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Jaber HM, Ebdah S, Al Haj Mahmoud SA, Abu-Qatouseh L, Jaber YH. Comparison of T cells mediated immunity and side effects of mRNA vaccine and conventional COVID-19 vaccines administrated in Jordan. Hum Vaccin Immunother 2024; 20:2333104. [PMID: 38584118 PMCID: PMC11000609 DOI: 10.1080/21645515.2024.2333104] [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: 11/27/2023] [Accepted: 03/18/2024] [Indexed: 04/09/2024] Open
Abstract
Various COVID-19 vaccines can affect the immune system. Discrepancies have been noted in immune system characteristics, such as T-lymphocyte levels, between vaccinated and non-vaccinated individuals. This study investigates the variations in immune responses among the four administered COVID-19 vaccines, influencing factors, and clinical outcomes in Jordan. A total of 350 adults, who were at least two doses vaccinated, were interviewed and blood samples were collected for subsequent laboratory analyses. The study involved the quantification of T-cells specifically targeting anti-SARS CoV-2 using Flow cytometry analysis. BNT162b2 (Pfizer) recipients displayed significantly higher CD3+/CD4+ T-helper cell responses (90.84%, 87.46% - 94.22%) compared to non-Pfizer-BioNTech recipients {BBIBP-CorV (Sinopharm) and Sputnik V (Gamaleya Research Institute), then ChAdOx1 nCoV-19 (AstraZeneca)} (83.62%, 77.91% - 89.33%). The CD3+/CD8+ (T cytotoxic) level was notably elevated in non-Pfizer-BioNTech recipients {Sinopharm and Sputnik V then ChAdOx1 nCoV-19 AstraZeneca (73.94%, 69.38% - 78.49%) compared to BNT162b2 (Pfizer) recipients (58.26%, 53.07% - 63.44%). The CD3+ (T-cells) level showed no significant difference between BNT162b2 recipients (73.74%) and non-Pfizer-BioNTech recipients (77.83%), with both types generating T-cells. Comparing two doses of non-Pfizer-BioNTech vaccines with the third dose of BNT162b2 recipients (Pfizer), no difference in the type of immune reaction was observed, with non-Pfizer-BioNTech recipients still stimulating endogenous pathways like cell-mediated cytotoxic effects for cells. All COVID-19 vaccines administered in Jordan were effective, with respect to the total number of T cells. Non-Pfizer-BioNTech had higher in toxic T-cells and Pfizer-BioNTech was higher in helper T-cells that stimulate plasma cells to produce antibodies.
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Affiliation(s)
- Hatim M. Jaber
- Department of Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Saja Ebdah
- Department of Biological Sciences, Jordan University, Amman, Jordan
| | - Sameer A. Al Haj Mahmoud
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Luay Abu-Qatouseh
- Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy, University of Petra, Amman, Jordan
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Nasr SS, Paul P, Loretz B, Lehr CM. Realizing time-staggered expression of nucleic acid-encoded proteins by co-delivery of messenger RNA and plasmid DNA on a single nanocarrier. Drug Deliv Transl Res 2024:10.1007/s13346-024-01668-w. [PMID: 39009932 DOI: 10.1007/s13346-024-01668-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2024] [Indexed: 07/17/2024]
Abstract
Co-delivery of different protein-encoding polynucleotide species with varying expression kinetics of their therapeutic product will become a prominent requirement in the realm of combined nucleic acid(NA)-based therapies in the upcoming years. The current study explores the capacity for time-staggered expression of encoded proteins by simultaneous delivery of plasmid DNA (pDNA) in the core and mRNA on the shell of the same nanocarrier. The core is based on a Gelatin Type A-pDNA coacervate, thermally stabilized to form an irreversible nanogel stable enough for the deposition of cationic coats namely, protamine sulfate or LNP-related lipid mixtures. Only the protamine-coated nanocarriers remained colloidally stable following mRNA loading and could successfully co-transfect murine dendritic cell line DC2.4 with fluorescent reporter mRNA(mCherry) and pDNA (pAmCyan1). Further investigation of the protamine-coated nanosystem only, the transfection efficiency (percentage of transfected cells) and level of protein expression (mean fluorescence intensity, MFI) of mRNA and pDNA, simultaneously delivered by the same nanocarrier, were compared and kinetically assessed over 48 h in DC2.4 using flow cytometry. The onset of transfection for both nucleotides was initially delayed, with levels < 5% at 6 h. Thereafter, mRNA transfection reached 90% after 24 h and continued to slightly increase until 48 h. In contrast, pDNA transfection was clearly slower, reaching approximately 40% after 24 h, but continuing to increase to reach 94% at 48 h. The time course of protein expression (represented by MFI) for both NAs essentially followed that of transfection. Model-independent as well as model-dependent kinetic parameters applied to the data further confirmed such time-staggered expression of the two NA's where mRNA's rate of transfection and protein expression initially exceeded those of pDNA in the first 24 h of the experiment whereas the opposite was true during the second 24 h of the experiment where pDNA displayed the higher response rates. We expect that innovative nanocarriers capable of time-staggered co-delivery of different nucleotides could open new perspectives for multi-dosing, pulsatile or sustained expression of nucleic acid-based therapeutics in protein replacement, vaccination, and CRISPR-mediated gene editing scenarios.
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Affiliation(s)
- Sarah S Nasr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Campus E8 1, 66123, Saarbrücken, Germany.
- Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany.
- Fischell Department of Bioengineering, University of Maryland, College Park, USA.
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, 21521, Egypt.
| | - Pascal Paul
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Campus E8 1, 66123, Saarbrücken, Germany
| | - Brigitta Loretz
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Campus E8 1, 66123, Saarbrücken, Germany
| | - Claus-Michael Lehr
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Campus E8 1, 66123, Saarbrücken, Germany.
- Department of Pharmacy, Saarland University, 66123, Saarbrücken, Germany.
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Cheng TM, Chen YS, Wei KC, Chang YC, Huang YT, Chen CL. Assessment of the herpes zoster risk among renal transplant recipients administered the influenza vaccine. Vaccine 2024:S0264-410X(24)00716-3. [PMID: 38897892 DOI: 10.1016/j.vaccine.2024.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Reactivation of the latent varicella-zoster virus can cause herpes zoster (HZ) infection, and renal transplant recipients undergoing immunosuppressive therapy are particularly susceptible to this condition. This study aims to evaluate the potential increase in HZ incidence following influenza vaccination among this specific patient population. METHODS This study was a population-based, retrospective, self-controlled case series. Data were retrieved from Taiwan's National Health Insurance Research Database spanning the years 2008 to 2017. Patients diagnosed with HZ within a 6-month period before and after receiving the influenza vaccine were eligible for inclusion. Two distinct time intervals were defined for analysis: the initial 15 days and 30 days following vaccination were categorized as risk intervals, while all other periods served as control intervals. Incidence rate ratios (IRRs) were computed to compare HZ incidence during the risk intervals with that during the control intervals. RESULTS This study encompassed a cohort of 4,222 renal transplant recipients who had received the influenza vaccine. Among this group, 67 recipients were subsequently diagnosed with HZ. The IRR during both the initial 15 days (IRR = 0.63; 95 % CI, 0.23-1.89) and the first 30 days (IRR = 1.50; 95 % CI, 0.71-3.16) following influenza vaccination did not demonstrate a statistically significant increase when compared to the post-exposure observation times. Comparable results were also observed when comparing these IRR values to the pre-exposure observation times. The subgroup analysis, stratified by age, sex, and underlying medical conditions (including cancer and autoimmune diseases), revealed that the IRRs did not exhibit statistically significant differences. CONCLUSIONS No significant association between the influenza vaccine and an elevated risk of HZ was detected. The administration of annual influenza vaccines appears to be a reasonable practice for renal transplant recipients.
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Affiliation(s)
- Tzu-Ming Cheng
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Hsinchu City 30010, Taiwan
| | - Yin-She Chen
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kai-Che Wei
- Faculty of Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Hsinchu City 30010, Taiwan; Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung Taiwan
| | - Yu-Chia Chang
- Department of Long-Term Care, College of Health and Nursing, National Quemoy University, Kinmen County Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung Taiwan
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Department of Medical Research and Development, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan Taiwan; Department of Health Care Management, Chang Gung University, Taoyuan Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Hsinchu City 30010, Taiwan; Division of Medical Research, Kaohsiung Veterans General Hospital, Kaohsiung 813779, Taiwan; Faculty of Medicine, School of Medicine, National Sun Yat-sen University, Taiwan.
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Torres-Flores A, Ontiveros-Padilla LA, Madera-Sandoval RL, Tepale-Segura A, Gajón-Martínez J, Rivera-Hernández T, Ferat-Osorio EA, Cérbulo-Vázquez A, Arriaga-Pizano LA, Bonifaz L, Paz-De la Rosa G, Rojas-Martínez O, Suárez-Martínez A, Peralta-Sánchez G, Sarfati-Mizrahi D, Sun W, Chagoya-Cortés HE, Palese P, Krammer F, García-Sastre A, Lozano-Dubernard B, López-Macías C. Newcastle disease virus vector-based SARS-CoV-2 vaccine candidate AVX/COVID-12 activates T cells and is recognized by antibodies from COVID-19 patients and vaccinated individuals. Front Immunol 2024; 15:1394114. [PMID: 38873610 PMCID: PMC11169921 DOI: 10.3389/fimmu.2024.1394114] [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: 03/01/2024] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Several effective vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed and implemented in the population. However, the current production capacity falls short of meeting global demand. Therefore, it is crucial to further develop novel vaccine platforms that can bridge the distribution gap. AVX/COVID-12 is a vector-based vaccine that utilizes the Newcastle Disease virus (NDV) to present the SARS-CoV-2 spike protein to the immune system. Methods This study aims to analyze the antigenicity of the vaccine candidate by examining antibody binding and T-cell activation in individuals infected with SARS-CoV-2 or variants of concern (VOCs), as well as in healthy volunteers who received coronavirus disease 2019 (COVID-19) vaccinations. Results Our findings indicate that the vaccine effectively binds antibodies and activates T-cells in individuals who received 2 or 3 doses of BNT162b2 or AZ/ChAdOx-1-S vaccines. Furthermore, the stimulation of T-cells from patients and vaccine recipients with AVX/COVID-12 resulted in their proliferation and secretion of interferon-gamma (IFN-γ) in both CD4+ and CD8+ T-cells. Discussion The AVX/COVID-12 vectored vaccine candidate demonstrates the ability to stimulate robust cellular responses and is recognized by antibodies primed by the spike protein present in SARS-CoV-2 viruses that infected patients, as well as in the mRNA BNT162b2 and AZ/ChAdOx-1-S vaccines. These results support the inclusion of the AVX/COVID-12 vaccine as a booster in vaccination programs aimed at addressing COVID-19 caused by SARS-CoV-2 and its VOCs.
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Affiliation(s)
- Alejandro Torres-Flores
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
- Posgrado en Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Luis Alberto Ontiveros-Padilla
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Ruth Lizzeth Madera-Sandoval
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
- Departamento de Biología Molecular y Validación de Técnicas, Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE) “Dr, Manuel Martínez Báez”, Secretaría de Salud, Ciudad de México, Mexico
| | - Araceli Tepale-Segura
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
| | - Julián Gajón-Martínez
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
| | - Tania Rivera-Hernández
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
- Investigadores por México, Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Ciudad de México, Mexico
| | - Eduardo Antonio Ferat-Osorio
- División de Investigación en Salud, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Cuauhtémoc, Ciudad de México, Mexico
| | - Arturo Cérbulo-Vázquez
- Servicio de Medicina Genómica. Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | - Lourdes Andrea Arriaga-Pizano
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
| | - Laura Bonifaz
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
- Coordinación de Investigación en Salud, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, Mexico
| | | | | | | | | | | | - Weina Sun
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Center for Vaccine Research and Pandemic Preparedness (C-VaRPP), Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- The Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Constantino López-Macías
- UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunoquímica, Ciudad de México, Mexico
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Sheng WH, Lin PH, Cheng YC, Wu YY, Hsieh MJ, Yang HC, Chang SY, Chang SC. Immunogenicity and safety of heterologous booster with protein-based COVID-19 vaccine (NVX-CoV2373) in healthy adults: A comparative analysis with mRNA vaccines. J Formos Med Assoc 2024; 123:340-346. [PMID: 37996322 DOI: 10.1016/j.jfma.2023.10.012] [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: 05/11/2023] [Revised: 08/07/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Information on the protein-based severe acute respiratory syndrome (SARS-CoV-2) vaccine-NVX-CoV2373 (Novavax), as a heterologous booster remains limited. We investigated the immunogenicity and adverse events of NVX-CoV2373 as a second booster and compared them with those of mRNA vaccines in healthy adults. METHODS Healthcare workers who had received an mRNA vaccine (mRNA-1273 or BNT-162b2) as the first booster (third dose) 12 weeks prior were recruited. Participants voluntarily received either NVX-CoV2373 or an mRNA vaccine as a second booster. Participants with a history of SARS-CoV-2 infection were excluded. The primary outcomes included serum anti-SARS-CoV-2 spike protein (SP) and neutralizing antibody titers against B.1.1.7 (Alpha), B.1.1.529 (Omicron) BA2, and BA5 variants on the 28th day after the boost. Secondary outcomes included new SARS-CoV-2 infections and adverse events reported during the study period. RESULTS A total of 160 participants were enrolled in this study. Compared with the mRNA vaccination group (n = 59), the NVX-CoV2373 vaccination group (n = 101) had significantly lower anti-SARS-CoV-2 SP antibody titers and neutralizing antibody titers against all variants tested after the boost. During the study period, higher rates of new SARS-CoV-2 infections and a lower incidence of adverse events were observed in the NVX-CoV2373 vaccination group. No significant differences in cellular immune responses were observed between the two groups. CONCLUSION Compared to a homologous mRNA booster vaccination, heterologous boosters with NVX-CoV2373 showed lower antibody responses, a higher incidence of new SARS-CoV-2 infections, and fewer adverse events.
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Affiliation(s)
- Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Pin-Hung Lin
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chen Cheng
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Yun Wu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Chih Yang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Shan-Chwen Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.
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Wu X, Xu K, Zhan P, Liu H, Zhang F, Song Y, Lv T. Comparative efficacy and safety of COVID-19 vaccines in phase III trials: a network meta-analysis. BMC Infect Dis 2024; 24:234. [PMID: 38383356 PMCID: PMC10880292 DOI: 10.1186/s12879-023-08754-3] [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: 03/24/2023] [Accepted: 10/25/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Over a dozen vaccines are in or have completed phase III trials at an unprecedented speed since the World Health Organization (WHO) declared COVID-19 a pandemic. In this review, we aimed to compare and rank these vaccines indirectly in terms of efficacy and safety using a network meta-analysis. METHODS We searched Embase, MEDLINE, and the Cochrane Library for phase III randomized controlled trials (RCTs) from their inception to September 30, 2023. Two investigators independently selected articles, extracted data, and assessed the risk of bias. Outcomes included efficacy in preventing symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the incidence of serious adverse events (SAEs) according to vaccine type and individual vaccines in adults and elderly individuals. The risk ratio and mean differences were calculated with 95% confidence intervals using a Bayesian network meta-analysis. RESULTS A total of 25 RCTs involving 22 vaccines were included in the study. None of vaccines had a higher incidence of SAEs than the placebo. Inactivated virus vaccines might be the safest, with a surface under the cumulative ranking curve (SUCRA) value of 0.16. BIV1-CovIran showed the highest safety index (SUCRA value: 0.13), followed by BBV152, Soberana, Gam-COVID-Vac, and ZF2001. There were no significant differences among the various types of vaccines regarding the efficacy in preventing symptomatic SARS-CoV-2 infection, although there was a trend toward higher efficacy of the mRNA vaccines (SUCRA value: 0.09). BNT162b2 showed the highest efficacy (SUCRA value: 0.02) among the individual vaccines, followed by mRNA-1273, Abdala, Gam-COVID-Vac, and NVX-CoV2373. BNT162b2 had the highest efficacy (SUCRA value: 0.08) in the elderly population, whereas CVnCoV, CoVLP + AS03, and CoronaVac were not significantly different from the placebo. CONCLUSIONS None of the different types of vaccines were significantly superior in terms of efficacy, while mRNA vaccines were significantly inferior in safety to other types. BNT162b2 had the highest efficacy in preventing symptomatic SARS-CoV-2 infection in adults and the elderly, whereas BIV1-CovIran had the lowest incidence of SAEs in adults.
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Affiliation(s)
- Xiaodi Wu
- Medical School of Nanjing University, Nanjing, 210000, China
| | - Ke Xu
- Medical School of Nanjing University, Nanjing, 210000, China
| | - Ping Zhan
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210000, China
| | - Hongbing Liu
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210000, China
| | - Fang Zhang
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210000, China
| | - Yong Song
- Medical School of Nanjing University, Nanjing, 210000, China.
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210000, China.
| | - Tangfeng Lv
- Medical School of Nanjing University, Nanjing, 210000, China.
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210000, China.
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Yang T, Tang D, Zhan Y, Seyler BC, Li F, Zhou B. SARS-CoV-2 vaccination and semen quality: a study based on sperm donor candidate data in southwest China. Transl Androl Urol 2024; 13:80-90. [PMID: 38404555 PMCID: PMC10891393 DOI: 10.21037/tau-23-395] [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: 07/28/2023] [Accepted: 11/20/2023] [Indexed: 02/27/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has been a global health crisis and continues to pose risk to population health at the present. Vaccination against this disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has become a public health priority worldwide. Yet, limited information is available on the potential impact of such vaccines on human fertility. Methods To examine the relationship between COVID-19 vaccination and male fertility, we conducted an observational study on sperm donor candidates in China who received Chinese COVID-19 vaccines between January 1, 2020 to December 31, 2021. Results A total of 2,955 semen samples from 564 individuals were assessed along with vaccination information. Statistical analyses were conducted on both the entire study population and the subgroup of individuals who provided repeated semen samples before and after vaccination. While motility related parameters [progressive rate, curvilinear velocity (VCL), average path velocity (VAP), straight-line velocity (VSL), wobble (WOB), straightness (STR), linearity (LIN), amplitude of lateral head displacement (ALH), beat-cross frequency (BCF)] exhibited statistically significant difference before and after vaccination based on Welch two-sample test, mixed effects regression results based on repeated measures from the same individuals indicated that vaccination was not statistically associated with sperm quality parameters except for VCL, VAP, and VSL. Individual variability was the key determinant of sperm quality variance, with contribution ranging from 19% to 82%. Conclusions Findings from our study could help to enhance current understanding of male reproductive health in the context of the global pandemic.
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Affiliation(s)
- Tingting Yang
- Department of Andrology/Human Sperm Bank of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Die Tang
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Barnabas C. Seyler
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, Chengdu, China
| | - Fuping Li
- Department of Andrology/Human Sperm Bank of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Bin Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
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Sulaiman SK, Musa MS, Tsiga-Ahmed FI, Sulaiman AK, Bako AT. A systematic review and meta-analysis of the global prevalence and determinants of COVID-19 vaccine acceptance and uptake in people living with HIV. Nat Hum Behav 2024; 8:100-114. [PMID: 37904021 PMCID: PMC10810755 DOI: 10.1038/s41562-023-01733-3] [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: 03/01/2023] [Accepted: 09/26/2023] [Indexed: 11/01/2023]
Abstract
People living with HIV (PLHIV) are at higher risk of poor outcomes of SARS-CoV-2 infection. Here we report the pooled prevalence of COVID-19 vaccine acceptance/uptake and determinants among this vulnerable population of PLHIV based on a systematic review and meta-analysis of studies published by 25 August 2023. Among the 54 included studies (N = 167,485 participants), 53 (N = 166,455) provided data on vaccine acceptance rate, while 27 (N = 150,926) provided uptake data. The global prevalences of COVID-19 vaccine acceptance and uptake were 67.0% and 56.6%, respectively. Acceptance and uptake rates were 86.6% and 90.1% for the European Region, 74.9% and 71.6% for the Region of the Americas, 62.3% and 78.9% for the South-East Asian Region, 64.6% and 19.3% for the Eastern Mediterranean Region, 58.0% and 35.5% for the African Region, and 57.4% and 44.0% for the Western Pacific Region. The acceptance rate increased from 65.9% in 2020 to 71.0% in 2022, and the uptake rate increased from 55.9% in 2021 to 58.1% in 2022. Men, PLHIV aged ≥40 years and those who had recently received the influenza vaccine were more likely to accept and receive the COVID-19 vaccine. Factors associated with lower uptake included Black race, other races (Latinx/Hispanic/mixed race), low education level and being unemployed. Vaccine-related factors associated with higher acceptance included belief in vaccine effectiveness, vaccine trust, perceived high susceptibility to SARS-CoV-2 infection and fear of potential COVID-19 effect in PLHIV. Sustained efforts and targeted interventions are needed to reduce regional disparities in COVID-19 vaccine uptake among PLHIV.
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Affiliation(s)
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | | | - Abdulwahab Kabir Sulaiman
- Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
- Kwanar Dawaki COVID-19 Isolation Center, Kano, Nigeria
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9
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Li G, Zhang R, Song B, Wang C, Shen Q, He X, Cao Y. Effects of SARS-CoV-2 Vaccines on Sperm Quality: Systematic Review. JMIR Public Health Surveill 2023; 9:e48511. [PMID: 37976132 DOI: 10.2196/48511] [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: 04/26/2023] [Revised: 06/06/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by SARS-CoV-2, has triggered a global public health crisis of unprecedented proportions. SARS-CoV-2 vaccination is a highly effective strategy for preventing infections and severe COVID-19 outcomes. Although several studies have concluded that COVID-19 vaccines are unlikely to affect fertility, concerns have arisen regarding adverse events, including the potential impact on fertility; these concerns are plagued by limited and inconsistent evidence. OBJECTIVE This review aims to provide a recent assessment of the literature on the impact of COVID-19 vaccines on male sperm quality. The possible impact of COVID-19 vaccines on fertility potential was also examined to draw a clearer picture and to evaluate the effects of COVID-19 on male reproductive health. METHODS PubMed, Scopus, Web of Science, Embase, and Cochrane databases were searched from their inception to October 2023. Eligible studies included articles reporting SARS-CoV-2 vaccination and human semen quality and fertility, as well as the impact of vaccination on assisted reproductive technology treatment outcomes. The quality of cohort studies was assessed using the Newcastle-Ottawa Scale, and the quality of cross-sectional studies was assessed using the quality evaluation criteria recommended by the Agency for Healthcare Research and Quality. The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS The initial literature search yielded 4691 records by searching 5 peer-reviewed databases (PubMed, Scopus, Web of Science, Embase, and Cochrane). Finally, 24 relevant studies were selected for our study. There were evident research inequalities at the regional level, with the United States and Western European countries contributing 38% (9/24) of the studies, Middle Eastern countries contributing 38% (9/24), China accounting for 21% (5/24), and Africa and South America accounting for none. Nonetheless, the overall quality of the included studies was generally good. Our results demonstrated that serious side effects of the COVID-19 vaccine are extremely rare, and men experience few problems with sperm parameters or reproductive potential after vaccination. CONCLUSIONS On the basis of the studies published so far, the COVID-19 vaccine is safe for male reproductive health. Obviously, vaccination is a wise option rather than experience serious adverse symptoms of viral infections. These instances of evidence may help reduce vaccine hesitancy and increase vaccination coverage, particularly among reproductive-age couples. As new controlled trials and prospective cohort studies with larger sample sizes emerge, the possibility of a negative effect of the COVID-19 vaccine on sperm quality must be further clarified.
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Affiliation(s)
- Guanjian Li
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Rongqiu Zhang
- Reproductive Medicine Center, the Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China
- The Second People's Hospital of Guiyang, Guiyang, China
| | - Bing Song
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Chao Wang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Qunshan Shen
- Reproductive Medicine Center, Human Sperm Bank, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, China
| | - Xiaojin He
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunxia Cao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
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Liu X, Wang Q, Ren L, Fang X, He Z, Ding J, Wang K, Xu H, Zhang H, Song Y, Lu Q, Sun M, Han X, Cao L, Lin W, Li X, Zhang Q, Ding Y, Wang F, Wang T, Wang J, Liu X, Wu Y, Chen Y, Feng Z, Wang S, Wang X, Guan Y, Xie X, Huang H, Zhang M, Wang X, Hong Z, Jiang W, Han Y, Deng Y, Zhao J, Liao J, Wang Y, Lian Y. COVID-19 vaccination for patients with epilepsy: A Chinese expert consensus. Epilepsy Behav 2023; 147:109387. [PMID: 37625346 DOI: 10.1016/j.yebeh.2023.109387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
Coronavirus disease-2019 (COVID-19) first emerged in late 2019 and has since spread worldwide. More than 600 million people have been diagnosed with COVID-19, and over 6 million have died. Vaccination against COVID-19 is one of the best ways to protect humans. Epilepsy is a common disease, and there are approximately 10 million patients with epilepsy (PWE) in China. However, China has listed "uncontrolled epilepsy" as a contraindication for COVID-19 vaccination, which makes many PWE reluctant to get COVID-19 vaccination, greatly affecting the health of these patients in the COVID-19 epidemic. However, recent clinical practice has shown that although a small percentage of PWE may experience an increased frequency of seizures after COVID-19 vaccination, the benefits of COVID-19 vaccination for PWE far outweigh the risks, suggesting that COVID-19 vaccination is safe and recommended for PWE. Nonetheless, vaccination strategies vary for different PWE, and this consensus provides specific recommendations for PWE to be vaccinated against COVID-19.
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Affiliation(s)
- Xuewu Liu
- Department of Neurology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China.
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Liankun Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Disorders, Beijing, China
| | - Xiqin Fang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China
| | - Zhiyi He
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kang Wang
- Department of Neurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Huiqin Xu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hua Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, China
| | - Yijun Song
- Hematology Hospital, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences), Tianjing, China
| | - Qiang Lu
- Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China
| | - Meizhen Sun
- Departmen of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiong Han
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lili Cao
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xiaoyi Li
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Qing Zhang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuang, China
| | - Yao Ding
- Department of Neurology, Epilepsy Center, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Furong Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Tiancheng Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiwen Wang
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaorong Liu
- Department of Neurology, Second Affiliated Hospital of Guangzhou Medical University, China
| | - Yuan Wu
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Guangzhou, China
| | - Yangmei Chen
- Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhanhui Feng
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shoulei Wang
- Department of Pediatrics, Qinghai Province Women and Children's Hospital, Xining, China
| | - Xiangqing Wang
- Department of Neurology, The First Medical Center of PLA General Hospital, Beijnig, China
| | - Yuguang Guan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijnig, China
| | - Xufang Xie
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huapin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ming Zhang
- Department of Neurology, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshan Wang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen Hong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Jiang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yanbing Han
- Department of Neurology, First Affiliated Hospital Kunming Medical University, Kunming, China
| | - Yulei Deng
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangming Zhao
- Department of Neurology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei, China
| | - Jianxiang Liao
- Department of Pediatrics, Shenzhen Children's Hospital, Shenzhen, China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Jiesisibieke ZL, Liu WY, Yang YP, Chien CW, Tung TH. Effectiveness and Safety of COVID-19 Vaccinations: An Umbrella Meta-Analysis. Int J Public Health 2023; 68:1605526. [PMID: 37485047 PMCID: PMC10361396 DOI: 10.3389/ijph.2023.1605526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives: This umbrella meta-analysis aims to provide comprehensive and synthesized evidence regarding the effectiveness and safety of COVID-19 vaccinations based on current studies. Methods: Studies from the Cochrane Library, PubMed, and EMBASE, published before 10 December 2021, were included in the analysis. The pooled results of effectiveness and safety were estimated and shown in forest plots. Results: We included nineteen studies (fifteen studies regarding safety and nine regarding effectiveness) in the analysis. The mRNA vaccines, adenovirus vector vaccines, subunit vaccines, and inactivated vaccines were found to be effective; however, mRNA vaccines, adenovirus vector vaccines and subunit vaccines were associated with local adverse events and systemic events when compared with inactivated vaccines. Conclusion: Our study suggested that till date, COVID-19 vaccination is still a preferred pharmaceutical way to control the widespread pandemic. However, all reported adverse events should be revisited to provide further evidence for mass vaccinations.
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Affiliation(s)
- Zhu Liduzi Jiesisibieke
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Wen-Yi Liu
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Shanghai Bluecross Medical Science Institute, Shanghai, China
| | - Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China
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12
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Khan UI, Niaz M, Azam I, Hasan Z, Hassan I, Mahmood SF, Ali A. Effectiveness of inactivated COVID-19 vaccines against SARS-CoV-2 infections among healthcare personnel in Pakistan: a test-negative case-control study. BMJ Open 2023; 13:e071789. [PMID: 37369396 PMCID: PMC10410856 DOI: 10.1136/bmjopen-2023-071789] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE During the COVID-19 pandemic, several vaccines that were efficacious in randomised controlled trials were authorised for mass vaccination. In developing countries, inactivated vaccines were widely administered. While inactivated vaccines have been deemed effective in reducing disease severity, for healthcare personnel (HCP), effectiveness against SARS-CoV-2 infections is essential to reduce the risk to vulnerable patients and ensure a stable healthcare workforce. There are limited studies examining inactivated vaccines' effectiveness against SARS-CoV-2 variants of concern (VOCs) in real-world settings. We estimated the effectiveness of inactivated vaccines (BBIBP-CorV and CoronaVac) against reverse transcription PCR (RT-PCR)-confirmed SARS-CoV-2 infections among HCP in the setting of emerging SARS-CoV-2 VOCs in Pakistan. DESIGN A retrospective matched, test-negative case-control analysis using existing data from an Employee Health database on HCP at a large, private healthcare system in Pakistan. PARTICIPANTS 4599 HCP were tested between 1 April and 30 September 2021. Each case (PCR positive) was matched to two to six controls (PCR negative) by the date of the RT-PCR test (±7 days) to reduce bias. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was vaccine effectiveness (VE) against SARS-CoV-2 infection. The secondary outcome was VE against symptomatic SARS-CoV-2 infection. Per cent VE was calculated using (1-OR)*100, with the OR of getting a PCR-confirmed SARS-COV-2 infection estimated using conditional logistic regression, after adjusting for age, gender, work area and history of SARS-CoV-2 infection. RESULTS Inactivated vaccines were ineffective against SARS-CoV-2 infections after receiving the first dose (VE 17%, 95% CI -10, 39; p=0.261). They showed modest effectiveness ≥14 days after the second dose against SARS-CoV-2 infections (VE 30%, 95% CI 7, 48; p=0.015) and symptomatic SARS-CoV-2 infections (VE 33%, 95% CI 6, 52; p=0.002). CONCLUSIONS Inactivated vaccines show modest effectiveness against SARS-CoV-2 infections in the setting of emerging VOCs. This builds a strong case for boosters and/or additional vaccination.
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Affiliation(s)
| | - Mahnoor Niaz
- Department of Family Medicine, Dean's Clinical Research Fellowship Program, Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Pathology, Aga Khan University, Karachi, Pakistan
| | - Imran Hassan
- Family Medicine, Aga Khan University, Karachi, Pakistan
| | | | - Asad Ali
- Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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13
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Xu W, Ren W, Wu T, Wang Q, Luo M, Yi Y, Li J. Real-World Safety of COVID-19 mRNA Vaccines: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1118. [PMID: 37376508 DOI: 10.3390/vaccines11061118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
With the mass vaccination program for COVID-19 mRNA vaccines, there has been sufficient real-world study (RWS) on the topic to summarize their safety in the total population and in immunocompromised (IC) patients who were excluded from phase 3 clinical trials. We conducted a systematic review and meta-analysis to evaluate the safety of COVID-19 mRNA vaccines, with a total of 5,132,799 subjects from 122 articles. In the case of the total population vaccinated with first, second, and third doses, the pooled incidence of any adverse events (AEs) was 62.20%, 70.39%, and 58.60%; that of any local AEs was 52.03%, 47.99%, and 65.00%; that of any systemic AEs was 29.07%, 47.86%, and 32.71%. Among the immunocompromised patients, the pooled odds ratio of any AEs, any local AEs, and systemic AEs were slightly lower than or similar to those of the healthy controls at 0.60 (95% CI: 0.33-1.11), 0.19 (95% CI: 0.10-0.37), and 0.36 (95% CI: 0.25-0.54), with pooled incidences of 51.95%, 38.82%, and 31.00%, respectively. The spectrum of AEs associated with the vaccines was broad, but most AEs were transient, self-limiting, and mild to moderate. Moreover, younger adults, women, and people with prior SARS-CoV-2 infection were more likely to experience AEs.
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Affiliation(s)
- Wanqian Xu
- School of Public Health, The Second Hospital of Nanjing, Nanjing Medical University, Nanjing 211166, China
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
| | - Weigang Ren
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Tongxin Wu
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Qin Wang
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Mi Luo
- School of Public Health, The Second Hospital of Nanjing, Nanjing Medical University, Nanjing 211166, China
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
| | - Yongxiang Yi
- School of Public Health, The Second Hospital of Nanjing, Nanjing Medical University, Nanjing 211166, China
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
| | - Junwei Li
- The Clinical Infectious Disease Center of Nanjing, Nanjing 210003, China
- Department of Infectious Diseases, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
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14
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Yıldız Y, Özger HS, Acar A, Seremet-Keskin A, Binay UD, Ünlü G, Bayram H, Asan A, Akça MÖ, Karamanlioğlu D, İnan O, Kaya Ş, Yıldırım Ç, Arslan Y, Kömür S, Saygıdeğer Y, Kandemir FÖ, Yaşar S, Akdemir-Kalkan İ, Tekin-Taş Z, Sakız A, Bayındır Y, Özer AB, Mete AÖ, Erol Ç, Mermutluoğlu Ç, Kadiroğlu AK, Azap A, Şenol E. The Impact of Vaccination Among Hospitalized Patients with the Diagnosis of COVID-19. INFECTIOUS DISEASES & CLINICAL MICROBIOLOGY 2023; 5:118-126. [PMID: 38633011 PMCID: PMC10986718 DOI: 10.36519/idcm.2023.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/31/2023] [Indexed: 04/19/2024]
Abstract
Objective We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients. Materials and Methods This multi-center point-prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status. Results Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower (p=0.021). Conclusion We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection.
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Affiliation(s)
- Yeşim Yıldız
- Department of Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Hasan Selçuk Özger
- Department of Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Ali Acar
- Department of Infectious Disease and Clinical Microbiology, Atılım University School of Medicine, Ankara, Turkey
| | - Ayşegül Seremet-Keskin
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Umut Devrim Binay
- Department of Infectious Diseases and Clinical Microbiology, Erzincan Binali Yildirim University School of Medicine, Erzincan, Turkey
| | - Gülten Ünlü
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Halim Bayram
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep Dr Ersin Arslan Tranining and Research Hospital, Gaziantep, Turkey
| | - Ali Asan
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Bursa Training and Research Hospital, Bursa, Turkey
| | - Mustafa Özgür Akça
- Department of Infectious Diseases and Clinical Microbiology, University of Health Science, Bursa Training and Research Hospital, Bursa, Turkey
| | - Dilek Karamanlioğlu
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Osman İnan
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Şafak Kaya
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Çiğdem Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Pursaklar State Hospital, Ankara, Turkey
| | - Yusuf Arslan
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Süheyla Kömür
- Department of Infectious Disease and Clinical Microbiology, Çukurova University School of Medicine, Adana, Turkey
| | - Yasemin Saygıdeğer
- Department of Pulmonary, Çukurova University School of Medicine, Adana, Turkey
| | - Fatma Özlem Kandemir
- Department of Infectious Disease and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - Simge Yaşar
- Department of Infectious Disease and Clinical Microbiology, Mersin University School of Medicine, Mersin, Turkey
| | - İrem Akdemir-Kalkan
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Tekin-Taş
- Department of Infectious Diseases and Clinical Microbiology, Sincan Dr. Nafiz Körez State Hospital, Ankara, Turkey
| | - Ayşe Sakız
- Department of Infectious Diseases and Clinical Microbiology, Mardin Training and Research Hospital, Mardin, Turkey
| | - Yaşar Bayındır
- Department of Infectious Diseases and Clinical Microbiology, İnönü University School of Medicine, Malatya, Turkey
| | - Ayşe Belin Özer
- Department of Anesthesiology and Reanimation, İnönü University School of Medicine, Malatya, Turkey
| | - Ayşe Özlem Mete
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Çiğdem Erol
- Department of Infectious Diseases and Clinical Microbiology, Başkent University School of Medicine, Ankara, Turkey
| | - Çiğdem Mermutluoğlu
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Ali Kemal Kadiroğlu
- Department of Nephrology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Esin Şenol
- Department of Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
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LI Z, WAN Y, XU L, ZHANG W, ZHANG Y, LIAO P. Clinical and laboratory features in health care volunteers with inactivated SARS-CoV-2 vaccination. Turk J Med Sci 2023; 53:1185-1193. [PMID: 38813035 PMCID: PMC10763784 DOI: 10.55730/1300-0144.5684] [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: 10/30/2022] [Revised: 10/26/2023] [Accepted: 05/25/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim To better optimize the inactivated vaccine-induced immune response and improve vaccine protection efficiency, a preliminary study was conducted on the influencing factors of producing neutralizing antibody (NAb) titers against the inactivated coronavirus disease 2019 (COVID-19) vaccine. Materials and methods A total of 91 health care volunteers were enrolled from the Immunology Division of the Laboratory Department of Chongqing General Hospital from February to March 2021. The study had a cross-sectional design. All of the volunteers were scheduled to receive a complete dose regimen of the inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine and the vaccination interval between 2 doses was 14 days. Clinical and laboratory features were collected for further analysis. Results The NAb titers gradually increased after COVID-19 vaccination, and 72.53% (n = 66) of the volunteers had NAbs after the second dose. Eight variables, including CD16+CD56+ NK cell level before the first dose (HR = 0.94, p = 0.02), CD16+CD56+ NK cell level after the second dose (HR = 0.94, p = 0.03), interleukin (IL)-2 level before the first dose (HR = 2.09, p = 0.05), mean corpuscular volume (HR = 0.86, p = 0.02), serum urea level (HR = 0.69, p = 0.05), increment of CD19+ B cells (HR = 0.86, p = 0.03), increment of CD4+/CD8+ T cells (HR = 0.21, p = 0.03), and increment of the IL-6 level (HR = 0.75, p = 0.04) demonstrated a correlation with the NAb titers after COVID-19 vaccination. In the multivariate logistical regression analysis, the serum urea level (HR = 2.32, P = 0.03) and increment of CD19+ B cells (HR = 1.96, p = 0.03) were positively correlated with the NAb titers. The principal component analysis effectively distinguished the response after COVID-19 vaccination. The Pearson correlation analysis indicated that the CD19+ B cell level (r = 0.23, p < 0.001) and IL-2 (r = 0.24, p < 0.001) and IL-6 levels (r = 0.22, p < 0.001) were weakly positively correlated with the concentration of NAbs. Conclusion The NAbs titers of the inactivated vaccines were positively correlated with the ratio of CD19+ B cell, IL-6, and IL-2 levels in the serum, which provide clinical guidance for inactivated SARS-CoV-2 vaccines.
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Affiliation(s)
- Zhijie LI
- Chongqing Medical University, Chongqing,
China
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing,
China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing,
China
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing,
China
| | - Yafang WAN
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing,
China
| | - Lanlan XU
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing,
China
| | - Wenjia ZHANG
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing,
China
| | - Yu ZHANG
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing,
China
| | - Pu LIAO
- Chongqing Medical University, Chongqing,
China
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing,
China
- Chongqing School, University of Chinese Academy of Sciences, Chongqing,
China
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing,
China
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Roytenberg R, García-Sastre A, Li W. Vaccine-induced immune thrombotic thrombocytopenia: what do we know hitherto? Front Med (Lausanne) 2023; 10:1155727. [PMID: 37261122 PMCID: PMC10227460 DOI: 10.3389/fmed.2023.1155727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/28/2023] [Indexed: 06/02/2023] Open
Abstract
Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a catastrophic and life-threatening reaction to coronavirus disease 2019 (COVID-19) vaccines, which occurs disproportionately in response to vaccination with non-replicating adenovirus vector (AV) vaccines. The mechanism of VITT is not well defined and it has not been resolved why cases of VITT are predominated by vaccination with AV vaccines. However, virtually all VITT patients have positive platelet-activating anti-platelet factor 4 (PF4) antibody titers. Subsequently, platelets are activated and depleted in an Fcγ-receptor IIa (FcγRIIa or CD32a)-dependent manner, but it is not clear why or how the anti-PF4 response is mounted. This review describes the pathogenesis of VITT and provides insight into possible mechanisms that prompt the formation of a PF4/polyanion complex, which drives VITT pathology, as an amalgam of current experimental data or hypotheses.
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Affiliation(s)
- Renat Roytenberg
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine at Marshall University, Huntington, WV, United States
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Wei Li
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine at Marshall University, Huntington, WV, United States
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Thammathiwat T, Banjongjit A, Iampenkhae K, Townamchai N, Kanjanabuch T. ANCA Associated Glomerulonephritis Following SARS-CoV-2 Vaccination: A Case Series and Systematic Review. Vaccines (Basel) 2023; 11:vaccines11050983. [PMID: 37243087 DOI: 10.3390/vaccines11050983] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccines against SARS-CoV-2 (COVID-19) proved beneficial for COVID-19 disease attenuation and preventing virus spreading. Cumulative reports of the rarity of antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis (AAV) raise concerns about its relationship with COVID-19 vaccination. Several case reports described ANCA-associated pauci-immune glomerulonephritis (ANCA-GN) following COVID-19 vaccination with some uniqueness. We systematically reviewed COVID-19 vaccine-induced ANCA-GN from PubMed, SCOPUS, and Cochrane library databases until 1 January 2023 according to PRISMA guidelines and presented our three cases. Twenty-six cases from 25 articles, including our 3 cases, were analyzed. Most cases were diagnosed following the second dose of the COVID-19 vaccine (59%) with a median (IQR) interval onset of 14 (16) days. The highest prevalence was related to the mRNA-type vaccine. Anti-myeloperoxidase (MPO) ANCA was far more common than the other ANCAs, with various positive autoantibodies. Fourteen cases (out of 29 cases, 48%) had extra-kidney AAV manifestation. Although severe kidney injury was observed in 10/29 (34%), remission was achieved in 89% (25/28) with no death. The mechanisms of the vaccine-inducing ANCA-GN were postulated here. Since ANCA-GN after the COVID-19 vaccine was rare, the benefit of the COVID-19 vaccine could outweigh the risk of ANCA-GN side effects in the pandemic era.
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Affiliation(s)
- Theerachai Thammathiwat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok 10400, Thailand
| | - Kroonpong Iampenkhae
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Natavudh Townamchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
- Excellence Center for Solid Organ Transplantation, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
- Renal Immunology and Renal Transplant Research Unit, Chulalongkorn University, Bangkok 10330, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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Hernández-Bernal F, Ricardo-Cobas MC, Martín-Bauta Y, Rodríguez-Martínez E, Urrutia-Pérez K, Urrutia-Pérez K, Quintana-Guerra J, Navarro-Rodríguez Z, Piñera-Martínez M, Rodríguez-Reinoso JL, Chávez-Chong CO, Baladrón-Castrillo I, Melo-Suárez G, Batista-Izquierdo A, Pupo-Micó A, Mora-Betancourt R, Bizet-Almeida J, Martínez-Rodríguez MC, Lobaina-Lambert L, Velázquez-Pérez VM, Soler-Díaz J, Laurencio-Vallina S, Meriño-Hechavarría T, Carmenaty-Campos N, Rodríguez-Montero E, Limonta-Fernández M, Alonso-Valdés M, Hernández-Rodríguez R, Pimentel-Vázquez E, Catasús-Álvarez KM, Cabrera-Núñez MV, Ayala-Ávila M, Muzio-González VL. A phase 3, randomised, double-blind, placebo-controlled clinical trial evaluation of the efficacy and safety of a SARS-CoV-2 recombinant spike RBD protein vaccine in adults (ABDALA-3 study). LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100497. [PMID: 37192953 PMCID: PMC10160525 DOI: 10.1016/j.lana.2023.100497] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 05/18/2023]
Abstract
Background The pandemic of COVID-19 raised the urgent need for safe and efficacious vaccines against SARS-CoV-2. We evaluated the efficacy and safety of a new SARS-CoV-2 virus receptor-binding domain (RBD) vaccine. Methods A phase 3, multicentre, randomised, double-blind, placebo-controlled trial was carried out at 18 clinical sites in three provinces of the south-eastern region of Cuba. Subjects (healthy or those with controlled chronic diseases) aged between 19 and 80 years, who gave written informed consent were eligible. Subjects were randomly assigned (1:1, in blocks) to two groups: placebo, and 50 μg RBD vaccine (Abdala). The product was administered intramuscularly, 0.5 mL in the deltoid region, in a three-dose immunization schedule at 0-14-28 days. The organoleptic characteristics and presentations of the vaccine and placebo were identical. All participants (subjects, clinical researchers, statisticians, laboratory technicians, and monitors) remained blinded during the study period. The main endpoint was to evaluate the efficacy of the Abdala vaccine in the prevention of symptomatic COVID-19. The trial is registered with the Cuban Public Registry of Clinical Trials, RPCEC00000359. Findings Between March 22 to April 03, 2021, 48,290 subjects were included (24,144 and 24,146 in the placebo and Abdala groups, respectively) in the context of predominant D614G variant circulation. The evaluation of the main efficacy outcomes occurred during May-June 2021, starting at May 3rd, in the context of high circulation of mutant viruses, predominantly VOC Beta. The incidence of adverse reactions for individuals in the placebo and Abdala vaccine groups were 1227/24,144 (5.1%) and 1621/24,146 (6.7%), respectively. Adverse reactions were mostly mild, and from the injection site, which resolved in the first 24-48 h. No severe adverse events with demonstrated cause-effect relationship attributable to the vaccine were reported. Symptomatic COVID-19 disease was confirmed in 142 participants in the placebo group (78.44 incidence per 1000 person-years, 95% confidence interval [CI], 66.07-92.46) and in 11 participants in Abdala vaccine group (6.05 incidence per 1000 person years; 95% CI 3.02-10.82). The Abdala vaccine efficacy against symptomatic COVID-19 was 92.28% (95% CI 85.74-95.82). Moderate/serious forms of COVID-19 occurred in 30 participants (28 in the placebo group and only 2 in the Abdala vaccine group) for a vaccine efficacy of 92.88% (95% CI 70.12-98.31). There were five critical patients (of which four died), all in the placebo group. Interpretation The Abdala vaccine was safe, well tolerated, and highly effective, fulfilling the WHO target product profile for COVID-19 vaccines. Those results, along with its immunization schedule and the advantage of easy storage and handling conditions at 2-8 °C, make this vaccine an option for the use in immunization strategies as a key tool for the control of the pandemic. Funding Centre for Genetic Engineering and Biotechnology (CIGB), Havana, Cuba.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Maria V. Cabrera-Núñez
- Virology Laboratory of the Center for Hygiene, Epidemiology and Microbiology, Santiago de Cuba, Cuba
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Fang X, Qiao S, Zhang R, Yang T, Wang Z, Kong Q, Sun M, Geng J, Fang C, Chen Y, Sun Y, Zhang D, Qu L, Shang W, Wang J, Liu X. Effects of coronavirus disease 2019 vaccination on seizures in patients with epilepsy. Chin Med J (Engl) 2023; 136:571-577. [PMID: 36848187 PMCID: PMC10106124 DOI: 10.1097/cm9.0000000000002558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Given that seizures may be triggered by vaccination, this study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated against coronavirus disease 2019 (COVID-19). METHODS This study retrospectively enrolled PWE who were vaccinated against COVID-19 in the epilepsy centers of 11 hospitals in China. We divided the PWE into two groups as follows: (1) patients who developed seizures within 14 days of vaccination were assigned to the SAV (with seizures after vaccination) group; (2) patients who were seizure-free within 14 days of vaccination were assigned to the SFAV (seizure-free after vaccination) group. To identify potential risk factors for seizure reccurence, the binary logistic regression analysis was performed. Besides, 67 PWE who had not been vaccinated were also included for elucidating the effects of vaccination on seizures recurrence, and binary logistic regression analysis was performed to determine whether vaccination would affect the recurrence rate of PWE who had drug reduction or withdrawal. RESULTS The study included a total of 407 patients; of which, 48 (11.8%) developed seizures within 14 days after vaccination (SAV group), whereas 359 (88.2%) remained seizure-free (SFAV group). The binary logistic regression analysis revealed that duration of seizure freedom ( P < 0.001) and withdrawal from anti-seizure medications (ASMs) or reduction in their dosage during the peri-vaccination period were significantly associated with the recurrence of seizures (odds ratio = 7.384, 95% confidence interval = 1.732-31.488, P = 0.007). In addition, 32 of 33 patients (97.0%) who were seizure-free for more than three months before vaccination and had a normal electroencephalogram before vaccination did not have any seizures within 14 days of vaccination. A total of 92 (22.6%) patients experienced non-epileptic adverse reactions after vaccination. Binary logistic regression analysis results showed that vaccine did not significantly affect the recurrence rate of PWE who had the behavior of ASMs dose reduction or withdrawal ( P = 0.143). CONCLUSIONS PWE need protection from the COVID-19 vaccine. PWE who are seizure-free for >3 months before vaccination should be vaccinated. Whether the remaining PWE should be vaccinated depends on the local prevalence of COVID-19. Finally, PWE should avoid discontinuing ASMs or reducing their dosage during the peri-vaccination period.
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Affiliation(s)
- Xiqin Fang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China
- Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China
| | - Shan Qiao
- Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong 250000, China
| | - Ranran Zhang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China
- Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China
| | - Tingting Yang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China
- Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China
| | - Zhihao Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China
- Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China
| | - Qingxia Kong
- Department of Neurology, Affiliated Hospital of Jining Medical College, Jining, Shandong 272000, China
| | - Meihua Sun
- Department of Neurology, Tengzhou Central People's Hospital, Jining, Shandong 277599, China
| | - Jianhong Geng
- Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, Shandong 261000, China
| | - Chunyan Fang
- Department of Neurology, Zhucheng People's Hospital, Weifang, Shandong 262200, China
| | - Yanxiu Chen
- Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Dongmei Zhang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276000, China
| | - Lixing Qu
- Department of Neurology, Dezhou People's Hospital, Dezhou, Shandong 253000, China
| | - Wei Shang
- Department of Neurology, Second Hospital of Shandong University, Jinan, Shandong 250000, China
| | - Jianguo Wang
- Department of Neurology, Jinan Central Hospital, Jinan, Shandong 250000, China
| | - Xuewu Liu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China
- Department of Neurology, Institute of Epilepsy, Shandong University, Jinan, Shandong 250000, China
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Efficacy of SARS-CoV-2 vaccines and the dose-response relationship with three major antibodies: a systematic review and meta-analysis of randomised controlled trials. THE LANCET. MICROBE 2023; 4:e236-e246. [PMID: 36868258 PMCID: PMC9974155 DOI: 10.1016/s2666-5247(22)00390-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 03/04/2023]
Abstract
BACKGROUND The efficacy of SARS-CoV-2 vaccines in preventing severe COVID-19 illness and death is uncertain due to the rarity of data in individual trials. How well the antibody concentrations can predict the efficacy is also uncertain. We aimed to assess the efficacy of these vaccines in preventing SARS-CoV-2 infections of different severities and the dose-response relationship between the antibody concentrations and efficacy. METHODS We did a systematic review and meta-analysis of randomised controlled trials (RCTs). We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, WHO, bioRxiv, and medRxiv for papers published between Jan 1, 2020 and Sep 12, 2022. RCTs on the efficacy of SARS-CoV-2 vaccines were eligible. Risk of bias was assessed using the Cochrane tool. A frequentist, random-effects model was used to combine efficacy for common outcomes (ie, symptomatic and asymptomatic infections) and a Bayesian random-effects model was used for rare outcomes (ie, hospital admission, severe infection, and death). Potential sources of heterogeneity were investigated. The dose-response relationships of neutralising, spike-specific IgG and receptor binding domain-specific IgG antibody titres with efficacy in preventing SARS-CoV-2 symptomatic and severe infections were examined by meta-regression. This systematic review is registered with PROSPERO, CRD42021287238. FINDINGS 28 RCTs (n=286 915 in vaccination groups and n=233 236 in placebo groups; median follow-up 1-6 months after last vaccination) across 32 publications were included in this review. The combined efficacy of full vaccination was 44·5% (95% CI 27·8-57·4) for preventing asymptomatic infections, 76·5% (69·8-81·7) for preventing symptomatic infections, 95·4% (95% credible interval 88·0-98·7) for preventing hospitalisation, 90·8% (85·5-95·1) for preventing severe infection, and 85·8% (68·7-94·6) for preventing death. There was heterogeneity in the efficacy of SARS-CoV-2 vaccines against asymptomatic and symptomatic infections but insufficient evidence to suggest whether the efficacy could differ according to the type of vaccine, age of the vaccinated individual, and between-dose interval (p>0·05 for all). Vaccine efficacy against symptomatic infection waned over time after full vaccination, with an average decrease of 13·6% (95% CI 5·5-22·3; p=0·0007) per month but can be enhanced by a booster. We found a significant non-linear relationship between each type of antibody and efficacy against symptomatic and severe infections (p<0·0001 for all), but there remained considerable heterogeneity in the efficacy, which cannot be explained by antibody concentrations. The risk of bias was low in most studies. INTERPRETATION The efficacy of SARS-CoV-2 vaccines is higher for preventing severe infection and death than for preventing milder infection. Vaccine efficacy wanes over time but can be enhanced by a booster. Higher antibody titres are associated with higher estimates of efficacy but precise predictions are difficult due to large unexplained heterogeneity. These findings provide an important knowledge base for interpretation and application of future studies on these issues. FUNDING Shenzhen Science and Technology Programs.
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Thammathiwat T, Chompuk L, Worawichawong S, Boonpucknavig V, Sirilak S, Pongcharoen S, Pichitsiri W, Kanjanabuch T. Membranous Nephropathy following Full-Dose of Inactivated SARS-CoV-2 Virus Vaccination: A Case Report and Literature Review. Vaccines (Basel) 2022; 11:vaccines11010080. [PMID: 36679925 PMCID: PMC9864915 DOI: 10.3390/vaccines11010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Vaccination against the SARS-CoV-2 virus (COVID-19) has proven to be the most effective measure to prevent the spread and reduce infection severity. A case report of de novo membranous nephropathy (MN) following immunization with inactivated virus vaccine (CoronaVac®, Sinovac Biotech) is presented here. A 53-year-old man presented with a sudden onset of leg edema a week after receiving an inactivated virus vaccine and a relapse of nephrotic syndrome (NS) with acute kidney injury (AKI) after a booster dose. Screening for serum anti-phospholipase A2 receptor antibody and secondary causes of MN were negative. Kidney biopsy revealed an early MN pattern with focal spike formation, whilst numerous subepithelial electron-dense deposits and a few small deposits in the mesangial area were observed through electron microscopy. A short course of steroids and oral cyclophosphamide was prescribed, resulting in the complete remission of NS and AKI. MN following SARS-CoV-2 vaccination should call for medical importance. Awareness of the association between vaccination and MN should be kept in mind to avoid unnecessary treatment with long-term immunosuppressive agents.
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Affiliation(s)
- Theerachai Thammathiwat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
| | - Laor Chompuk
- Department of Pathology, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
| | - Suchin Worawichawong
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | | | - Supinda Sirilak
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
| | - Sutatip Pongcharoen
- Division of Immunology, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
- Correspondence: (S.P.); (W.P.); Tel.: +66-55965105 (S.P.); +66-55965105 (W.P.)
| | - Watchara Pichitsiri
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
- Correspondence: (S.P.); (W.P.); Tel.: +66-55965105 (S.P.); +66-55965105 (W.P.)
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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22
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Fang X, Hu S, Han T, Yang T, Hu J, Song Y, Li C, Ma A, Li Y, Kong Q, Tang L, Chen W, Sun W, Fang C, Sun Y, Chen J, Sun W, Yan Y, Gao Y, Geng J, Li N, Li Q, Jiang Z, Lv S, Li W, Lang X, Wang S, Chen Y, Li B, Li L, Liu X, Liu Y, Zhan Y, Gao Z, Qu L, Fu Q, Liu X. Effect of inactivated COVID-19 vaccines on seizure frequency in patients with epilepsy: A multicenter, prospective study. Front Immunol 2022; 13:984789. [PMID: 36569941 PMCID: PMC9769399 DOI: 10.3389/fimmu.2022.984789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Several COVID-19 vaccines list "uncontrolled epilepsy" as a contraindication for vaccination. This consequently restricts vaccination against COVID-19 in patients with epilepsy (PWE). However, there is no strong evidence that COVID-19 vaccination can exacerbate conditions in PWE. This study aims to determine the impact of COVID-19 vaccination on PWE. Methods PWE were prospectively recruited from 25 epilepsy centers. We recorded the seizure frequency at three time periods (one month before the first vaccination and one month after the first and second vaccinations). A generalized linear mixed-effects model (GLMM) was used for analysis, and the adjusted incidence rate ratio (AIRR) with 95% CI was presented and interpreted accordingly. Results Overall, 859 PWE were included in the analysis. Thirty-one (3.6%) and 35 (4.1%) patients were found to have increased seizure frequency after the two doses, respectively. Age had an interaction with time. The seizure frequency in adults decreased by 81% after the first dose (AIRR=0.19, 95% CI:0.11-0.34) and 85% after the second dose (AIRR=0.16, 95% CI:0.08-0.30). In juveniles (<18), it was 25% (AIRR=0.75, 95% CI:0.42-1.34) and 51% (AIRR=0.49, 95% CI:0.25-0.95), respectively. Interval between the last seizure before vaccination and the first dose of vaccination (ILSFV) had a significant effect on seizure frequency after vaccination. Seizure frequency in PWE with hereditary epilepsy after vaccination was significantly higher than that in PWE with unknown etiology (AIRR=1.95, 95% CI: 1.17-3.24). Two hundred and seventeen (25.3%) patients experienced non-epileptic but not serious adverse reactions. Discussion The inactivated COVID-19 vaccine does not significantly increase seizure frequency in PWE. The limitations of vaccination in PWE should focus on aspects other than control status. Juvenile PWE should be of greater concern after vaccination because they have lower safety. Finally, PWE should not reduce the dosage of anti-seizure medication during the peri-vaccination period.
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Affiliation(s)
- Xiqin Fang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,Institute of Epilepsy, Shandong University, Jinan, China
| | - Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,Beijing Key Laboratory of Neuromodulation, Beijing, China,Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Tao Han
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Tingting Yang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,Institute of Epilepsy, Shandong University, Jinan, China
| | - Junji Hu
- Department of Neurology, Zibo Changguo Hospital, Zibo, China
| | - Yucheng Song
- Department of Neurology, Jining City Dai Zhuang Hospital, Jining, China
| | - Chunxiang Li
- Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China
| | - Aihua Ma
- Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Yufeng Li
- Department of Pediatrics, Linyi People’s Hospital, Linyi, China
| | - Qingxia Kong
- Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China
| | - Liou Tang
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Chen
- Department of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, China
| | - Wenxiu Sun
- Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Chunyan Fang
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Juan Chen
- Department of Neurology, Heze Third People’s Hospital, Heze, China
| | - Wenying Sun
- Department of Pediatrics, Liaocheng People’s Hospital, Liaocheng, China
| | - Yibing Yan
- Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Yuxing Gao
- Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Jianhong Geng
- Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, China
| | - Nan Li
- Department of Neurology, Shengli Oilfield Central Hospital, Dongying, China
| | - Qiubo Li
- Department of Pediatrics, Affiliated Hospital of Jining Medical, Jining, China
| | - Zhaolun Jiang
- Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Shishen Lv
- Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Wenke Li
- Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Xiaoling Lang
- Department of Neurology, Laizhou People’s Hospital, Qingdao, China
| | - Suli Wang
- Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China
| | - Yanxiu Chen
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng, China
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ling Li
- Department of Neurology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Xinjie Liu
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yong Liu
- Department of Pediatrics, Qilu Children’s Hospital of Shandong University, Jinan, China
| | - Yan Zhan
- Department of Neurology, Affiliated Hospital of Binzhou Medical College, Yantai, China
| | - Zaifen Gao
- Department of Pediatrics, Qilu Children’s Hospital of Shandong University, Jinan, China
| | - Lixin Qu
- Department of Neurology, Dezhou People’s Hospital, Dezhou, China
| | - Qingxi Fu
- Department of Neurology, Linyi People’s Hospital, Linyi, China
| | - Xuewu Liu
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,Institute of Epilepsy, Shandong University, Jinan, China,*Correspondence: Xuewu Liu,
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23
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Porcari A. Filling the gap in epidemiology, management and clinical course of COVID-19 vaccination-related pericarditis. J Cardiovasc Med (Hagerstown) 2022; 23:784-786. [PMID: 36349943 DOI: 10.2459/jcm.0000000000001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Corona G, Vena W, Pizzocaro A, Pallotti F, Paoli D, Rastrelli G, Baldi E, Cilloni N, Gacci M, Semeraro F, Salonia A, Minhas S, Pivonello R, Sforza A, Vignozzi L, Isidori AM, Lenzi A, Maggi M, Lombardo F. Andrological effects of SARS-Cov-2 infection: a systematic review and meta-analysis. J Endocrinol Invest 2022; 45:2207-2219. [PMID: 35527294 PMCID: PMC9080963 DOI: 10.1007/s40618-022-01801-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The short- and long-term andrological effects of coronavirus disease 2019 (COVID-19) have not been clarified. Our aim is to evaluate the available evidence regarding possible andrological consequences of COVID-19 either on seminal or hormonal parameters. The safety of the COVID-19 vaccines in terms of sperm quality was also investigated. METHODS All prospective and retrospective observational studies reporting information on severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) mRNA semen and male genitalia tract detection (n = 19), as well as those reporting data on semen analysis (n = 5) and hormonal parameters (n = 11) in infected/recovered patients without any arbitrary restriction were included. RESULTS Out of 204 retrieved articles, 35 were considered, including 2092 patients and 1138 controls with a mean age of 44.1 ± 12.6 years, and mean follow-up 24.3 ± 18.9 days. SARS-CoV-2 mRNA can be localized in male genitalia tracts during the acute phase of the disease. COVID-19 can result in short-term impaired sperm and T production. Available data cannot clarify long-term andrological effects. Low T observed in the acute phase of the disease is associated with an increased risk of being admitted to the Intensive Care Unit or death. The two available studies showed that the use of mRNA COVID-19 vaccines does not affect sperm quality. CONCLUSIONS The results of our analysis clearly suggest that each patient recovering from COVID-19 should be monitored to rule out sperm and T abnormalities. The specific contribution of reduced T levels during the acute phase of the infection needs to be better clarified.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - F Pallotti
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - D Paoli
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - E Baldi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - N Cilloni
- Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| | - M Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - F Semeraro
- Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| | - A Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - S Minhas
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- Staff of UNESCO Chair for Health Education and Sustainable Development Baldi E, Federico II University, Naples, Italy
| | - A Sforza
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
| | - F Lombardo
- Department of Experimental Medicine, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
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25
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Du Y, Chen L, Shi Y. Booster COVID-19 vaccination against the SARS-CoV-2 Omicron variant: A systematic review. Hum Vaccin Immunother 2022; 18:2062983. [PMID: 35499517 PMCID: PMC9897643 DOI: 10.1080/21645515.2022.2062983] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/10/2022] [Accepted: 04/01/2022] [Indexed: 02/06/2023] Open
Abstract
There is a wealth of data suggesting that the effectiveness of existing vaccines against the Omicron variant, the most mutated SARS-CoV-2 variant to date, has been substantially reduced if only primary vaccination is administered. Therefore, the effectiveness of booster vaccination against the Omicron variant has become a topic of current interest. We conducted a comprehensive search in PubMed, Embase, and the Cochrane Library to collect various pseudovirus neutralization tests or live virus neutralization tests for the Omicron variant, with serum specimens from booster vaccinees. We extracted neutralization titers for the Omicron variant, the original strain, and the other variants before and after booster vaccination, and then manually calculated the fold increase or decrease in neutralization titers for the Omicron variant relative to the other variants, and the fold increase in neutralization titers for the Omicron variant after booster vaccination compared with that before booster vaccination. In the two-dose vaccination regimen, the neutralization titers against the Omicron variant decreased substantially compared to the original strain and other variants. However, after booster vaccination, both homologous and heterologous booster vaccination, the neutralization of serum antibodies against the Omicron variant was significantly improved, although still lower than that of the original strain and other variants. The booster vaccination program based on existing vaccines can produce broad but incomplete immunity against the Omicron variant.
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Affiliation(s)
- Yuxuan Du
- Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Long Chen
- Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yuan Shi
- Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
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26
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Rinchai D, Deola S, Zoppoli G, Kabeer BSA, Taleb S, Pavlovski I, Maacha S, Gentilcore G, Toufiq M, Mathew L, Liu L, Vempalli FR, Mubarak G, Lorenz S, Sivieri I, Cirmena G, Dentone C, Cuccarolo P, Giacobbe DR, Baldi F, Garbarino A, Cigolini B, Cremonesi P, Bedognetti M, Ballestrero A, Bassetti M, Hejblum BP, Augustine T, Van Panhuys N, Thiebaut R, Branco R, Chew T, Shojaei M, Short K, Feng CG, Zughaier SM, De Maria A, Tang B, Ait Hssain A, Bedognetti D, Grivel JC, Chaussabel D. High-temporal resolution profiling reveals distinct immune trajectories following the first and second doses of COVID-19 mRNA vaccines. SCIENCE ADVANCES 2022; 8:eabp9961. [PMID: 36367935 PMCID: PMC9651857 DOI: 10.1126/sciadv.abp9961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/26/2022] [Indexed: 05/31/2023]
Abstract
Knowledge of the mechanisms underpinning the development of protective immunity conferred by mRNA vaccines is fragmentary. Here, we investigated responses to coronavirus disease 2019 (COVID-19) mRNA vaccination via high-temporal resolution blood transcriptome profiling. The first vaccine dose elicited modest interferon and adaptive immune responses, which peaked on days 2 and 5, respectively. The second vaccine dose, in contrast, elicited sharp day 1 interferon, inflammation, and erythroid cell responses, followed by a day 5 plasmablast response. Both post-first and post-second dose interferon signatures were associated with the subsequent development of antibody responses. Yet, we observed distinct interferon response patterns after each of the doses that may reflect quantitative or qualitative differences in interferon induction. Distinct interferon response phenotypes were also observed in patients with COVID-19 and were associated with severity and differences in duration of intensive care. Together, this study also highlights the benefits of adopting high-frequency sampling protocols in profiling vaccine-elicited immune responses.
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Affiliation(s)
- Darawan Rinchai
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
- Laboratory of Human Genetics of Infectious Diseases, The Rockefeller University, New York, NY, USA
| | - Sara Deola
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | - Gabriele Zoppoli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | | | - Sara Taleb
- Division of Genomics and Translational Biomedicine, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Igor Pavlovski
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | - Selma Maacha
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | | | | | - Lisa Mathew
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | - Li Liu
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | | | - Ghada Mubarak
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | - Stephan Lorenz
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | - Irene Sivieri
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy
- Department of Experimental and Clinical Medicine, School of Internal Medicine, University of Florence, Florence, Italy
| | | | | | - Paola Cuccarolo
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Daniele Roberto Giacobbe
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Federico Baldi
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alberto Garbarino
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Benedetta Cigolini
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | | | | | - Alberto Ballestrero
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Matteo Bassetti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Boris P. Hejblum
- Univ. Bordeaux, Department of Public Health, Inserm U1219 Bordeaux Population Health Research Centre, Inria SISTM, F-33000 Bordeaux, France
| | | | | | - Rodolphe Thiebaut
- Univ. Bordeaux, Department of Public Health, Inserm U1219 Bordeaux Population Health Research Centre, Inria SISTM, F-33000 Bordeaux, France
| | - Ricardo Branco
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
| | - Tracey Chew
- Sydney Informatic Hub, The University of Sydney, Sydney, New South Wales, Australia
| | - Maryam Shojaei
- Nepean Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute for Medical Research, Westmead, New South Wales, Australia
- Department of Medicine, Sydney Medical School, Nepean Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsty Short
- The University of Queensland, School of Chemistry and Molecular Biosciences, St Lucia, Brisbane, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Carl G. Feng
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Tuberculosis Research Program, Centenary Institute, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Susu M. Zughaier
- College of Medicine, QU Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Andrea De Maria
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Benjamin Tang
- Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, PO BOX 3050, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| | - Davide Bedognetti
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | | | - Damien Chaussabel
- Research Branch, Sidra Medicine, PO Box 26999, Doha, Qatar
- Computational Sciences Department, The Jackson Laboratory, Farmington, CT, USA
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27
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Nowroozi A, Rezaei N. Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) delta variant of concern breakthrough infections: Are vaccines failing us? Infect Control Hosp Epidemiol 2022; 43:1754-1755. [PMID: 34353385 PMCID: PMC8387681 DOI: 10.1017/ice.2021.363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Ali Nowroozi
- 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
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- 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
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28
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Alhinai Z, Park S, Choe YJ, Michelow IC. A global epidemiological analysis of COVID-19 vaccine types and clinical outcomes. Int J Infect Dis 2022; 124:206-211. [PMID: 36155824 PMCID: PMC9499984 DOI: 10.1016/j.ijid.2022.09.014] [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: 06/26/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To compare messenger RNA (mRNA)–based and adenovirus-vectored vaccines (ADVVs) with inactivated virus vaccines (IVVs) using real-world aggregate data. Methods We performed longitudinal analyses of publicly accessible epidemiological, clinical, virological, vaccine-related, and other public health data from 41 eligible countries during the first half of 2021. The relationships between vaccination coverage and clinical outcomes were analyzed using repeated measures correlation analyses and mixed-effects modeling to adjust for potential mediating and confounding factors. Results Countries that used mRNA and/or ADVV (n = 31) vs IVV, among other vaccine types (n = 10), had different distributions of age (42.4 vs 33.9 years, respectively; P-value = 0.0006), gross domestic product per capita ($ 38,606 vs $ 20,422, respectively; P <0.0001), and population sizes (8,655,541 vs 5,139,162, respectively; P-value = 0.36). After adjustment for country differences, the stringency of nonpharmaceutical interventions, and dominant SARS-CoV-2 variant types, populations that received mRNA and/or ADVV had significantly lower rates of cases and deaths over time (P <0.001 for each analysis). Populations vaccinated with IVV, among others, had significantly higher rates of cases and deaths over time (P <0.05 for each analysis). Conclusion The real-world effectiveness of IVV may be inferior to mRNA and/or ADVV, and prospective comparative studies are needed to critically evaluate the role of IVV in the context of contemporary SARS-CoV-2 variants.
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Affiliation(s)
- Zaid Alhinai
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, 123, Oman.
| | - Sangshin Park
- Graduate School of Urban Public Health & Department of Urban Big Data Convergence, University of Seoul, Seoul, 02504, Republic of Korea
| | - Young-June Choe
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Ian C Michelow
- Department of Pediatrics, Division of Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, 02903, Rhode Island, United States
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29
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Oh S, Purja S, Shin H, Kim MS, Park S, Kronbichler A, Smith L, Eisenhut M, Shin JI, Kim E. Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Randomized Control Trials in the Pre-Delta Era: A Systematic Review and Network Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10101572. [PMID: 36298440 PMCID: PMC9608197 DOI: 10.3390/vaccines10101572] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
The most effective method of limiting the coronavirus disease pandemic of 2019 (COVID-19) is vaccination. For the determination of the comparative efficacy and safety of COVID-19 vaccines and their platforms during the pre-Delta era, a systematic review and network meta-analysis was conducted. The MEDLINE, Embase, and MedRxiv databases were searched, and the gray literature was manually searched up to 8 July 2021. The review includes the phase II and III randomized controlled trials (RCTs) that assessed the efficacy, immunogenicity, and safety of the COVID-19 vaccines. The network meta-analysis used a Bayesian model and used the surface under the cumulative ranking to rank the comparisons between the vaccines. All included studies were quality appraised according to their design, and the heterogeneity of the analyses was assessed using I2. In terms of vaccine efficacy, the mRNA-1273 vaccine ranked the highest, and the CoronaVac vaccine ranked the lowest. The mRNA-1273 ranked the highest for neutralizing antibody responses to live SARS-CoV-2. The WIV04 vaccine was associated with the lowest incidence of both local and systemic adverse reactions. All studies except one had a low to moderate risk of bias. The mRNA platform vaccines showed higher efficacy and more adverse reactions than the other vaccines.
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Affiliation(s)
- SuA Oh
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
| | - Sujata Purja
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
| | - Hocheol Shin
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
| | - Min Seo Kim
- Genomics and Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 03063, Korea
| | - Seoyeon Park
- Yonsei University College of Medicine, Seoul 03722, Korea
| | | | - Lee Smith
- Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB2 1TN, UK
| | - Michael Eisenhut
- Luton & Dunstable University Hospital, NHS Foundation Trust, Luton LU40DZ, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (J.I.S.); (E.K.)
| | - Eunyoung Kim
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
- Correspondence: (J.I.S.); (E.K.)
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30
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Kang L, Shang W, Gao P, Wang Y, Liu J, Liu M. Immunogenicity and Safety of COVID-19 Vaccines among People Living with HIV: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10091569. [PMID: 36146647 PMCID: PMC9503586 DOI: 10.3390/vaccines10091569] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The immunogenicity and safety of COVID-19 vaccines among people living with human immunodeficiency virus (PLWH) are unclear. We aimed to evaluate the immunogenicity and safety of COVID-19 vaccines among PLWH. METHODS We systematically searched PubMed, EMBASE, and Web of Science from 1 January 2020 to 28 April 2022 and included observational studies, randomized clinical trials, and non-randomized clinical trials reporting extractable data about the immunogenicity and safety of COVID-19 vaccines among PLWH. RESULTS A total of 34 eligible studies covering 4517 PLWH were included. The pooled seroconversion rates among PLWH after the first and second doses were 67.51% (95% confident interval (CI) 49.09-85.93%) and 96.65% (95%CI 95.56-97.75%), respectively. The seroconversion was similar between PLWH and healthy controls after the first (risk ratio (RR) = 0.89, 95%CI 0.76-1.04) and the second (RR = 0.97, 95%CI 0.93-1.00) dose. Moreover, the geometric mean titer (GMT) showed no significant difference between PLWH and healthy controls after the first dose (standardized mean difference (SMD) = 0.30, 95%CI -1.11, 1.70) and the second dose (SMD = -0.06, 95%CI -0.18, 0.05). Additionally, the pooled incidence rates of total adverse events among PLWH after the first and the second dose were 46.55% (95%CI 28.29-64.82%) and 30.96% (95%CI 13.23-48.70%), respectively. There was no significant difference in risks of total adverse events between PLWH and healthy controls after the first (RR = 0.86, 95%CI 0.67-1.10) and the second (RR = 0.88, 95%CI 0.68-1.14) dose. CONCLUSIONS The available evidence suggested that the immunogenicity and safety of COVID-19 vaccines among PLWH were acceptable. There was no significant difference in the seroconversion rates and incidence rates of adverse events of COVID-19 vaccines between PLWH and healthy controls.
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Affiliation(s)
| | | | | | | | | | - Min Liu
- Correspondence: ; Tel./Fax: +86-10-82805146
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Wei K, Chang Y, Huang Y. Influenza vaccine and subsequent development of zoster. Influenza Other Respir Viruses 2022; 17:e13055. [PMID: 36114790 PMCID: PMC9835400 DOI: 10.1111/irv.13055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/29/2022] [Accepted: 09/04/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Herpes zoster (HZ), which is caused by reactivation of the latent varicella zoster virus, was not listed as a side effect of any vaccines until the introduction of coronavirus disease 2019 (COVID-19) vaccine. This study used a nationwide population database to examine whether the HZ risk is increased after receiving the influenza vaccination. METHODS This population-based retrospective self-controlled case series evaluated the association between influenza vaccine exposure and HZ risk. Data were collected from Taiwan's National Health Insurance Research Database between 2015 and 2017. Patients with HZ diagnosed within 6 months before and after receiving the influenza vaccination were included. After receiving the influenza vaccine, the first 15 and 30 days were defined as risk intervals, while the other periods were defined as control intervals. Poisson regression was used to compare the incidence rate ratio (IRR) for HZ during the risk interval vs. the control interval. RESULTS In total, 13,728 patients were diagnosed with HZ before and after receiving the influenza vaccine. The IRR for days 1-15 was significantly higher (IRR = 1.11; 95% confidence interval [CI], 1.02-1.20), but insignificant for days 1-30 (IRR = 1.04; 95% CI, 0.98-1.10). In a subgroup analysis, the IRRs were significantly higher in participants, including 50-64 years old (1.16; 95% CI, 1.02-1.33), males (1.14; 95% CI, 1.01-1.28), and healthier individuals (i.e., no history of cancer or autoimmune diseases). CONCLUSIONS There was a slight increase in risk of HZ in people receiving influenza vaccine in the first 1-15 days after vaccination.
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Affiliation(s)
- Kai‐Che Wei
- Department of DermatologyKaohsiung Veterans General HospitalKaohsiungTaiwan,School of MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Yu‐Chia Chang
- Department of Long‐Term Care, College of Health and NursingNational Quemoy UniversityKinmen CountyTaiwan,Department of Healthcare Administration, College of Medical and Health ScienceAsia UniversityTaichungTaiwan
| | - Yu‐Tung Huang
- Center for Big Data Analytics and Statistics, Department of Medical Research and DevelopmentChang Gung Memorial Hospital Linkou Main BranchTaoyuanTaiwan,Department of Health Care ManagementChang Gung UniversityTaoyuanTaiwan
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Li Z, Liu S, Li F, Li Y, Li Y, Peng P, Li S, He L, Liu T. Efficacy, immunogenicity and safety of COVID-19 vaccines in older adults: a systematic review and meta-analysis. Front Immunol 2022; 13:965971. [PMID: 36177017 PMCID: PMC9513208 DOI: 10.3389/fimmu.2022.965971] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/24/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundOlder adults are more susceptible to severe health outcomes for coronavirus disease 2019 (COVID-19). Universal vaccination has become a trend, but there are still doubts and research gaps regarding the COVID-19 vaccination in the elderly. This study aimed to investigate the efficacy, immunogenicity, and safety of COVID-19 vaccines in older people aged ≥ 55 years and their influencing factors.MethodsRandomized controlled trials from inception to April 9, 2022, were systematically searched in PubMed, EMBASE, the Cochrane Library, and Web of Science. We estimated summary relative risk (RR), rates, or standardized mean difference (SMD) with 95% confidence interval (CI) using random-effects meta-analysis. This study was registered with PROSPERO (CRD42022314456).ResultsOf the 32 eligible studies, 9, 21, and 25 were analyzed for efficacy, immunogenicity, and safety, respectively. In older adults, vaccination was efficacious against COVID-19 (79.49%, 95% CI: 60.55−89.34), with excellent seroconversion rate (92.64%, 95% CI: 86.77−96.91) and geometric mean titer (GMT) (SMD 3.56, 95% CI: 2.80−4.31) of neutralizing antibodies, and provided a significant protection rate against severe disease (87.01%, 50.80−96.57). Subgroup and meta-regression analyses consistently found vaccine types and the number of doses to be primary influencing factors for efficacy and immunogenicity. Specifically, mRNA vaccines showed the best efficacy (90.72%, 95% CI: 86.82−93.46), consistent with its highest seroconversion rate (98.52%, 95% CI: 93.45−99.98) and GMT (SMD 6.20, 95% CI: 2.02−10.39). Compared to the control groups, vaccination significantly increased the incidence of total adverse events (AEs) (RR 1.59, 95% CI: 1.38−1.83), including most local and systemic AEs, such as pain, fever, chill, etc. For inactivated and DNA vaccines, the incidence of any AEs was similar between vaccination and control groups (p > 0.1), while mRNA vaccines had the highest risk of most AEs (RR range from 1.74 to 7.22).ConclusionCOVID-19 vaccines showed acceptable efficacy, immunogenicity and safety in older people, especially providing a high protection rate against severe disease. The mRNA vaccine was the most efficacious, but it is worth surveillance for some AEs it caused. Increased booster coverage in older adults is warranted, and additional studies are urgently required for longer follow-up periods and variant strains.
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Affiliation(s)
- Zejun Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shouhuan Liu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fengming Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yifeng Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Yilin Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Pu Peng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sai Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Li He
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu, ; Li He,
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu, ; Li He,
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Toubasi AA, Al‐Sayegh TN, Obaid YY, Al‐Harasis SM, AlRyalat SAS. Efficacy and safety of COVID-19 vaccines: A network meta-analysis. J Evid Based Med 2022; 15:245-262. [PMID: 36000160 PMCID: PMC9538745 DOI: 10.1111/jebm.12492] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 07/27/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Several vaccines showed a good safety profile and significant efficacy against COVID-19. Moreover, in the absence of direct head to head comparison between COVID-19 vaccines, a network meta-analysis that indirectly compares between them is needed. METHODS Databases PubMed, CENTRAL, medRxiv, and clinicaltrials.gov were searched. Studies were included if they were placebo-controlled clinical trials and reported the safety profile and/or effectiveness of COVID-19 vaccines. The quality of the included studies was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the Revised Cochrane risk-of-bias tool for nonrandomized trials. RESULTS Forty-nine clinical trials that included 421,173 participants and assessed 28 vaccines were included in this network meta-analysis. The network meta-analysis showed that Pfizer is the most effective in preventing COVID-19 infection whereas the Sputnik Vaccine was the most effective in preventing severe COVID-19 infection. In terms of the local and systemic side, the Sinopharm and V-01 vaccines were the safest. CONCLUSION We found that almost all of the vaccines included in this study crossed the threshold of 50% efficacy. However, some of them did not reach the previously mentioned threshold against the B.1.351 variant while the remainder have not yet investigated vaccine efficacy against this variant. Since each vaccine has its own strong and weak points, we strongly advocate continued vaccination efforts in individualized manner that recommend the best vaccine for each group in the community which is abundantly required to save lives and to avert the emergence of future variants.
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Etemadifar M, Nouri H, Pitzalis M, Idda ML, Salari M, Baratian M, Mahdavi S, Abhari AP, Sedaghat N. Multiple sclerosis disease-modifying therapies and COVID-19 vaccines: a practical review and meta-analysis. J Neurol Neurosurg Psychiatry 2022; 93:986-994. [PMID: 35688629 DOI: 10.1136/jnnp-2022-329123] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/10/2022] [Indexed: 12/19/2022]
Abstract
Studies among people with multiple sclerosis (pwMS) receiving disease-modifying therapies (DMTs) have provided adequate evidence for an appraisal of COVID-19 vaccination policies among them. To synthesise the available evidence addressing the effect of MS DMTs on COVID-19 vaccines' immunogenicity and effectiveness, following the Cochrane guidelines, we systematically reviewed all observational studies available in MEDLINE, Scopus, Web of Science, MedRxiv and Google Scholar from January 2021 to January 2022 and extracted their relevant data. Immunogenicity data were then synthesised in a quantitative, and other data in a qualitative manner. Evidence from 28 studies suggests extensively lower B-cell responses in sphingosine-1-phosphate receptor modulator (S1PRM) treated and anti-CD20 (aCD20) treated, and lower T-cell responses in interferon-treated, S1PRM-treated and cladribine-treated pwMS-although most T cell evidence currently comprises of low or very low certainty. With every 10-week increase in aCD20-to-vaccine period, a 1.94-fold (95% CI 1.57 to 2.41, p<0.00001) increase in the odds of seroconversion was observed. Furthermore, the evidence points out that B-cell-depleting therapies may accelerate postvaccination humoral waning, and boosters' immunogenicity is predictable with the same factors affecting the initial vaccination cycle. Four real-world studies further indicate that the comparative incidence/severity of breakthrough COVID-19 has been higher among the pwMS treated with S1PRM and aCD20-unlike the ones treated with other DMTs. S1PRM and aCD20 therapies were the only DMTs reducing the real-world effectiveness of COVID-19 vaccination among pwMS. Hence, it could be concluded that optimisation of humoral immunogenicity and ensuring its durability are the necessities of an effective COVID-19 vaccination policy among pwMS who receive DMTs.
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Affiliation(s)
- Masoud Etemadifar
- Neurosurgery Research Department, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hosein Nouri
- Neurosurgery Research Department, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.,Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran
| | - Maristella Pitzalis
- Institute of Genetic and Biomedical Research (IRGB) of the National Research Council (CNR), Cagliari, Italy
| | - Maria Laura Idda
- Institute of Genetic and Biomedical Research (IRGB) of the National Research Council (CNR), Cagliari, Italy
| | - Mehri Salari
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Baratian
- Clinical Research Developement Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Sepide Mahdavi
- Clinical Research Developement Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Amir Parsa Abhari
- Neurosurgery Research Department, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.,Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran
| | - Nahad Sedaghat
- Neurosurgery Research Department, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran .,Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran
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Boroumand AB, Forouhi M, Karimi F, Moghadam AS, Naeini LG, Kokabian P, Naderi D. Immunogenicity of COVID-19 vaccines in patients with diabetes mellitus: A systematic review. Front Immunol 2022; 13:940357. [PMID: 36105809 PMCID: PMC9465310 DOI: 10.3389/fimmu.2022.940357] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/12/2022] [Indexed: 12/16/2022] Open
Abstract
Purpose To evaluate the immunogenicity of COVID-19 vaccines in patients with diabetes mellitus (DM) through a systematic approach. Method A comprehensive search was conducted in PubMed, Scopus, and Web of Science with no time restrictions. The search was based on the three main concepts: Covid-19, Vaccine immunogenicity and Diabetes Mellitus. Results After excluding irrelevant studies, 16 studies remained for the quantitative assay. Among the sixteen studies, eleven had controls. Type of diabetes was specifically mentioned in six studies (T2DM; n=4, T1DM and T2DM; n=2). Twelve of the included studies were conducted on the immunogenicity of vaccines that included mRNA vaccines (i.e. BNT162b2 and mRNA-1273) in DM, five studies included vector-based vaccines (i.e. Ad5-nCoV and ChAdOx1-S), and five studies assessed the immunogenicity of vaccines in DM, including inactivated vaccines (i.e. BBV-152, CoronaVac, Sinopharm or SinoVac). Most of the current studies indicate lower antibody response in patients with DM compared to individuals without DM, after the second dose of vaccine and irrespective of vaccine type. Several studies have shown that higher age and higher BMI are associated with lower antibody response, while optimum glycemic control and higher GFR are associated with higher antibody response among patients with DM. Conclusion Immunogenicity of the vaccines has mostly been reported to be lower among patients with DM compared to healthy controls. There are also few studies assessing variables that significantly affect this association, including age, type of diabetes, BMI, glycemic control and eGFR. Investigating these associations could help us provide the most advantageous condition for patients with DM before, during and after vaccination for optimum antibody response. Many unresolved issues concerning potential factors affecting vaccine immunogenicity, including type of vaccine, numbers of administered doses, re-vaccination intervals and hyperglycemia in patients with DM need to be addressed through future research.
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Affiliation(s)
- Amir Bahador Boroumand
- Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahtab Forouhi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | - Pajman Kokabian
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Naderi
- Student Research Committee, Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
- *Correspondence: Delaram Naderi,
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He X, Su J, Ma Y, Zhang W, Tang S. A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines. Front Immunol 2022; 13:945930. [PMID: 36090988 PMCID: PMC9459021 DOI: 10.3389/fimmu.2022.945930] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
It is urgently needed to update the comprehensive analysis about the efficacy or effectiveness of COVID-19 vaccines especially during the COVID-19 pandemic caused by SARS-CoV-2 Delta and Omicron variants. In general, the current COVID-19 vaccines showed a cumulative efficacy of 66.4%, 79.7%, and 93.6% to prevent SARS-CoV-2 infection, symptomatic COVID-19, and severe COVID-19, respectively, but could not prevent the asymptomatic infection of SARS-CoV-2. Furthermore, the current COVID-19 vaccines could effectively prevent COVID-19 caused by the Delta variant although the incidence of breakthrough infection of the SARS-CoV-2 Delta variant increased when the intervals post full vaccination extended, suggesting the waning effectiveness of COVID-19 vaccines. In addition, one-dose booster immunization showed an effectiveness of 74.5% to prevent COVID-19 caused by the Delta variant. However, current COVID-19 vaccines could not prevent the infection of Omicron sub-lineage BA.1.1.529 and had about 50% effectiveness to prevent COVID-19 caused by Omicron sub-lineage BA.1.1.529. Furthermore, the effectiveness was 87.6% and 90.1% to prevent severe COVID-19 and COVID-19-related death caused by Omicron sub-lineage BA.2, respectively, while one-dose booster immunization could enhance the effectiveness of COVID-19 vaccines to prevent the infection and COVID-19 caused by Omicron sub-lineage BA.1.1.529 and sub-lineage BA.2. Two-dose booster immunization showed an increased effectiveness of 81.8% against severe COVID-19 caused by the Omicron sub-lineage BA.1.1.529 variant compared with one-dose booster immunization. The effectiveness of the booster immunization with RNA-based vaccine BNT162b2 or mRNA-1273 was over 75% against severe COVID-19 more than 17 weeks after booster immunization whereas the heterogenous booster immunization showed better effectiveness than homologous booster immunization. In summary, the current COVID-19 vaccines could effectively protect COVID-19 caused by Delta and Omicron variants but was less effective against Omicron variant infection. One-dose booster immunization could enhance protection capability, and two-dose booster immunization could provide additional protection against severe COVID-19.
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Affiliation(s)
- Xiaofeng He
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Institute of Evidence-Based Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Jiao Su
- Department of biochemistry, Changzhi Medical College, Changzhi, China
| | - Yu’nan Ma
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenping Zhang
- Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Shixing Tang,
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37
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Navarro AP, Pilkington V, Pepperrell T, Mirchandani M, Levi J, Hill A. Efficacy of Approved versus Unapproved Vaccines for SARS-CoV-2 Infection in Randomised Blinded Clinical Trials. Open Forum Infect Dis 2022; 9:ofac408. [PMID: 36092832 PMCID: PMC9452066 DOI: 10.1093/ofid/ofac408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background Five severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are approved in North America and/or Europe: Pfizer/BioNTech, Moderna, Janssen, Oxford-AstraZeneca, and Novavax. Other vaccines have been developed, including Sinopharm, SinoVac, QazVac, Covaxin, Soberana, Zifivax, Medicago, Clover, and Cansino, but they are not approved in high-income countries. This meta-analysis compared the efficacy of US Food and Drug Administration (FDA)/European Medicines Agency (EMA)-approved and -unapproved vaccines in randomized clinical trials (RCTs). Methods A systematic review of trial registries identified RCTs of SARS-CoV-2 vaccines. Risk of bias was assessed using the Cochrane tool (RoB 2). In the meta-analysis, relative risks of symptomatic infection and severe disease were compared for each vaccine versus placebo, using Cochrane-Mantel Haenszel Tests (random effects method). Results Twenty-two RCTs were identified and 1 was excluded for high-risk of bias. Ten RCTs evaluated 5 approved vaccines and 11 RCTs evaluated 9 unapproved vaccines. In the meta-analysis, prevention of symptomatic infection was 84% (95% confidence interval [CI], 68%–92%) for approved vaccines versus 72% (95% CI, 66%–77%) for unapproved vaccines, with no significant difference between vaccine types (P = .12). Prevention of severe SARS-CoV-2 infection was 94% (95% CI, 75%–98%) for approved vaccines versus 86% (95% CI, 76%–92%) for unapproved vaccines (P = .33). The risk of serious adverse events was similar between vaccine types (P = .12). Conclusions This meta-analysis of 21 RCTs in 390 459 participants showed no significant difference in efficacy between the FDA/EMA-approved and -unapproved vaccines for symptomatic or severe infection. Differences in study design, endpoint definitions, variants, and infection prevalence may have influenced results. New patent-free vaccines could lower costs of worldwide SARS-CoV-2 vaccination campaigns significantly.
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Affiliation(s)
| | - Victoria Pilkington
- Oxford University Clinical Academic Graduate School, University of Oxford , United Kingdom
| | - Toby Pepperrell
- University of Edinburgh, School of Medicine and Veterinary Medicine , Edinburgh , UK
| | | | - Jacob Levi
- Royal Free University Hospital NHS Trust , London , UK
| | - Andrew Hill
- Department of Pharmacology and Therapeutics, University of Liverpool , Liverpool, L69 3GF , UK
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Luo J, Gellad WF. Myocarditis and pericarditis risk after covid-19 vaccination. BRITISH MEDICAL JOURNAL 2022. [DOI: 10.1136/bmj.o1554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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39
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Higdon MM, Wahl B, Jones CB, Rosen JG, Truelove SA, Baidya A, Nande AA, ShamaeiZadeh PA, Walter KK, Feikin DR, Patel MK, Deloria Knoll M, Hill AL. A Systematic Review of Coronavirus Disease 2019 Vaccine Efficacy and Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Disease. Open Forum Infect Dis 2022; 9:ofac138. [PMID: 35611346 PMCID: PMC9047227 DOI: 10.1093/ofid/ofac138] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/17/2022] [Indexed: 01/13/2023] Open
Abstract
Billions of doses of coronavirus disease 2019 (COVID-19) vaccines have been administered globally, dramatically reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidence and severity in some settings. Many studies suggest vaccines provide a high degree of protection against infection and disease, but precise estimates vary and studies differ in design, outcomes measured, dosing regime, location, and circulating virus strains. In this study, we conduct a systematic review of COVID-19 vaccines through February 2022. We included efficacy data from Phase 3 clinical trials for 15 vaccines undergoing World Health Organization Emergency Use Listing evaluation and real-world effectiveness for 8 vaccines with observational studies meeting inclusion criteria. Vaccine metrics collected include protection against asymptomatic infection, any infection, symptomatic COVID-19, and severe outcomes including hospitalization and death, for partial or complete vaccination, and against variants of concern Alpha, Beta, Gamma, Delta, and Omicron. We additionally review the epidemiological principles behind the design and interpretation of vaccine efficacy and effectiveness studies, including important sources of heterogeneity.
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Affiliation(s)
- Melissa M Higdon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brian Wahl
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carli B Jones
- Department of Pathology Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph G Rosen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shaun A Truelove
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anurima Baidya
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anjalika A Nande
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Parisa A ShamaeiZadeh
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Karoline K Walter
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Daniel R Feikin
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Minal K Patel
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Maria Deloria Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Stosic M, Milic M, Markovic M, Kelic I, Bukumiric Z, Veljkovic M, Kisic Tepavcevic D, Saponjic V, Plavsa D, Jovanovic S, Jovanovic V. Immunogenicity and Reactogenicity of the Booster Dose of COVID-19 Vaccines and Related Factors: A Panel Study from the General Population in Serbia. Vaccines (Basel) 2022; 10:838. [PMID: 35746446 PMCID: PMC9228276 DOI: 10.3390/vaccines10060838] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 01/14/2023] Open
Abstract
The Republic of Serbia applied the booster dose of the following COVID-19 vaccines: BNT162b2 mRNA (Pfizer-BioNTech), Sinopharm BBIBP-CorV (Vero Cell®), Gam-COVID-Vac (Sputnik V) and ChAdOk1 nCoV-19 (AstraZeneca). We aimed to examine the immunogenicity and reactogenicity of the booster dose and identify factors related to immune response and adverse events. Panel study, conducted during August and September 2021, included 300 persons receiving the booster dose at the Institute of Public Health of Serbia. Blood samples were taken on the day of receiving the booster dose, and after 7 and 28 days. When applying homologous regimen, the average increase in anti-spike immunoglobulin G was 8782.2 (after 7 days), 1213.9 after 28 days, while 9179.5 (after 7 days) and 16,728.1 after 28 days of heterologous regimen. Sinopharm BBIBP-CorV (p < 0.001) and Sputnik V (p < 0.001), age 65 and over (p = 0.001) and currently smoking (p < 0.001) were independently associated with lower levels of anti-spike immunoglobulin G. Female sex (OR = 1.77; 95%CI = 1.01−3.12), previous COVID-19 infection (OR = 3.62; 95%CI = 1.13−11.63) and adverse events after the second dose (OR = 2.66; 95%CI = 1.33−5.32) were independently associated with intense systemic adverse events 7 days after. Booster dose significantly increased antibodies titers, especially 28 days after heterologous regimen, without a significant increase in reactogenicity.
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Affiliation(s)
- Maja Stosic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
| | - Marija Milic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
- Department of Epidemiology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, 38220 Kosovska Mitrovica, Serbia
| | - Milos Markovic
- Faculty of Medicine, Institute for Microbiology and Immunology, University of Belgrade, Dr Subotica 1, 11000 Belgrade, Serbia;
| | - Ivana Kelic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
| | - Zoran Bukumiric
- Faculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, Dr Subotica 9, 11000 Belgrade, Serbia;
| | - Marko Veljkovic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
| | - Darija Kisic Tepavcevic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Visegradska 26A, 11000 Belgrade, Serbia;
| | - Vladan Saponjic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
| | - Dragana Plavsa
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
| | - Sofija Jovanovic
- Faculty of Medicine, University of Belgrade, Dr Subotica 9, 11000 Belgrade, Serbia;
| | - Verica Jovanovic
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Dr Subotica 5, 11000 Belgrade, Serbia; (M.M.); (I.K.); (M.V.); (V.S.); (D.P.)
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Wang K, Wang L, Li M, Xie B, He L, Wang M, Zhang R, Hou N, Zhang Y, Jia F. Real-Word Effectiveness of Global COVID-19 Vaccines Against SARS-CoV-2 Variants: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:820544. [PMID: 35665358 PMCID: PMC9160927 DOI: 10.3389/fmed.2022.820544] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/05/2022] [Indexed: 12/14/2022] Open
Abstract
Background Currently, promoted vaccinations against SARS-CoV-2 are being given out globally. However, the occurrence of numerous COVID-19 variants has hindered the goal of rapid mitigation of the COVID-19 pandemic by effective mass vaccinations. The real-word effectiveness of the current vaccines against COVID-19 variants has not been assessed by published reviews. Therefore, our study evaluated the overall effectiveness of current vaccines and the differences between the various vaccines and variants. Methods PubMed, Embase, Cochrane Library, medRxiv, bioRxiv, and arXiv were searched to screen the eligible studies. The Newcastle-Ottawa scale and the Egger test were applied to estimate the quality of the literature and any publication bias, respectively. The pooled incident rates of different variants after vaccination were estimated by single-arm analysis. Meanwhile, the pooled efficacies of various vaccines against variants were evaluated by two-arm analysis using odds ratios (ORs) and vaccine effectiveness (VE). Results A total of 6,118 studies were identified initially and 44 articles were included. We found that the overall incidence of variants post first/second vaccine were 0.07 and 0.03, respectively. The VE of the incidence of variants post first vaccine between the vaccine and the placebo or unvaccinated population was 40% and post second vaccine was 96%, respectively. The sub-single-arm analysis showed a low prevalence rate of COVID-19 variants after specific vaccination with the pooled incidence below 0.10 in most subgroups. Meanwhile, the sub-two-arm analysis indicated that most current vaccines had a good or moderate preventive effect on certain variants considering that the VE in these subgroups was between 66 and 95%, which was broadly in line with the results of the sub-single-arm analysis. Conclusion Our meta-analysis shows that the current vaccines that are used globally could prevent COVID-19 infection and restrict the spread of variants to a great extent. We would also support maximizing vaccine uptake with two doses, as the effectiveness of which was more marked compared with one dose. Although the mRNA vaccine was the most effective against variants according to our study, specific vaccines should be taken into account based on the local dominant prevalence of variants.
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Affiliation(s)
- Kai Wang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Lin Wang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Mingzhe Li
- Independent Researcher, Leeds, United Kingdom
| | - Bing Xie
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Lu He
- Hubei University of Medicine, Shiyan, China
| | - Meiyu Wang
- Department of Cardiology, The People's Hospital of Zhangdian District, Zibo, China
| | - Rumin Zhang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Nianzong Hou
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Yi Zhang
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Fusen Jia
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
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Plans-Rubió P. Percentages of Vaccination Coverage Required to Establish Herd Immunity against SARS-CoV-2. Vaccines (Basel) 2022; 10:736. [PMID: 35632492 PMCID: PMC9144560 DOI: 10.3390/vaccines10050736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
The pandemic associated with SARS-CoV-2 is a worldwide public health challenge. The WHO has proposed to achieve 70% COVID-19 vaccination coverage in all countries by mid-2022. Nevertheless, the prevention strategy based on COVID-19 vaccination and other applied prevention measures has not been sufficient to prevent SARS-CoV-2 epidemic waves. This study assessed the vaccination coverage that would be required to establish herd immunity against SARS-CoV-2, taking into account virus transmissibility (Ro values from 1.1 to 10) and COVID-19 vaccination effectiveness. The study found that high percentages of vaccination coverage and high levels of vaccination effectiveness are necessary to block the transmission of Omicron and other SARS-CoV-2 variants with greater infectious capacity. COVID-19 vaccination programs could establish herd immunity against SARS-CoV-2, with Ro values ranging from 3 to 10 and levels of COVID-19 vaccination effectiveness of 70-100%. Factors reducing COVID-19 vaccination effectiveness (emergent variants, infections among vaccinated individuals, high risk individuals) and factors increasing SARS-CoV-2 transmissibility (close settings) increased the percentages of vaccination coverage that would be required to establish herd immunity. Two measures should be implemented to establish herd immunity against SARS-CoV-2: (1) achieve ≥ 90% COVID-19 vaccination coverage in all countries worldwide, and (2) increase the effectiveness of COVID-19 vaccines in preventing Omicron infection to at least 88%.
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Affiliation(s)
- Pedro Plans-Rubió
- Public Health Agency of Catalonia, Department of Health of Catalonia, 08005 Barcelona, Spain;
- Ciber of Epidemiology and Public Health (CIBERESP), 28028 Madrid, Spain
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Ballesteros-Sanabria L, Pelaez-Prestel HF, Ras-Carmona A, Reche PA. Resilience of Spike-Specific Immunity Induced by COVID-19 Vaccines against SARS-CoV-2 Variants. Biomedicines 2022; 10:biomedicines10050996. [PMID: 35625733 PMCID: PMC9138591 DOI: 10.3390/biomedicines10050996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 12/10/2022] Open
Abstract
The outbreak of SARS-CoV-2 leading to the declaration of the COVID-19 global pandemic has led to the urgent development and deployment of several COVID-19 vaccines. Many of these new vaccines, including those based on mRNA and adenoviruses, are aimed to generate neutralizing antibodies against the spike glycoprotein, which is known to bind to the receptor angiotensin converting enzyme 2 (ACE2) in host cells via the receptor-binding domain (RBD). Antibodies binding to this domain can block the interaction with the receptor and prevent viral entry into the cells. Additionally, these vaccines can also induce spike-specific T cells which could contribute to providing protection against the virus. However, the emergence of new SARS-CoV-2 variants can impair the immunity generated by COVID-19 vaccines if mutations occur in cognate epitopes, precluding immune recognition. Here, we evaluated the chance of five SARS-CoV-2 variants of concern (VOCs), Alpha, Beta, Gamma, Delta and Omicron, to escape spike-specific immunity induced by vaccines. To that end, we examined the impact of the SARS-CoV-2 variant mutations on residues located on experimentally verified spike-specific epitopes, deposited at the Immune Epitope Database, that are targeted by neutralizing antibodies or recognized by T cells. We found about 300 of such B cell epitopes, which were largely overlapping, and could be grouped into 54 B cell epitope clusters sharing ≥ 7 residues. Most of the B cell epitope clusters map in the RBD domain (39 out of 54) and 20%, 50%, 37%, 44% and 57% of the total are mutated in SARS-CoV-2 Alpha, Beta, Gamma, Delta and Omicron variants, respectively. We also found 234 experimentally verified CD8 and CD4 T cell epitopes that were distributed evenly throughout the spike protein. Interestingly, in each SARS-CoV-2 VOC, over 87% and 79% of CD8 and CD4 T cell epitopes, respectively, are not mutated. These observations suggest that SARS-CoV-2 VOCs—particularly the Omicron variant—may be prone to escape spike-specific antibody immunity, but not cellular immunity, elicited by COVID-19 vaccines.
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Pettoello-Mantovani M, Cardemil C, Cohen R, Levy C, Giardino I, Indrio F, Somekh E. Importance of Coronavirus Disease 2019 Vaccination in Children: Viewpoint and Recommendations of the Union of European National Societies of Pediatrics. J Pediatr 2022; 243:242-245. [PMID: 34973285 PMCID: PMC8716156 DOI: 10.1016/j.jpeds.2021.12.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Association pour l'Activité et la Recherche Scìentifiques, ARS, Nouchatel, Switzerland; Italian Academy of Pediatrics, Milan, Italy; Department of Pediatrics, University of Foggia, "Casa Sollievo" Scientific Institute, San Giovanni Rotondo, Italy
| | - Cristina Cardemil
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), Rockville, MD
| | - Robert Cohen
- Pediatric Infectious Disease Group (GPIP), Créteil, France; Association Clinique et thérapeutique Infantile du Val de Marne, Créteil, France; Paris Est University, IMRB-GRC GEMINI, Créteil, France
| | - Corinne Levy
- Pediatric Infectious Disease Group (GPIP), Créteil, France; Association Clinique et thérapeutique Infantile du Val de Marne, Créteil, France; Paris Est University, IMRB-GRC GEMINI, Créteil, France
| | - Ida Giardino
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Flavia Indrio
- Department of Pediatrics, University of Foggia, "Casa Sollievo" Scientific Institute, San Giovanni Rotondo, Italy
| | - Eli Somekh
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Association pour l'Activité et la Recherche Scìentifiques, ARS, Nouchatel, Switzerland; Department of Pediatrics, Mayanei Hayeshuah Medical Center, Bnei Brak, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Pediatric Society, Tel Aviv, Israel
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45
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Zhang G, Kuang S, Zhang X. Assessing the reporting quality of randomized controlled trials on COVID-19 vaccines: a systematic review. Hum Vaccin Immunother 2022; 18:2031453. [PMID: 35176960 PMCID: PMC8993078 DOI: 10.1080/21645515.2022.2031453] [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] [Indexed: 11/04/2022] Open
Abstract
This systematic review evaluated the reporting quality of COVID-19 vaccine randomized controlled trials (RCTs). Relevant RCTs published between July 20, 2020 and June 11, 2021 were identified in the PubMed database by two independent reviewers. Study quality was evaluated with the 2010 AND 2001 Consolidated Standards of Reporting Trials (CONSORT) adherence scores. A total of 22 RCTs were included. The median CONSORT adherence score according to the 2010 criteria was 21 (range, 12-25), thus indicating that 75% of the items in more than half of the RCTs had clear reports. Univariate analysis showed that CONSORT adherence scores were not predicted by category; analysis of variance also showed no significant difference between groups. Our results indicated that the overall quality of COVID-19 vaccine RCTs was very good. Current evidence indicates that a variety of COVID-19 vaccines are effective. No RCTs have reported serious adverse effects such as mortality.
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Affiliation(s)
- Guanran Zhang
- Key Laboratory for Experimental Teratology of Ministry of Education, Department of Histology & Embryology, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
| | - Sirui Kuang
- Master of Public Health, Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau, China
| | - Xiaoli Zhang
- Key Laboratory for Experimental Teratology of Ministry of Education, Department of Histology & Embryology, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
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Mehrabi Nejad MM, Moosaie F, Dehghanbanadaki H, Haji Ghadery A, Shabani M, Tabary M, Aryannejad A, SeyedAlinaghi S, Rezaei N. Immunogenicity of COVID-19 mRNA vaccines in immunocompromised patients: a systematic review and meta-analysis. Eur J Med Res 2022; 27:23. [PMID: 35151362 PMCID: PMC8840778 DOI: 10.1186/s40001-022-00648-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/28/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Immunocompromised (IC) patients are at higher risk of severe SARS-CoV-2 infection, morbidity, and mortality compared to the general population. They should be prioritized for primary prevention through vaccination. This study aimed to evaluate the efficacy of COVID-19 mRNA vaccines in IC patients through a systematic review and meta-analysis approach. METHOD PubMed-MEDLINE, Scopus, and Web of Science were searched for original articles reporting the immunogenicity of two doses of mRNA COVID-19 vaccines in adult patients with IC condition between June 1, 2020 and September 1, 2021. Meta-analysis was performed using either random or fixed effect according to the heterogeneity of the studies. Subgroup analysis was performed to identify potential sources of heterogeneity. RESULTS A total of 26 studies on 3207 IC patients and 1726 healthy individuals were included. The risk of seroconversion in IC patients was 48% lower than those in controls (RR = 0.52 [0.42, 0.65]). IC patients with autoimmune conditions were 54%, and patients with malignancy were 42% more likely to have positive seroconversion than transplant recipients (P < 0.01). Subgroup meta-analysis based on the type of malignancy, revealed significantly higher proportion of positive seroconversion in solid organ compared to hematologic malignancies (RR = 0.88 [0.85, 0.92] vs. 0.61 [0.44, 0.86], P = 0.03). Subgroup meta-analysis based on type of transplantation (kidney vs. others) showed no statistically significant between-group difference of seroconversion (P = 0.55). CONCLUSIONS IC patients, especially transplant recipients, developed lower immunogenicity with two-dose of COVID-19 mRNA vaccines. Among patients with IC, those with autoimmune conditions and solid organ malignancies are mostly benefited from COVID-19 vaccination. Findings from this meta-analysis could aid healthcare policymakers in making decisions regarding the importance of the booster dose or more strict personal protections in the IC patients.
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Affiliation(s)
- Mohammad-Mehdi Mehrabi Nejad
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Moosaie
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hojat Dehghanbanadaki
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolkarim Haji Ghadery
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahya Shabani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Tabary
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Armin Aryannejad
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, 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, Qarib St, Keshavarz Blvd, 1419733141, Tehran, Iran.
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Batatinha H, Baker FL, Smith KA, Zúñiga TM, Pedlar CR, Burgess SC, Katsanis E, Simpson RJ. Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people. J Appl Physiol (1985) 2022; 132:275-282. [PMID: 34882029 PMCID: PMC8799387 DOI: 10.1152/japplphysiol.00629.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 12/16/2022] Open
Abstract
Athletes are advised to receive the COVID-19 vaccination to protect themselves from SARS-CoV-2 infection during major competitions. Despite this, many athletes are reluctant to get the COVID-19 vaccine due to concerns that symptoms of vaccinosis may impair athletic performance. This study aimed to determine the effects of COVID-19 vaccination on the physiological responses to graded exercise. Healthy physically active participants completed a 20-min bout of graded cycling exercise at intensities corresponding to 50%, 60%, 70%, and 80% of the predetermined V̇O2max before and ∼21 days after receiving the COVID-19 vaccine (2-dose Pfizer mRNA or 1-dose Johnson & Johnson). Vaccination had no effect on a large number of physiological responses to exercise measured in blood (e.g., lactate, epinephrine, and cortisol) and by respiratory gas exchange (e.g., oxygen uptake, CO2 production, ventilation, respiratory exchange ratio, predicted V̇O2max, and ventilatory threshold) (P > 0.05). We did, however, find significant elevations in heart rate (∼5 beats/min) and norepinephrine (P = 0.006 and 0.04, respectively) in response to vigorous (i.e., 70%-80% V̇O2max) intensity exercise after vaccination, particularly in those who received the two-shot Pfizer mRNA vaccine regimen. These findings held true when compared with demographically matched controls who completed identical bouts of exercise several weeks apart without receiving a vaccine; delta values for heart rate (P = 0.03) and norepinephrine (P = 0.01) were elevated in the second trial for those who received the Pfizer mRNA vaccine compared with the controls at the 70% and 80% V̇O2max stages, respectively. Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people. The small elevations in cardiovascular and neuroendocrine responses to exercise after the Pfizer mRNA vaccine regimen could have implications for athletes at the elite level and warrants investigation.NEW & NOTEWORTHY Recent COVID-19 vaccination does not affect a large number of physiological responses to graded exercise, indicating that vaccination is unlikely to impair exercise capacity in normal healthy people. Heart rate and norepinephrine levels were elevated in response to exercise after the two-dose Pfizer mRNA vaccination compared to controls. Small elevations in cardiovascular and neuroendocrine responses to exercise after recent COVID-19 vaccination could have implications for exercise performance in elite athletes and warrants investigation.
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Affiliation(s)
- Helena Batatinha
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona
| | - Forrest L Baker
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona
- Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Kyle A Smith
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona
| | - Tiffany M Zúñiga
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona
| | - Charles R Pedlar
- Faculty of Sport, Allied Health and Performance Science, St. Mary's University, London, United Kingdom
- Institute of Sport Exercise and Health, University College London, London, United Kingdom
| | - Shane C Burgess
- Department of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, Arizona
- The University of Arizona Cancer Center, Tucson, Arizona
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, Tucson, Arizona
- The University of Arizona Cancer Center, Tucson, Arizona
- Department of Immunobiology, University of Arizona, Tucson, Arizona
- Department of Medicine, University of Arizona, Tucson, Arizona
- Department of Pathology, University of Arizona, Tucson, Arizona
| | - Richard J Simpson
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, Arizona
- Department of Pediatrics, University of Arizona, Tucson, Arizona
- The University of Arizona Cancer Center, Tucson, Arizona
- Department of Immunobiology, University of Arizona, Tucson, Arizona
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Alves AMDB, Boscardin SB, Ngono AE. Editorial: DNA Vaccines. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 3:782986. [PMID: 35047970 PMCID: PMC8757835 DOI: 10.3389/fmedt.2021.782986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ada Maria de Barcelos Alves
- Laboratory of Biotechnology and Physiology of Viral Infections, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Silvia Beatriz Boscardin
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Annie Elong Ngono
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
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Lin N, Fu H, Pu D, Quan Y, Li Y, Yin X, Wei Y, Wang H, Ma X, Wei X. Criteria for judging the immune markers of COVID-19 disease vaccines. MedComm (Beijing) 2022; 3:1-12. [PMID: 35005708 PMCID: PMC8719528 DOI: 10.1002/mco2.109] [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: 11/12/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 02/05/2023] Open
Abstract
As severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) sweeping the world, effective and affordable vaccines are in urgent need. A reliable system for the assessment of SARS‐CoV‐2 vaccines would boost the development of vaccines and reduce the research cost. We constructed a logistic regression model and analyzed the relationship between antibody (Ab) level and efficacy of different vaccine types. The relationship between assessment dates and Ab levels was depicted by plotting the mean of Ab levels evolved over time and a fitted cubic polynomial model. Anti‐spike immunoglobulin G (IgG) could best estimate the vaccine efficacy (VE) (adjusted R2 = 0.731) and neutralizing Ab to live SARS‐CoV‐2 also explained a fine relationship (adjusted R2 = 0.577). Neutralizing Abs to live SARS‐CoV‐2 in inactivated virus vaccines reached a peak during days 40–60, and their receptor‐binding domain (RBD)‐IgG peaked during days 40–50. For messenger RNA (mRNA) and viral vector vaccines, their neutralizing Ab to live SARS‐CoV‐2 peaked later than day 40, and for RBD‐IgG during days 30–50. For mRNA and viral vector vaccines, their peak time of Abs was later than that in inactivated virus vaccines. RBD‐IgG peaked earlier than Ab to live SARS‐CoV‐2. Anti‐spike IgG and Ab to live SARS‐CoV‐2 may be good immune markers for VE assessment.
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Affiliation(s)
- Nan Lin
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Haoxuan Fu
- Department of Statistics University of Illinois at Urbana Champaign Urbana Illinois USA
| | - Dan Pu
- Department of Radiation Oncology Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Yuxin Quan
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Yueyi Li
- Department of Biotherapy Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Xiaomeng Yin
- Department of Biotherapy Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Yuhao Wei
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Hang Wang
- West China School of Medicine West China Hospital Sichuan University Chengdu China
| | - Xuelei Ma
- Department of Biotherapy Cancer Center, West China Hospital, Sichuan University Chengdu China
| | - Xiawei Wei
- Laboratory of Aging Research and Nanotoxicology, State Key Laboratory of Biotherapy National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University Chengdu China
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50
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Rotshild V, Hirsh-Raccah B, Miskin I, Muszkat M, Matok I. Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis. Sci Rep 2021; 11:22777. [PMID: 34815503 PMCID: PMC8611039 DOI: 10.1038/s41598-021-02321-z] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/07/2021] [Indexed: 01/07/2023] Open
Abstract
New Coronavirus Disease 2019 (COVID-19) vaccines are available to prevent the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We compared the efficacy of new COVID-19 vaccines to prevent symptomatic and severe disease in the adult population and to prevent symptomatic COVID-19 among the elderly. Leading medical databases were searched until August 30, 2021. Published phase 3 randomized controlled trials (RCTs) evaluated efficacy of the vaccine to prevent symptomatic and sever COVID-19 in adults were included. Two reviewers independently evaluated the literature search results and independently extracted summary data. The risk of bias was evaluated using the Cochrane Risk of Bias Assessment Tool. We performed a network meta-analysis (NMA) according to PRISMA-NMA 2015 to pool indirect comparisons between different vaccines regarding their relative efficacy. The primary outcomes were the efficacy of the vaccine against symptomatic COVID-19 in adults (PROSPERO registration number: CRD42021235364). Above 200,000 adult participants from eight phase 3 RCTs were included in NMA, of whom 52% received the intervention (active COVID-19 vaccine). While each of nine vaccines was tested in the unique clinical trial as compared to control, based on indirect comparison, BNT162b2 and mRNA-1273 vaccines were ranked with the highest probability of efficacy against symptomatic COVID-19 (P-scores 0.952 and 0.843, respectively), followed by Gam-COVID-Vac (P-score 0.782), NVX-CoV23730 (P-score 0.700), CoronaVac (P-score 0.570), BN02 (P-score 0.428), WIV04 (P-score 0.327), and Ad26.COV2.S (P-score 0.198). No statistically significant difference was seen in the ability of the vaccines to prevent symptomatic disease in the elderly population. No vaccine was statistically significantly associated with a decreased risk for severe COVID-19 than other vaccines, although mRNA-1273 and Gam-COVID-Vac have the highest P-scores (0.899 and 0.816, respectively), indicating greater protection against severe disease than other vaccines. In our indirect comparison, the BNT162b2 and mRNA-1273 vaccines, which use mRNA technology, were associated with the highest efficacy to prevent symptomatic COVID-19 compared to other vaccines. This finding may have importance when deciding which vaccine to use, together with other important factors as availability of the vaccines, costs, logistics, side effects, and patient acceptability.
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Affiliation(s)
- Victoria Rotshild
- Pharmacoepidemiology Research Unit, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, P.O.B. 12272, 9112102, Jerusalem, Israel.
- Jerusalem Distric, Clalith Health Services Community Division, Jerusalem, Israel.
| | - Bruria Hirsh-Raccah
- Pharmacoepidemiology Research Unit, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, P.O.B. 12272, 9112102, Jerusalem, Israel
- Department of Cardiology, Hadassah University Hospital Ein Karem, Jerusalem, Israel
| | - Ian Miskin
- Jerusalem Distric, Clalith Health Services Community Division, Jerusalem, Israel
| | - Mordechai Muszkat
- Department of Medicine, Hadassah University Hospital Mt. Scopus, Jerusalem, Israel
| | - Ilan Matok
- Pharmacoepidemiology Research Unit, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, P.O.B. 12272, 9112102, Jerusalem, Israel
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