Effectiveness of a bivalent mRNA vaccine dose against symptomatic SARS-CoV-2 infection among U.S. Healthcare personnel, September 2022-May 2023

BACKGROUND

Bivalent mRNA vaccines were recommended since September 2022. However, coverage with a recent vaccine dose has been limited, and there are few robust estimates of bivalent VE against symptomatic SARS-CoV-2 infection (COVID-19). We estimated VE of a bivalent mRNA vaccine dose against COVID-19 among eligible U.S. healthcare personnel who had previously received monovalent mRNA vaccine doses.

METHODS

We conducted a case-control study in 22 U.S. states, and enrolled healthcare personnel with COVID-19 (case-participants) or without COVID-19 (control-participants) during September 2022-May 2023. Participants were considered eligible for a bivalent mRNA dose if they had received 2-4 monovalent (ancestral-strain) mRNA vaccine doses, and were ≥67 days after the most recent vaccine dose. We estimated VE of a bivalent mRNA dose using conditional logistic regression, accounting for matching by region and four-week calendar period. We adjusted estimates for age group, sex, race and ethnicity, educational level, underlying health conditions, community COVID-19 exposure, prior SARS-CoV-2 infection, and days since the last monovalent mRNA dose.

RESULTS

Among 3,647 healthcare personnel, 1,528 were included as case-participants and 2,119 as control-participants. Participants received their last monovalent mRNA dose a median of 404 days previously; 1,234 (33.8%) also received a bivalent mRNA dose a median of 93 days previously. Overall, VE of a bivalent dose was 34.1% (95% CI, 22.6%-43.9%) against COVID-19 and was similar by product, days since last monovalent dose, number of prior doses, age group, and presence of underlying health conditions. However, VE declined from 54.8% (95% CI, 40.7%-65.6%) after 7-59 days to 21.6% (95% CI 5.6%-34.9%) after ≥60 days.

CONCLUSIONS

Bivalent mRNA COVID-19 vaccines initially conferred approximately 55% protection against COVID-19 among U.S. healthcare personnel. However, protection waned after two months. These findings indicate moderate initial protection against symptomatic SARS-CoV-2 infection by remaining up-to-date with COVID-19 vaccines.

Residential social vulnerability among healthcare personnel with and without severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in Five US states, May-December 2020

OBJECTIVE

To characterize residential social vulnerability among healthcare personnel (HCP) and evaluate its association with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection.

DESIGN

Case-control study.

SETTING

This study analyzed data collected in May-December 2020 through sentinel and population-based surveillance in healthcare facilities in Colorado, Minnesota, New Mexico, New York, and Oregon.

PARTICIPANTS

Data from 2,168 HCP (1,571 cases and 597 controls from the same facilities) were analyzed.

METHODS

HCP residential addresses were linked to the social vulnerability index (SVI) at the census tract level, which represents a ranking of community vulnerability to emergencies based on 15 US Census variables. The primary outcome was SARS-CoV-2 infection, confirmed by positive antigen or real-time reverse-transcriptase- polymerase chain reaction (RT-PCR) test on nasopharyngeal swab. Significant differences by SVI in participant characteristics were assessed using the Fisher exact test. Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) for associations between case status and SVI, controlling for HCP role and patient care activities, were estimated using logistic regression.

RESULTS

Significantly higher proportions of certified nursing assistants (48.0%) and medical assistants (44.1%) resided in high SVI census tracts, compared to registered nurses (15.9%) and physicians (11.6%). HCP cases were more likely than controls to live in high SVI census tracts (aOR, 1.76; 95% CI, 1.37-2.26).

CONCLUSIONS

These findings suggest that residing in more socially vulnerable census tracts may be associated with SARS-CoV-2 infection risk among HCP and that residential vulnerability differs by HCP role. Efforts to safeguard the US healthcare workforce and advance health equity should address the social determinants that drive racial, ethnic, and socioeconomic health disparities.

INCIDENCE OF GASTRIC ULCER IN ALBINO RATS FED DIETS DEFICIENT IN VITAMIN B (B(1))

73 per cent of a group of albino rats whose diet was deficient in vitamin B have been found to have ulcerations of the gastric mucosa. A control group was found to be free from gastric lesions. Of 74 observed lesions eight were chronic, indurated ulcers resembling chronic peptic ulcer in man. The chronicity of the ulcers seems to be related to the duration rather than the degree of the deficiency. The lesions were generally located along the lesser curvature of the stomach, as is true in man. The size of the lesions in rat and man are comparable if adjustment is made for differences in the sizes of the organs.

Vanishing Hall resistance at high magnetic field in a double-layer two-dimensional electron system

At total Landau level filling factor nu(tot)=1 a double-layer two-dimensional electron system with small interlayer separation supports a collective state possessing spontaneous interlayer phase coherence. This state exhibits the quantized Hall effect when equal electrical currents flow in parallel through the two layers. In contrast, if the currents in the two layers are equal, but oppositely directed, both the longitudinal and Hall resistances of each layer vanish in the low-temperature limit. This finding supports the prediction that the ground state at nu(tot)=1 is an excitonic superfluid.

Bilayer quantum hall systems at nu(T)=1: coulomb drag and the transition from weak to strong interlayer coupling

Measurements revealing anomalously large frictional drag at the transition between the weakly and strongly coupled regimes of a bilayer two-dimensional electron system at total Landau level filling factor nu(T)=1 are reported. This result suggests the existence of fluctuations, either static or dynamic, near the phase boundary separating the quantized Hall state at small layer separations from the compressible state at larger separations. Interestingly, the anomalies in drag seem to persist to larger layer separations than does interlayer phase coherence as detected in tunneling.

Observation of quantized Hall drag in a strongly correlated bilayer electron system

The frictional drag between parallel two-dimensional electron systems has been measured in a regime of strong interlayer correlations. When the bilayer system enters the excitonic quantized Hall state at total Landau level filling factor nu(T) = 1, the longitudinal component of the drag vanishes but a strong Hall component develops. The Hall drag resistance is observed to be accurately quantized at h/e(2).

The use of radiolabeled anti-CD33 antibody to augment marrow irradiation prior to marrow transplantation for acute myelogenous leukemia

Disease recurrence remains a major limitation to the use of marrow transplantation to treat leukemia. Previous transplant studies have demonstrated that higher doses of total-body irradiation result in less disease recurrence, but more toxicity. In this study, the possibility of delivering radiotherapy specifically to marrow using a radiolabeled anti-CD33 antibody (p67) was explored. Biodistribution studies were performed in nine patients using .05-.5 mg/kg p67 trace-labeled with 131I. In most patients initial specific uptake of 131I-p67 in the marrow was seen, but the half-life of the radiolabel in the marrow space was relatively brief, ranging from 9-41 hr, presumably due to modulation of the 131I-p67-CD33 complex with subsequent digestion and release of 131I from the marrow space. In four of nine patients these biodistribution studies demonstrated that with 131I-p67 marrow and spleen would receive more radiation than any normal nonhematopoietic organ, and therefore these four patients were treated with 110-330 mCi 131I conjugated to p67 followed by a standard transplant regimen of cyclophosphamide plus 12 Gy TBI. All four patients tolerated the procedure well and three of the four are alive in remission 195-477 days posttransplant. This study demonstrates the feasibility of using a radiolabeled antimyeloid antibody as part of a marrow transplant preparative regimen and also highlights a major limitation of using conventionally labeled anti-CD33--namely, the short residence time in marrow. Strategies to overcome this limitation include the use of alternative labeling techniques or the selection of cell surface stable antigens as targets.

Pharmacokinetic studies in animals of a new parenteral penem CP-65,207 and its oral prodrug ester

The pharmacokinetics of penem CP-65,207 diastereomeric mixture were studied following parenteral administration in mice, rats, beagle dogs and cynomolgus monkeys. As is characteristic for most penems, the serum elimination T1/2 of CP-65,207 in rodents was only 13 minutes for mice and 18 minutes for rats. A linear relationship was observed between dose and Cmax following subcutaneous injection of drug in mice. The T1/2 in the beagle dog and monkey following intravenous injection was approximately 23 minutes. CP-65,207 demonstrated binding to human serum proteins of only 10%. In vitro studies using purified porcine renal dehydropeptidase-I (RDHP) indicated that the pure S-isomer of CP-65,207 was 7-fold more stable to inactivation than imipenem. Urinary recovery of CP-65,207 in the dog was 42% compared to 1% for imipenem without RDHP inhibitor. Unlike results obtained with imipenem, coadministration of probenecid with CP-65,207 in the dog doubled the elimination T1/2 and AUC of the penem demonstrating its relative stability in vivo in the absence of a RDHP inhibitor. The pivaloyloxymethyl esters of each pure isomer of CP-65,207 showed significantly different degrees of oral absorption in rats.