|
151
|
Edwards DK, Carfi A. Messenger ribonucleic acid vaccines against infectious diseases: current concepts and future prospects. Curr Opin Immunol 2022; 77:102214. [PMID: 35671599 PMCID: PMC9612403 DOI: 10.1016/j.coi.2022.102214] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 01/06/2023]
Abstract
Over the past two decades, scientific
and technological advancements have revealed messenger ribonucleic acid
(mRNA)-based vaccines as a well-tolerated and effective platform to
combat infectious disease. The potential of mRNA-based vaccines was
epitomized during the severe acute respiratory syndrome coronavirus 2
pandemic, wherein mRNA-based vaccines were rapidly developed and found
highly efficacious with an acceptable safety profile. These properties
together with the capability to quickly address pathogens of pandemic
potential, pathogens with complex antigens, and multiple pathogens within
a single vaccine have revitalized the field, and multiple mRNA-based
vaccines have now entered clinical development. This review summarizes
current mRNA-based vaccine technology, perspectives on ongoing clinical
studies, and future prospects for the field.
Collapse
Affiliation(s)
| | - Andrea Carfi
- Moderna, Inc., 200 Technology Square, Cambridge, MA, USA.
| |
Collapse
|
|
152
|
Bloise S, Marcellino A, Frasacco B, Gizzone P, Proietti Ciolli C, Martucci V, Sanseviero M, Del Giudice E, Ventriglia F, Lubrano R. Cross-Sectional Survey on BNT162b2 mRNA COVID-19 Vaccine Serious Adverse Events in Children 5 to 11 Years of Age: A Monocentric Experience. Vaccines (Basel) 2022; 10:vaccines10081224. [PMID: 36016112 PMCID: PMC9416594 DOI: 10.3390/vaccines10081224] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: Our aim was to evaluate the safety of COVID-19 vaccine in children resident in the Latina Local Health Authority. Methods: We conducted a telephone survey among children aged 5–11 years receiving BNT162b2 mRNA COVID-19 vaccine between December 15 and 21. The main outcomes included the presence of allergic reactions or anaphylaxis, adverse events after 24–48 h, 7 and 20 days of taking the first and second doses of medications, and documented SARS-CoV-2 infection after vaccination. The information obtained was automatically linked to a spreadsheet and analyzed. Results: 569 children were enrolled. The mean age was 114 ± 4.24 months; there were 251 males in the study. The vaccine showed a favorable safety profile; no anaphylaxis or serious adverse events were reported. The most common symptoms both after the first and second dose were injection site reactions, asthenia, and headache. Injection site reactions were more frequent after the first dose (p = 0.01), while systemic symptoms were more frequent after the second dose (p = 0.022). These symptoms were more frequent in patients with comorbidities (p = 0.0159). Conclusion: Our findings confirm the safety of COVID-19 vaccine in children younger 11 years and could be useful to promote its diffusion in pediatric ages in order to achieve “herd immunity” and prevent the virus’s circulation.
Collapse
|
|
153
|
Inchingolo AD, Malcangi G, Ceci S, Patano A, Corriero A, Vimercati L, Azzollini D, Marinelli G, Coloccia G, Piras F, Barile G, Settanni V, Mancini A, De Leonardis N, Garofoli G, Palmieri G, Isacco CG, Rapone B, Scardapane A, Curatoli L, Quaranta N, Ribezzi M, Massaro M, Jones M, Bordea IR, Tartaglia GM, Scarano A, Lorusso F, Macchia L, Larocca AMV, Aityan SK, Tafuri S, Stefanizzi P, Migliore G, Brienza N, Dipalma G, Favia G, Inchingolo F. Effectiveness of SARS-CoV-2 Vaccines for Short- and Long-Term Immunity: A General Overview for the Pandemic Contrast. Int J Mol Sci 2022; 23:ijms23158485. [PMID: 35955621 PMCID: PMC9369331 DOI: 10.3390/ijms23158485] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/22/2022] Open
Abstract
Background: The recent COVID-19 pandemic produced a significant increase in cases and an emergency state was induced worldwide. The current knowledge about the COVID-19 disease concerning diagnoses, patient tracking, the treatment protocol, and vaccines provides a consistent contribution for the primary prevention of the viral infection and decreasing the severity of the SARS-CoV-2 disease. The aim of the present investigation was to produce a general overview about the current findings for the COVID-19 disease, SARS-CoV-2 interaction mechanisms with the host, therapies and vaccines’ immunization findings. Methods: A literature overview was produced in order to evaluate the state-of-art in SARS-CoV-2 diagnoses, prognoses, therapies, and prevention. Results: Concerning to the interaction mechanisms with the host, the virus binds to target with its Spike proteins on its surface and uses it as an anchor. The Spike protein targets the ACE2 cell receptor and enters into the cells by using a special enzyme (TMPRSS2). Once the virion is quietly accommodated, it releases its RNA. Proteins and RNA are used in the Golgi apparatus to produce more viruses that are released. Concerning the therapies, different protocols have been developed in observance of the disease severity and comorbidity with a consistent reduction in the mortality rate. Currently, different vaccines are currently in phase IV but a remarkable difference in efficiency has been detected concerning the more recent SARS-CoV-2 variants. Conclusions: Among the many questions in this pandemic state, the one that recurs most is knowing why some people become more seriously ill than others who instead contract the infection as if it was a trivial flu. More studies are necessary to investigate the efficiency of the treatment protocols and vaccines for the more recent detected SARS-CoV-2 variant.
Collapse
Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Alberto Corriero
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70121 Bari, Italy; (A.C.); (M.R.); (N.B.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giovanni Coloccia
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giuseppe Barile
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Vito Settanni
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Nicole De Leonardis
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Grazia Garofoli
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Arnaldo Scardapane
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Luigi Curatoli
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Nicola Quaranta
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Mario Ribezzi
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70121 Bari, Italy; (A.C.); (M.R.); (N.B.)
| | - Maria Massaro
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Megan Jones
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (F.L.); (F.I.); Tel.: +39-3282132586 (F.L.)
| | - Luigi Macchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Angela Maria Vittoria Larocca
- Hygiene Complex Operating Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Place Giulio Cesare 11 BARI CAP, 70124 Bari, Italy;
| | | | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari, 70121 Bari, Italy;
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University Hospital of Bari, 70100 Bari, Italy; (P.S.); (G.M.)
| | - Giovanni Migliore
- Interdisciplinary Department of Medicine, University Hospital of Bari, 70100 Bari, Italy; (P.S.); (G.M.)
| | - Nicola Brienza
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70121 Bari, Italy; (A.C.); (M.R.); (N.B.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (G.M.); (S.C.); (A.P.); (L.V.); (D.A.); (G.M.); (G.C.); (F.P.); (G.B.); (V.S.); (A.M.); (N.D.L.); (G.G.); (G.P.); (C.G.I.); (B.R.); (A.S.); (N.Q.); (M.J.); (G.D.); (G.F.)
- Correspondence: (F.L.); (F.I.); Tel.: +39-3282132586 (F.L.)
| |
Collapse
|
|
154
|
Zhang W, Huggins T, Zheng W, Liu S, Du Z, Zhu H, Raza A, Tareq AH. Assessing the Dynamic Outcomes of Containment Strategies against COVID-19 under Different Public Health Governance Structures: A Comparison between Pakistan and Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159239. [PMID: 35954595 PMCID: PMC9368361 DOI: 10.3390/ijerph19159239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
COVID-19 scenarios were run using an epidemiological mathematical model (system dynamics model) and counterfactual analysis to simulate the impacts of different control and containment measures on cumulative infections and deaths in Bangladesh and Pakistan. The simulations were based on national-level data concerning vaccination level, hospital capacity, and other factors, from the World Health Organization, the World Bank, and the Our World in Data web portal. These data were added to cumulative infections and death data from government agencies covering the period from 18 March 2020 to 28 February 2022. Baseline curves for Pakistan and Bangladesh were obtained using piecewise fitting with a consideration of different events against the reported data and allowing for less than 5% random errors in cumulative infections and deaths. The results indicate that Bangladesh could have achieved more reductions in each key outcome measure by shifting its initial lockdown at least five days backward, while Pakistan would have needed to extend its lockdown to achieve comparable improvements. Bangladesh’s second lockdown appears to have been better timed than Pakistan’s. There were potential benefits from starting the third lockdown two weeks earlier for Bangladesh and from combining this with the fourth lockdown or canceling the fourth lockdown altogether. Adding a two-week lockdown at the beginning of the upward slope of the second wave could have led to a more than 40 percent reduction in cumulative infections and a 35 percent reduction in cumulative deaths for both countries. However, Bangladesh’s reductions were more sensitive to the duration of the lockdown. Pakistan’s response was more constrained by medical resources, while Bangladesh’s outcomes were more sensitive to both vaccination timing and capacities. More benefits were lost when combining multiple scenarios for Bangladesh compared to the same combinations in Pakistan. Clearly, cumulative infections and deaths could have been highly impacted by adjusting the control and containment measures in both national settings. However, COVID-19 outcomes were more sensitive to adjustment interventions for the Bangladesh context. Disaggregated analyses, using a wider range of factors, may reveal several sub-national dynamics. Nonetheless, the current research demonstrates the relevance of lockdown timing adjustments and discrete adjustments to several other control and containment measures.
Collapse
Affiliation(s)
- Weiwei Zhang
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu 610074, China; (W.Z.); (H.Z.); (A.R.)
| | - Thomas Huggins
- Division of Science & Technology, BNU-HKBU United International College, Zhuhai 519087, China;
| | - Wenwen Zheng
- Personal Finance Department, HQ of China Construction Bank, Beijing 100033, China;
| | - Shiyong Liu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai 519087, China
- Correspondence: or
| | - Zhanwei Du
- Division of Epidemiology and Biostatistics, School of Public Health, Hong Kong University, Hong Kong, China;
| | - Hongli Zhu
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu 610074, China; (W.Z.); (H.Z.); (A.R.)
| | - Ahmad Raza
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu 610074, China; (W.Z.); (H.Z.); (A.R.)
| | - Ahmad Hussen Tareq
- Ministry of National Health Services Regulations and Coordination, Islamabad 44010, Pakistan;
- Health Services Academy, Islamabad 44010, Pakistan
| |
Collapse
|
|
155
|
Guo Y, Cowman K, Chang M, Bao H, Golia A, Mcsweeney T, Bard L, Simpson R, Andrews E, Pirofski LA, Nori P. Assessment of unvaccinated and vaccinated patients with coronavirus disease 2019 (COVID-19) treated with monoclonal antibodies during the delta wave (July 1-August 20, 2021): a retrospective observational monocentric study. BMC Infect Dis 2022; 22:645. [PMID: 35896965 PMCID: PMC9325951 DOI: 10.1186/s12879-022-07626-6] [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: 01/23/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Monoclonal antibodies (mAb) prevent COVID-19 progression when administered early. We compared mAb treatment outcomes among vaccinated and unvaccinated patients during Delta wave and assessed the feasibility of implementing stricter eligibility criteria in the event of mAb scarcity. Methods We conducted a retrospective observational study of casirivimab/imdevimab recipients with mild-to-moderate COVID-19 infection in an emergency department or outpatient infusion center (July 1–August 20, 2021). Primary outcome was all-cause hospital admission within 30 days post-treatment between vaccinated vs. unvaccinated patients during Delta surge in the Bronx, NY. Results A total of 250 patients received casirivimab/imdevimab (162 unvaccinated vs. 88 vaccinated). The median age was 39 years for unvaccinated patients, and 52 years for vaccinated patients (p < 0.0001). The median number of EUA criteria met was 1 for unvaccinated and 2 for vaccinated patients (p < 0.0001). Overall, 6% (15/250) of patients were admitted within 30 days post-treatment. Eleven unvaccinated patients (7%) were admitted within 30-days compared to 4 (5%) vaccinated patients (p = 0.48). Conclusions All-cause 30-day admission was not statistically different between vaccinated and unvaccinated patients. When federal allocation of therapies is limited, programs must prioritize patients at highest risk of hospitalization and death regardless of vaccination status.
Collapse
Affiliation(s)
- Yi Guo
- Department of Pharmacy, Montefiore Medical Center Moses, 111 East 210th Street, Bronx, NY, 10467, USA. .,Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3411 Wayne Avenue, #4H, Bronx, NY, 10467, USA.
| | - Kelsie Cowman
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3411 Wayne Avenue, #4H, Bronx, NY, 10467, USA.,Network Performance Group, Montefiore Health System, Bronx, NY, USA
| | - Mei Chang
- Department of Pharmacy, Montefiore Medical Center Weiler, 1825 Eastchester Rd, Bronx, NY, 10461, USA
| | - Hongkai Bao
- Department of Pharmacy, Montefiore Medical Center Wakefield, 500 East 233rd St, Bronx, NY, 10466, USA
| | - Austin Golia
- Department of Pharmacy, Montefiore Medical Center Moses, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Terrence Mcsweeney
- Department of Pharmacy, Montefiore Medical Center Moses, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Linda Bard
- Faculty Practice Group, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Roxanne Simpson
- Department of Nursing, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Erin Andrews
- Network Performance Group, Montefiore Health System, Bronx, NY, USA.,Network Performance Group, Montefiore Health System, 5 Executive Plaza, Suite 112B, Yonkers, NY, 10701, USA
| | - Liise-Anne Pirofski
- Division of Infectious Diseases, Department of Microbiology and Immunology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Priya Nori
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3411 Wayne Avenue, #4H, Bronx, NY, 10467, USA
| |
Collapse
|
|
156
|
Ray JG, Park AL. SARS-CoV-2 vaccination, ABO blood group and risk of COVID-19: population-based cohort study. BMJ Open 2022; 12:e059944. [PMID: 35851010 PMCID: PMC9297000 DOI: 10.1136/bmjopen-2021-059944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To compare outcomes between O and non-O blood groups, and by modified RNA (mRNA) and adenovirus-vectored (Ad-V) vaccines. DESIGN Population-based cohort study. SETTING All of Ontario, Canada. Linked data sets captured clinical encounters, vaccinations and laboratory testing for SARS-CoV-2. PARTICIPANTS Individuals aged 12+ years with known ABO blood group and free of SARS-CoV-2 before 15 January 2021. MAIN OUTCOMES MEASURES The main exposure, first SARS-CoV-2 vaccination, was modelled in a time-varying manner. O and non-O blood group was known prior to vaccination. SARS-CoV-2 infection, and severe COVID-19 (hospitalisation or death), were assessed starting 14 days after vaccination, up to 27 June 2021. RESULTS 2 472 261 individuals were included. 1 743 916 (70.5%) had at least one vaccination, of which 24.6% were fully vaccinated. Those vaccinated were more likely to be women, older in age, residing in a higher-income area and have higher rates of certain comorbid conditions, like cancer, diabetes and hypertension. Relative to unvaccinated, after receiving their first mRNA (adjusted HR (aHR) 0.46, 95% CI 0.44 to 0.47) or Ad-V (aHR 0.49, 95% CI 0.44 to 0.54) vaccine, the risk of SARS-CoV-2 infection was lower, as was severe COVID-19 (aHR 0.29, 95% CI 0.20 to 0.43 (mRNA); aHR 0.29, 95% CI 0.26 to 0.33 (Ad-V)). Stratifying by blood group produced similar results. For example, after first mRNA vaccination, the aHR of severe COVID-19 was 0.31 (95% CI 0.27 to 0.36) among non-O blood groups, and 0.27 (95% CI 0.22 to 0.32) among O blood groups, relative to unvaccinated. Fully vaccinated individuals had the lowest risk of SARS-CoV-2 and severe COVID-19. CONCLUSIONS SARS-CoV-2 infection and severe COVID-19 are reduced by vaccination. This effect does not vary by vaccine type or blood group, but is more pronounced among fully, than partially, vaccinated individuals.
Collapse
Affiliation(s)
- Joel G Ray
- Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | | |
Collapse
|
|
157
|
Torres R, Toro L, Sanhueza ME, Lorca E, Ortiz M, Pefaur J, Clavero R, Machuca E, Gonzalez F, Herrera P, Mocarquer A, Frias A, Roessler E, Muñoz C, Nuñez M, Aravena C, Quintana E, Lemus J, Lillo M, Reynolds E, Morales A, Pais E, Fiabane A, Parra-Lucares A, Garrido C, Mendez G, Villa E, Mansilla R, Sotomayor G, Gonzalez M, Miranda C, Briones E, Gomez E, Mezzano S, Bernales W, Rocca X, Espinoza O, Zuñiga E, Aragon H, Badilla M, Valenzuela M, Escobar L, Zamora D, Flores I, Tapia B, Borquez T, Herrera P. Clinical efficacy of SARS-CoV-2 vaccination in hemodialysis patients. Kidney Int Rep 2022; 7:2176-2185. [PMID: 35874643 PMCID: PMC9287586 DOI: 10.1016/j.ekir.2022.07.007] [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: 11/19/2021] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, there are currently limited data on the clinical efficacy of vaccinations in the hemodialysis population. Methods A national multicenter observational cohort was performed in Chile to evaluate the clinical efficacy of anti-SARS-CoV-2 vaccination in end-stage renal disease patients on chronic hemodialysis from February 2021 to August 2021. In addition, the BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines were evaluated. The efficacy of vaccination in preventing SARS-CoV-2 infection, hospitalizations, and deaths associated with COVID-19 was determined. Results A total of 12,301 patients were evaluated; 10,615 (86.3%) received a complete vaccination (2 doses), 490 (4.0%) received incomplete vaccination, and 1196 (9.7%) were not vaccinated. During follow-up, 1362 (11.0%) patients developed COVID-19, and 150 died (case fatality rate: 11.0%). The efficacy of the complete vaccination in preventing infection was 18.1% (95% confidence interval [CI]:11.8–23.8%), and prevention of death was 66.0% (95% CI:60.6–70.7%). When comparing both vaccines, BNT162b2 and CoronaVac were effective in reducing infection and deaths associated with COVID-19. Nevertheless, the BNT162b2 vaccine had higher efficacy in preventing infection (42.6% vs. 15.0%) and deaths (90.4% vs. 64.8%) compared to CoronaVac. Conclusion The results of our study suggest that vaccination against SARS-CoV-2 in patients on chronic hemodialysis was effective in preventing infection and death associated with COVID-19.
Collapse
Affiliation(s)
- Rubén Torres
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Luis Toro
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.,Centro de Investigación Clínica Avanzada, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - María E Sanhueza
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Eduardo Lorca
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Mireya Ortiz
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Department of Nephrology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jacqueline Pefaur
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Rene Clavero
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Dr. Gustavo Fricke, Valparaiso, Chile
| | - Eduardo Machuca
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Fresenius Medical Care Chile, Chile
| | | | - Patricia Herrera
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Alfredo Mocarquer
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Dialisis Gran Avenida, Santiago, Chile
| | - Alondra Frias
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Regional de Talca, Talca, Chile
| | - Eric Roessler
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Department of Nephrology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Muñoz
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Puerto Montt, Puerto Montt, Chile
| | - Miguel Nuñez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Puerto Montt, Puerto Montt, Chile
| | - Cesar Aravena
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Dialisis Municipal La Granja, Santiago, Chile
| | - Enrique Quintana
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Padre Hurtado, Santiago, Chile
| | - Juan Lemus
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Dialisis Antares, Santiago, Chile
| | - Mario Lillo
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Centro Médico y de Diálisis Ltda, Santiago, Chile
| | - Enrique Reynolds
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Alvaro Morales
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Edgard Pais
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Complejo Asistencial Sótero del Río, Santiago, Chile
| | - Andrea Fiabane
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Alfredo Parra-Lucares
- Centro de Investigación Clínica Avanzada, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Cristian Garrido
- Department of Radiology, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Gabriel Mendez
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Eduardo Villa
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Rodrigo Mansilla
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Critical Care Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Germana Sotomayor
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Marcela Gonzalez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Clínico de Magallanes, Punta Arenas, Chile
| | - Cecilia Miranda
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Militar de Santiago, Santiago, Chile
| | - Eduardo Briones
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,CID Servicio Integral de Salud S.A, Santiago, Chile
| | - Esteban Gomez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Clinica Indisa, Santiago, Chile
| | - Sergio Mezzano
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Clinico San Borja Arriaran, Santiago, Chile
| | - Waldo Bernales
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Faculty of Medicine, Universidad Austral de Chile, Valdivia, Santiago
| | - Ximena Rocca
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Oscar Espinoza
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Eric Zuñiga
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Regional de Coyhaique, Coyhaique, Chile
| | - Henry Aragon
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Clinica Bupa Antofagasta, Antofagasta, Chile
| | - Marta Badilla
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital San José, Santiago, Chile
| | - Marcela Valenzuela
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Complejo Asistencial Sótero del Río, Santiago, Chile
| | - Luis Escobar
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Clinica Bupa Antofagasta, Antofagasta, Chile
| | - Daniela Zamora
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Ivan Flores
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital de Puerto Natales, Puerto Natales, Chile
| | - Beatriz Tapia
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Dr. Gustavo Fricke, Valparaiso, Chile
| | - Tamara Borquez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital San Juan de Dios de Curicó, Curicó, Chile
| | - Patricio Herrera
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Clínico del Sur, Concepción, Chile
| |
Collapse
|
|
158
|
Rao IJ, Brandeau ML. Sequential allocation of vaccine to control an infectious disease. Math Biosci 2022; 351:108879. [PMID: 35843382 PMCID: PMC9288241 DOI: 10.1016/j.mbs.2022.108879] [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: 12/03/2021] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022]
Abstract
The problem of optimally allocating a limited supply of vaccine to control a communicable disease has broad applications in public health and has received renewed attention during the COVID-19 pandemic. This allocation problem is highly complex and nonlinear. Decision makers need a practical, accurate, and interpretable method to guide vaccine allocation. In this paper we develop simple analytical conditions that can guide the allocation of vaccines over time. We consider four objectives: minimize new infections, minimize deaths, minimize life years lost, or minimize quality-adjusted life years lost due to death. We consider an SIR model with interacting population groups. We approximate the model using Taylor series expansions, and develop simple analytical conditions characterizing the optimal solution to the resulting problem for a single time period. We develop a solution approach in which we allocate vaccines using the analytical conditions in each time period based on the state of the epidemic at the start of the time period. We illustrate our method with an example of COVID-19 vaccination, calibrated to epidemic data from New York State. Using numerical simulations, we show that our method achieves near-optimal results over a wide range of vaccination scenarios. Our method provides a practical, intuitive, and accurate tool for decision makers as they allocate limited vaccines over time, and highlights the need for more interpretable models over complicated black box models to aid in decision making.
Collapse
Affiliation(s)
- Isabelle J Rao
- Department of Management Science and Engineering, Stanford University, Stanford, CA, United States of America.
| | - Margaret L Brandeau
- Department of Management Science and Engineering, Stanford University, Stanford, CA, United States of America.
| |
Collapse
|
|
159
|
Godoy P, Castilla J, Astray J, Godoy S, Tuells J, Barrabeig I, Domínguez Á. [Towards COVID-19 control through vaccination: obstacles, challenges and opportunities. SESPAS Report 2022]. GACETA SANITARIA 2022; 36 Suppl 1:S82-S86. [PMID: 35781154 PMCID: PMC9244662 DOI: 10.1016/j.gaceta.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 01/09/2023]
Abstract
En España se inició el programa de vacunación en un contexto de alta transmisión y baja disponibilidad de vacunas. El objetivo de este artículo es revisar el programa de vacunación frente a la COVID-19 (3-3-2022) y valorar los obstáculos, los desafíos y las oportunidades que plantea el control de esta enfermedad. Se dispone actualmente de cinco vacunas: dos basadas en la tecnología ARNm (Comirnaty® y Spikevax®), dos basadas en un vector no replicativo (Vaxzevria® y Janssen) y una basada en la subunidad S (Novavax®). Las autoridades sanitarias han desarrollado estrategias de vacunación priorizando la prevención de hospitalizaciones y defunciones. En marzo de 2022 se superó el 90% de la población diana con vacunación completa y el 95% de cobertura en mayores de 50 años. El nuevo reto es conseguir coberturas similares para una tercera dosis. La vacunación en la infancia y la adolescencia se ha convertido en una prioridad por las implicaciones educativas y sociales que comporta la COVID-19. Se deberán renovar las estrategias comunicativas y eliminar las barreras de acceso para conseguir buenas coberturas. En España se han publicado estudios que muestran una alta efectividad de la vacunación. La principal estrategia para el control de la pandemia y para recuperar la actividad social es la vacunación, pero todo indica que serán necesarios niveles muy altos de cobertura vacunal y seguir con medidas no farmacológicas. En un mundo globalizado, el control de la COVID-19 solo se alcanzará con una estrategia global coordinada y el apoyo a la vacunación en los países con pocos recursos.
Collapse
Affiliation(s)
- Pere Godoy
- Agència de Salut Pública de Catalunya, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España.
| | - Jesús Castilla
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, España
| | - Jenaro Astray
- Dirección General de Salud Pública, Subdirección General de Epidemiología, Comunidad de Madrid, Madrid, España
| | - Sofía Godoy
- Institut Català de la Salut (ICS), Lleida, España
| | - José Tuells
- Departamento de Salud Pública, Universidad de Alicante, Alicante, España
| | - Irene Barrabeig
- Agència de Salut Pública de Catalunya, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Ángela Domínguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departament de Medicina, Universitat de Barcelona, Barcelona, España
| |
Collapse
|
|
160
|
Rennert L, Ma Z, McMahan CS, Dean D. Effectiveness and protection duration of Covid-19 vaccines and previous infection against any SARS-CoV-2 infection in young adults. Nat Commun 2022; 13:3946. [PMID: 35803915 PMCID: PMC9263799 DOI: 10.1038/s41467-022-31469-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/19/2022] [Indexed: 12/12/2022] Open
Abstract
Data on effectiveness and protection duration of Covid-19 vaccines and previous infection against general SARS-CoV-2 infection in general populations are limited. Here we evaluate protection from Covid-19 vaccination (primary series) and previous infection in 21,261 university students undergoing repeated surveillance testing between 8/8/2021-12/04/2021, during which B.1.617 (delta) was the dominant SARS-CoV-2 variant. Estimated mRNA-1273, BNT162b2, and AD26.COV2.S effectiveness against any SARS-CoV-2 infection is 75.4% (95% CI: 70.5-79.5), 65.7% (95% CI: 61.1-69.8), and 42.8% (95% CI: 26.1-55.8), respectively. Among previously infected individuals, protection is 72.9% when unvaccinated (95% CI: 66.1-78.4) and increased by 22.1% with full vaccination (95% CI: 15.8-28.7). Statistically significant decline in protection is observed for mRNA-1273 (P < .001), BNT162b2 (P < .001), but not Ad26.CoV2.S (P = 0.40) or previous infection (P = 0.12). mRNA vaccine protection dropped 29.7% (95% CI: 17.9-41.6) six months post- vaccination, from 83.2% to 53.5%. We conclude that the 2-dose mRNA vaccine series initially offers strong protection against general SARS-CoV-2 infection caused by the delta variant in young adults, but protection substantially decreases over time. These findings indicate that vaccinated individuals may still contribute to community spread. While previous SARS-CoV-2 infection consistently provides moderately strong protection against repeat infection from delta, vaccination yields a substantial increase in protection.
Collapse
Affiliation(s)
- Lior Rennert
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA.
| | - Zichen Ma
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Christopher S McMahan
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA
| | - Delphine Dean
- Department of Bioengineering, Clemson University, Clemson, SC, USA
| |
Collapse
|
|
161
|
Jain V, Serisier A, Lorgelly P. The Real-World Impact of Vaccination on COVID-19 Cases During Europe’s Fourth Wave. Int J Public Health 2022; 67:1604793. [PMID: 35865144 PMCID: PMC9294143 DOI: 10.3389/ijph.2022.1604793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: Disease control is important to limit the social, economic and health effects of COVID-19 and reduce the risk of novel variants emerging. Evidence suggests vaccines are less effective against the Omicron variant, but their impact on disease control is unclear. Methods: We used a longitudinal fixed effects Poisson regression model to assess the impact of vaccination on COVID-19 case rates across 32 countries in Europe from 13th October to 01st January 2022. We controlled for country and time fixed effects and the severity of public health restrictions. Results: Full vaccination coverage increased by 4.2%, leading to a 54% reduction in case rates across Europe (p < 0.001). This protection decreased over time but remained significant at 5 weeks after the detection of Omicron. Mean booster vaccination rates increased from 2.71% to 24.5% but provided no significant additional benefit. For every one-unit increase in the severity of public health restrictions, case rates fell by a further 2% (p = 0.019). Conclusion: Full vaccination significantly limited the spread of COVID-19 and blunted the impact of the Omicron variant, despite becoming less useful over time.
Collapse
Affiliation(s)
- Vageesh Jain
- Institute for Global Health, UCL, London, United Kingdom
- *Correspondence: Vageesh Jain,
| | | | - Paula Lorgelly
- Institute for Epidemiology & Health Care, UCL, London, United Kingdom
| |
Collapse
|
|
162
|
Niesen MJM, Murugadoss K, Lenehan PJ, Marchler-Bauer A, Wang J, Connor R, Brister JR, Venkatakrishnan AJ, Soundararajan V. Quantifying the immunological distinctiveness of emerging SARS-CoV-2 variants in the context of prior regional herd exposure. PNAS NEXUS 2022; 1:pgac105. [PMID: 35899067 PMCID: PMC9308564 DOI: 10.1093/pnasnexus/pgac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/29/2022] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic has seen the persistent emergence of immune-evasive SARS-CoV-2 variants under the selection pressure of natural and vaccination-acquired immunity. However, it is currently challenging to quantify how immunologically distinct a new variant is compared to all the prior variants to which a population has been exposed. Here, we define "Distinctiveness" of SARS-CoV-2 sequences based on a proteome-wide comparison with all prior sequences from the same geographical region. We observe a correlation between Distinctiveness relative to contemporary sequences and future change in prevalence of a newly circulating lineage (Pearson r = 0.75), suggesting that the Distinctiveness of emergent SARS-CoV-2 lineages is associated with their epidemiological fitness. We further show that the average Distinctiveness of sequences belonging to a lineage, relative to the Distinctiveness of other sequences that occur at the same place and time (n = 944 location/time data points), is predictive of future increases in prevalence (Area Under the Curve, AUC = 0.88 [95% confidence interval 0.86 to 0.90]). By assessing the Delta variant in India versus Brazil, we show that the same lineage can have different Distinctiveness-contributing positions in different geographical regions depending on the other variants that previously circulated in those regions. Finally, we find that positions that constitute epitopes contribute disproportionately (20-fold higher than the average position) to Distinctiveness. Overall, this study suggests that real-time assessment of new SARS-CoV-2 variants in the context of prior regional herd exposure via Distinctiveness can augment genomic surveillance efforts.
Collapse
Affiliation(s)
| | | | | | - Aron Marchler-Bauer
- National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA
| | - Jiyao Wang
- National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA
| | - Ryan Connor
- National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA
| | - J Rodney Brister
- National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD 20894, USA
| | | | | |
Collapse
|
|
163
|
Malhotra V, Oberoi S, Khaira R, Balgir RS, Kaur B, Kaura S. A Study to Assess Symptom Profile and Break Through Infections Among Health Care Workers Post Covid Vaccination at Tertiary Care Health Facility. Indian J Community Med 2022; 47:369-374. [PMID: 36438513 PMCID: PMC9693936 DOI: 10.4103/ijcm.ijcm_1105_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/09/2022] [Accepted: 03/07/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Breakthrough infections in fully vaccinated persons pose a major challenge to the ongoing vaccine campaign against SARS-CoV-2 globally. OBJECTIVES To investigate the occurrence of breakthrough infections and the association of Covid symptoms with the vaccination status of health care workers (HCWs). MATERIAL AND METHODS Done in Government Medical College, Patiala among Covid-positive HCWs who have received one or both doses of Covid vaccine, using pretested semi-structured validated Proforma and telephonic interview from April 1, 2021 to June 15, 2021. RESULTS Among 3388 HCWs, 115 vaccinated HCWs (1st or 2nd dose) became Covid positive. Among vaccinated Covid positive HCWs, 54 received the first dose and 61 both doses. Breakthrough infections (≥14 days post 2nd dose) occurred in 4.6% (47 of 1021) HCWs. The vaccine is significantly protective as shown by an odds ratio of 0.27; thus, vaccinated HCWs are 73% less likely to get Covid infection as compared to non-vaccinated HCWs. There was no statistically significant difference between symptom profiles of cases whether they took one or both doses of vaccine, except headache. Only tiredness and headache were reported significantly higher in the unvaccinated group in comparison to vaccinated HCWs. CONCLUSION Research is needed on tracking the immune response and viral genomic sequence of samples of vaccinated Covid-positive HCWs to have constant vigilance on remerging new strains of the SARS-CoV-2.
Collapse
Affiliation(s)
- Vishal Malhotra
- Community Medicine Department, Government Medical College, Patiala, Punjab, India
| | - Simmi Oberoi
- Community Medicine Department, Government Medical College, Patiala, Punjab, India
| | - Ravinder Khaira
- Community Medicine Department, Government Medical College, Patiala, Punjab, India
| | - Rajinder S. Balgir
- Community Medicine Department, Government Medical College, Patiala, Punjab, India
| | - Balpreet Kaur
- Community Medicine Department, Government Medical College, Patiala, Punjab, India
| | - Sakshi Kaura
- Department of Prosthodontics, Gian Sagar Dental College and Hospital, Patiala, Punjab, India
| |
Collapse
|
|
164
|
Poland CM, Ratishvili T, Poland GA. Distorted Human Decision-Making as a Critical Aspect of Pandemic Planning and Preparedness. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:281-292. [PMID: 35782478 PMCID: PMC9235264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The United States continues to experience lower than expected vaccination rates against COVID-19 due to a variety of barriers such as lack of trust, lack of planning, cultural perspectives and issues, suboptimal communication, and political/economic conflicts of interest. In this paper issues of human behavior and decision-making are highlighted as integral to understanding the generally poor US response to the SARS-CoV-2 pandemic. In particular, the US pandemic response was significantly distorted through a combination of cultural and human behavior issues related to conflicting leadership, cultural individualism, the prevalent idea of the democratization of expertise, and a false epistemological lens for decision-making. Including experts from multiple disciplines reveals how to address the human behavioral side of pandemic planning and operations to increase vaccine coverage rates. Including content experts from psychology and the social sciences allows the explicit recognition and preparation for distorted human behavior in planning for future pandemic response.
Collapse
Affiliation(s)
- Caroline M. Poland
- Poland and Associates Consulting, Indianapolis, IN, USA,To whom all correspondence should be addressed: Caroline M. Poland, MA, Poland
and Associates Consulting, 10401 N. Meridian St, Suite 450, Indianapolis, IN 46290;
; ORCID iD: https://orcid.org/0000-0002-5617-9543
| | - Tamar Ratishvili
- Mayo
Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, USA
| | | |
Collapse
|
|
165
|
Tallmadge RL, Laverack M, Cronk B, Venugopalan R, Martins M, Zhang X, Elvinger F, Plocharczyk E, Diel DG. Viral RNA Load and Infectivity of SARS-CoV-2 in Paired Respiratory and Oral Specimens from Symptomatic, Asymptomatic, or Postsymptomatic Individuals. Microbiol Spectr 2022; 10:e0226421. [PMID: 35575498 PMCID: PMC9241670 DOI: 10.1128/spectrum.02264-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 04/17/2022] [Indexed: 11/30/2022] Open
Abstract
In the present study, we assessed the diagnostic sensitivity and determined the viral RNA load and infectivity of SARS-CoV-2 in paired respiratory (nasopharyngeal and anterior nares) and oral samples (saliva and sublingual swab). Samples were collected from 77 individuals of which 75 were diagnosed with COVID-19 and classified as symptomatic (n = 29), asymptomatic (n = 31), or postsymptomatic (n = 15). Specimens were collected at one time point from each individual, between day 1 and 23 after the initial COVID-19 diagnosis, and included self-collected saliva (S), or sublingual (SL) swab, and bilateral anterior nares (AN) swab, followed by health care provider collected nasopharyngeal (NP) swab. Sixty-three specimen sets were tested using five assay/platforms. The diagnostic sensitivity of each assay/platform and specimen type was determined. Of the 63 specimen sets, SARS-CoV-2 was detected in 62 NP specimens, 52 AN specimens, 59 saliva specimens, and 31 SL specimens by at least one platform. Infectious SARS-CoV-2 was isolated from 21 NP, 13 AN, 12 saliva, and one SL specimen out of 50 specimen sets. SARS-CoV-2 isolation was most successful up to 5 days after initial COVID-19 diagnosis using NP specimens from symptomatic patients (16 of 24 positives, 66.67%), followed by specimens from asymptomatic patients (5 of 17 positives, 29.41%), while it was not very successful with specimens from postsymptomatic patients. Benefits of self-collected saliva and AN specimens balance the loss of sensitivity relative to NP specimens. Therefore, saliva and AN specimens are acceptable alternatives for symptomatic SARS-CoV-2 diagnostic testing or surveillance with increased sampling frequency of asymptomatic individuals. IMPORTANCE The dynamics of infection with SARS-CoV-2 have a significant impact on virus infectivity and in the diagnostic sensitivity of molecular and classic virus detection tests. In the present study we determined the diagnostic sensitivity of paired respiratory (nasopharyngeal and anterior nares swabs) and oral secretions (saliva and sublingual swab) and assessed infectious virus shedding patterns by symptomatic, asymptomatic, or postsymptomatic individuals. Understanding the diagnostic performance of these specimens and the patterns of infectious virus shedding in these bodily secretions provides critical information to control COVID-19, and may help to refine guidelines on isolation and quarantine of positive individuals and their close contacts identified through epidemiological investigations.
Collapse
Affiliation(s)
- Rebecca L. Tallmadge
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Melissa Laverack
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Brittany Cronk
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Roopa Venugopalan
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Mathias Martins
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - XiuLin Zhang
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - François Elvinger
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | | | - Diego G. Diel
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell COVID-19 Testing Laboratory, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| |
Collapse
|
|
166
|
Bansal D, Abdulmajeed J, Al-Shamali MHMA, Albayat SSA, Himatt SM, Cyprian FS, Chivese T, Mundodan JMA, Khogali HS, Baaboura R, Kaleeckal AH, Kandy MC, Latif AN, Al-Kuwari MG, Al-Romaihi HE, Al Khal A, Bertollini R, Al-Thani MH, Farag E, Doi SAR. Duration of COVID-19 mRNA Vaccine Effectiveness against Severe Disease. Vaccines (Basel) 2022; 10:vaccines10071036. [PMID: 35891199 PMCID: PMC9321581 DOI: 10.3390/vaccines10071036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023] Open
Abstract
Waning immunity following administration of mRNA-based COVID-19 vaccines remains a concern for many health systems. We undertook a study to determine if recent reports of waning for severe disease could have been attributed to design-related bias by conducting a study only among those detected with a first SARS-CoV-2 infection. We used a matched case-control study design with the study base being all individuals with first infection with SARS-CoV-2 reported in the State of Qatar between 1 January 2021 and 20 February 2022. Cases were those detected with first SARS-CoV-2 infection requiring intensive care (hard outcome), while controls were those detected with first SARS-CoV-2 infection who recovered without the need for intensive care. Cases and controls were matched in a 1:30 ratio for the calendar month of infection and the comorbidity category. Duration and magnitude of conditional vaccine effectiveness against requiring intensive care and the number needed to vaccinate (NNV) to prevent one more case of COVID-19 requiring intensive care was estimated for the mRNA (BNT162b2/mRNA-1273) vaccines. Conditional vaccine effectiveness against requiring intensive care was 59% (95% confidence interval (CI), 50 to 76) between the first and second dose, and strengthened to 89% (95% CI, 85 to 92) between the second dose and 4 months post the second dose in persons who received a primary course of the vaccine. There was no waning of vaccine effectiveness in the period from 4 to 6, 6 to 9, and 9 to 12 months after the second dose. This study demonstrates that, contrary to mainstream reports using hierarchical measures of effectiveness, conditional vaccine effectiveness against requiring intensive care remains robust till at least 12 months after the second dose of mRNA-based vaccines.
Collapse
Affiliation(s)
- Devendra Bansal
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Jazeel Abdulmajeed
- Primary Health Care Corporation, Al Mina Street, Doha 26555, Qatar; (J.A.); (M.C.K.); (M.G.A.-K.)
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, University Street, Doha 2713, Qatar;
| | - Maha H. M. A. Al-Shamali
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Soha S. A. Albayat
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Sayed M. Himatt
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Farhan S. Cyprian
- Immunology Division, Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Arab League Street, Doha 2713, Qatar;
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, University Street, Doha 2713, Qatar;
| | - Jesha M. A. Mundodan
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Hayat S. Khogali
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Rekayahouda Baaboura
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Anvar H. Kaleeckal
- Hamad Medical Corporation, Doha 3050, Qatar; (A.H.K.); (A.N.L.); (A.A.K.)
| | - Mujeeb C. Kandy
- Primary Health Care Corporation, Al Mina Street, Doha 26555, Qatar; (J.A.); (M.C.K.); (M.G.A.-K.)
| | - Ali Nizar Latif
- Hamad Medical Corporation, Doha 3050, Qatar; (A.H.K.); (A.N.L.); (A.A.K.)
| | - Mohamed Ghaith Al-Kuwari
- Primary Health Care Corporation, Al Mina Street, Doha 26555, Qatar; (J.A.); (M.C.K.); (M.G.A.-K.)
| | - Hamad Eid Al-Romaihi
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Abdullatif Al Khal
- Hamad Medical Corporation, Doha 3050, Qatar; (A.H.K.); (A.N.L.); (A.A.K.)
| | - Roberto Bertollini
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Mohamed Hamad Al-Thani
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Elmobashar Farag
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Suhail A. R. Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, University Street, Doha 2713, Qatar;
- Correspondence: ; Tel.: +974-6600-1271
| |
Collapse
|
|
167
|
Merrick E, Weissman JP, Patel SJ. Utilizing Google trends to monitor coronavirus vaccine interest and hesitancies. Vaccine 2022; 40:4057-4063. [PMID: 35660035 PMCID: PMC9149202 DOI: 10.1016/j.vaccine.2022.05.070] [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: 08/08/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022]
Abstract
Introduction Vaccine hesitancy remains a serious challenge for ending the coronavirus disease 2019 (COVID-19) pandemic. Digital media has played an immense role in the spread of information during the pandemic. One method to gauge public interest in COVID-19 related information is to examine patterns of online search queries. Methods Google Trends (GT) was used to analyze results for search terms relating to COVID-19 vaccine misinformation, information, and accessibility from October 1st, 2020 to May 27th, 2021. GT allows you to compare multiple queries at one time. The resultant relative search volumes (RSVs) range from 0 to 100. The search term and point in time on the graph that has the greatest search volume is given a score of 100 and all other terms and times are given values relative to that maximum. Search interest peaks were analyzed by subgroups (misinformation, information seeking, and access seeking) and across key time points throughout the pandemic. Results GT analysis revealed that search interest related to vaccine misinformation, general information, and access seeking changed in relation to events taking place throughout the pandemic. The most commonly searched terms in each subgroup were: “Covid vaccine infertility”, “Covid vaccine side effects”, and “Covid vaccine appointment”. Searches related to misinformation peaked in December 2020. Search terms in the general information category peaked in April 2021. RSVs for access seeking terms peaked in March 2021 and have decreased since April 2021. Conclusion Misinformation RSVs were highest after FDA authorization and have multiple repeated spikes after subsequent vaccine announcements. General information seeking terms peaked concurrently with increased vaccination uptake in the United States. Search interest has decreased with wider vaccine availability, despite many individuals in the United States remaining unvaccinated. GT can be used to monitor trends in public attitudes and misinformation regarding COVID-19 vaccines and further target education.
Collapse
Affiliation(s)
- Emily Merrick
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joshua P Weissman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sameer J Patel
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Infectious Diseases, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| |
Collapse
|
|
168
|
Fernández-Rivas G, Barallat J, Quirant-Sánchez B, González V, Doladé M, Martinez-Caceres E, Piña M, Matllo J, Blanco I, Cardona PJ. Follow up of the Humoral Response in Healthcare Workers after the Administration of Two Dose of the Anti SARS-CoV-2 Vaccines-Effectiveness in Delta Variant Breakthrough Infections. Viruses 2022; 14:v14071385. [PMID: 35891366 PMCID: PMC9315723 DOI: 10.3390/v14071385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 12/10/2022] Open
Abstract
The implementation of vaccination among healthcare workers (HCWs) allowed the management of the pandemic in a manner that differed from that in the first waves. It has been demonstrated that the mRNA vaccines elicit good humoral responses but that there are still breakthrough infections. In summer 2021, a fifth wave emerged, despite the good coverage of HCWs in Spain. We aimed to study the SARS-CoV-2 IgG antibody levels as a marker to predict the possibility of Delta variant infections after vaccination after a seroepidemiological campaign. Of the 5000 participants, a total of 4902 (98.04%) showed a positive result in the serological anti-S test and only 98 (1.96%) were negative. Among the 4368 fully vaccinated participants, only in five cases was the serology negative. Of the total number of participants that received antibody results during the study, 162 were PCR positive in the subsequent two months. Among these, 151 were fully vaccinated (two doses). Significant differences between antibody BAU/mL levels were found between PCR positive and non-PCR positive participants (p < 0.01). The median of BAU/mL was higher in those vaccinated patients with no infection (1260 BAU/mL; 465−2080) versus infected patients (661 BAU/mL; 361−2080). These data support the idea that vaccines play an important role in the control of the pandemic, especially among HCWs at the time of the Delta variant circulation. More studies with other variants of concern must be performed in order to establish a correlation between the levels of IgG and the new infections.
Collapse
Affiliation(s)
- Gema Fernández-Rivas
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (V.G.); (P.-J.C.)
- Department of Genetics and Microbiology, Autonomous University of Barcelona, 08916 Badalona, Spain
- Correspondence:
| | - Jaume Barallat
- Biochemistry Department, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (J.B.); (M.D.)
| | - Bibiana Quirant-Sánchez
- Immunology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (B.Q.-S.); (E.M.-C.)
| | - Victoria González
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (V.G.); (P.-J.C.)
- Center for Epidemiological Studies on Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome (HIV/AIDS) and Sexually Transmitted Infections (STI) of Catalonia (CEEISCAT), Generalitat de Catalunya, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red (CIBER) in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - María Doladé
- Biochemistry Department, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (J.B.); (M.D.)
| | - Eva Martinez-Caceres
- Immunology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (B.Q.-S.); (E.M.-C.)
| | - Monica Piña
- Department of Prevention and Risks, Primary Care Management, Northern Metropolitan Territorial Management, Catalan Health Institute, 08916 Badalona, Spain;
| | - Joan Matllo
- Department of Prevention and Risks, Germans Trias i Pujol University Hospital, Northern Metropolitan Territorial Management, Catalan Health Institute, 08916 Badalona, Spain;
| | - Ignacio Blanco
- Metropolitana Nord Laboratory, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain;
| | - Pere-Joan Cardona
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain; (V.G.); (P.-J.C.)
- Department of Genetics and Microbiology, Autonomous University of Barcelona, 08916 Badalona, Spain
| |
Collapse
|
|
169
|
Yang P, Yang Z, Zhao C, Li X, Shao Z, Liu K, Shang L. Vaccination and Government Stringent Control as Effective Strategies in Preventing SARS-CoV-2 Infections: A Global Perspective. Front Public Health 2022; 10:903511. [PMID: 35812484 PMCID: PMC9263831 DOI: 10.3389/fpubh.2022.903511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
With the rapid implementation of global vaccination against the coronavirus disease 2019 (COVID-19), the threat posed by the disease has been mitigated, yet it remains a major global public health concern. Few studies have estimated the effects of vaccination and government stringent control measures on the disease transmission from a global perspective. To address this, we collected 216 countries' data on COVID-19 daily reported cases, daily vaccinations, daily government stringency indexes (GSIs), and the human development index (HDI) from the dataset of the World Health Organization (WHO) and the Our World in Data COVID-19 (OWID). We utilized the interrupted time series (ITS) model to examine how the incidence was affected by the vaccination and GSI at continental and country levels from 22 January 2020 to 13 February 2022. We found that the effectiveness of vaccination was better in Europe, North America, and Africa than in Asia, South America, and Oceania. The long-term effects outperformed the short-term effects in most cases. Countries with a high HDI usually had a high vaccination coverage, resulting in better vaccination effects. Nonetheless, some countries with high vaccination coverage did not receive a relatively low incidence due to the weaker GSI. The results suggest that in addition to increasing population vaccination coverage, it is crucial to maintain a certain level of government stringent measures to prevent and control the disease. The strategy is particularly appropriate for countries with low vaccination coverage at present.
Collapse
Affiliation(s)
- Peng Yang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Zhe Yang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Chenxi Zhao
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
- School of Public Health, Baotou Medical College, Baotou, China
| | - Xinrui Li
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
- School of Medicine, Northwest University, Xi'an, China
| | - Zhongjun Shao
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
- Kun Liu
| | - Lei Shang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
- *Correspondence: Lei Shang
| |
Collapse
|
|
170
|
Korves C, Izurieta HS, Smith J, Zwain GM, Powell EI, Balajee A, Ryder KM, Young-Xu Y. Relative effectiveness of booster vs. 2-dose mRNA Covid-19 vaccination in the Veterans Health Administration: Self-controlled risk interval analysis. Vaccine 2022; 40:4742-4747. [PMID: 35773122 PMCID: PMC9212417 DOI: 10.1016/j.vaccine.2022.06.047] [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: 04/01/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Objective To estimate relative effectiveness of the booster mRNA Covid-19 vaccination versus the 2-dose primary series for both Delta and Omicron variants with self-controlled study design. Methods We used the Veterans Health Administration (VHA) Corporate Data Warehouse to identify U.S. Veterans who received the 2-dose primary mRNA Covid-19 vaccine series and a mRNA Covid-19 booster, and who had a positive SARS-CoV-2 test during the Delta (9/23/2021–11/30/2021) or Omicron (1/1/22–3/19/22) predominant period. Among them, we conducted a self-controlled risk interval (SCRI) analysis to compare odds of SARS-CoV-2 infection during a booster exposure interval versus a control interval. Exposures were a control interval (days 4–6 post-booster vaccination, presumably prior to gain of booster immunity), and booster exposure interval (days 14–16 post-booster vaccination, presumably following gain of booster immunity). Cases had a positive PCR or antigen SARS-CoV-2 test. Separately for Delta and Omicron periods, we used conditional logistic regression to calculate odds ratios (OR) of a positive test for the booster versus control interval and calculated relative effectiveness of booster versus 2-dose primary series as (1-OR)*100. The SCRI approach implicitly controlled for time-fixed confounders. Results We found 42 individuals with a positive SARS-CoV-2 test in the control interval and 14 in the booster exposure interval during the Delta period, and 141 and 70, respectively, in the Omicron period. For the booster versus 2-dose primary series, the odds of infection were 70% (95 %CI: 42%, 84%) lower during the Delta period and 54% (95 %CI: 38%, 66%) lower during Omicron. In sensitivity analyses among those with prior Covid-19 history, and age stratification, ORs were similar to the main analysis. Conclusions Booster vaccination was more effective relative to a 2-dose primary series during the Delta and Omicron predominant periods, and the relative effectiveness was consistent across age groups.
Collapse
Affiliation(s)
- Caroline Korves
- White River Junction Veterans Affairs Medical Center, White River Junction, VT USA.
| | - Hector S Izurieta
- Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, White Oak, MD USA.
| | - Jeremy Smith
- White River Junction Veterans Affairs Medical Center, White River Junction, VT USA.
| | - Gabrielle M Zwain
- White River Junction Veterans Affairs Medical Center, White River Junction, VT USA.
| | - Ethan I Powell
- White River Junction Veterans Affairs Medical Center, White River Junction, VT USA.
| | - Abirami Balajee
- White River Junction Veterans Affairs Medical Center, White River Junction, VT USA.
| | - Kathryn M Ryder
- Veterans Affairs Pacific Island Health Care, Honolulu, HI USA.
| | - Yinong Young-Xu
- White River Junction Veterans Affairs Medical Center, White River Junction, VT USA; Geisel School of Medicine at Dartmouth, Hanover, NH USA.
| |
Collapse
|
|
171
|
Noda H. A Macro-Level Association of Vaccination Rate with the Number of Confirmed COVID-19 Cases in the United States and Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127435. [PMID: 35742690 PMCID: PMC9223554 DOI: 10.3390/ijerph19127435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Aiming to evaluate a macro-level association of vaccination rate as well as booster vaccination rate with the number of confirmed COVID-19 cases in the United States and Japan, a cross-sectional study was conducted using data in each jurisdiction. Data on the total number of people who were fully vaccinated as of the end of December 2021, data on the total number of people who have received a booster dose as of the end of March 2022 and data on the cumulative number of confirmed COVID-19 cases were obtained from the website of the national governments. A generalized regression model was used to examine the association. This study showed that a higher vaccination rate was associated with a lower number of confirmed COVID-19 cases per year in 2021 for both the United States and Japan. The number of confirmed COVID-19 cases per 1000 population per year (95% confidence intervals) as a 1% increment of the vaccination rate was −0.74 (−1.29, −0.20), p = 0.007 for the United States and −1.48 (−1.95, −1.00), p < 0.0001 for Japan. A similar association was observed for the booster vaccination rate in 2022, although the association was attenuated in a multivariable model, particularly for the United States. This study provided macro-level evidence that vaccination may reduce the number of confirmed COVID-19 cases.
Collapse
Affiliation(s)
- Hiroyuki Noda
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan;
- Cabinet Secretariat, Tokyo 100-8968, Japan
| |
Collapse
|
|
172
|
Özüdoğru O, Bahçe YG, Acer Ö. SARS CoV-2 reinfection rate is higher in the Omicron variant than in the Alpha and Delta variants. Ir J Med Sci 2022; 192:751-756. [PMID: 35711013 PMCID: PMC9203229 DOI: 10.1007/s11845-022-03060-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/07/2022] [Indexed: 12/19/2022]
Abstract
Background and objectives Many mutations in variants for instance Delta and Alpha are associated with immune evasion and higher infectious potential. There are uncertainties regarding Omicron. In this regard, we aimed to compare the frequency of reinfection of SARS CoV-2 variants in our hospital between April 22, 2021 and January 26, 2022. Method The reinfection rates and demographic characteristics of a total of 27,487 COVID-19 patients infected with different SARS CoV-2 variants were examined. Results Reinfection was found in 26 (0.46%) of 5554 Alpha, 209 (1.16%) of 17,941 Delta, and 520 (13.0%) of 3992 Omicron variants. A statistically significant difference was observed between the reinfection rates of the variants (p = 0.000). The mean reinfection days were calculated as 204.4 ± 51.1 in the Alpha variant, 291.2 ± 58.2 in the Delta variant, and 361.2 ± 131.6 in the Omicron variant (p = 0.000). It was observed that 16.5% of reinfection cases caught COVID-19 for the second time 3–6 months after the first COVID-19 infection, 36.7% after 6–12 months, and 46.8% after more than 12 months. There was a significant difference between the times in reinfection cases. Most reinfections occurred more than 12 months apart. Among those with a reinfection time > 12 months, 0% had Alpha, 3.4% had Delta, and 96.6% had Omicron variants. Conclusion The highest reinfection rate was observed in the Omicron variant. Reinfection was approximately 30 times more frequent in the Omicron variant than in the Alpha variant and 10 times more frequent in the Delta variant.
Collapse
Affiliation(s)
- Osman Özüdoğru
- Department of Internal Medicine, Medical Faculty, Siirt University, Siirt, 56100, Turkey
| | - Yasemin Genç Bahçe
- Microbiology Laboratory, Siirt Training and Research Hospital, Siirt, 56100, Turkey
| | - Ömer Acer
- Department of Medical Microbiology, Medical Faculty, Siirt University, Siirt, 56100, Turkey.
| |
Collapse
|
|
173
|
Immune response to COVID-19 vaccination in a population with and without a previous SARS-CoV-2 infection. Ir J Med Sci 2022; 192:731-739. [PMID: 35676470 PMCID: PMC9177345 DOI: 10.1007/s11845-022-03044-4] [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: 04/20/2022] [Accepted: 06/01/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate IgG production in a group of vaccinated and unvaccinated subjects previously infected, or not, with SARS-CoV-2. METHODS A total of 316 subjects were enrolled at different times after vaccination and/or infection. IgG against target S1 subunit of the spike protein of SARS-COV-2 was assessed by a chemiluminescent microparticle immunoassay. Participant data was collected using a clinical-epidemiological survey. RESULTS A total of 56.2% (n = 146) of our cohort was vaccinated, with 27.5% (n = 36) reporting a previous infection. Of these, all were IgG positive at the time of the study, regardless of gender, age category, vaccine type, and elapsed time since vaccination. The vaccinated group without a previous infection (72.5%, n = 95) showed a slightly lower IgG seropositivity and median values, overall, although significantly higher in females and lower with the ChAdOx1 nCoV-19 (AstraZeneca) vaccine. Vaccinated subjects above the age of 65 showed a trend towards higher median IgG values (13,911.0 AU/mL), when previously infected with SARS-CoV-2, but comparatively lower IgG median value (5158.7 AU/mL) in its absence. In all vaccinated groups, IgG antibody production increased at 1-2 weeks, peaking at 4-6 weeks. Afterward, IgG decreased progressively but almost all subjects (97.7%, n = 128) were seropositive for the remainder of our study. Fully vaccinated individuals with a past infection showed a lower IgG rate of decrease versus their uninfected counterparts (17.9 vs 22.6%, respectively). CONCLUSION Our findings suggest a higher effect of vaccination on the production IgG antibodies, as opposed to natural infection. Nonetheless, in general, antibody titers waned rapidly.
Collapse
|
|
174
|
Puranik A, Lenehan PJ, O'Horo JC, Pawlowski C, Niesen MJM, Virk A, Swift MD, Kremers W, Venkatakrishnan AJ, Gordon JE, Geyer HL, Speicher LL, Soundararajan V, Badley AD. Durability analysis of the highly effective BNT162b2 vaccine against COVID-19. PNAS NEXUS 2022; 1:pgac082. [PMID: 35832867 PMCID: PMC9272171 DOI: 10.1093/pnasnexus/pgac082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/02/2022] [Indexed: 02/05/2023]
Abstract
COVID-19 vaccines are effective, but breakthrough infections have been increasingly reported. We conducted a test-negative case-control study to assess the durability of protection after full vaccination with BNT162b2 against polymerase chain reaction (PCR)-confirmed symptomatic SARS-CoV-2 infection, in a national medical practice from January 2021 through January 2022. We fit conditional logistic regression (CLR) models stratified on residential county and calendar time of testing to assess the association between time elapsed since vaccination and the odds of symptomatic infection or non-COVID-19 hospitalization (negative control), adjusted for several covariates. There were 5,985 symptomatic individuals with a positive test after full vaccination with BNT162b2 (cases) and 32,728 negative tests contributed by 27,753 symptomatic individuals after full vaccination (controls). The adjusted odds of symptomatic infection were higher 250 days after full vaccination versus at the date of full vaccination (Odds Ratio [OR]: 3.62, 95% CI: 2.52 to 5.20). The odds of infection were still lower 285 days after the first BNT162b2 dose as compared to 4 days after the first dose (OR: 0.50, 95% CI: 0.37 to 0.67), when immune protection approximates the unvaccinated status. Low rates of COVID-19 associated hospitalization or death in this cohort precluded analyses of these severe outcomes. The odds of non-COVID-19 associated hospitalization (negative control) decreased with time since vaccination, suggesting a possible underestimation of waning protection by this approach due to confounding factors. In summary, BNT162b2 strongly protected against symptomatic SARS-CoV-2 infection for at least 8 months after full vaccination, but the degree of protection waned significantly over this period.
Collapse
Affiliation(s)
| | | | | | | | | | - Abinash Virk
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Melanie D Swift
- Division of Aerospace, Occupational and Preventive Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Walter Kremers
- Division of Biomedical Statistics, Mayo Clinic, Rochester, MN 55902, USA
| | | | - Joel E Gordon
- Department of Family Medicine, Mayo Clinic Health System, Mankato, MN 56001, USA
| | - Holly L Geyer
- Division of Hospital Internal Medicine, Mayo Clinic, Scottsdale, AZ 85259, USA
| | | | | | - Andrew D Badley
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA,Department of Molecular Medicine, Mayo Clinic, Rochester, MN 55902, USA
| |
Collapse
|
|
175
|
Mravčík V, Kumpanová Valachovičová S, Vobořil J. Declining neutralizing antibody levels after SARS-CoV-2 mRNA vaccination: observational data from community point-of-care testing service in Brno, Czechia. Cent Eur J Public Health 2022; 30:111-118. [PMID: 35876600 DOI: 10.21101/cejph.a7230] [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: 10/07/2021] [Accepted: 05/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Understanding immune response is critical for control of COVID-19 pandemic. However, recent studies show that vaccine-induced humoral immunity may not be long-lasting and weaker in SARS-CoV-2 variants of concern. METHODS In May 2021, 253 self-nominated persons were tested for antibodies against SARS-CoV-2 in 1 to 104 days (mean 41, median 28) after two doses of Moderna and Pfizer-BioNTech vaccines in the city of Brno, Czechia. Two point-of-care iCHROMA™ II immunofluorescence assays were used: COVID-19 Ab against mix of SARS-CoV-2 nucleocapsid and spike proteins (IgG Ab); and COVID-19 nAb against S1-RBD protein (nAb). Results were analysed in relation to gender, age, vaccine, and past COVID-19 disease. RESULTS Antibodies nAb were detectable in 92.9% (95% CI: 89.7-96.0) of vaccinees. We observed statistically insignificant decrease of positive results from 93.9% (95% CI: 89.5-98.3) and 97.0% (95% CI: 92.8-100.0) in the first and second month after vaccination, respectively, to 91.7% (95% CI: 83.8-99.5) and 78.3% (95% CI: 61.4-95.1) in the third and fourth month, respectively. Quantitative results showed decreasing level of nAb in both genders, age groups and vaccines. Higher levels of nAb were found in younger age group and in COVID-19 convalescents. IgG Ab showed little dynamics in time. CONCLUSIONS We found robust humoral response after vaccination with mRNA vaccines, however, decreasing nAb levels suggest that vaccine-induced humoral immunity is rapidly waning. This finding is relevant for adjustment of vaccination strategies with regard to inclusion of booster dose(s).
Collapse
Affiliation(s)
- Viktor Mravčík
- Spolecnost Podane ruce, Brno, Czech Republic.,Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | | | | |
Collapse
|
|
176
|
Gächter M, Huber F, Meier M. A shot for the US economy. FINANCE RESEARCH LETTERS 2022; 47:102638. [PMID: 35013671 PMCID: PMC8734056 DOI: 10.1016/j.frl.2021.102638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
While previous literature examines the effects of increasing COVID-19 incidences and fatality rates on economic activity, the impact of vaccination roll-outs on public health and the economy is not yet well understood. We examine the effect of a vaccination shock in the United States on various pandemic and economic indicators. By employing a BVAR model to overcome the short data sample, we show that an increase in vaccinations is not only associated with declining incidences, reproduction and fatality rates, but also increases mobility, which dampens the effect on public health indicators in the medium term. With respect to the economy, a vaccination shock is associated with lower unemployment, higher GDP growth and also reduces uncertainty in financial markets.
Collapse
Affiliation(s)
- Martin Gächter
- Liechtenstein Financial Market Authority, Liechtenstein
- University of Innsbruck, Austria
| | | | - Martin Meier
- Liechtenstein Financial Market Authority, Liechtenstein
- University of Salzburg, Austria
| |
Collapse
|
|
177
|
Goh FT, Chew YZ, Tam CC, Yung CF, Clapham H. A country-specific model of COVID-19 vaccination coverage needed for herd immunity in adult only or population wide vaccination programme. Epidemics 2022; 39:100581. [PMID: 35636311 PMCID: PMC9119722 DOI: 10.1016/j.epidem.2022.100581] [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: 06/11/2021] [Revised: 01/06/2022] [Accepted: 05/16/2022] [Indexed: 01/31/2023] Open
Abstract
We present a country specific method to calculate the COVID-19 vaccination coverage needed for herd immunity by considering age structure, age group-specific contact patterns, relative infectivity and susceptibility of children to adults, vaccination effectiveness and seroprevalence prior to vaccination. We find that across all six countries, vaccination of adults age 60 and above has little impact on Reff and this is could be due to the smaller number of contacts between this age group and the rest of the population according to the contact matrices used. If R0 is above 6, herd immunity by vaccine alone is unattainable for most countries either if vaccination is only available for adults or that vaccine effectiveness is lower at 65% against symptomatic infections. In this situation, additional control measures, booster shots, if they improve protection against infection, or the extension of vaccination to children, are required. For a highly transmissible variant with R0 up to 8, herd immunity is possible for all countries and for all four scenarios of varying relative infectivity and susceptibility of children compared to adults, if vaccine effectiveness is very high at 95% against symptomatic infections and that high vaccination coverage is achieved for both adults and children. In addition, we show that the effective reproduction number will vary between countries even if the same proportion of the population is vaccinated, depending on the demographics, the contact rates and the previous pre-vaccination seroprevalence in the country. This therefore means that care must be taken in extrapolating population level impacts of certain vaccine coverages from one country to another.
Collapse
Affiliation(s)
- Fang Ting Goh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yi Zhen Chew
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Clarence C. Tam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chee Fu Yung
- Infectious Disease Service, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore, Singapore,Lee Kong Chian School of Medicine, Imperial College, Nanyang Technological University, Singapore
| | - Hannah Clapham
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore,Correspondence to: Saw Swee Hock School of Public Health, Tahir Foundation Building (MD1), 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| |
Collapse
|
|
178
|
Coburn SB, Humes E, Lang R, Stewart C, Hogan BC, Gebo KA, Napravnik S, Edwards JK, Browne LE, Park LS, Justice AC, Gordon KS, Horberg MA, Certa JM, Watson E, Jefferson CR, Silverberg MJ, Skarbinski J, Leyden WA, Williams CF, Althoff KN. Analysis of Postvaccination Breakthrough COVID-19 Infections Among Adults With HIV in the United States. JAMA Netw Open 2022; 5:e2215934. [PMID: 35671054 PMCID: PMC9175076 DOI: 10.1001/jamanetworkopen.2022.15934] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/21/2022] [Indexed: 02/02/2023] Open
Abstract
Importance Recommendations for additional doses of COVID-19 vaccines for people with HIV (PWH) are restricted to those with advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk after vaccination among PWH is essential for informing vaccination guidelines. Objective To estimate the rate and risk of breakthrough infections among fully vaccinated PWH and people without HIV (PWoH) in the United States. Design, Setting, and Participants This cohort study used the Corona-Infectious-Virus Epidemiology Team (CIVET)-II (of the North American AIDS Cohort Collaboration on Research and Design [NA-ACCORD], which is part of the International Epidemiology Databases to Evaluate AIDS [IeDEA]), collaboration of 4 prospective, electronic health record-based cohorts from integrated health systems and academic health centers. Adult PWH who were fully vaccinated prior to June 30, 2021, were matched with PWoH on date of full vaccination, age, race and ethnicity, and sex and followed up through December 31, 2021. Exposures HIV infection. Main Outcomes and Measures COVID-19 breakthrough infections, defined as laboratory evidence of SARS-CoV-2 infection or COVID-19 diagnosis after a patient was fully vaccinated. Results Among 113 994 patients (33 029 PWH and 80 965 PWoH), most were 55 years or older (80 017 [70%]) and male (104 967 [92%]); 47 098 (41%) were non-Hispanic Black, and 43 218 (38%) were non-Hispanic White. The rate of breakthrough infections was higher in PWH vs PWoH (55 [95% CI, 52-58] cases per 1000 person-years vs 43 [95% CI, 42-45] cases per 1000 person-years). Cumulative incidence of breakthroughs 9 months after full vaccination was low (3.8% [95% CI, 3.7%-3.9%]), albeit higher in PWH vs PWoH (4.4% vs 3.5%; log-rank P < .001; risk difference, 0.9% [95% CI, 0.6%-1.2%]) and within each vaccine type. Breakthrough infection risk was 28% higher in PWH vs PWoH (adjusted hazard ratio, 1.28 [95% CI, 1.19-1.37]). Among PWH, younger age (<45 y vs 45-54 y), history of COVID-19, and not receiving an additional dose (aHR, 0.71 [95% CI, 0.58-0.88]) were associated with increased risk of breakthrough infections. There was no association of breakthrough with HIV viral load suppression, but high CD4 count (ie, ≥500 cells/mm3) was associated with fewer breakthroughs among PWH. Conclusions and Relevance In this study, COVID-19 vaccination, especially with an additional dose, was effective against infection with SARS-CoV-2 strains circulating through December 31, 2021. PWH had an increased risk of breakthrough infections compared with PWoH. Expansion of recommendations for additional vaccine doses to all PWH should be considered.
Collapse
Affiliation(s)
- Sally B. Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth Humes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Raynell Lang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Cameron Stewart
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Brenna C. Hogan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kelly A. Gebo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sonia Napravnik
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Jessie K. Edwards
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Lindsay E. Browne
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill
| | - Lesley S. Park
- Stanford Center for Population Health Sciences, Palo Alto, California
| | - Amy C. Justice
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven
| | - Kirsha S. Gordon
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven
| | - Michael A. Horberg
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Julia M. Certa
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Eric Watson
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | - Celeena R. Jefferson
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, Maryland
| | | | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland
- Department of Infectious Diseases, Oakland Medical Center, Oakland, California
| | - Wendy A. Leyden
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Carolyn F. Williams
- Epidemiology Branch, Division of AIDS at National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
|
179
|
Mostafa HH, Luo CH, Morris CP, Li M, Swanson NJ, Amadi A, Gallagher N, Pekosz A. SARS-CoV-2 infections in mRNA vaccinated individuals are biased for viruses encoding spike E484K and associated with reduced infectious virus loads that correlate with respiratory antiviral IgG levels. J Clin Virol 2022; 150-151:105151. [PMID: 35398602 PMCID: PMC8979609 DOI: 10.1016/j.jcv.2022.105151] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/12/2022] [Accepted: 03/31/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION COVID-19 large scale immunization in the US has been associated with breakthrough positive molecular testing. In this study, we investigated whether a positive test is associated with a high anti-viral IgG, specific viral variant, recovery of infectious virus, or symptomatic infection during an early phase after vaccination rollout. METHODS We identified 133 SARS-CoV-2 positive patients who had received two doses of either Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccines, the 2nd of which was received between January and April of 2021. The positive samples were collected between January and May of 2021. Samples were sequenced to characterize the whole genome and Spike protein changes and cycle thresholds that reflect viral loads were determined using a single molecular assay. Respiratory SARS-CoV-2 IgG antibodies were examined using ELISA and specimens were grown on cell culture to assess the recovery of infectious virus as compared to a control unvaccinated cohort. RESULTS Of 133 specimens, 24 failed sequencing and yielded a negative or very low viral load on the repeat PCR. Of 109 specimens that were used for further genome analysis, 68 (62.4%) were from symptomatic infections, 11 (10.1%) were admitted for COVID-19, and 2 (1.8%) required ICU admission with no associated mortality. The predominant virus variant was the Alpha (B.1.1.7), however a significant association between lineage B.1.526 and amino acid change S: E484K with positives after vaccination was noted. A significant reduction of the recovery of infectious virus on cell culture was accompanied by an increase in localized IgG levels in respiratory samples of vaccinated individuals. CONCLUSIONS Vaccination reduces the recovery of infectious virus in breakthrough infections caused primarily by the Alpha variant accompanied by an increase in upper respiratory tract IgG levels.
Collapse
Affiliation(s)
- Heba H Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA.
| | - Chun Huai Luo
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA
| | - C Paul Morris
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA; National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas J Swanson
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adannaya Amadi
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA
| | - Nicholas Gallagher
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, 600 N. Wolfe St, Meyer B-121F, Baltimore, MD, 21287 USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Emergency Medicine, Johns Hopkins School of Medicine, 615 North Wolfe Street, rm W2116, Baltimore, MD, 21205-2103 USA.
| |
Collapse
|
|
180
|
Pugh J, Savulescu J, Brown RCH, Wilkinson D. The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity. JOURNAL OF MEDICAL ETHICS 2022; 48:371-377. [PMID: 35256487 PMCID: PMC9132858 DOI: 10.1136/medethics-2021-107956] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/17/2022] [Indexed: 05/07/2023]
Abstract
COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausible claims about natural immunity: (1) natural immunity is superior to 'artificial' vaccine-induced immunity simply because it is 'natural' and (2) it is better to acquire immunity through natural infection than via vaccination. We then briefly survey the evidence base for the comparison between naturally acquired immunity and vaccine-induced immunity. While we clearly cannot settle the scientific debates on this point, we suggest that we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity. Subjecting them to vaccine mandates is therefore not justified. We conclude by defending the standard of proof that this argument from necessity invokes, and address other pragmatic and practical considerations that may speak against natural immunity exemptions.
Collapse
Affiliation(s)
- Jonathan Pugh
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Julian Savulescu
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Rebecca C H Brown
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Dominic Wilkinson
- The Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Newborn Care, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
|
181
|
Abstract
This paper simulates the spread of COVID-19 at universities via airborne transmission in classroom settings. The transmission risk model used for these simulations accounts for student-specific class schedules, classroom sizes and occupancy, and ventilation rates, as well as vaccination rate and efficacy. We show the simulations reproduce trends observed in weekly infection rates at a large US university. We also evaluate the impact of campus operational policies. Model predictions show moving 90% of classes online can reduce new infections by as much as 18×, and universal mask usage can reduce new infections by up to 3.6×. For full-time in-person instruction, high vaccination rates are predicted to curb transmission even for more contagious variants of severe acute respiratory syndrome coronavirus 2. We study the airborne transmission risk associated with holding in-person classes on university campuses for the original strain and a more contagious variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We adopt a model for airborne transmission risk in an enclosed room that considers room properties, mask efficiency, and initial infection probability of the occupants. Additionally, we study the effect of vaccination on the spread of the virus. The presented model has been evaluated in simulations using fall 2019 (prepandemic) and fall 2020 (hybrid instruction) course registration data of a large US university, allowing for assessing the difference in transmission risk between in-person and hybrid programs and the impact of occupancy reduction, mask-wearing, and vaccination. The simulations indicate that without vaccination, moving 90% of the classes online leads to a 17 to 18× reduction in new cases, and universal mask usage results in an ∼2.7 to 3.6× reduction in new infections through classroom interactions. Furthermore, the results indicate that for the original variant and using vaccines with efficacy greater than 90%, at least 23% (64%) of students need to be vaccinated with (without) mask usage in order to operate the university at full occupancy while preventing an increase in cases due to classroom interactions. For the more contagious variant, even with universal mask usage, at least 93% of the students need to be vaccinated to ensure the same conditions. We show that the model is able to predict trends observed in weekly infection rates for fall 2021.
Collapse
|
|
182
|
Zeng B, Gao L, Zhou Q, Yu K, Sun F. Effectiveness of COVID-19 vaccines against SARS-CoV-2 variants of concern: a systematic review and meta-analysis. BMC Med 2022; 20:200. [PMID: 35606843 PMCID: PMC9126103 DOI: 10.1186/s12916-022-02397-y] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND It was urgent and necessary to synthesize the evidence for vaccine effectiveness (VE) against SARS-CoV-2 variants of concern (VOC). We conducted a systematic review and meta-analysis to provide a comprehensive overview of the effectiveness profile of COVID-19 vaccines against VOC. METHODS Published randomized controlled trials (RCTs), cohort studies, and case-control studies that evaluated the VE against VOC (Alpha, Beta, Gamma, Delta, or Omicron) were searched until 4 March 2022. Pooled estimates and 95% confidence intervals (CIs) were calculated using random-effects meta-analysis. VE was defined as (1-estimate). RESULTS Eleven RCTs (161,388 participants), 20 cohort studies (52,782,321 participants), and 26 case-control studies (2,584,732 cases) were included. Eleven COVID-19 vaccines (mRNA-1273, BNT162b2, ChAdOx1, Ad26.COV2.S, NVX-CoV2373, BBV152, CoronaVac, BBIBP-CorV, SCB-2019, CVnCoV, and HB02) were included in this analysis. Full vaccination was effective against Alpha, Beta, Gamma, Delta, and Omicron variants, with VE of 88.0% (95% CI, 83.0-91.5), 73.0% (95% CI, 64.3-79.5), 63.0% (95% CI, 47.9-73.7), 77.8% (95% CI, 72.7-82.0), and 55.9% (95% CI, 40.9-67.0), respectively. Booster vaccination was more effective against Delta and Omicron variants, with VE of 95.5% (95% CI, 94.2-96.5) and 80.8% (95% CI, 58.6-91.1), respectively. mRNA vaccines (mRNA-1273/BNT162b2) seemed to have higher VE against VOC over others; significant interactions (pinteraction < 0.10) were observed between VE and vaccine type (mRNA vaccines vs. not mRNA vaccines). CONCLUSIONS Full vaccination of COVID-19 vaccines is highly effective against Alpha variant, and moderate effective against Beta, Gamma, and Delta variants. Booster vaccination is more effective against Delta and Omicron variants. mRNA vaccines seem to have higher VE against Alpha, Beta, Gamma, and Delta variants over others.
Collapse
Affiliation(s)
- Baoqi Zeng
- Department of Science and Education, Peking University Binhai Hospital, Tianjin, China
| | - Le Gao
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Qingxin Zhou
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Kai Yu
- Department of Science and Education, Peking University Binhai Hospital, Tianjin, China.
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China.
| |
Collapse
|
|
183
|
Qin S, Tang X, Chen Y, Chen K, Fan N, Xiao W, Zheng Q, Li G, Teng Y, Wu M, Song X. mRNA-based therapeutics: powerful and versatile tools to combat diseases. Signal Transduct Target Ther 2022; 7:166. [PMID: 35597779 PMCID: PMC9123296 DOI: 10.1038/s41392-022-01007-w] [Citation(s) in RCA: 153] [Impact Index Per Article: 76.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 02/06/2023] Open
Abstract
The therapeutic use of messenger RNA (mRNA) has fueled great hope to combat a wide range of incurable diseases. Recent rapid advances in biotechnology and molecular medicine have enabled the production of almost any functional protein/peptide in the human body by introducing mRNA as a vaccine or therapeutic agent. This represents a rising precision medicine field with great promise for preventing and treating many intractable or genetic diseases. In addition, in vitro transcribed mRNA has achieved programmed production, which is more effective, faster in design and production, as well as more flexible and cost-effective than conventional approaches that may offer. Based on these extraordinary advantages, mRNA vaccines have the characteristics of the swiftest response to large-scale outbreaks of infectious diseases, such as the currently devastating pandemic COVID-19. It has always been the scientists’ desire to improve the stability, immunogenicity, translation efficiency, and delivery system to achieve efficient and safe delivery of mRNA. Excitingly, these scientific dreams have gradually been realized with the rapid, amazing achievements of molecular biology, RNA technology, vaccinology, and nanotechnology. In this review, we comprehensively describe mRNA-based therapeutics, including their principles, manufacture, application, effects, and shortcomings. We also highlight the importance of mRNA optimization and delivery systems in successful mRNA therapeutics and discuss the key challenges and opportunities in developing these tools into powerful and versatile tools to combat many genetic, infectious, cancer, and other refractory diseases.
Collapse
Affiliation(s)
- Shugang Qin
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoshan Tang
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuting Chen
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kepan Chen
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Na Fan
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Xiao
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Zheng
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Guohong Li
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuqing Teng
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Min Wu
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, 58203, USA
| | - Xiangrong Song
- Department of Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
|
184
|
Akkız H. The Biological Functions and Clinical Significance of SARS-CoV-2 Variants of Corcern. Front Med (Lausanne) 2022; 9:849217. [PMID: 35669924 PMCID: PMC9163346 DOI: 10.3389/fmed.2022.849217] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/04/2022] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuing to evolve, emerging novel variants with spike protein mutations. Although most mutations emerged in the SARS-CoV-2 genome are neutral or mildly deleterious, a small number of mutations can affect virus phenotype that confers the virus a fitness advantage. These mutations can enhance viral replication, raise the risk of reinfection and blunt the potency of neutralizing antibodies triggered by previous infection and vaccination. Since December 2020, the SARS-CoV-2 has emerged five quickly spreading strains, designated variants of concern (VOCs), including the Alpha (B.1.1.7) variant, the Beta (B.1.351) variant, the Gamma (P.1) variant, the Delta (B.1.617.2) variant and the Omicron (B.1.1.529) variant. These variants have a high number of the mutations in the spike protein that promotes viral cell entry through the angiotensin-converting enzyme -2 (ACE2). Mutations that have arisen in the receptor binding domain (RBD) of the spike protein are of great concern due to their potential to evade neutralizing antibodies triggered by previous infection and vaccines. The Alpha variant emerged in the United Kingdom in the second half of 2020 that has spread quickly globally and acquired the E484K mutation in the United Kingdom and the United States. The Beta and Gamma variants emerged in South Africa and Brazil, respectively, that have additional mutations at positions E484 and K417 in the RBD. SARS-CoV-2 variants containing the combination of N501Y, E484K, and K417N/T mutations exhibit remarkably decreased sensitivity to neutralizing antibodies mediated by vaccination or previous infection. The Gamma variant may result in more severe disease than other variants do even in convalescent individuals. The Delta variant emerged in India in December 2020 and has spread to many countries including the United States and the United Kingdom. The Delta variant has 8 mutations in the spike protein, some of which can influence immune responses to the key antigenic regions of RBD. In early November 2021, the Omicron (B.1.1.529) variant was first detected in Botswana and South Africa. The Omicron variant harbors more than 30 mutations in the spike protein, many of which are located within the RBD, which have been associated with increased transmissibility and immune evasion after previous infection and vaccination. Additionally, the Omicron variant contains 3 deletions and one insertion in the spike protein. Recently, the Omicron variant has been classified into three sublineages, including BA.1, BA.2, and BA.3, with strikingly different genetic characteristics. The Omicron BA.2 sublineage has different virological landscapes, such as transmissibility, pathogenicity and resistance to the vaccine-induced immunity compared to BA.1 and BA.3 sublineages. Mutations emerged in the RBD of the spike protein of VOCs increase viral replication, making the virus more infectious and more transmissible and enable the virus to evade vaccine-elicited neutralizing antibodies. Unfortunately, the emergence of novel SARS-CoV-2 VOCs has tempered early optimism regarding the efficacy of COVID-19 vaccines. This review addresses the biological and clinical significance of SARS-CoV-2 VOCs and their impact on neutralizing antibodies mediated by existing COVID-19 vaccines.
Collapse
Affiliation(s)
- Hikmet Akkız
- Department of Gastroenterology and Hepatology, The University of Çukurova, Adana, Turkey
| |
Collapse
|
|
185
|
Puranik A, Lenehan PJ, O'Horo JC, Pawlowski C, Virk A, Swift MD, Kremers W, Venkatakrishnan AJ, Challener DW, Breeher L, Gordon JE, Geyer HL, Speicher LL, Soundararajan V, Badley AD. Durability analysis of the highly effective mRNA-1273 vaccine against COVID-19. PNAS NEXUS 2022; 1:pgac058. [PMID: 36713311 PMCID: PMC9802296 DOI: 10.1093/pnasnexus/pgac058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/17/2022] [Indexed: 02/01/2023]
Abstract
COVID-19 vaccines are effective, but breakthrough infections have been increasingly reported. We conducted a test-negative case-control study to assess the durability of protection against symptomatic infection after vaccination with mRNA-1273. We fit conditional logistic regression (CLR) models stratified on residential county and calendar date of SARS-CoV-2 PCR testing to assess the association between the time elapsed since vaccination and the odds of symptomatic infection, adjusted for several covariates. There were 2,364 symptomatic individuals who had a positive SARS-CoV-2 PCR test after full vaccination with mRNA-1273 ("cases") and 12,949 symptomatic individuals who contributed 15,087 negative tests after full vaccination ("controls"). The odds of symptomatic infection were significantly higher 250 days after full vaccination compared to the date of full vaccination (Odds Ratio [OR]: 2.47, 95% confidence interval [CI]: 1.19-5.13). The odds of non-COVID-19 associated hospitalization and non-COVID-19 pneumonia (negative control outcomes) remained relatively stable over the same time interval (Day 250 ORNon-COVID Hospitalization: 0.68, 95% CI: 0.47-1.0; Day 250 ORNon-COVID Pneumonia: 1.11, 95% CI: 0.24-5.2). The odds of symptomatic infection remained significantly lower almost 300 days after the first mRNA-1273 dose as compared to 4 days after the first dose, when immune protection approximates the unvaccinated state (OR: 0.26, 95% CI: 0.17-0.39). Low rates of COVID-19 associated hospitalization or death in this cohort precluded analyses of these severe outcomes. In summary, mRNA-1273 robustly protected against symptomatic SARS-CoV-2 infection at least 8 months after full vaccination, but the degree of protection waned over this time period.
Collapse
Affiliation(s)
| | | | | | | | - Abinash Virk
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Melanie D Swift
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Walter Kremers
- Division of Biomedical Statistics, Mayo Clinic, Rochester, MN 55902, USA
| | | | - Doug W Challener
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Laura Breeher
- Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Joel E Gordon
- Department of Family Medicine, Mayo Clinic Health System, Mankato, MN 56001, USA
| | - Holly L Geyer
- Division of Hospital Internal Medicine, Mayo Clinic, Scottsdale, AZ 85259, USA
| | | | | | - Andrew D Badley
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA,Department of Molecular Medicine, Mayo Clinic, Rochester, MN 55902, USA
| |
Collapse
|
|
186
|
Singh BK, Walker J, Paul P, Reddy S, Gowler CD, Jernigan J, Slayton RB. De-escalation of asymptomatic testing and potential of future COVID-19 outbreaks in US nursing homes amidst rising community vaccination coverage: A modeling study. Vaccine 2022; 40:3165-3173. [PMID: 35487811 PMCID: PMC9013672 DOI: 10.1016/j.vaccine.2022.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/09/2022]
Abstract
As of 2 September 2021, United States nursing homes have reported >675,000 COVID-19 cases and >134,000 deaths according to the Centers for Medicare & Medicaid Services (CMS). More than 205,000,000 persons in the United States had received at least one dose of a COVID-19 vaccine (62% of total population) as of 2 September 2021. We investigate the role of vaccination in controlling future COVID-19 outbreaks. We developed a stochastic, compartmental model of SARS-CoV-2 transmission in a 100-bed nursing home with a staff of 99 healthcare personnel (HCP) in a community of 20,000 people. We parameterized admission and discharge of residents in the model with CMS data, for a within-facility basic reproduction number (R0) of 3.5 and a community R0 of 2.5. The model also included: importation of COVID-19 from the community, isolation of SARS-CoV-2 positive residents, facility-wide adherence to personal protective equipment (PPE) use by HCP, and testing. We systematically varied coverage of mRNA vaccine among residents, HCP, and the community. Simulations were run for 6 months after the second dose in the facility, with results summarized over 1,000 simulations. Expected resident cases decreased as community vaccination increased, with large reductions at high HCP coverage. The probability of a COVID-19 outbreak was lower as well: at HCP vaccination coverage of 60%, probability of an outbreak was below 20% for community coverage of 50% or above. At high coverage, stopping asymptomatic screening and facility-wide testing yielded similar results. Results suggest that high coverage among HCP and in the community can prevent infections in residents. When vaccination is high in nursing homes, but not in their surrounding communities, asymptomatic and facility-wide testing remains necessary to prevent the spread of COVID-19. High adherence to PPE may increase the likelihood of containing future COVID-19 outbreaks if they occur.
Collapse
Affiliation(s)
- Brajendra K Singh
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Joseph Walker
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Prabasaj Paul
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Sujan Reddy
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Camden D Gowler
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - John Jernigan
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Rachel B Slayton
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| |
Collapse
|
|
187
|
Iwamoto M, Ukimura A, Ogawa T, Kawanishi F, Osaka N, Kubota M, Mori T, Sawamura R, Nishihara M, Suzuki T, Uchiyama K. Association between history of HBV vaccine response and anti-SARS-CoV-2 spike antibody response to the BioNTech/Pfizer's BNT162b2 mRNA SARS-CoV-2 vaccine among healthcare workers in Japan: A prospective observational study. PLoS One 2022; 17:e0268529. [PMID: 35576209 PMCID: PMC9109930 DOI: 10.1371/journal.pone.0268529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/02/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Inadequate vaccine response is a common concern among healthcare workers at the frontlines of the COVID-19 pandemic. We aimed to investigate if healthcare workers with history of weak immune response to HBV vaccination are more likely to have weak responses against the BioNTech/Pfizer's BNT162b2 mRNA SARS-CoV-2 vaccine. METHODS We prospectively tested 954 healthcare workers for the Anti-SARS-CoV-2 spike (S) protein antibody titers prior to the first and second BNT162b2 vaccination doses and after four weeks after the second dose using Roche's Elecsys® assay. We calculated the percentage of patients who seroconverted after the first and second doses. We estimated the relative risk of non-seroconversion after the first BNT162b2 vaccine (defined as anti-SARS-CoV-2-S titer <15 U/mL) among HBV vaccine non-responders (HBs-Ab titer <10 mIU/mL) and weak responders (≥10 and <100 mIU/mL) compared to normal responders (≥100 mIU/mL). RESULTS Among 954 healthcare workers recruited between March 9 and March 24, 2021 at Osaka Medical and Pharmaceutical University, weak and normal HBV vaccine responders had comparable S-protein titers after the first BNT162b2 dose (51.4 [95% confidence interval 25.2-137.0] versus 59.7 [29.8-138.0] U/mL, respectively). HBV vaccine non-responders were more likely than normal responders to not seroconvert after a single dose (age and sex-adjusted relative risk 1.85 95% confidence interval [1.10-3.13]) although nearly all participants seroconverted after the second dose. After limiting the analysis to 382 patients with baseline comorbidity data, the comorbidity-adjusted relative risk of non-seroconversion among HBV vaccine non-responders to normal responders was 1.32 (95% confidence interval [0.59-2.98]). DISCUSSION Long term follow-up studies are needed to understand if protective immunity against SARS-CoV-2 wanes faster among those with history of HBV vaccine non-response and when booster doses are warranted for these healthcare workers.
Collapse
Affiliation(s)
- Momoko Iwamoto
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Nakagyo Ward, Japan
| | - Akira Ukimura
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Taku Ogawa
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Fumiko Kawanishi
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Naofumi Osaka
- Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Mari Kubota
- Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Tatsuhiko Mori
- Health Administration Center Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Ritsuko Sawamura
- Health Administration Center Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Masami Nishihara
- Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Tomio Suzuki
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Kazuhisa Uchiyama
- Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| |
Collapse
|
|
188
|
Windsor IW, Tong P, Lavidor O, Sanjari Moghaddam A, McKay LGA, Gautam A, Chen Y, MacDonald EA, Yoo DK, Griffiths A, Wesemann DR, Harrison SC. Antibodies induced by ancestral SARS-CoV-2 strain that cross-neutralize variants from Alpha to Omicron BA.1. Sci Immunol 2022; 7:eabo3425. [PMID: 35536154 PMCID: PMC9097876 DOI: 10.1126/sciimmunol.abo3425] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Neutralizing antibodies that recognize the SARS-CoV-2 spike glycoprotein are the principal host defense against viral invasion. Variants of SARS-CoV-2 bear mutations that allow escape from neutralization by many antibodies, especially those belonging to classes widely distributed in the human population. Identifying antibodies that neutralize these variants of concern and determining their prevalence are important goals for understanding immune protection. To determine the Delta- and Omicron BA.1-variant specificity of B cell repertoires established by an initial Wuhan strain infection, we measured neutralization potencies of 73 antibodies from an unbiased survey of the early memory B cell response. Antibodies recognizing each of three, previously defined, epitopic regions on the spike receptor-binding domain (RBD) varied in neutralization potency and variant-escape resistance. The ACE2 binding surface (“RBD-2”) harbored the binding sites of the neutralizing antibodies with highest potency but with the greatest sensitivity to viral escape; two other epitopic regions on the RBD (“RBD-1 and “RBD-3”) bound antibodies of more modest potency but greater breadth. The structures of several Fab:spike complexes that neutralized all five variants of concern tested, including one Fab each from the RBD-1, -2 and -3 clusters, illustrated the determinants of broad neutralization and showed that B cell repertoires can have specificities that avoid immune escape driven by widely distributed (“public”) antibodies. The structure of the RBD-2-binding, broad neutralizer shows why it retains neutralizing activity for Omicron BA.1, unlike most others in the same public class. Our results correlate with real-world data on vaccine efficacy, which indicate mitigation of disease caused by Omicron BA.1.
Collapse
Affiliation(s)
- Ian W Windsor
- Boston Children's Hospital, Boston, MA 02115, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA.,Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Pei Tong
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Olivia Lavidor
- Boston Children's Hospital, Boston, MA 02115, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - Ali Sanjari Moghaddam
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Lindsay G A McKay
- Department of Microbiology, Boston University School of Medicine, Boston, MA 02115.,National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115
| | - Avneesh Gautam
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Yuezhou Chen
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Elizabeth A MacDonald
- Boston Children's Hospital, Boston, MA 02115, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - Duck Kyun Yoo
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Anthony Griffiths
- Department of Microbiology, Boston University School of Medicine, Boston, MA 02115.,National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115.,Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA
| | - Duane R Wesemann
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.,Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA
| | - Stephen C Harrison
- Boston Children's Hospital, Boston, MA 02115, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA.,Howard Hughes Medical Institute, Boston, MA 02115, USA
| |
Collapse
|
|
189
|
Wang R, Wang J, Hu T, Zhou XH. Population-Level Effectiveness of COVID-19 Vaccination Program in the United States: Causal Analysis Based on Structural Nested Mean Model. Vaccines (Basel) 2022; 10:vaccines10050726. [PMID: 35632481 PMCID: PMC9144931 DOI: 10.3390/vaccines10050726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/04/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
Though COVID-19 vaccines have shown high efficacy, real-world effectiveness at the population level remains unclear. Based on the longitudinal data on vaccination coverage and daily infection cases from fifty states in the United States from March to May 2021, causal analyses were conducted using structural nested mean models to estimate the population-level effectiveness of the COVID-19 vaccination program against infection with the original strain. We found that in the US, every 1% increase of vaccination coverage rate reduced the weekly growth rate of COVID-19 confirmed cases by 1.02% (95% CI: 0.26%, 1.69%), and the estimated population-level effectiveness of the COVID-19 program was 63.9% (95% CI: 18.0%, 87.5%). In comparison to a no-vaccination scenario, the COVID-19 vaccination campaign averted 8.05 million infections through the study period. Scenario analyses show that a vaccination program with doubled vaccination speed or with more rapid vaccination speed at the early stages of the campaign would avert more infections and increase vaccine effectiveness. The COVID-19 vaccination program demonstrated a high population-level effectiveness and significantly reduced the disease burden in the US. Accelerating vaccine rollout, especially at an early stage of the campaign, is crucial for reducing COVID-19 infections.
Collapse
Affiliation(s)
- Rui Wang
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (R.W.); (T.H.)
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing 100191, China;
- China Center for Health Development Studies, Peking University, Beijing 100191, China
| | - Taojun Hu
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (R.W.); (T.H.)
| | - Xiao-Hua Zhou
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (R.W.); (T.H.)
- Beijing International Center for Mathematical Research, Peking University, Beijing 100871, China
- Correspondence:
| |
Collapse
|
|
190
|
Li M, Wang H, Tian L, Pang Z, Yang Q, Huang T, Fan J, Song L, Tong Y, Fan H. COVID-19 vaccine development: milestones, lessons and prospects. Signal Transduct Target Ther 2022; 7:146. [PMID: 35504917 PMCID: PMC9062866 DOI: 10.1038/s41392-022-00996-y] [Citation(s) in RCA: 127] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 12/15/2022] Open
Abstract
With the constantly mutating of SARS-CoV-2 and the emergence of Variants of Concern (VOC), the implementation of vaccination is critically important. Existing SARS-CoV-2 vaccines mainly include inactivated, live attenuated, viral vector, protein subunit, RNA, DNA, and virus-like particle (VLP) vaccines. Viral vector vaccines, protein subunit vaccines, and mRNA vaccines may induce additional cellular or humoral immune regulations, including Th cell responses and germinal center responses, and form relevant memory cells, greatly improving their efficiency. However, some viral vector or mRNA vaccines may be associated with complications like thrombocytopenia and myocarditis, raising concerns about the safety of these COVID-19 vaccines. Here, we systemically assess the safety and efficacy of COVID-19 vaccines, including the possible complications and different effects on pregnant women, the elderly, people with immune diseases and acquired immunodeficiency syndrome (AIDS), transplant recipients, and cancer patients. Based on the current analysis, governments and relevant agencies are recommended to continue to advance the vaccine immunization process. Simultaneously, special attention should be paid to the health status of the vaccines, timely treatment of complications, vaccine development, and ensuring the lives and health of patients. In addition, available measures such as mix-and-match vaccination, developing new vaccines like nanoparticle vaccines, and optimizing immune adjuvant to improve vaccine safety and efficacy could be considered.
Collapse
Affiliation(s)
- Maochen Li
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Han Wang
- Laboratory for Clinical Immunology, Harbin Children's Hospital, Harbin, China
| | - Lili Tian
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Zehan Pang
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Qingkun Yang
- College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing, China
| | - Tianqi Huang
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Junfen Fan
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Lihua Song
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China.
| | - Yigang Tong
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China. .,Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China.
| | - Huahao Fan
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China.
| |
Collapse
|
|
191
|
Tenforde MW, Patel MM, Ginde AA, Douin DJ, Talbot HK, Casey JD, Mohr NM, Zepeski A, Gaglani M, McNeal T, Ghamande S, Shapiro NI, Gibbs KW, Files DC, Hager DN, Shehu A, Prekker ME, Erickson HL, Exline MC, Gong MN, Mohamed A, Henning DJ, Peltan ID, Brown SM, Martin ET, Monto AS, Khan A, Hough CT, Busse L, ten Lohuis CC, Duggal A, Wilson JG, Gordon AJ, Qadir N, Chang SY, Mallow C, Gershengorn HB, Babcock HM, Kwon JH, Halasa N, Chappell JD, Lauring AS, Grijalva CG, Rice TW, Jones ID, Stubblefield WB, Baughman A, Womack KN, Lindsell CJ, Hart KW, Zhu Y, Olson SM, Stephenson M, Schrag SJ, Kobayashi M, Verani JR, Self WH. Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States. Clin Infect Dis 2022; 74:1515-1524. [PMID: 34358310 PMCID: PMC8436392 DOI: 10.1093/cid/ciab687] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people at increased risk for poor outcomes. METHODS In a multicenter case-control analysis of US adults hospitalized March 11-May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2. RESULTS Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7-91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.4%; 95% CI, 79.3-9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI,20.8-82.6) than without immunosuppression (91.3%; 95% CI, 85.6-94.8). CONCLUSION During March-May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population.
Collapse
Affiliation(s)
| | | | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - David J Douin
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado
| | - H Keipp Talbot
- Department of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan D Casey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nicholas M Mohr
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa
| | - Anne Zepeski
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa
| | - Manjusha Gaglani
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Tresa McNeal
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Shekhar Ghamande
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - D Clark Files
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Arber Shehu
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew E Prekker
- Department of Emergency Medicine and Medicine, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Heidi L Erickson
- Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Matthew C Exline
- Department of Medicine, The Ohio State University, Columbus, Ohio
| | - Michelle N Gong
- Department of Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York
| | - Amira Mohamed
- Department of Medicine, Montefiore Medical Center, Bronx, New York
| | - Daniel J Henning
- Department of Emergency Medicine, University of Washington, Seattle, Washington
| | - Ithan D Peltan
- Department of Medicine, Baystate Medical Center, Springfield, Massachusetts
| | - Samuel M Brown
- Department of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah
| | - Emily T Martin
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Arnold S Monto
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Akram Khan
- Department of Medicine, Oregon Health and Sciences University, Portland, Oregon
| | - C Terri Hough
- Department of Medicine, Oregon Health and Sciences University, Portland, Oregon
| | - Laurence Busse
- Department of Medicine, Emory University, Atlanta, Georgia
| | | | - Abhijit Duggal
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Jennifer G Wilson
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Alexandra June Gordon
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Nida Qadir
- Department of Medicine, University of California-Los Angeles, Los Angeles, California
| | - Steven Y Chang
- Department of Medicine, University of California-Los Angeles, Los Angeles, California
| | | | | | - Hilary M Babcock
- Department of Medicine, Washington University, St. Louis, Missouri
| | - Jennie H Kwon
- Department of Medicine, Washington University, St. Louis, Missouri
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Adam S Lauring
- Department of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Todd W Rice
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ian D Jones
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Kimberly W Hart
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yuwei Zhu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | | | | | | | - Wesley H Self
- Department of Emergency Medicine and Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | | |
Collapse
|
|
192
|
Zeng S, Pelzer KM, Gibbons RD, Peek ME, Parker WF. Association of Zip Code Vaccination Rate With COVID-19 Mortality in Chicago, Illinois. JAMA Netw Open 2022; 5:e2214753. [PMID: 35622360 PMCID: PMC9142872 DOI: 10.1001/jamanetworkopen.2022.14753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 04/13/2022] [Indexed: 11/14/2022] Open
Abstract
Importance There has been large geographic inequity in vaccination coverage across Chicago, Illinois, with higher vaccination rates in zip codes with residents who predominantly have high incomes and are White. Objective To determine the association between inequitable zip code-level vaccination coverage and COVID-19 mortality in Chicago. Design, Setting, and Participants This retrospective cohort study used Chicago Department of Public Health vaccination and mortality data and Cook County Medical Examiner mortality data from March 1, 2020, through November 6, 2021, to assess the association of COVID-19 mortality with zip code-level vaccination rates. Data were analyzed from June 1, 2021, to April 13, 2022. Exposures Zip code-level first-dose vaccination rates before the Alpha and Delta waves of COVID-19. Main Outcomes and Measures The primary outcome was deaths from COVID-19 during the Alpha and Delta waves. The association of a marginal increase in zip code-level vaccination rate with weekly mortality rates was estimated with a mixed-effects Poisson regression model, and the total number of preventable deaths in the least vaccinated quartile of zip codes was estimated with a linear difference-in-difference design. Results The study population was 2 686 355 Chicago residents in 52 zip codes (median [IQR] age 34 [32-38] years; 1 378 658 [51%] women; 773 938 Hispanic residents [29%]; 783 916 non-Hispanic Black residents [29%]; 894 555 non-Hispanic White residents [33%]). Among residents in the least vaccinated quartile, 80% were non-Hispanic Black, compared with 8% of residents identifying as non-Hispanic Black in the most vaccinated quartile (P < .001). After controlling for age distribution and recovery from COVID-19, a 10-percentage point increase in zip code-level vaccination 6 weeks before the peak of the Alpha wave was associated with a 39% lower relative risk of death from COVID-19 (incidence rate ratio [IRR], 0.61 [95% CI, 0.52-0.72]). A 10-percentage point increase in zip code vaccination rate 6 weeks before the peak of the Delta wave was associated with a 24% lower relative risk of death (IRR, 0.76 [95% CI, 0.66-0.87]). The difference-in-difference estimate was that 119 Alpha wave deaths (72% [95% CI, 63%-81%]) and 108 Delta wave deaths (75% [95% CI, 66%-84%]) might have been prevented in the least vaccinated quartile of zip codes if it had had the vaccination coverage of the most vaccinated quartile. Conclusions and Relevance These findings suggest that low zip code-level vaccination rates in Chicago were associated with more deaths during the Alpha and Delta waves of COVID-19 and that inequitable vaccination coverage exacerbated existing racial and ethnic disparities in COVID-19 deaths.
Collapse
Affiliation(s)
- Sharon Zeng
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Kenley M. Pelzer
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Robert D. Gibbons
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Monica E. Peek
- Department of Medicine, University of Chicago, Chicago, Illinois
- Division of the Biological Sciences, University of Chicago, Chicago, Illinois
| | - William F. Parker
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
- MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois
| |
Collapse
|
|
193
|
Markewitz R, Pauli D, Dargvainiene J, Steinhagen K, Engel S, Herbst V, Zapf D, Krüger C, Sharifzadeh S, Schomburg B, Leypoldt F, Rupp J, Görg S, Junker R, Wandinger KP. The temporal course of T- and B-cell responses to vaccination with BNT162b2 and mRNA-1273. Clin Microbiol Infect 2022; 28:701-709. [PMID: 34547457 PMCID: PMC8450229 DOI: 10.1016/j.cmi.2021.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the response of the immune system (and its influencing factors) to vaccination with BNT162b2 or mRNA-1273. METHODS 531 vaccinees, recruited from healthcare professionals, donated samples before, in between, and after the administration of the two doses of the vaccine. T- and B-cell responses were examined via interferon-γ (IFN-γ) release assay, and antibodies against different epitopes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (S1 and NCP) were detected via ELISA and surrogate neutralization assay. Results were correlated with influencing factors such as age, sex, prior infection, vaccine received (BNT162b2 or mRNA-1273), and immunosuppression. Furthermore, antinuclear antibodies (ANAs) were measured to screen for autoimmune responses following vaccination with an mRNA vaccine. RESULTS No markers of immunity against SARS-CoV-2 were found before the first vaccination. Two weeks after it, specific responses against SARS-CoV-2 were already measurable (median ± median absolute deviation (MAD): anti-S1 IgG 195.5 ± 172.7 BAU/mL; IgA 6.7 ± 4.9 OD; surrogate neutralization 39 ± 23.7%), and were significantly increased two weeks after the second dose (anti-S1 IgG 3744 ± 2571.4 BAU/mL; IgA 12 ± 0 OD; surrogate neutralization 100 ± 0%, IFN-γ 1897.2 ± 886.7 mIU/mL). Responses were stronger for younger participants (this difference decreasing after the second dose). Further influences were previous infection with SARS-CoV-2 (causing significantly stronger responses after the first dose compared to unexposed individuals (p ≤ 0.0001)) and the vaccine received (significantly stronger reactions for recipients of mRNA-1273 after both doses, p < 0.05-0.0001). Some forms of immunosuppression significantly impeded the immune response to the vaccination (with no observable immune response in three immunosuppressed participants). There was no significant induction of ANAs by the vaccination (no change in qualitative ANA results (p 0.2592) nor ANA titres (p 0.08) from pre-to post-vaccination. CONCLUSIONS Both vaccines elicit strong and specific immune responses against SARS-CoV-2 which become detectable one week (T-cell response) or two weeks (B-cell response) after the first dose.
Collapse
Affiliation(s)
- Robert Markewitz
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany.
| | - Daniela Pauli
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Katja Steinhagen
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Sarah Engel
- Department of Anesthesiology and Intensive Care, University Hospital of Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Victor Herbst
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Dorinja Zapf
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Christina Krüger
- Institute for Experimental Immunology, EUROIMMUN AG, Lübeck, Germany
| | - Shahpour Sharifzadeh
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Benjamin Schomburg
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany; Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck, Lübeck, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Ralf Junker
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Klaus-Peter Wandinger
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
|
194
|
Alharbi NK, Al-Tawfiq JA, Alghnam S, Alwehaibe A, Alasmari A, Alsagaby SA, Alsubaie F, Alshomrani M, Farahat FM, Bosaeed M, Alharbi A, Aldibasi O, Assiri AM. Outcomes of single dose COVID-19 vaccines: Eight month follow-up of a large cohort in Saudi Arabia. J Infect Public Health 2022; 15:573-577. [PMID: 35472755 PMCID: PMC8986276 DOI: 10.1016/j.jiph.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2022] [Accepted: 04/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Two vaccines for COVID-19 have been approved and administered in the Kingdom of Saudi Arabia (KSA); Pfizer-BioNtech BNT162b2 and AstraZeneca-Oxford AZD1222 vaccines. The purpose of this study was to describe the real-world data on the outcome of single dose of these COVID-19 vaccines in a large cohort in KSA and to analyse demographics and co-morbidities as risk factors for infection post one-dose vaccination. METHODS In this prospective cohort study, a total of 18,543 subjects received one dose of either of the vaccines at a vaccination centre in KSA, and were followed up for three to eight months. Data were collected from three sources; clinical data from medical records, adverse events (AEs) from a self-reporting system, and COVID-19 infection data from the national databases. The study was conducted during the pandemic restrictions on travel, mobility, and social interactions. RESULTS The median age of participants was 33 years with an average body mass index of 27.3. The majority were males (60.1%). Results showed that 92.17% of the subjects had no COVID-19 infection post-vaccination as infection post-vaccination was documented for 1452 (7.83%). Diabetes mellitus 03), organ transplantation (p = 0.02), and obesity (p < 0.01) were associated with infection post-vaccination. Unlike vaccine type, being Saudi, male, or obese was associated with the occurrence breakthrough infections more than other parameters. AEs included injection site pain, fatigue, fever, myalgia, headache and was reported by 5.8% of the subjects. CONCLUSION Single dose COVID-19 vaccines showed a protection rate of 92.17% up to eight months follow-up in this cohort. This rate in AZD1222 was higher than what have been previously reported in effectiveness studies and clinical trials. Obese, male, and Saudi were at higher risk of contracting the infection post-vaccination, Saudi and male might have more social interaction with the public when mobility and social interactions were limited during the pandemic. Side effects and AEs were within what has been reported in clinical trials.
Collapse
Affiliation(s)
- Naif Khalaf Alharbi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia.
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Suliman Alghnam
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Amal Alwehaibe
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Abrar Alasmari
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Suliman A Alsagaby
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Faisal Alsubaie
- Assistant Agency for Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Majid Alshomrani
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia; King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Fayssal M Farahat
- King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia; King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Mohammad Bosaeed
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia; King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Ahmad Alharbi
- King Abdulaziz Medical City (KAMC), Ministry of National Guard - Health Affairs (MNG-HA), Riyadh, Saudi Arabia
| | - Omar Aldibasi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Abdullah M Assiri
- Assistant Agency for Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| |
Collapse
|
|
195
|
McLaughlin JM, Khan F, Pugh S, Swerdlow DL, Jodar L. County-level vaccination coverage and rates of COVID-19 cases and deaths in the United States: An ecological analysis. LANCET REGIONAL HEALTH. AMERICAS 2022; 9:100191. [PMID: 35128511 PMCID: PMC8802692 DOI: 10.1016/j.lana.2022.100191] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background On Dec 14, 2020, the United States initiated a nationwide COVID-19 vaccination campaign. Demonstrating clear population-level impact following vaccine introduction helps to further elucidate and quantify the public-health benefits of vaccination. Methods Using a negative binomial regression model we evaluated the ecological association between county-level COVID-19 vaccine uptake and rates of COVID-19 cases and deaths in the United States from April 1, 2021 through October 31, 2021 controlling for a broad set of county-level environmental, sociodemographic, economic, and health-status-related characteristics. County-level data were obtained from several publicly available databases that were merged for analysis. Findings After adjustment for county-level characteristics, US counties with ≥ 80% of their residents ≥ 12 years of age fully vaccinated against COVID-19 had 30% (95% CI: 25−35; P < .001) and 46% (38−52; P < .001) lower rates of COVID-19 cases and deaths, respectively, versus those with <50% coverage (reference group). A dose response was observed: counties with 70−79% uptake had 20% (95% CI: 16−24; P < .001) and 35% (29−40; P < .001) lower rates of cases and deaths, respectively; counties with 60−69% uptake had 8% (5−11; P < .001) and 20% (15−24; P < .001) lower rates; and counties with 50−59% uptake had 2% (0−4; P =.09) and 8% (4−12; P < .001) lower rates. Restricting the analysis to the period when the Delta variant was predominant (June 1, 2021 ‒ October 31, 2021) showed similar findings. Interpretation Our results showed that US counties with higher proportions of persons ≥ 12 years of age fully vaccinated against COVID-19 had substantially lower rates of COVID-19 cases and deaths—a finding that showed dose response and persisted even in the period when Delta was predominant. Funding Pfizer.
Collapse
Affiliation(s)
| | - Farid Khan
- Pfizer Vaccines, 500 Arcola Rd., Collegeville, PA, USA
| | - Sarah Pugh
- Pfizer Vaccines, 500 Arcola Rd., Collegeville, PA, USA
| | | | - Luis Jodar
- Pfizer Vaccines, 500 Arcola Rd., Collegeville, PA, USA
| |
Collapse
|
|
196
|
Tartof SY, Slezak JM, Puzniak L, Hong V, Frankland TB, Ackerson BK, Takhar HS, Ogun OA, Simmons SR, Zamparo JM, Gray S, Valluri SR, Pan K, Jodar L, McLaughlin JM. Effectiveness of a third dose of BNT162b2 mRNA COVID-19 vaccine in a large US health system: A retrospective cohort study. LANCET REGIONAL HEALTH. AMERICAS 2022; 9:100198. [PMID: 35187521 PMCID: PMC8841530 DOI: 10.1016/j.lana.2022.100198] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Globally, recommendations are expanding for third (booster) doses of BNT162b2 (Pfizer-BioNTech). In the United States, as of November 19, 2021, boosters were recommended for all adults aged 18 years and older. We evaluated the effectiveness of a third dose of BNT162b2 among adults in a large US integrated health system. Methods In this retrospective cohort study, we analyzed electronic health records from Kaiser Permanente Southern California between Dec 14, 2020 and Dec 5, 2021 to assess vaccine effectiveness (VE) of two and three doses of BNT162b2 against SARS-CoV-2 infections (without hospital admission) andCOVID-19-related hospital admission. VE was calculated using hazards ratios from adjusted Cox models. Findings After only two doses, VE against infection declined from 85% (95% CI 83-86) during the first month to 49% (46-51) ≥ 7 months following vaccination. Overall VE against hospitalization was 90% (95% CI 86-92) within one month and did not wane, however, effectiveness against hospitalization appeared to wane among immunocompromised individuals but was not statistically significant (93% [72-98] at 1 month to 74% [45-88] after ≥ 7 months; p=0·490). Three-dose VE (median follow-up 1·3 months [SD 0·6]) was 88% (95% CI 86-89) against infection and 97% (95-98) against hospitalization. Effectiveness after three doses was higher than that seen one month after receiving only two doses for both outcomes. Relative VE of three doses compared to two (with at least six months after the second dose) was 75% (95% CI 71-78) against infections and 70% (48-83) against hospital admissions. Interpretation These data support the benefit of broad BNT162b2 booster recommendations, as three doses confers comparable, if not better, protection against SARS-CoV-2 infections and hospital admission as was seen soon after receiving two doses. Funding Pfizer Inc.
Collapse
Affiliation(s)
- Sara Y. Tartof
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Corresponding author at: Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA.
| | - Jeff M. Slezak
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | | | - Vennis Hong
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | | | | | - Harpreet S. Takhar
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | - Oluwaseye A. Ogun
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | - Sarah R. Simmons
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | | | | | | | | | | | | |
Collapse
|
|
197
|
Abstract
RNA-based gene therapy requires therapeutic RNA to function inside target cells without eliciting unwanted immune responses. RNA can be ferried into cells using non-viral drug delivery systems, which circumvent the limitations of viral delivery vectors. Here, we review the growing number of RNA therapeutic classes, their molecular mechanisms of action, and the design considerations for their respective delivery platforms. We describe polymer-based, lipid-based, and conjugate-based drug delivery systems, differentiating between those that passively and those that actively target specific cell types. Finally, we describe the path from preclinical drug delivery research to clinical approval, highlighting opportunities to improve the efficiency with which new drug delivery systems are discovered.
Collapse
Affiliation(s)
- Kalina Paunovska
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA
| | - David Loughrey
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA
| | - James E Dahlman
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA.
| |
Collapse
|
|
198
|
The Effect of Waning on Antibody Levels and Memory B Cell Recall following SARS-CoV-2 Infection or Vaccination. Vaccines (Basel) 2022; 10:vaccines10050696. [PMID: 35632452 PMCID: PMC9143792 DOI: 10.3390/vaccines10050696] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
In order to longitudinally track SARS-CoV-2 antibody levels after vaccination or infection, we assessed anti-RBD antibody levels in over 1000 people and found no significant decrease in antibody levels during the first 14 months after infection in unvaccinated participants, however, a significant waning of antibody levels was observed following vaccination. Participants who were pre-immune to SARS-CoV-2 prior to vaccination seroconverted to higher antibody levels, which were maintained at higher levels than in previously infected, unvaccinated participants. Older participants exhibited lower level of antibodies after vaccination, but a higher level after infection than younger people. The rate of antibody waning was not affected by pre-immunity or age. Participants who received a third dose of an mRNA vaccine not only increased their antibody levels ~14-fold, but also had ~3 times more antibodies compared to when they received their primary vaccine series. PBMC-derived memory B cells from 13 participants who lost all circulating antibodies were differentiated into antibody secreting cells (ASCs). There was a significant recall of memory B cell ASCs in the absence of serum antibodies in 5–8 of the 10 vaccinated participants, but not in any of the 3 infected participants, suggesting a strong connection between antibody levels and the effectiveness of memory B cell recall.
Collapse
|
|
199
|
Andrejko KL, Pry J, Myers JF, Jewell NP, Openshaw J, Watt J, Jain S, Lewnard JA. Prevention of Coronavirus Disease 2019 (COVID-19) by mRNA-Based Vaccines Within the General Population of California. Clin Infect Dis 2022; 74:1382-1389. [PMID: 34282839 PMCID: PMC8406879 DOI: 10.1093/cid/ciab640] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Estimates of coronavirus disease 2019 (COVID-19) vaccine effectiveness under real-world conditions, and understanding of barriers to uptake, are necessary to inform vaccine rollout. METHODS We enrolled cases (testing positive) and controls (testing negative) from among the population whose SARS-CoV-2 molecular diagnostic test results from 24 February to 29 April 2021 were reported to the California Department of Public Health. Participants were matched on age, sex, and geographic region. We assessed participants' self-reported history of mRNA-based COVID-19 vaccine receipt (BNT162b2 and mRNA-1273). Participants were considered fully vaccinated 2 weeks after second dose receipt. Among unvaccinated participants, we assessed willingness to receive vaccination. We measured vaccine effectiveness (VE) via the matched odds ratio of prior vaccination, comparing cases with controls. RESULTS We enrolled 1023 eligible participants aged ≥18 years. Among 525 cases, 71 (13.5%) received BNT162b2 or mRNA-1273; 20 (3.8%) were fully vaccinated with either product. Among 498 controls, 185 (37.1%) received BNT162b2 or mRNA-1273; 86 (16.3%) were fully vaccinated with either product. Two weeks after second dose receipt, VE was 87.0% (95% confidence interval: 68.6-94.6%) and 86.2% (68.4-93.9%) for BNT162b2 and mRNA-1273, respectively. Fully vaccinated participants receiving either product experienced 91.3% (79.3-96.3%) and 68.3% (27.9-85.7%) VE against symptomatic and asymptomatic infection, respectively. Among unvaccinated participants, 42.4% (159/375) residing in rural regions and 23.8% (67/281) residing in urban regions reported hesitancy to receive COVID-19 vaccination. CONCLUSIONS Authorized mRNA-based vaccines are effective at reducing documented SARS-CoV-2 infections within the general population of California. Vaccine hesitancy presents a barrier to reaching coverage levels needed for herd immunity.
Collapse
Affiliation(s)
- Kristin L Andrejko
- Division of Epidemiology and Biostatistics, School of Public Health, University of California at Berkeley, Berkeley, California, USA
| | - Jake Pry
- California Department of Public Health, Richmond, California, USA
| | - Jennifer F Myers
- California Department of Public Health, Richmond, California, USA
| | - Nicholas P Jewell
- Division of Epidemiology and Biostatistics, School of Public Health, University of California at Berkeley, Berkeley, California, USA
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - John Openshaw
- California Department of Public Health, Richmond, California, USA
| | - James Watt
- California Department of Public Health, Richmond, California, USA
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA
| | - Joseph A Lewnard
- Division of Epidemiology and Biostatistics, School of Public Health, University of California at Berkeley, Berkeley, California, USA
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California at Berkeley, Berkeley, California, USA
- Center for Computational Biology, College of Engineering, University of California at Berkeley, Berkeley, California, USA
| |
Collapse
|
|
200
|
Ekowo OE, Manafa C, Isielu RC, Okoli CM, Chikodi I, Onwuasoanya AF, Echendu ST, Ihedoro I, Nwabueze UD, Nwoke OC. A cross-sectional regional study looking at the factors responsible for the low COVID-19 vaccination rate in Nigeria. Pan Afr Med J 2022; 41:114. [PMID: 35465378 PMCID: PMC8994467 DOI: 10.11604/pamj.2022.41.114.30767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/31/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction COVID-19 vaccination has been rolled out in Nigeria, with low uptake often attributed to shortage of the vaccine. We set out to find out the current trend so far and to the best of our knowledge, our study is one of the early studies since the roll out in the region looking at the real situation on ground. This will guide multidisciplinary decision making at increasing uptake of the vaccine. Methods this is a descriptive cross-sectional study in the 5 South-Eastern States in Nigeria. A structured questionnaire was given to the members of the public to answer themselves or via the help of an interviewer. Data was analysed in SPSS and associations between variables compared using Chi square. Results there are 1283 respondents in this study. Of this number, only 105 (8.2%) have had at least one of the vaccine doses. Stated reasons for not having been vaccinated are side effects (n=370, 31.5%), access to a vaccination centre (n= 239, 20.4%) and belief in one’s own immunity 186 (15.5). Having a health-related degree (p-value of 0.021), non-governmental employees (p-value of 0.003), private sector employees (p-value of 0.029) and public sector employees (p-value of 0.009) are associated with relatively higher vaccination rates. Conclusion vaccination rate in Nigeria is still very low. Fear of side effect which is enhanced by mystical thinking is the leading factor for low turnout not just shortages. All forms of employed jobs, age and higher qualification all have significant p-values (p<0.05) and associated with higher uptake of the vaccine.
Collapse
Affiliation(s)
| | - Chibuzo Manafa
- Royal Stoke University Hospitals, Stoke-on-Trent, England
| | | | - Chinedu Michael Okoli
- Department of Medical Laboratory Science, Alex Ekweme Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Ibe Chikodi
- Department of Family Medicine, Federal Medical Centre, Owerri, Nigeria
| | - Azuka Favour Onwuasoanya
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - Sylvia Tochukwu Echendu
- Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Uchenna Dean Nwabueze
- Department of Accident and Emergency, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | |
Collapse
|