose for Johnson & Johnson's Janssen COVID-19 vaccine). The study spanned 16 provinces in the Casablanca-Settat region from February to June 2022, during which comprehensive demographic and comorbidity data were collected. We screened samples for the presence of IgG antibodies using the SARS-CoV-2 IgG II Quant assay, which quantifies antibodies against the receptor-binding domain (RBD) of the spike (S) protein, measured on the Abbott Architect i2000SR. The overall crude seroprevalence was 96% (95% CI: 95.6-96.3%), and after adjustment for assay performance, it was estimated as 96.2% (95% CI: 95.7-96.6). The adjusted overall seroprevalences according to vaccine brands showed no significant difference (96% for BBIBP-CorV/Sinopharm, 97% for ChAdOx1 nCoV-19/Oxford/AstraZeneca, 98.5% for BNT162b2/Pfizer-BioNTech, and 98% for Janssen) (p = 0.099). Participants of older age, female sex, those with a history of previous COVID-19 infection, and those with certain chronic diseases were more likely to be seropositive among ChAdOx1 nCoV-19/Oxford/AstraZeneca and BBIBP-CorV/Sinopharm vaccinee groups. Median RBD antibody concentrations were 2355 AU/mL, 3714 AU/mL, 5838 AU/mL, and 2495 AU/mL, respectively, after two doses of BBIBP-CorV/Sinopharm, ChAdOx1 nCoV-19/Oxford/AstraZeneca, BNT162b2/Pfizer-BioNTech, and after one dose of Janssen (p < 0.0001). Furthermore, we observed that participants vaccinated with ChAdOx1 nCoV-19/Oxford/AstraZeneca and BBIBP-CorV/Sinopharm with comorbid chronic diseases exhibited a more pronounced response to vaccination compared to those without comorbidities. In contrast, no significant differences were observed among Pfizer-vaccinated participants (p > 0.05). In conclusion, our serosurvey findings indicate that all four investigated vaccines provide a robust humoral immune response in the majority of participants (more than 96% of participants had antibodies against SARS-CoV-2). The BNT162b2 vaccine was found to be effective in eliciting a strong humoral response compared to the other three vaccines. However, challenges still remain in examining the dynamics and durability of immunoprotection in the Moroccan context.
Collapse
Affiliation(s)
- Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco.
| | - Raji Tajudeen
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Hind Majidi
- Ministry of Health and Social Protection, Rabat, Morocco
| | - Soad Redwane
- Direction Régionale de la santé Casablanca-Settat, Observatoire régional de santé, Casablanca, Morocco
| | - Safaa Aqillouch
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco
| | - Mohammed Abdulaziz
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Merawi Aragaw
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Mosoka Papa Fallah
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Senga Sembuche
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Serge Batcho
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Patrick Kabwe
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Elizabeth Gonese
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Oumaima Laazaazia
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco
| | - Mohcine Elmessaoudi-Idrissi
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco
| | - Nadia Meziane
- Centre Régional de Transfusion Sanguine, Casablanca, Morocco
| | - Abdelhakim Ainahi
- Hormonology and Tumor Markers Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - M'hammed Sarih
- Service de Parasitologie et des Maladies Vectorielles, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Ahmed E Ogwell Ouma
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Abderrahmane Maaroufi
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20360, Casablanca, Morocco
| |
Collapse
|
3
|
Molnár GA, Vokó Z, Sütő G, Rokszin G, Nagy D, Surján G, Surján O, Nagy P, Kenessey I, Wéber A, Pálosi M, Müller C, Kásler M, Wittmann I, Kiss Z. Effectiveness of SARS-CoV-2 primary vaccines and boosters in patients with type 2 diabetes mellitus in Hungary (HUN-VE 4 Study). BMJ Open Diabetes Res Care 2024; 12:e003777. [PMID: 38267204 PMCID: PMC10823926 DOI: 10.1136/bmjdrc-2023-003777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/14/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus is a risk factor for severe COVID-19 infection and is associated with increased risk of complications. The present study aimed to investigate effectiveness and persistence of different COVID vaccines in persons with or without diabetes during the Delta wave in Hungary. RESEARCH DESIGN AND METHODS Data sources were the national COVID-19 registry data from the National Public Health Center and the National Health Insurance Fund on the total Hungarian population. The adjusted incidence rate ratios and corresponding 95% CIs were derived from a mixed-effect negative binomial regression model. RESULTS A population of 672 240 cases with type 2 diabetes and a control group of 2 974 102 non-diabetic persons free from chronic diseases participated. Unvaccinated elderly persons with diabetes had 2.68 (95% CI 2.47 to 2.91) times higher COVID-19-related mortality rate as the 'healthy' controls. Primary immunization effectively equalized the risk of COVID-19 mortality between the two groups. Vaccine effectiveness declined over time, but the booster restored the effectiveness against mortality to over 90%. The adjusted vaccine effectiveness of the primary Pfizer-BioNTech against infection in the 14-120 days of postvaccination period was 71.6 (95% CI 66.3 to 76.1)% in patients aged 65-100 years with type 2 diabetes and 64.52 (95% CI 59.2 to 69.2)% in the controls. Overall, the effectiveness tended to be higher in individuals with diabetes than in controls. The booster vaccines could restore vaccine effectiveness to over 80% concerning risk of infection (eg, patients with diabetes aged 65-100 years: 89.1 (88.1-89.9)% with Pfizer-on-Pfizer, controls 65-100 years old: 86.9 (85.8-88.0)% with Pfizer-on-Pfizer, or patients with diabetes aged 65-100 years: 88.3 (87.2-89.2)% with Pfizer-on-Sinopharm, controls 65-100 years old: 87.8 (86.8-88.7)% with Pfizer-on-Sinopharm). CONCLUSIONS Our data suggest that people with type 2 diabetes may have even higher health gain when getting vaccinated as compared with non-diabetic persons, eliminating the marked, COVID-19-related excess risk of this population. Boosters could restore protection.
Collapse
Affiliation(s)
- Gergő A Molnár
- Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Gábor Sütő
- Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| | | | - Dávid Nagy
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
| | - György Surján
- Institute of Digital Health Sciences, Semmelweis University, Budapest, Hungary
| | - Orsolya Surján
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Péter Nagy
- National Institute of Oncology, Budapest, Hungary
- Institute of Oncochemistry, University of Debrecen, Debrecen, Hungary
| | - István Kenessey
- National Institute of Oncology, Budapest, Hungary
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - András Wéber
- National Institute of Oncology, Budapest, Hungary
| | | | - Cecília Müller
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Miklós Kásler
- National Institute of Oncology, Budapest, Hungary
- Central-Eastern European Academy of Oncology, Budapest, Hungary
| | - István Wittmann
- Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| | - Zoltan Kiss
- Second Department of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, Pécs, Hungary
| |
Collapse
|
4
|
Zhou X, Lu H, Sang M, Qiu S, Yuan Y, Wu T, Chen J, Sun Z. Impaired antibody response to inactivated COVID-19 vaccines in hospitalized patients with type 2 diabetes. Hum Vaccin Immunother 2023; 19:2184754. [PMID: 36864628 PMCID: PMC10026888 DOI: 10.1080/21645515.2023.2184754] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Patients with type 2 diabetes (T2D) are at an increased risk of morbidity and mortality of coronavirus disease 2019 (COVID-19). Data on the antibody response to COVID-19 vaccines in T2D patients are less studied. This study aimed to evaluate IgG antibody response to inactivated COVID-19 vaccines in hospitalized T2D patients. Hospitalized patients with no history of COVID-19 and received two doses of inactivated COVID-19 vaccines (Sinopharm or CoronaVac) were included in this study from March to October 2021. SARS-CoV-2 specific IgG antibodies were measured 14-60 days after the second vaccine dose. A total of 209 participants, 96 with T2D and 113 non-diabetes patients, were included. The positive rate and median titer of IgG antibody against receptor-binding domain (anti-RBD) of spike (S) protein of SARS-CoV-2 in T2D group were lower than in control group (67.7% vs 83.2%, p = .009; 12.93 vs 17.42 AU/ml, p = .014) respectively. Similarly, seropositivity and median titers of IgG antibody against the nucleocapsid (N) and S proteins of SARS-CoV-2 (anti-N/S) in T2D group were lower than in control group (68.8% vs 83.2%, p = .032; 18.81 vs 29.57 AU/mL, p = .012) respectively. After adjustment for age, sex, BMI, vaccine type, days after the second vaccine dose, hypertension, kidney disease, and heart disease, T2D was identified as an independent risk factor for negative anti-RBD and anti-N/S seropositivity, odd ratio 0.42 (95% confidence interval 0.19, 0.89) and 0.42 (95% CI 0.20, 0.91), respectively. T2D is associated with impaired antibody response to inactivated COVID-19 vaccine.
Collapse
Affiliation(s)
- Xiaoying Zhou
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Huixia Lu
- Department of Clinical Laboratory Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Miaomiao Sang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Shanhu Qiu
- Department of General Practice, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Yang Yuan
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
| | - Junhao Chen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| |
Collapse
|
5
|
Sun N, Zhang Y, Dong J, Liu G, Liu Z, Wang J, Qiao Z, Zhang J, Duan K, Nian X, Ma Z, Yang X. Metabolomics profiling reveals differences in proliferation between tumorigenic and non-tumorigenic Madin-Darby canine kidney (MDCK) cells. PeerJ 2023; 11:e16077. [PMID: 37744241 PMCID: PMC10517658 DOI: 10.7717/peerj.16077] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/20/2023] [Indexed: 09/26/2023] Open
Abstract
Background Madin-Darby canine kidney (MDCK) cells are a cellular matrix in the production of influenza vaccines. The proliferation rate of MDCK cells is one of the critical factors that determine the vaccine production cycle. It is yet to be determined if there is a correlation between cell proliferation and alterations in metabolic levels. This study aimed to explore the metabolic differences between MDCK cells with varying proliferative capabilities through the use of both untargeted and targeted metabolomics. Methods To investigate the metabolic discrepancies between adherent cell groups (MDCK-M60 and MDCK-CL23) and suspension cell groups (MDCK-XF04 and MDCK-XF06), untargeted and targeted metabolomics were used. Utilizing RT-qPCR analysis, the mRNA expressions of key metabolites enzymes were identified. Results An untargeted metabolomics study demonstrated the presence of 81 metabolites between MDCK-M60 and MDCK-CL23 cells, which were mainly affected by six pathways. An analysis of MDCK-XF04 and MDCK-XF06 cells revealed a total of 113 potential metabolites, the majority of which were impacted by ten pathways. Targeted metabolomics revealed a decrease in the levels of choline, tryptophan, and tyrosine in MDCK-CL23 cells, which was in accordance with the results of untargeted metabolomics. Additionally, MDCK-XF06 cells experienced a decrease in 5'-methylthioadenosine and tryptophan, while S-adenosylhomocysteine, kynurenine, 11Z-eicosenoic acid, 3-phosphoglycerate, glucose 6-phosphate, and phosphoenolpyruvic acid concentrations were increased. The mRNA levels of MAT1A, MAT2B, IDO1, and IDO2 in the two cell groups were all increased, suggesting that S-adenosylmethionine and tryptophan may have a significant role in cell metabolism. Conclusions This research examines the effect of metabolite fluctuations on cell proliferation, thus offering a potential way to improve the rate of MDCK cell growth.
Collapse
Affiliation(s)
- Na Sun
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
- Engineering Research Center of Key Technology and Industrialization of Cell-based Vaccine, Ministry of Education, Lanzhou, China
| | - Yuchuan Zhang
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Jian Dong
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Geng Liu
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Zhenbin Liu
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
- Engineering Research Center of Key Technology and Industrialization of Cell-based Vaccine, Ministry of Education, Lanzhou, China
| | - Jiamin Wang
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
- Engineering Research Center of Key Technology and Industrialization of Cell-based Vaccine, Ministry of Education, Lanzhou, China
- Gansu Provincial Bioengineering Materials Engineering Research Center, Lanzhou, China
| | - Zilin Qiao
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
- Engineering Research Center of Key Technology and Industrialization of Cell-based Vaccine, Ministry of Education, Lanzhou, China
- Gansu Provincial Bioengineering Materials Engineering Research Center, Lanzhou, China
| | - Jiayou Zhang
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, China
- National Engineering Technology Research Center for Combined Vaccines, Wuhan, China
| | - Kai Duan
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, China
- National Engineering Technology Research Center for Combined Vaccines, Wuhan, China
| | - Xuanxuan Nian
- Wuhan Institute of Biological Products Co., Ltd., Wuhan, China
- National Engineering Technology Research Center for Combined Vaccines, Wuhan, China
| | - Zhongren Ma
- Gansu Technology Innovation Center of Animal Cell, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
- Engineering Research Center of Key Technology and Industrialization of Cell-based Vaccine, Ministry of Education, Lanzhou, China
- Key Laboratory of Biotechnology and Bioengineering of National Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Xiaoming Yang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan, China
- China National Biotech Group Company Limited, Beijing, China
| |
Collapse
|
6
|
Ashrafian F, Bagheri Amiri F, Bavand A, Zali M, Sadat Larijani M, Ramezani A. A Comparative Study of Immunogenicity, Antibody Persistence, and Safety of Three Different COVID-19 Boosters between Individuals with Comorbidities and the Normal Population. Vaccines (Basel) 2023; 11:1376. [PMID: 37631944 PMCID: PMC10459403 DOI: 10.3390/vaccines11081376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023] Open
Abstract
Data on immunogenicity, immune response persistency, and safety of COVID-19 boosters in patients with comorbidities are limited. Therefore, we aimed to evaluate three different boosters' immunogenicity and safety in individuals with at least one underlying disease (UD) (obesity, hypertension, and diabetes mellitus) with healthy ones (HC) who were primed with two doses of the BBIBP-CorV vaccine and received a booster shot of the same priming vaccine or protein subunit vaccines, PastoCovac Plus or PastoCovac. One hundred and forty subjects including sixty-three ones with a comorbidity and seventy-seven healthy ones were enrolled. The presence of SARS-CoV-2 antibodies was assessed before the booster injection and 28, 60, 90, and 180 days after it. Moreover, the adverse events (AEs) were recorded on days 7 and 21 postbooster shot for evaluating safety outcomes. Significantly increased titers of antispike, antiRBD, and neutralizing antibodies were observed in both UD and HC groups 28 days after the booster dose. Nevertheless, the titer of antispike IgG and anti-RBD IgG was lower in the UD group compared to the HC group. The long-term assessment regarding persistence of humoral immune responses showed that the induced antibodies were detectable up to 180 days postbooster shots though with a declined titer in both groups with no significant differences (p > 0.05). Furthermore, no significant difference in antibody levels was observed between each UD subgroup and the HC group, except for neutralizing antibodies in the hypertension subgroup. PastoCovac Plus and PastoCovac boosters induced a higher fold rise in antibodies in UD individuals than BBIBP-CorV booster recipients. No serious AEs after the booster injection were recorded. The overall incidence of AEs after the booster injection was higher in the UD group than the HC group among whom the highest systemic rate of AEs was seen in the BBIBP-CorV booster recipients. In conclusion, administration of COVID-19 boosters could similarly induce robust and persistent humoral immune responses in individuals with or without UD primarily vaccinated with two doses of the BBIBP-CorV. Protein-based boosters with higher a higher fold rise in antibodies and lower AEs in individuals with comorbidities might be considered a better choice for these individuals.
Collapse
Affiliation(s)
- Fatemeh Ashrafian
- Clinical Research Department, Pasteur Institute of Iran, Tehran 1316943551, Iran; (F.A.); (A.B.); (M.Z.)
| | - Fahimeh Bagheri Amiri
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran 1316943551, Iran;
| | - Anahita Bavand
- Clinical Research Department, Pasteur Institute of Iran, Tehran 1316943551, Iran; (F.A.); (A.B.); (M.Z.)
| | - Mahsan Zali
- Clinical Research Department, Pasteur Institute of Iran, Tehran 1316943551, Iran; (F.A.); (A.B.); (M.Z.)
| | - Mona Sadat Larijani
- Clinical Research Department, Pasteur Institute of Iran, Tehran 1316943551, Iran; (F.A.); (A.B.); (M.Z.)
| | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran 1316943551, Iran; (F.A.); (A.B.); (M.Z.)
| |
Collapse
|
7
|
He YF, Ouyang J, Hu XD, Wu N, Jiang ZG, Bian N, Wang J. Correlation between COVID-19 vaccination and diabetes mellitus: A systematic review. World J Diabetes 2023; 14:892-918. [PMID: 37383586 PMCID: PMC10294060 DOI: 10.4239/wjd.v14.i6.892] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/05/2023] [Accepted: 04/24/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is one of the current global public health threats and vaccination is the most effective tool to reduce the spread and decrease the severity of COVID-19. Diabetes is one of the important chronic diseases threatening human health and is a common comorbidity of COVID-19. What is the impact of diabetes on the immunization effect of COVID-19 vaccination? Conversely, does vaccination against COVID-19 exacerbate the severity of pre-existing diseases in patients with diabetes? There are limited and conflicting data on the interrelationship between diabetes and COVID-19 vaccination.
AIM To explore the clinical factors and possible mechanisms underlying the interaction between COVID-19 vaccination and diabetes.
METHODS We conducted a comprehensive search of PubMed, MEDLINE, EMBASE, and Reference Citation Analysis (https://www.referencecitationanalysis.com) online databases, and medRxiv and bioRxiv gray literature using the keywords "SARS-CoV-2", "COVID-19", "vaccine", "vaccination", "antibody", and "diabetes" individually or in combination, with a cut-off date of December 2, 2022. We followed inclusion and exclusion criteria and after excluding duplicate publications, studies with quantifiable evidence were included in the full-text review, plus three manually searched publications, resulting in 54 studies being included in this review.
RESULTS A total of 54 studies were included, from 17 countries. There were no randomized controlled studies. The largest sample size was 350963. The youngest of the included samples was 5 years old and the oldest was 98 years old. The included population included the general population and also some special populations with pediatric diabetes, hemodialysis, solid organ transplantation, and autoimmune diseases. The earliest study began in November 2020. Thirty studies discussed the effect of diabetes on vaccination, with the majority indicating that diabetes reduces the response to COVID-19 vaccination. The other 24 studies were on the effect of vaccination on diabetes, which included 18 case reports/series. Most of the studies concluded that COVID-19 vaccination had a risk of causing elevated blood glucose. A total of 12 of the 54 included studies indicated a "no effect" relationship between diabetes and vaccination.
CONCLUSION There is a complex relationship between vaccination and diabetes with a bidirectional effect. Vaccination may contribute to the risk of worsening blood glucose in diabetic patients and diabetic patients may have a lower antibody response after vaccination than the general population.
Collapse
Affiliation(s)
- Yan-Fei He
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Jing Ouyang
- Casualty Management Section, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Xiao-Dong Hu
- Department of Endocrinology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Ni Wu
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Zhi-Gang Jiang
- Department of Statistics, Zunyi Medical University, Zunyi 563006, Guizhou Province, China
| | - Ning Bian
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Jie Wang
- Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| |
Collapse
|
8
|
Wu J, Guo X, Zhou X, Wang M, Gu J, Miao Y, Tarimo CS, He Y, Xing Y, Ye B. The pattern from the first three rounds of vaccination: declining vaccination rates. Front Public Health 2023; 11:1124548. [PMID: 37250076 PMCID: PMC10213674 DOI: 10.3389/fpubh.2023.1124548] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/04/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Vaccination rates for the COVID-19 vaccine have recently been stagnant worldwide. We aim to analyze the potential patterns of vaccination development from the first three doses to reveal the possible trends of the next round of vaccination and further explore the factors influencing vaccination in the selected populations. Methods On July 2022, a stratified multistage random sampling method in the survey was conducted to select 6,781 people from 4 provinces China, who were above the age of 18 years. Participants were divided into two groups based on whether they had a chronic disease. The data were run through Cochran-Armitage trend test and multivariable regression analyses. Results A total of 957 participants with chronic disease and 5,454 participants without chronic disease were included in this survey. Vaccination rates for the first, second and booster doses in chronic disease population were93.70% (95% CI: 92.19-95.27%), 91.12% (95%CI: 94.43-95.59%), and 83.18% (95%CI: 80.80-85.55%) respectively. By contrast, the first, second and booster vaccination rates for the general population were 98.02% (95% CI: 97.65-98.39%), 95.01% (95% CI: 94.43-95.59%) and 85.06% (95% CI: 84.11-86.00%) respectively. The widening gap in vaccination rates was observed as the number of vaccinations increases. Higher self-efficacy was a significant factor in promoting vaccination, which has been observed in all doses of vaccines. Higher education level, middle level physical activity and higher public prevention measures play a positive role in vaccination among the general population, while alcohol consumption acts as a significant positive factor in the chronic disease population (p < 0.05). Conclusion As the number of vaccinations increases, the trend of decreasing vaccination rate is becoming more pronounced. In future regular vaccinations, we may face low vaccination rates as the increasing number of infections and the fatigue associated with the prolonged outbreak hamper vaccination. Measures need to be found to counter this downward trend such as improving the self-efficacy of the population.
Collapse
Affiliation(s)
- Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Enginering, Research Center of Health Economy and Health Technology Assessment, Zhengzhou, Henan, China
| | - Xinghong Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Xue Zhou
- Department of Public Utilities Management, College of Health Management, Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
| | - Meiyun Wang
- Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
- Henan Province Enginering, Research Center of Health Economy and Health Technology Assessment, Zhengzhou, Henan, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Yilin He
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Yuhan Xing
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Henan, China
| |
Collapse
|
9
|
Dechates B, Porntharukchareon T, Sirisreetreerux S, Therawit P, Worawitchawong S, Sornsamdang G, Soonklang K, Tawinprai K. Immune Response to CoronaVac and Its Safety in Patients with Type 2 Diabetes Compared with Healthcare Workers. Vaccines (Basel) 2023; 11:vaccines11030684. [PMID: 36992267 DOI: 10.3390/vaccines11030684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023] Open
Abstract
Background: Vaccines for SARS-CoV-2 have been critical for preventing disease. Previous research showed patients with diabetes have impaired immunity. This study aimed to determine the immunity to coronavirus after CoronaVac by comparing patients with type 2 diabetes (T2D) and healthcare workers (HCW). Materials and methods: A prospective cohort study evaluated immune responses and safety after two doses of CoronaVac in T2D and HCW groups at Chulabhorn Hospital. The levels of total antibodies against the receptor-binding domain (anti-RBD) of the SARS-CoV-2 spike protein at baseline and 4 weeks after vaccination were collected. The level of anti-RBD concentrations was reported as geometric mean concentration (GMC) and compared between groups using the geometric mean ratio (GMR). Results: 81 participants were included; 27 had T2D and 54 were HCW. After complete vaccination, anti-RBD concentrations were not significantly different between T2D (57.68 binding antibody units (BAU)/mL, 95% confidence interval (CI) = 29.08; 114.44) and HCW (72.49 BAU/mL, 95% CI = 55.77; 94.22) groups. Subgroup analysis showed the GMC of anti-RBD was significantly lower in T2D patients with dyslipidaemia (50.04 BAU/mL) than in T2D patients without dyslipidaemia (341.64 BAU/mL). Conclusions: The immune response at 4 weeks after two doses of CoronaVac did not significantly differ between patients with T2D and HCW.
Collapse
Affiliation(s)
- Bothamai Dechates
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Thachanun Porntharukchareon
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Supamas Sirisreetreerux
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Phonthip Therawit
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Supanat Worawitchawong
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Gaidganok Sornsamdang
- Central Laboratory Center, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Kamonwan Soonklang
- Center of Learning and Research in Celebration of HRH Princess Chulabhorn 60th Birthday Anniversary, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| | - Kriangkrai Tawinprai
- Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Thung Song Hong, Lak Si, Bangkok 10210, Thailand
| |
Collapse
|
10
|
Blaga Z, Czine P, Takacs B, Szilagyi A, Szekeres R, Wachal Z, Hegedus C, Buchholcz G, Varga B, Priksz D, Bombicz M, Szabo AM, Kiss R, Gesztelyi R, Romanescu DD, Szabo Z, Szucs M, Balogh P, Szilvassy Z, Juhasz B. Examination of Preferences for COVID-19 Vaccines in Hungary Based on Their Properties-Examining the Impact of Pandemic Awareness with a Hybrid Choice Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1270. [PMID: 36674026 PMCID: PMC9858986 DOI: 10.3390/ijerph20021270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has posed a huge challenge to the world in recent years. The development of vaccines that are as effective as possible and accessible to society offers a promising alternative for addressing the problems caused by this situation as soon as possible and to restore the pre-epidemic system. The present study investigated the preferences of residents in Hungary's second-largest city (Debrecen) for the COVID-19 vaccine. To achieve this aim, a discrete choice experiment was conducted with 1011 participants, and the vaccine characteristics included in the design of the experiment were determined by qualitative methods and a pilot survey: (1) country of origin; (2) efficiency; (3) side effect; and (4) duration of protection. During the data collection at three vaccination sites, respondents were asked to choose between three vaccine alternatives and one "no choice" option in eight decision situations. Discrete choice model estimations were performed using a random parameter logit (RPL) specification with the final model extended to include a latent variable measuring pandemic awareness. The results showed that the vaccine with a Chinese country of origin is the least preferred among the respondents, while the Hungarian and the European vaccines are the most preferred. Furthermore, the increase in the vaccine efficiency level increased the respondents' sense of utility for the vaccine; the short-term side effect was preferred to the long-term one; and the increase in the duration of protection provided by the vaccine increased the respondents' sense of utility for the vaccine. Based on the parameter estimated for the latent variable, it can be concluded that as the level of pandemic awareness (which is more positive among people with chronic diseases and less important among health workers) increases, the choice of a vaccine option becomes more preferred among respondents compared to the "no choice". The results of our investigation could contribute towards increasing compliance in the case of the vaccination-rejecting population, not only for COVID-19, but for any kind of vaccination procedure.
Collapse
Affiliation(s)
- Zsanett Blaga
- University Pharmacy, Clinical Centre, University of Debrecen, H-4032 Debrecen, Hungary
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Peter Czine
- Institute of Statistics and Methodology, University of Debrecen, H-4032 Debrecen, Hungary
| | - Barbara Takacs
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Anna Szilagyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Reka Szekeres
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Zita Wachal
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Csaba Hegedus
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Gyula Buchholcz
- University Pharmacy, Clinical Centre, University of Debrecen, H-4032 Debrecen, Hungary
| | - Balazs Varga
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Daniel Priksz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Mariann Bombicz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Adrienn Monika Szabo
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Rita Kiss
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Dana Diana Romanescu
- Department of Diabetology, Pelican Clinical Hospital, 410087 Oradea, Romania
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Zoltan Szabo
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Miklos Szucs
- Department of Urology and Andrology, Clinical Centre, Kenezy Gyula Campus, University of Debrecen, H-4001 Debrecen, Hungary
| | - Peter Balogh
- Institute of Statistics and Methodology, University of Debrecen, H-4032 Debrecen, Hungary
| | - Zoltan Szilvassy
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| | - Bela Juhasz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
| |
Collapse
|
11
|
Zhang F, Zhu Y, He Z, Lan X, Song M, Chen X, Li M, Yang J, Xu J, Xu J. Uptake of Heterologous or Homologous COVID-19 Booster Dose and Related Adverse Events Among Diabetic Patients: A Multicenter Cross-Sectional Study - China, 2022. China CDC Wkly 2023; 5:5-10. [PMID: 36777467 PMCID: PMC9902747 DOI: 10.46234/ccdcw2023.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/25/2022] [Indexed: 01/09/2023] Open
Abstract
What is already known about this topic? Although a third coronavirus disease 2019 (COVID-19) vaccination (booster) dose is highly recommended for diabetic patients, the vaccination behaviors and related adverse events are unclear among diabetic patients with a COVID-19 booster dose. What is added by this report? Diabetic patients with higher postprandial blood glucose, worrying about the safety of the booster dose were less likely to get the vaccine. While having positive attitudes towards COVID-19 booster vaccination, trusting the health professionals' advice on vaccination, diabetic patients were more likely to get the booster vaccine. Furthermore, the prevalence of adverse events was not significantly different between the homologous and heterologous boosting groups. What are the implications for public health practice? Effective measures should be taken to promote the COVID-19 booster dose uptake among diabetic patients. Health professionals should educate Chinese diabetic patients about the safety and efficacy of booster doses and continue to increase the COVID-19 booster dose vaccination coverage.
Collapse
Affiliation(s)
- Fan Zhang
- Department of Endocrinology, Peking University Shenzhen Hospital, Peking University, Shenzhen City, Guangdong Province, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang City, Liaoning Province, China
| | - Zhong He
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen City, Guangdong Province, China
| | - Xinquan Lan
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen City, Guangdong Province, China
| | - Moxin Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen City, Guangdong Province, China
| | - Xi Chen
- School of Health Management, China Medical University, Shenyang City, Liaoning Province, China
| | - Mufan Li
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Jianzhou Yang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi City, Shanxi Province, China,Junjie Xu,
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen City, Guangdong Province, China,Jianzhou Yang,
| | | | | | | | | | | | | |
Collapse
|
12
|
Xu K, Wang Z, Qin M, Gao Y, Luo N, Xie W, Zou Y, Wang J, Ma X. A systematic review and meta-analysis of the effectiveness and safety of COVID-19 vaccination in older adults. Front Immunol 2023; 14:1113156. [PMID: 36936964 PMCID: PMC10020204 DOI: 10.3389/fimmu.2023.1113156] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
In the coronavirus disease 2019 (COVID-19) pandemic, vaccinations were essential in preventing COVID-19 infections and related mortality in older adults. The objectives of this study were to evaluate the effectiveness and safety of the COVID-19 vaccines in older adults. We systematically searched the electronic bibliographic databases of PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, Research Square, and OpenGrey, as well as other sources of gray literature, for studies published between January 1, 2020, and October 1, 2022. We retrieved 22 randomized controlled trials (RCTs), with a total of 3,404,696 older adults (aged over 60 years) participating, that were included in the meta-analysis. No significant publication bias was found. In the cumulative meta-analysis, we found that the COVID-19 vaccines were effective in preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR = 0.38, 95% CI = 0.23-0.65, p = 0.0004) and in reducing the number of COVID-19-related deaths (OR = 0.16, 95% CI = 0.10-0.25, p < 0.00001) in elderly people. Antibody seroconversion (AS) and geometric mean titer (GMT) levels significantly increased in vaccinated older adults [OR = 24.42, 95% CI = 19.29-30.92; standardized mean difference (SMD) = 0.92, 95% CI = 0.64-1.20, respectively]. However, local and systemic adverse events after COVID-19 vaccine administration were found in older adults (OR = 2.57, 95% CI = 1.83-3.62, p < 0.00001). Although vaccination might induce certain adverse reactions in the elderly population, the available evidence showed that the COVID-19 vaccines are effective and tolerated, as shown by the decrease in COVID-19-related deaths in older adults. It needs to be made abundantly clear to elderly people that the advantages of vaccination far outweigh any potential risks. Therefore, COVID-19 vaccination should be considered as the recommended strategy for the control of this disease by preventing SARS-CoV-2 infection and related deaths in older adults. More RCTs are needed to increase the certainty of the evidence and to verify our conclusions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319698, identifier CRD42022319698.
Collapse
Affiliation(s)
- Kun Xu
- School of Health Management, Xihua University, Chengdu, China
| | - Zihan Wang
- Faculty of Geosciences and Environmental Engineering, Southwest Jiaotong University, Chengdu, China
| | - Maorong Qin
- School of Health Management, Xihua University, Chengdu, China
| | - Yangyu Gao
- School of Health Management, Xihua University, Chengdu, China
| | - Na Luo
- School of Health Management, Xihua University, Chengdu, China
| | - Wanting Xie
- School of Health Management, Xihua University, Chengdu, China
| | - Yihan Zou
- School of Health Management, Xihua University, Chengdu, China
| | - Jie Wang
- School of Food and Biological Engineering, Xihua University, Chengdu, China
| | - Xingming Ma
- School of Health Management, Xihua University, Chengdu, China
- Health Promotion Center, Xihua University, Chengdu, China
- *Correspondence: Xingming Ma,
| |
Collapse
|