Immunogenicity and safety of SARS-CoV-2 recombinant protein subunit vaccine (IndoVac) adjuvanted with alum and CpG 1018 in Indonesian adults: A phase 3, randomized, active-controlled, multicenter trial

BACKGROUND

Bio Farma has developed a recombinant protein subunit vaccine (IndoVac) that is indicated for active immunization in population of all ages. This article reported the results of the phase 3 immunogenicity and safety study in Indonesian adults aged 18 years and above.

METHODS

We conducted a randomized, active-controlled, multicenter, prospective intervention study to evaluate the immunogenicity and safety of IndoVac in adults aged 18 years and above. Participants who were SARS-CoV-2 vaccine-naïve received two doses of either IndoVac or control (Covovax) with 28 days interval between doses and were followed up until 12 months after complete vaccination.

RESULTS

A total of 4050 participants were enrolled from June to August 2022 and received at least one dose of vaccine. The geometric mean ratio (GMR) of neutralizing antibody at 14 days after the second dose was 1.01 (95 % confidence interval (CI) 0.89-1.16), which met the WHO non-inferiority criteria for immunobridging (95 % CI lower bound > 0.67). The antibody levels were maintained through 12 months after the second dose. The incidence rate of adverse events (AEs) were 27.95 % in IndoVac group and 32.15 % in Covovax group with mostly mild intensity (27.70 %). The most reported solicited AEs were pain (14.69 %) followed by myalgia (7.48 %) and fatigue (6.77 %). Unsolicited AEs varied, with each of the incidence rate under 5 %. There were no serious AEs assessed as possibly, probably, or likely related to vaccine.

CONCLUSIONS

IndoVac in adults showed favourable safety profile and elicited non-inferior immune response to Covovax. (ClinicalTrials.gov: NCT05433285, Indonesian Clinical Research Registry: INA-R5752S9).

Faktor-faktor yang Memengaruhi Insiden Miopia Pada Siswa Sekolah Menengah Atas di Kota Padang

Abstrak Miopia merupakan kelainan refraktif yang paling banyak ditemukan di dunia. Hampir 90% miopia terjadi di negara berkembang. Berbagai faktor diduga berhubungan dengan insiden miopia seperti jenis kelamin, indeks masa tubuh (IMT), aktivitas dekat (dengan atau tanpa layar), aktivitas jauh (dengan atau tanpa layar), sosioekonomi, orangtua menderita miopia, serta riwayat kelahiran prematur atau berat badan lahir rendah (BBLR). Tujuan penelitian ini adalah menentukan hubungan antara faktor-faktor tersebut dan insiden miopia pada siswa Sekolah Menengah Atas(SMA) di Kota Padang. Penelitian dilakukan pada siswa SMA di Kota Padang yang berusia 15-17 tahun, dengan desain case-control study, population based dengan jumlah sampel 140 orang, yang terdiri dari 70 orang untuk kelompok kontrol dan 70 orang untuk kelompok kasus. Dikelompokkan setelah menguji ketajaman visus. Kemudian dilanjutkan dengan pengukuran tinggi badan, berat badan, serta pengisian kuesioner. Selanjutnya, data diolah dengan uji statistik chi-square. Aktivitas dekat dengan layar, IMT dan aktivitas jauh dengan layar merupakan faktor dominan yang memengaruhi insiden miopia pada siswa SMA di Kota Padang. Dibuktikan juga bahwa jenis kelamin, sosioekonomi, orangtua menderita miopia, riwayat lahir prematur ataupun BBLR tidak  memengaruhi insiden miopia. Kesimpulan penelitian ini adalah ada hubungan positif antara faktor risiko dengan insiden miopia.Kata kunci: miopia, faktor risiko, pelajar SMAAbstract Myopia is the most common refractive error in the world. Almost 90% of myopia patients are found in the developing countries. There are several factors suspected to be related to the incidence of myopia, such as gender, body mass index, close-range activities (with or without screen), distance activities (with or without screen), socioeconomic state, history of myopia in parents, and history of prematurity or low birth weight. The objective of this study was to determine the relation of those factors and the incidence of myopia on senior high school students in Padang city.This study was conducted on senior high school students in Padang city aged 15-17 years old. This study used population based case control design with 140 samples, consisted of 70 students for the control group and 70students for the case group. The process of data collection was conducted by initially classifying the respondents into case or control group using visual acuity test. It was followed by measuring body height and weight and filling the questionnaire.  Finally, those data were analyzed by using the chi square statistic test.The result of this study proved that the close-range activities with screen, were the dominant variable influencing myopia in senior high school students in Padang city, followed by BMI and distance activities with screen. It was also proved that none of thegender, socioeconomic state, history of myopia in parents, and history of prematurity or low birth weight have any influence toward myopia incidence. Conclusion of this study is that a positive correlation between suspected factors with myopia incidence. Keywords: myopia, risk factors, high school students

Hereditary Gottron's acrogeria with recessive transmission: a report of four cases in one family

Four cases of acrogeria in one large family with multiple consanguineous marriages are reported. Inheritance is autosomal recessive. Evaluation of six generations of this family also showed six individuals with congenital blindness; this pedigree suggests autosomal recessive inheritance also for this disorder. Association of the two conditions was not seen in living members. The initial presentation in the patients with acrogeria was failure of growth during the first year of life, accompanied by characteristic facial appearance and cutaneous atrophy of the face and extremities. The radiologic features of these patients were acro-osteolysis, wide sutures and fontanelles, wormian bones, mandibular hypoplasia and avascular necrosis of the femoral heads. Other features were osteolysis of the clavicles, soft tissue calcification, osteoporosis and coxa valga, which have not been described in previous reported cases.

Relationship between murine macrophage Fc receptor-mediated phagocytic function and competency for activation for non-specific tumor cytotoxicity

The relationship between Fc receptor (FcR) function and activation of murine macrophage populations for non-specific tumor cytotoxicity was studied. Oil-elicited inflammatory peritoneal macrophages (PM phi) from C3HeB/FeJ mice had higher FcR function upon harvest than resident PM phi from the same strain or elicited PM phi from genetically deficient C3H/HeJ mice. C3HeB/FeJ inflammatory PM phi were uniformly responsive to activation by MAF and the complement activators: LPS, Poly I:C, cobra venom factor (CVF) and zymosan for tumoricidal activity. Resident cells from the same strain and C3H/HeJ-elicited PM phi were uniformly unresponsive to the same activators. In vitro culture of C3HeB/FeJ resident PM phi with fetal bovine serum for 24-48 h produced unregulation of FcR function which coincided with a conversion from an unresponsive to a responsive state for tumoricidal activity. Reconstitution of the FcR function of C3H/HeJ-elicited PM phi during 24-48 h culture with lymphokine or Poly I:C also coincided with the restoration of responsiveness to activation by LPS, CVF, and zymosan for tumor cytotoxicity. Thus, the consistent temporal relationship between upregulated FcR function and the capacity of macrophages to respond to activation for non-specific tumoricidal activity may be more than coincidental. Preincubation of responsive C3HeB/FeJ-elicited PM phi with insoluble immune complex or heat-aggregated IgG was shown to blockade FcR-mediated phagocytosis and to abrogate LPS-mediated tumoricidal activity. Interestingly, FcR blockade by IgG-opsonized sheep erythrocyte conjugates selectively inhibited activation by MAF, LPS, and Poly I:C, but had no inhibitory effect on activation by CVF or zymosan. Similar blockade of C3b receptors produced an identical pattern of selective inhibition of activation. This selective inhibition of non-specific tumoricidal activity by FcR/C3bR blockade suggests the existence of two pathways for antibody-independent activation of macrophages.