The COVID-19 Vaccination Still Matters: Omicron Variant Is a Final Wake-Up Call for the Rich to Help the Poor

Global trends in COVID-19 incidence and case fatality rates (2019-2023): a retrospective analysis

Objectives

Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics.

Methods

We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023.

Results

The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions.

Conclusions

COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

Respiratory syncytial virus immunoprophylaxis: Novel opportunities and a call for equity

With the approval of the first vaccines against respiratory syncytial virus (RSV) and a novel RSV-neutralizing antibody, 2023 has been perceived as a game-changing year in preventing severe outcomes of RSV infections in infants and the elderly. However, the costs of these pharmaceuticals are high, while RSV disproportionately impacts populations of low-to-middle-income regions, which may continue to suffer from a lack of pharmaceutical measures for RSV prevention under health and socioeconomic disparities. This paper presents an overview of the characteristics, clinical results, and approval status of various RSV vaccines and anti-RSV antibodies. It posits that wealthy nations cannot monopolize RSV immunoprophylaxis and should work jointly to make it available to lower-income countries. An approach toward RSV immunoprophylaxis equity based on five points is offered: (1) integration of RSV vaccines and antibodies into the existing global humanitarian distribution systems, (2) using affordable RSV vaccine pricing models, (3) enforcing equity as a part of national and global public health strategy, (4) implementing equitable allocation frameworks for RSV immunoprophylaxis, and (5) promoting local manufacturing. Such a plan needs to be put into action as soon as possible to avoid delays in serving the populations with the highest needs related to RSV burden.

The relative prevalence of the Omicron variant within SARS-CoV-2 infected cohorts in different countries: A systematic review

The Omicron variant of SARS-CoV-2 was detected in October 2021 and exhibited high transmissibility, immune evasion, and reduced severity when compared to the earlier variants. The lesser vaccine effectiveness against Omicron and its reduced severity created vaccination hesitancy among the public. This review compiled data reporting the relative prevalence of Omicron as compared to the early variants to give an insight into the existing variants, which may shape the decisions regarding the targets of the newly developed vaccines. Complied data revealed more than 90% prevalence within the infected cohorts in some countries. The BA.1 subvariant predominated over the BA.2 during the early stages of the Omicron wave. Moreover, BA.4/BA.5 subvariants were detected in South Africa, USA and Italy between October 2021 and April 2022. It is therefore important to develop vaccines that protect against Omicron as well as the early variants, which are known to cause more severe complications.

Willingness to vaccinate among adults, and factors associated with vaccine acceptance of COVID-19 vaccines in a nationwide study in Poland between March 2021 and April 2022

Introduction

Despite the availability, safety and effectiveness of COVID-19 vaccines, Poland remains one of the six countries of the European Union with the lowest cumulative uptake of the vaccine's primary course in the general population. This study examined willingness to vaccinate and the associated factors in samples of unvaccinated and vaccinated adults between March 2021 and April 2022.

Methods

Data were collected using OBSER-CO, a nationwide, repeated cross-sectional study, conducted at four different time points (rounds). Data on willingness to vaccinate among the unvaccinated (at all rounds) and willingness to receive another dose in the vaccinated (at 2 rounds-after booster introduction), reasons for reluctance, sociodemographic, health, and behavioral factors were collected using a uniform questionnaire via computer-assisted telephone interviewing. In each round, more than 20,000 respondents were interviewed. To assess associations between factors and willingness to vaccinate, separate multivariable logistic regression models were fitted for each factor at each round and adjusted for confounders.

Results

Between rounds 1 and 4 (March 2021-April 2022), in the unvaccinated, willingness to vaccinate declined from 73 to 12%, whereas in the vaccinated, willingness to receive another dose declined from 90 to 53%. The highest magnitude of decline between subsequent rounds occurred during the Omicron wave. Overall, concerns about side effects, effectiveness, and vaccine adverse effects were common but decreased over time. Age, gender, employment, place of residence, COVID-19 diagnosis or exposure, hospitalization, and participation in social activities were among the factors associated with willingness. However, associations changed over rounds highlighting the influence of different pandemic waves and variants.

Conclusion

We observed a declining and multifactorial willingness to vaccinate in Poland, with vaccine attitudes dynamically changing across subsequent rounds. To address vaccine concerns, sustained health communication about COVID-19 vaccines is essential, especially after the emergence of new variants.

Key Considerations during the Transition from the Acute Phase of the COVID-19 Pandemic: A Narrative Review

The COVID-19 pandemic has been met with an unprecedented response from the scientific community, leading to the development, investigation, and authorization of vaccines and antivirals, ultimately reducing the impact of SARS-CoV-2 on global public health. However, SARS-CoV-2 is far from being eradicated, continues to evolve, and causes substantial health and economic burdens. In this narrative review, we posit essential points on SARS-CoV-2 and its responsible management during the transition from the acute phase of the COVID-19 pandemic. As discussed, despite Omicron (sub)variant(s) causing clinically milder infections, SARS-CoV-2 is far from being a negligible pathogen. It requires continued genomic surveillance, particularly if one considers that its future (sub)lineages do not necessarily have to be milder. Antivirals and vaccines remain the essential elements in COVID-19 management. However, the former could benefit from further development and improvements in dosing, while the seasonal administration of the latter requires simplification to increase interest and tackle vaccine hesitancy. It is also essential to ensure the accessibility of COVID-19 pharmaceuticals and vaccines in low-income countries and improve the understanding of their use in the context of the long-term goals of SARS-CoV-2 management. Regardless of location, the primary role of COVID-19 awareness and education must be played by healthcare workers, who directly communicate with patients and serve as role models for healthy behaviors.

The biomedical potential of tardigrade proteins: A review

Tardigrades are ubiquitous microinvertebrates exhibiting extreme tolerance to various environmental stressors like low and high temperatures, lack of water, or high radiation. Although exact pathways behind the tardigrade extremotolerance are yet to be elucidated, some molecules involved have been identified. Their evidenced properties may lead to novel opportunities in biomedical and pharmacological development. This review aims to present the general characteristics of tardigrade intrinsically disordered proteins (TDPs: Dsup, CAHS, SAHS, MAHS) and late embryogenesis-abundant proteins (LEA) and provide an updated overview of their features and relevance for potential use in biomedicine and pharmacology. The Dsup reveals a promising action in attenuating oxidative stress, DNA damage, and pyrimidine dimerization, as well as increasing radiotolerance in transfected human cells. Whether Dsup can perform these functions when delivered externally is yet to be understood by in vivo preclinical testing. In turn, CAHS and SAHS demonstrate properties that could benefit the preservation of pharmaceuticals (e.g., vaccines) and biomaterials (e.g., cells). Selected CAHS proteins can also serve as inspiration for designing novel anti-apoptotic agents. The LEA proteins also reveal promising properties to preserve desiccated biomaterials and can act as anti-osmotic agents. In summary, tardigrade molecules reveal several potential biomedical applications advocating further research and development. The challenge of extracting larger amounts of these molecules can be solved with genetic engineering and synthetic biology tools. With new species identified each year and ongoing studies on their extremotolerance, progress in the medical use of tardigrade proteins is expected shortly.

COVID-19 Vaccines against Omicron Variant: Real-World Data on Effectiveness

The efficacy of vaccines against coronavirus disease 2019 (COVID-19) has now been well established in phase III clinical trials. However, clinical studies based on real-world data remain critical to assess vaccines effectiveness (VE), especially in specific populations and against variants of concern (VOC). This review presents the principles and methods of VE studies and the main available results on VE of COVID-19 vaccines at the time of Omicron circulation. References for this narrative review were identified through searches of PubMed database up to 13 September 2022. The results of phase III clinical trials have been globally confirmed by VE in real-life studies, including in the elderly. Emergence of VOC Omicron emphasized the importance of booster doses to maintain a high level of protection against severe forms. There are still numerous challenges regarding booster(s) and duration of immunity, particularly in specific subpopulations, and regarding the need for adapted vaccines.

COVID-19 vaccinations and rates of infections, hospitalizations, ICU admissions, and deaths in Europe during SARS-CoV-2 Omicron wave in the first quarter of 2022

The vaccination campaigns brought hope to minimizing the coronavirus disease 2019 (COVID-19) burden. However, the emergence of novel, highly transmissible Omicron lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the waning of neutralizing antibodies a few months after vaccination has brought concerns over the vaccine efficacy. The present work analyzed the relationships between COVID-19 vaccine coverage (completion of primary course and booster dose intake) in the European Economic Area and rates of infection, hospitalizations, admissions to intensive care units (ICU), and deaths during the Omicron wave in the first quarter of 2022 (January-April). As demonstrated, infection rates were not correlated to vaccine coverage in any considered month. For January and February, the rates of hospitalizations, intensive care unit (ICU) admissions, and death due to COVID-19 were strongly negatively correlated (r =- 0.54 to -0.82) with the percentage of individuals who completed initial vaccination protocol and the percentage of those who received a booster dose. However, in March and April, the percentage of the population with primary vaccination course correlated negatively only with ICU admissions (r = -0.77 and -0.46, respectively). The uptake of boosters in March still remained in significant negative correlation with hospitalizations (r = -0.45), ICU admissions (r = -0.70) and deaths due to COVID-19 (r = -0.37), although in April these relationships were no longer observed. The percentage of individuals with confirmed SARS-CoV-2 infection did not correlate with the pandemic indices for any considered month. The study indicates that COVID-19 vaccination, including booster administration, was beneficial in decreasing the overwhelming of healthcare systems during the Omicron wave, but novel vaccine strategies may be required in the long term to enhance the effectiveness and durability of vaccine-induced protection during future waves of SARS-CoV-2 infections.

COVID-19 Vaccine Booster Strategies for Omicron SARS-CoV-2 Variant: Effectiveness and Future Prospects

In the light of the lack of authorized COVID-19 vaccines adapted to the Omicron variant lineage, the administration of the first and second booster dose is recommended. It remains important to monitor the efficacy of such an approach in order to inform future preventive strategies. The present paper summarizes the research progress on the effectiveness of the first and second booster doses of COVID-19. It also discusses the potential approach in vaccination strategies that could be undertaken to maintain high levels of protection during the waves of SARS-CoV-2 infections. Although this approach can be based, with some shortcomings, on the first-generation vaccines, other vaccination strategies should be explored, including developing multiple antigen-based (multivariant-adapted) booster doses with enhanced durability of immune protection, e.g., through optimization of the half-life of generated antibodies.

Oral antiviral treatments for COVID-19: opportunities and challenges

The use of antiviral COVID-19 medications can successfully inhibit SARS-CoV-2 replication and prevent disease progression to a more severe form. However, the timing of antiviral treatment plays a crucial role in this regard. Oral antiviral drugs provide an opportunity to manage SARS-CoV-2 infection without a need for hospital admission, easing the general burden that COVID-19 can have on the healthcare system. This review paper (i) presents the potential pharmaceutical antiviral targets, including various host-based targets and viral-based targets, (ii) characterizes the first-generation anti-SARS-CoV-2 oral drugs (nirmatrelvir/ritonavir and molnupiravir), (iii) summarizes the clinical progress of other oral antivirals for use in COVID-19, (iv) discusses ethical issues in such clinical trials and (v) presents challenges associated with the use of oral antivirals in clinical practice. Oral COVID-19 antivirals represent a part of the strategy to adapt to long-term co-existence with SARS-CoV-2 in a manner that prevents healthcare from being overwhelmed. It is pivotal to ensure equal and fair global access to the currently available oral antivirals and those authorized in the future.