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Thomas J, Rajmohan P, Jose P, Kannan R, Jose R, Uttumadathil Gopinathan U, Raphael L, Baiju NM, Krishna S, Attokaran T, Bency A. T J, Venugopal A, Sheela S, Kallempadam A, Jose L, Innah SJ, Varghese PR, George A. Real-World Effectiveness of COVID-19 Vaccine and Identification of SARS-CoV-2 Variants among People Living with HIV on Highly Active Antiretroviral Therapy in Central Kerala of India-An Ambi-Directional Cohort Study. Viruses 2023; 15:2187. [PMID: 38005865 PMCID: PMC10674822 DOI: 10.3390/v15112187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Vaccine effectiveness for first-generation coronavirus disease (COVID-19) vaccines among People Living with HIV (PLHIV) in India remains unexplored. This study entails the estimation of the real-world effectiveness of COVID-19 vaccines (AZD1222/Covishield, BBV152/Covaxin) among PLHIV and the identification of variants of SARS-CoV-2 among those infected with COVID-19. METHODS An ambi-directional cohort study was conducted among 925 PLHIV above 18 years of age in two districts of central Kerala, India, from February 2022 to March 2023. Selected PLHIV were recruited as Participant Liaison Officers (PLOs) for the follow-up on the study participants. At enrolment, basic details, baseline CD4 count, and a Nasopharyngeal (NP) swab for RT-PCR were collected. In the follow-up phase, NP swabs were collected from subjects with COVID-19 symptoms. Positive subjects had a CD4 count and genomic sequencing performed. RESULTS The mean age of the participants was 46.93 ± 11.00 years. The majority, 819 (93.6%), of participants had received at least one dose of any vaccine, while 56 (6.4%) were unvaccinated. A total of 649 (79.24%) participants were vaccinated with Covishield and 169 (20.63%) with Covaxin. In the vaccinated group, 158 (19.3%) reported COVID-19 infection. Vaccine Effectiveness (VE) for one dose of any vaccine was 43.2% (95% CI: 11.8-64.5), p = 0.015. The effectiveness of full vaccination with Covishied was 63.8% (95% CI: 39.3-79.2), p < 0.001, and Covaxin was 73.4% (95% CI: 44.3-87.3). VE was highest, at 60.7% (95% CI: 23.6-81.3), when the two doses of the vaccine were given at an interval of less than 6 weeks. Participants with a baseline CD4 count > 350 had greater protection from COVID-19, at 53.4% (95% CI: 19.6-75.3) p = 0.004. The incident cases were sub-variants of Omicron (BA.2, BA.2.38, BA.2.10). CONCLUSIONS Full vaccination with Covishield and Covaxin was effective against COVID-19 infection among PLHIV on treatment; albeit, that of Covaxin was higher. A gap of 4 to 6 weeks between the two doses of COVID-19 vaccine was found to have higher VE among PLHIV.
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Affiliation(s)
- Joe Thomas
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Priyanka Rajmohan
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Ponnu Jose
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Radhika Kannan
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Rosmi Jose
- Department of Microbiology, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India;
| | - Unnikrishnan Uttumadathil Gopinathan
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Lucy Raphael
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Nithya M. Baiju
- Department of Transfusion Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (N.M.B.); (S.J.I.)
| | - Swathi Krishna
- KEM Hospital Research Centre, Pune 412216, Maharashtra, India;
| | - Teny Attokaran
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Jubina Bency A. T
- Department of Community Medicine, PK DAS Medical College, Vaniyamkulam 679522, Kerala, India;
| | - Aiswarya Venugopal
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Soorya Sheela
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Akhila Kallempadam
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Lee Jose
- Department of Community Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (J.T.); (P.R.); (P.J.); (U.U.G.); (L.R.); (T.A.); (A.V.); (S.S.); (A.K.); (L.J.)
| | - Susheela J. Innah
- Department of Transfusion Medicine, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (N.M.B.); (S.J.I.)
| | - Pulikkottil Raphael Varghese
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (P.R.V.); (A.G.)
| | - Alex George
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur 680005, Kerala, India; (P.R.V.); (A.G.)
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Abstract
Amidst the Coronavirus Disease 2019 (COVID-19) pandemic, vaccination against severe acute respiratory syndrome 2 (SARS-CoV-2) is recommended for everyone over 18 years in South Korea, with the exception of pregnant women. Unexpected adverse cutaneous reactions after the COVID-19 vaccination have been recently reported. Cutaneous small-vessel vasculitis (CSVV) predominantly affects small blood vessels, defined as small intraparenchymal arteries, arterioles, capillaries, and venules, without any detectable involvement of non-cutaneous organs. We report five cases of CSVV after the ChAdOx1 COVID-19 vaccination in 44- to 68-year-old women. The symptoms commonly appeared within 2 days after vaccination. The lesion was localized to the lower limbs in four patients and spread to the upper limbs in one patient. All patients demonstrated a favorable response to oral methylprednisolone, antihistamines, and topical steroids. Considering the importance of the COVID-19 vaccination, clinicians should be aware of CSVV as a potential adverse event. Further studies are required to elucidate the causative link and pathogenesis.
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Affiliation(s)
- Ji An Uh
- 65509Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Soo Kyung Lee
- 65509Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Joong Ho Kim
- 65509Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Jae Ho Lee
- 65509Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Myoung Shin Kim
- 65509Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Un Ha Lee
- 65509Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
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Klugar M, Riad A, Mekhemar M, Conrad J, Buchbender M, Howaldt HP, Attia S. Side Effects of mRNA-Based and Viral Vector-Based COVID-19 Vaccines among German Healthcare Workers. Biology (Basel) 2021; 10:752. [PMID: 34439984 PMCID: PMC8389568 DOI: 10.3390/biology10080752] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND the increasing number of COVID-19 vaccines available to the public may trigger hesitancy or selectivity towards vaccination. This study aimed to evaluate the post-vaccination side effects of the different vaccines approved in Germany; Methods: a cross-sectional survey-based study was carried out using an online questionnaire validated and tested for a priori reliability. The questionnaire inquired about demographic data, medical and COVID-19-related anamneses, and local, systemic, oral, and skin-related side effects following COVID-19 vaccination; Results: out of the 599 participating healthcare workers, 72.3% were females, and 79.1% received mRNA-based vaccines, while 20.9% received a viral vector-based vaccine. 88.1% of the participants reported at least one side effect. Injection site pain (75.6%) was the most common local side effect, and headache/fatigue (53.6%), muscle pain (33.2%), malaise (25%), chills (23%), and joint pain (21.2%) were the most common systemic side effects. The vast majority (84.9%) of side effects resolved within 1-3 days post-vaccination; Conclusions: the mRNA-based vaccines were associated with a higher prevalence of local side effects (78.3% vs. 70.4%; Sig. = 0.064), while the viral vector-based vaccine was associated with a higher prevalence of systemic side effects (87.2% vs. 61%; Sig. < 0.001). Females and the younger age group were associated with an increased risk of side effects either after mRNA-based or viral vector-based vaccines. The gender- and age-based differences warrant further rigorous investigation and standardized methodology.
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Affiliation(s)
- Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (M.K.); (A.R.)
- Institute of Health Information and Statistics of the Czech Republic, Palackého náměstí 4, 128 01 Prague, Czech Republic
| | - Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (M.K.); (A.R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Mohamed Mekhemar
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, Arnold Heller Str. 3, Haus B, 24105 Kiel, Germany; (M.M.); (J.C.)
| | - Jonas Conrad
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, Arnold Heller Str. 3, Haus B, 24105 Kiel, Germany; (M.M.); (J.C.)
| | - Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Glückstraße 11, 91054 Erlangen, Germany;
| | - Hans-Peter Howaldt
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, Germany;
| | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, Germany;
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Waqar U, Ahmed S, Gardezi SM, Tahir MS, Abidin ZU, Hussain A, Ali N, Mahmood SF. Thrombosis with Thrombocytopenia Syndrome After Administration of AZD1222 or Ad26.COV2.S Vaccine for COVID-19: A Systematic Review. Clin Appl Thromb Hemost 2021; 27:10760296211068487. [PMID: 34907794 PMCID: PMC8689609 DOI: 10.1177/10760296211068487] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cases of thrombosis with thrombocytopenia syndrome (TTS) have been reported following vaccination with AZD1222 or Ad26.COV2.S. This review aimed to explore the pathophysiology, epidemiology, diagnosis, management, and prognosis of TTS. METHODS A systematic review was conducted to identify evidence on TTS till 4th September 2021. Case reports and series reporting patient-level data were included. Descriptive statistics were reported and compared across patients with different sexes, age groups, vaccines, types of thrombosis, and outcomes. FINDINGS Sixty-two studies reporting 160 cases were included from 16 countries. Patients were predominantly females with a median age of 42.50 (22) years. AZD1222 was administered to 140 patients (87·5%). TTS onset occurred in a median of 9 (4) days after vaccination. Venous thrombosis was most common (61.0%). Most patients developed cerebral venous sinus thrombosis (CVST; 66.3%). CVST was significantly more common in female vs male patients (p = 0·001) and in patients aged <45 years vs ≥45 years (p = 0·004). The mortality rate was 36.2%, and patients with suspected TTS, venous thrombosis, CVST, pulmonary embolism, or intraneural complications, patients not managed with non-heparin anticoagulants or IVIG, patients receiving platelet transfusions, and patients requiring intensive care unit admission, mechanical ventilation, or inpatient neurosurgery were more likely to expire than recover. INTERPRETATION These findings help to understand the pathophysiology of TTS while also recommending diagnostic and management approaches to improve prognosis in patients. FUNDING This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Usama Waqar
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Shaheer Ahmed
- Islamabad Medical and Dental College, Islamabad, Pakistan
| | | | | | | | - Ali Hussain
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Natasha Ali
- Section of Hematology, Department of Pathology & Laboratory Medicine/Oncology, Aga Khan University, Karachi, Pakistan
| | - Syed Faisal Mahmood
- Section of Infectious Diseases, Department of Medicine, Aga Khan University, Karachi, Pakistan
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Onyeaka H, Al-Sharify ZT, Ghadhban MY, Al-Najjar SZ. A review on the advancements in the development of vaccines to combat coronavirus disease 2019. Clin Exp Vaccine Res 2021; 10:6-12. [PMID: 33628749 PMCID: PMC7892947 DOI: 10.7774/cevr.2021.10.1.6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), the deadly disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a global pandemic that has severely affected lives and economies around the globe. The spread of this virus will be very difficult to contain if no vaccine is ready for implementation. This is because of the high human-to-human transmission rate of this virus and the fact that the virus is in the community spread stage. As of 31st August 2020, 25.3 million individuals have been affected by this deadly virus resulting in about 850,673 deaths. To combat the spread of COVID-19, more than 100 applicant immunizations are being developed around the world. Among them, eight have begun or will be soon beginning preliminary clinical trials. This paper provides a review of the current developments of potential COVID-19 vaccines around the world. It specifically discusses the recombinant vaccine produced by the University of Oxford and AstraZeneca (Cambridge, UK), the use of novel self-amplifying RNA technique to create a vaccine and the progress made by UNAID (US National Institute of Allergy and Infectious Diseases) and World Health Organization (WHO). Furthermore, this review demonstrates the pharmaceutical prophylaxis and treatment protocols for COVID-19 by analysing the documentation set up by the WHO for up to date data with respect to the novel coronavirus of 2019-2020.
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Affiliation(s)
- Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
| | - Zainab T. Al-Sharify
- School of Chemical Engineering, University of Birmingham, Birmingham, UK
- Department of Environmental Engineering, College of Engineering, Mustansiriyah University, Baghdad, Iraq
| | | | - Shahad Z. Al-Najjar
- Department of Chemical Engineering, College of Engineering, Al-Nahrain University, Baghdad, Iraq
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