COVID-19 vaccines: rapid development, implications, challenges and future prospects

Attitudes and acceptance of vaccination against neglected tropical diseases: A multi-country study in Asia

This study aims to explore the willingness of individuals to be vaccinated against NTDs in Asian countries and China. Between June and December 2023, an anonymous cross-sectional survey was carried out in five Asian countries alongside China. Overall, 48.4% indicated being somewhat willing and 29.2% expressing extreme willingness to receive NTDs vaccination. High attitude scores (adjusted odds ratio [aOR] = 1.54, 95% confidence interval (CI): 11.35-1.75) was associated with higher willingness to be vaccinated against NTDs. The odds of accepting the NTDs vaccine increased among individuals without occupational exposure to NTDs (aOR = 1.46, 95% CI: 1.27-1.68). Those residing in very clean environments exhibited heightened odds of willingness (aOR = 2.94, 95% CI: 2.10-4.11), whereas individuals in somewhat dirty environments demonstrated reduced odds of willingness (aOR = 0.74, 95% CI: 0.56-0.98) compared to the baseline group (very dirty local environment). Moreover, a higher score in sanitation facilities also correlated with increased odds of willingness to receive the NTDs vaccine (aOR = 1.41, 95% CI: 1.21-1.64). The study highlighted key strategies for improving NTDs vaccine uptake in Asian countries, including China, such as fostering positive attitudes toward the vaccine and enhancing perception of infection risks.

Prospects of Innovative Therapeutics in Combating the COVID-19 Pandemic

The sudden global crisis of COVID-19, driven by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demands swift containment measures due to its rapid spread and numerous problematic mutations, which complicate the establishment of herd immunity. With escalating fatalities across various nations no foreseeable end in sight, there is a pressing need to create swiftly deployable, rapid, cost-effective detection, and treatment methods. While various steps are taken to mitigate the transmission and severity of the disease, vaccination is proven throughout mankind history as the best method to acquire immunity and circumvent the spread of infectious diseases. Nonetheless, relying solely on vaccination might not be adequate to match the relentless viral mutations observed in emerging variants of SARS-CoV-2, including alterations to their RBD domain, acquisition of escape mutations, and potential resistance to antibody binding. Beyond the immune system activation achieved through vaccination, it is crucial to develop new medications or treatment methods to either impede the infection or enhance existing treatment modalities. This review emphasizes innovative treatment strategies that aim to directly disrupt the virus's ability to replicate and spread, which could play a role in ending the SARS-CoV-2 pandemic.

Removing barriers to COVID-19 vaccine intention in a university population: Results of a serial mediation study through the dimensions of the Health Belief Model

BACKGROUND

While many studies have used the Health Belief Model (HBM) to understand vaccine intention, none claim to have used serial mediation to understand the relationship between HBM dimensions and COVID-19 vaccine intention. This study developed a serial mediation model to assess the direct and indirect effects of the latent HBM dimensions on COVID-19 primary vaccine intention.

METHODS

A cross-sectional study: from 01 April to 10 June 2021, a self-administered online questionnaire on vaccine intention against COVID-19 was distributed to staff and students at the University of Liège (Belgium). Direct and indirect effects of the HBM dimensions (perceived susceptibility, severity, benefits, barriers, self-efficacy and cues to action) on vaccine intention (score 0-100) were assessed with serial mediation models. Actually, each permutation of the latent HBM dimensions, i.e., each causal chain, was assessed using partial least squares path modelling (PLS-PM) according to the order of the HBM dimensions in that particular chain.

RESULTS

The sample was made up of 1256 participants. The final model revealed that the causal chain with the lowest Bayesian Information Criterion (BIC) value was barriers (Effect estimation (CI95%): -0.09 (-0.15 - -0.03)) ↘ severity (-0.13 (-0.20 - -0.07)) ↘ low self-efficacy (0.20 (0.15-0.25)) ↘ low susceptibility (-0.55 (-0.60 - -0.51)) ↘ vaccine intention (outcome). This revealed a significant indirect and direct effect (-0.20 (-0.25 - -0.15)) between barriers and vaccine intention.

CONCLUSIONS

The results demonstrated that perceived barriers are a key determinant in COVID-19 primary vaccine intention. Public health practitioners need to prioritise messaging that addresses the barriers reducing vaccine intention to enable individuals to make an informed choice. These messages could form part of a mass communication campaign aimed at hesitant individuals, with evidence-based information about vaccine safety a priority in order to establish a climate of trust.

Safety and utilisation of AZD1222 (ChAdOx1 nCoV-19) COVID-19 vaccine: a UK post-authorisation active surveillance study

OBJECTIVES

To monitor the safety and utilisation of AZD1222 under real-world use in the UK.

DESIGN

A non-interventional post-authorisation active surveillance study.

SETTING

Vaccination sites in the UK.

PARTICIPANTS

A total of 17 945 participants were eligible and provided consent to participate in the study between 1 March 2021 and 6 April 2023. Participants were followed up at weeks 1, 4 and 14 and at months 6, 9, 12 and 18 after the first dose of AZD1222 vaccination and prompted to complete electronic data capture forms. A total of 11 219 participants submitted a Follow-Up 1 form and 5189 participants submitted a Follow-Up 7 form (at 18 months).

PRIMARY AND SECONDARY OUTCOME MEASURES

The safety of AZD1222, including the identification, assessment and quantification of serious adverse events (SAEs) and adverse events of special interest (AESI), was examined. The utilisation of AZD1222 was described and characterised, including populations with missing information.

RESULTS

The majority of participants were women (n=10 845; 60.4%) and the median age (IQR) was 50 (43, 62) years. Most participants were from white ethnic groups (n=13 112; 73.1%). Headache and fatigue had the highest reported incidence rate (421.28 cases per 1000 person years and 386.00 cases per 1000 person years, respectively). The most frequently reported AESI was anosmia (6.25 cases per 1000 person years). An increased Observed versus Expected (O:E) ratio was seen for anaphylaxis (O:E 7.38 (95% CI 2.80 to 11.95); based on 10 observed cases (expected cases: 1.36)) and anosmia and/or ageusia (O:E 39.23 (95% CI 29.13 to 49.32), based on 58 observed cases (expected cases: 1.48)).

CONCLUSIONS

The most frequent vaccinee-reported adverse events (AEs) were headache and fatigue. An increased O:E ratio was seen for the AEs of anaphylaxis and anosmia and/or ageusia. No safety signals were identified throughout the course of this study.

TRIAL REGISTRATION NUMBER

This study is registered with the HMA-EMA Catalogue of RWD studies (EUPAS44035).

Revealing COVID-19 breakthrough infection rates among vaccinated individuals at a tertiary care centre in South India

Background and Objectives

The COVID-19 pandemic was mitigated by the rapid development and deployment of vaccines. While vaccines reduce infection severity, breakthrough infections (BTIs) still occur. The CDC defines BTI as a positive SARS-CoV-2 test ≥14 days post-vaccination. This study investigates the occurrence of COVID-19 BTIs at a tertiary care hospital in Puducherry, South India.

Materials and Methods

This retrospective study analysed hospital tested qRT-PCR data of individuals from the ICMR portal (March 2021-March 2022). Demographic and vaccination details were extracted.

Results

Among 8001 tested individuals, 1452 were vaccinated. The BTI rate decreased from 16.6% to 1.2% after the first dose and from 58% to 40% after the second one. Odds ratio indicated a 74% reduction in infection risk for vaccinated individuals compared to unvaccinated. Males had higher infection rates than females, regardless of vaccination status.

Conclusion

Our study demonstrates a higher BTI rate after one vaccine dose compared to two doses. The BTI rate also increased four months post-vaccination, even with two doses, potentially due to waning immunity and the emergence of new variants. Therefore, continued adherence to preventive measures in conjunction with vaccination is crucial for minimizing COVID-19 transmission.

GM-CBAM-ResNet: A Lightweight Deep Learning Network for Diagnosis of COVID-19

COVID-19 can cause acute infectious diseases of the respiratory system, and may probably lead to heart damage, which will seriously threaten human health. Electrocardiograms (ECGs) have the advantages of being low cost, non-invasive, and radiation free, and is widely used for evaluating heart health status. In this work, a lightweight deep learning network named GM-CBAM-ResNet is proposed for diagnosing COVID-19 based on ECG images. GM-CBAM-ResNet is constructed by replacing the convolution module with the Ghost module (GM) and adding the convolutional block attention module (CBAM) in the residual module of ResNet. To reveal the superiority of GM-CBAM-ResNet, the other three methods (ResNet, GM-ResNet, and CBAM-ResNet) are also analyzed from the following aspects: model performance, complexity, and interpretability. The model performance is evaluated by using the open 'ECG Images dataset of Cardiac and COVID-19 Patients'. The complexity is reflected by comparing the number of model parameters. The interpretability is analyzed by utilizing Gradient-weighted Class Activation Mapping (Grad-CAM). Parameter statistics indicate that, on the basis of ResNet19, the number of model parameters of GM-CBAM-ResNet19 is reduced by 45.4%. Experimental results show that, under less model complexity, GM-CBAM-ResNet19 improves the diagnostic accuracy by approximately 5% in comparison with ResNet19. Additionally, the interpretability analysis shows that CBAM can suppress the interference of grid backgrounds and ensure higher diagnostic accuracy under lower model complexity. This work provides a lightweight solution for the rapid and accurate diagnosing of COVD-19 based on ECG images, which holds significant practical deployment value.

Empowering African Expertise: Enhancing Safety Data Integration and Signal Detection for COVID-19 Vaccines Through the African Union Smart Safety Surveillance Joint Signal Management Group

INTRODUCTION

The COVID-19 pandemic accelerated new vaccine development. Limited safety data necessitated robust global safety surveillance to accurately identify and promptly communicate potential safety issues. The African Union Smart Safety Surveillance (AU-3S) program established the Joint Signal Management (JSM) group to support identification of potential vaccine safety concerns in five pilot countries (Ethiopia, Ghana, Kenya, Nigeria, South Africa), accounting for approximately 35% of the African population.

OBJECTIVE

Our objective was to provide an overview of the JSM group's role in supporting signal management activities for the AU-3S program during the COVID-19 pandemic.

METHODS

Spontaneous, electronically reported COVID-19 vaccine adverse events following immunization (AEFI) from each country's safety data were integrated into the interim Data Integration and Signal Detection system. Statistical disproportionality methods were used to identify and review vaccine-event combinations (VECs) for potential safety concerns. The JSM group-which comprised pharmacovigilance and subject matter experts from National Medicine Regulatory Authorities, Expanded Programs on Immunization, and vaccine safety committees-conducted signal detection activities on cross-country safety data and provided recommendations.

RESULTS

From April 2021 to December 2023, a total of 48,294 spontaneously reported AEFI were analyzed for six COVID-19 vaccines (NRVV Ad [ChAdOx1 nCoV-19]; Ad26.COV2.S; Elasomeran; Tozinameran; Covid-19 vaccine [Vero Cell], Inactivated; NRVV Ad26 [Gam-Covid-Vac]) administered in Ethiopia (34.6%), Nigeria (30.3%), South Africa (16.9%), Ghana (13.5%), and Kenya (4.7%). Overall, 2,742 VECs were validated. A causal association between the COVID-19 vaccines and the reported AEFI cannot be inferred, as data were reported spontaneously. JSM group recommendations included monitoring for further evidence, no immediate action required, engaging marketing authorization holder(s) for additional information, or sensitizing healthcare providers and/or the public about events. Although no new safety signals were identified, nine safety-related recommendations were issued, including patient and healthcare provider education.

CONCLUSIONS

The JSM group established a scalable and replicable model for future signal management of other priority health products in low- and middle-income countries, fostering ongoing collaboration and capacity building. Knowledge and experience gained from this pilot initiative will guide stakeholders in future safety surveillance initiatives within the African continent.

Real-world COVID-19 vaccine effectiveness in Zimbabwe: A test-negative case-control study

Background

COVID-19 vaccination is critical in sub-Saharan Africa to reduce the disease burden. This study assessed real-world vaccine effectiveness (VE) in Zimbabwe.

Aim

To determine COVID-19 VE and factors associated with disease severity and mortality in Zimbabwe.

Setting

The study setting comprised a test-negative case-control study across health facilities in Harare and Bulawayo (May 2023 - August 2023).

Methods

Adults (≥ 18 years) were recruited from COVID-19 registers (1:1 case-control; matched by sex, age and clinic visit date). Telephone interviews assessed vaccination status, disease severity (cases) and comorbidities. Conditional logistic regression estimated VE (1 - odds ratio*100), with stratification by age and comorbidities. Ordinal and simple logistic regression analysed factors associated with disease severity and vaccination-variant relationships.

Results

Overall vaccination coverage was 38% (fully vaccinated including boosters), with 62% unvaccinated. The median age was 38 years (interquartile range [IQR]: 30-50) with more females (n = 352). Overall VE against any COVID-19 infection was 32.2% (95% CI: 8.9, 49.5). Older age (45+ years) and chronic conditions were associated with increased hospitalisation risk. Among cases, hospitalisation rate was 34.8% (n = 174/500) and COVID-19-related mortality rate was 11.6% (n = 58/500).

Conclusion

This study found a moderate VE of COVID-19 vaccines in Zimbabwe, potentially influenced by age, comorbidities and variants. We highlight the need for targeted vaccination strategies and public health measures informed by these findings.

Contribution

This research informs public health strategies to optimise vaccination efforts and improve health outcomes across Africa, aligning with the journal's focus on public health issues.

Female versus viral: Understanding the UK gender health inequalities during the Covid-19 pandemic using e-archives

Despite the development of digital health infrastructure, female health inequalities have worsened during the pandemic. This transdisciplinary study, through health, feminist, and infrastructural geographical lens, examines how gender health inequalities may have emerged or worsened during Covid-19 in the UK. This study leverages a novel web archive collection, Python coding-powered data-handling text analysis (of over 0.2 billion words), and thematic analysis to examine three themes: vaccines, social minority groups, and women's self-care. The findings suggest that the pandemic has impacted health inequalities among British women and girls and more, in a 'more-than-gender' way in terms of health (care) outcomes and access. In addition to reflecting on the use of e-archives in this study including suggesting the potential of combining e-archiving, coding, natural language processing (NLP) and generative AI/Large Language Models (LLMs) in producing and analysing trans-temporal (big) datasets, I argue that a geographical crisis perspective that balances the needs of everyday life and possible crises can be considered when preparing for public health emergencies. I adopt the e-archiving of this study to rethink 'digital health infrastructure' as 'actors', 'facilitators', and 'voicers', revealing how human-computer interaction and people in the virtual realm can be infrastructure.

Integrative Korean medicine for recurrent lumbar disc herniation after coronavirus disease vaccination: A case report and literature review

RATIONALE

Many side effects have been associated with the coronavirus disease (COVID-19) vaccine. While most adverse events (AEs) are mild, serious adverse events are occasionally observed in the neurological and musculoskeletal systems. Nevertheless, articles reporting such serious adverse events after COVID-19 vaccination are limited, and only few case reports with detailed descriptions are available in the literature.

PATIENT CONCERNS

Herein, we report the case of a 41-year-old male office worker who developed symptoms of recurrent disc herniation 2 days after COVID-19 vaccination; the patient had no other factors that may have caused the recurrence of disc herniation, such as excessively vigorous activities, following vaccination.

DIAGNOSES

Consequently, the patient was suspected of having cauda equina syndrome owing to recurrent lumbar disc herniation, and he underwent surgery.

INTERVENTIONS

The patient underwent integrative Korean medicine treatment, including acupuncture, pharmacopuncture, and Chuna manual therapy, for 8 months postoperatively.

OUTCOMES

After treatment, the patient's postoperative complications improved; the Numerical Rating Scale score changed from 5 to 1, and the Oswestry Disability Index score changed from 30 to 3. A literature review showed various cases of adverse events related to musculoskeletal inflammation or immune-mediated pathogenesis.

LESSONS

This paper confirmed the possibility that COVID vaccination is related to lumbar disc herniation recurrence and the possibility of integrative Korean medicine as an effective treatment option after lumbar disc herniation surgery.

The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses

We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1st, 2022 (Phase I: univalent booster dose availability), and between November 21st, 2022 and January 11th, 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman (n = 11), the median age was 37 years (interquartile range: 32-48), and most participants were employed full-time (n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.

Impact of the COVID-19 vaccination on confusion around vaccination in general: A longitudinal study on a university population over 18 months

Even before the COVID-19 pandemic, vaccine hesitancy was one of the main global public health threats. Unfortunately, the COVID-19 crisis and its associated risks only reinforced this hesitancy. This study aimed to identify to what extent the COVID-19 vaccination affected confusion around vaccination in general, its change and any associated factors. A questionnaire was distributed to the university population of Liège between April-June 2021 (Time 1) and July-September 2022 (Time 2). The impact of the COVID-19 vaccination on confusion around vaccination in general (score 0 to 100) was divided into three groups based on the tertiles of the study sample at different times and whether or not any change had been observed. Ordinal and multinomial regression analyses were performed to assess the relationship between the confusion and various determinants. The sample consisted of 491 participants. Time 1 vs Time 2, 41.3% vs 35.4% seemed to be less confused, 24.2% vs 28.7% were moderately confused and 34.4% vs 35.8% more confused, respectively. In terms of change, 19.4% of participants were less confused, 55.2% had not changed their opinion and 25.5% were more confused. The determinants causing confusion at both times and regarding change were self-perception, health literacy, past vaccination experiences and COVID-19 related factors (COVID-19 vaccination intention and trust in source of information at Time 1; preferred source of information, trust in vaccine producers and conspiratorial beliefs at Time 2; trust in vaccine producers for change). The results demonstrated that the COVID-19 vaccination impacted confusion around vaccination in general. Both unrelated and related COVID-19 factors, particularly regarding the progression of the pandemic, seem to have contributed to this confusion. Contributing factors require a personalised approach, evidence-based information being communicated with messages adapted to the situation and its evolution designed to allay individuals' fears about vaccination.

Antibody Avidity Maturation Following Booster Vaccination with an Intranasal Adenovirus Salnavac Vaccine

BACKGROUND

The COVID-19 pandemic has led to the rapid development of new vaccines and methods of testing vaccine-induced immunity. Despite the extensive research that has been conducted on the level of specific antibodies, less attention has been paid to studying the avidity of these antibodies. The avidity of serum antibodies is associated with a vaccine showing high effectiveness and reflects the process of affinity maturation. In the context of vaccines against SARS-CoV-2, only a limited number of studies have investigated the avidity of antibodies, often solely focusing on the wild-type virus following vaccination. This study provides new insights into the avidity of serum antibodies following adenovirus-based boosters. We focused on the effects of an intranasal Salnavac booster, which is compared, using a single analytical platform, to an intramuscular Sputnik V.

METHODS

The avidity of RBD-specific IgGs and IgAs was investigated through ELISA using urea and biolayer interferometry.

RESULTS

The results demonstrated the similar avidities of serum antibodies, which were induced by both vaccines for six months post-booster. However, an increase in antibody avidity was observed for the wild-type and Delta variants, but not for the BA.4/5 variant.

CONCLUSIONS

Collectively, our data provide the insights into antibody avidity maturation after the adenovirus-based vaccines against SARS-CoV-2.

Safety of mRNA COVID-19 vaccines among persons 15- years and above in Ghana: A cohort event monitoring study

INTRODUCTION

The development of COVID-19 vaccines during the pandemic occurred with an unprecedented speed, requiring extraordinary post-approval safety monitoring to facilitate ongoing evaluation of their benefit-risk profile. In Ghana, the Food and Drugs Authority granted emergency use authorization to six of these vaccines including the two mRNA COVID-19 vaccines, namely, Pfizer-BioNTech and Moderna COVID-19 vaccines. The objective of the study was to estimate the incidence of adverse events following immunization (AEFIs) and adverse events of special interest (AESIs) in persons vaccinated with mRNA COVID-19 vaccines, and to identify factors associated with the development of AEFIs.

METHODS

We conducted a prospective cohort event monitoring study in seven selected static vaccination center in six of Ghana's 16 regions. The choice of regions was based on their geographical locations and the incidence rate of COVID-19 at the time of the study. The study was conducted with people aged 15 years and older who were vaccinated with mRNA COVID-19 vaccines, including pregnant women. Study participants were recruited starting in November 2021, with the last participant followed up in August 2022. Persons vaccinated were followed up on days 1, 7, and 28 post-dose 1 and up to 91 days after dose 2. AEFIs were described with the most specific, or lowest-level, term using the Medical Dictionary for Regulatory Activities (MedDRA) version 26.1. Frequencies of AEFIs after each vaccine dose and vaccination center were determined. Cox-proportional hazard regression was used to assess the independent risk factors associated with the incidence of AEFI among the participants.

RESULTS

Overall, 4678 persons who received Pfizer-BioNTech or Moderna COVID-19 vaccines from the seven vaccination centers were enrolled in the study. The mean age of participants was 32.9 years (SD ± 14.4). A total of 17.4 % (95 % CI: 16.3 % to 18.5 %) of participants experienced AEFI, with a higher incidence among Moderna COVID-19 vaccine recipients (20.4 %) compared to Pfizer-BioNTech COVID-19 vaccine recipients (14.0 %). The top five common AEFIs included injection site pain, headache, dizziness, fatigue, and fever. No serious AEFIs were reported during the study. Factors such as vaccination center and history of chronic medical conditions influenced the risk of experiencing an AEFI. Cox-proportional hazard regression revealed a 37 % lower risk of AEFI with the Pfizer-BioNTech COVID-19 vaccine compared to the Moderna COVID-19 vaccine.

CONCLUSION

The study on mRNA COVID-19 vaccines in Ghana showed that the vaccines are tolerated well with no significant safety concerns. Reports of systemic and local events were consistent with those reported in the summary of product characteristics of the two vaccines. The study's outcome showed that there were no safety issues with mRNA COVID-19 vaccines in Ghana. The results of this study can be used as a crucial advocacy tool to address vaccine hesitancy as countries plan to routinize COVID-19 vaccines. Additionally, the active monitoring study serves as a model for such studies in low- to middle-income countries (LMICs) with weak pharmacovigilance systems during future pandemics.

Does health anxiety and vaccine concern predict self-reported adverse events following COVID-19 vaccination?-A Danish national cohort study

OBJECTIVES

The nocebo effect refers to an expectation of sickness that leads to sickness in the expectant. Studies have found COVID-19 vaccines to be associated with the nocebo effect. However, the literature in this field is sparse yet important with the continuation of booster vaccines.

STUDY DESIGN

National cohort study.

METHODS

This study used data from the Danish national cohort "BiCoVac", which contains self-reported information on both health anxiety and specific COVID-19 vaccine concern, as well as 19 systemic AEs following COVID-19 vaccination. Simple and multiple logistic regression was used to estimate the association between health anxiety and specific COVID-19 vaccine concern with having one or more systemic AEs following COVID-19 vaccination. Inverse probability weights were used to compensate for the initial dropout and loss to follow-up.

RESULTS

Of the 85,080 participants in the study, 4 % reported health anxiety, 30 % reported specific COVID-19 vaccine concern, and 26 % one or more systemic AEs following vaccination. After adjusting for covariates, participants with health anxiety had higher odds of reporting one or more systemic AEs following vaccination compared to those without (OR, 1·21 CI 95 % [1·10; 1·33]). For specific COVID-19 vaccine concern, the OR was 1·51 CI 95 % [1·45; 1·58].

CONCLUSIONS

Participants with specific COVID-19 vaccine concern had higher odds of reporting one or more systemic AEs following vaccination compared with those who had no specific COVID-19 vaccine concern. There might be a potential to reduce AEs, with positive framing of AEs and information about nocebo. Reporting of AEs was also associated with health anxiety, but to a lesser degree.

A risk science perspective on vaccines

Vaccines can be seen as one of the greatest successes in modern medicine. Good examples are the vaccines against smallpox, polio, and measles. Unfortunately, vaccines can have side effects, but the risks are considered by the health authorities and experts to be small compared to their benefits. Nevertheless, there are many who are skeptical of vaccination, something which has been very clearly demonstrated in relation to the COVID-19 disease. Risk is the key concept when evaluating a vaccine, in relation to both its ability to protect against the disease and its side effects. However, risk is a challenging concept to measure, which makes communication about vaccines' performance and side effects difficult. The present article aims at providing new insights into vaccine risks-the understanding, perception, communication, and handling of them-by adopting what is here referred to as a contemporary risk science perspective. This perspective clarifies the relationships between the risk concept and terms like uncertainty, knowledge, and probability. The skepticism toward vaccines is multifaceted, and influenced by concerns that extend beyond the effectiveness and safety of the vaccines. However, by clarifying the relationships between key concepts of risk, particularly how uncertainty affects risk and its characterization, we can improve our understanding of this issue.

Dynamics of anti-SARS-CoV-2 antibodies in the Albanian population: Impact of infection- and vaccine-induced immunity during the COVID-19 pandemic

Objectives

Understanding immune response dynamics during the COVID-19 pandemic is crucial for optimizing future vaccine strategies. This study investigated the infection- and vaccine-induced SARS-CoV-2 antibody responses in the Albanian population from August 2021 to August 2022.

Methods

This used a cross-sectional approach, analyzing two independent, randomly selected population samples over 1 year. Participants' demographic, health, vaccination, and COVID-19 data were collected, with blood samples assessed via enzyme linked immunosorbent assay for immunoglobulin G class anti-spike and anti-nucleocapsid antibodies.

Results

By August 2022, all individuals receiving one vaccine dose achieved antibody levels comparable to those receiving two doses (median 7.71 index ratio [IR] vs 7.00 IR). In August 2021, those with previous COVID-19 infection receiving one vaccine dose showed median anti-spike immunoglobulin G levels of 7.22 IR compared with 4.84 IR in those without previous infection receiving two doses. However, individuals aged ≥61 years required two vaccine doses to achieve similar immune responses as younger individuals with one dose.

Conclusions

These findings underscore the importance of hybrid immunity, suggesting one vaccine dose may suffice for individuals with previous COVID-19 infection, whereas older adults require additional doses for optimal protection. This study provides insights into humoral immune response dynamics, which is crucial for refining COVID-19 vaccination strategies in middle-income countries with low vaccination coverage and high infection rates.

Regional variation in COVID-19 vaccine uptake and intention in Nigeria: A computer assisted telephone survey

Globally, vaccination has been known to reduce the burden of infectious diseases such as COVID-19, with its effectiveness relying on public acceptance and widespread uptake. Despite the efforts put into the rapid development of SARS-COV-2 vaccines, uptake remains a major challenge in many countries especially those with large population dynamics like Nigeria. Most studies in Nigeria have assessed the uptake of the SARS-COV-2 vaccine among groups of people without consideration for ethno-cultural diversity. This study therefore explored COVID-19 vaccine uptake, its determinants and future intention among adult Nigerians in the six geopolitical zones of Nigeria. This was a cross-sectional survey using a Computer Assisted Telephone Interview. The study enrolled 1148 adults from one representative state across each of the six geopolitical zones that had a high COVID-19 burden. Trained research assistants interviewed consenting respondents using a pretested semi-structured questionnaire configured in Survey CTO between May and June 2022. Descriptive statistics were provided as means for continuous variables, while categorical variables were expressed as frequencies and percentages. Prevalence ratios were used as the measure of association. Respondents' age was 37.8±13.4 years, 53.9% were men and majority (65.2%) from southern Nigeria. About half (50.9%) of the respondents had not received vaccination, 29.7% were fully vaccinated, and 19.3% had incomplete dose. Majority (65.5%) of the respondents in the Northern states had not received SARS-COV-2 vaccine. Participants' age, sex, place of residence, occupation, religion, and region of residence were associated with vaccine uptake (p<0.05). About 70% of respondents who had not received the vaccine had the intention to receive the vaccine. A low rate of SARS-COV-2 vaccine uptake, particularly in the Northern region, and a high level of intention to receive the vaccine were reported among adult Nigerians. Focused efforts are needed in the Northern region to enhance SARS-COV-2 vaccine uptake.

Amplifying youth voices: young people's recommendations for policy and practice to enhance vaccine acceptability

BACKGROUND

The COVID-19 pandemic has underscored the need for increased vaccine availability and uptake, with vaccine hesitancy posing a significant barrier, particularly among young adults. Evidence from various countries highlight high levels of hesitancy among young people, necessitating targeted interventions. Engaging young adults as key stakeholders in shaping public health strategies is crucial, as their perspectives can enhance vaccine acceptance. This study aimed to assess the overall acceptability of the COVID-19 vaccine among young people and to explore the factors influencing their willingness or reluctance to be vaccinated now and in the future.

METHODS

This study used qualitative data from 165 young adults in Nigeria, South Africa, and Zambia, to explore their suggestions for policies and strategies aimed at enhancing the acceptance of the Covid-19 vaccination among their age group. Data collection involved focus groups and interviews that explored participants' perceptions and recommendations regarding COVID-19 vaccination acceptability. Thematic analysis was used to analyse the data.

RESULTS

Thematic analysis identified several factors influencing vaccine acceptability among young people and suggested recommendations to improve it. The themes included developing targeted communication strategies for accurate vaccine information, offering alternative vaccination methods, promoting vaccine education in schools, and using trusted public figures to share accurate information.

CONCLUSIONS

Persistent dissatisfaction with vaccine information dissemination underscores the need for more targeted communication strategies among young adults. Recommendations include developing non-injection vaccine options, incorporating vaccine education into school curricula and community programs, and leveraging influential public figures to build credibility. These insights are valuable for designing future programs to enhance vaccine acceptance among adolescents.

COVID-19 vaccines: current and future challenges

As of December 2020, around 200 vaccine candidates for Coronavirus Disease 2019 (COVID-19) are being developed. COVID-19 vaccines have been created on a number of platforms and are still being developed. Nucleic acid (DNA, RNA) vaccines, viral vector vaccines, inactivated vaccines, protein subunit vaccines, and live attenuated vaccines are among the COVID-19 vaccine modalities. At this time, at least 52 candidate vaccines are being studied. Spike protein is the primary protein that COVID-19 vaccines are targeting. Therefore, it is critical to determine whether immunizations provide complete or fractional protection, whether this varies with age, whether vaccinated people are protected from reoccurring diseases, and whether they need booster shots if they've already been inoculated. Despite the enormous achievement of bringing several vaccine candidates to market in less than a year, acquiring herd immunity at the national level and much more so at the global level remains a major challenge. Therefore, we gathered information on the mechanism of action of presently available COVID-19 vaccines in this review and essential data on the vaccines' advantages and downsides and their future possibilities.

The Impact of COVID-19 on RNA Therapeutics: A Surge in Lipid Nanoparticles and Alternative Delivery Systems

The COVID-19 pandemic has significantly accelerated progress in RNA-based therapeutics, particularly through the successful development and global rollout of mRNA vaccines. This review delves into the transformative impact of the pandemic on RNA therapeutics, with a strong focus on lipid nanoparticles (LNPs) as a pivotal delivery platform. LNPs have proven to be critical in enhancing the stability, bioavailability, and targeted delivery of mRNA, facilitating the unprecedented success of vaccines like those developed by Pfizer-BioNTech and Moderna. Beyond vaccines, LNP technology is being explored for broader therapeutic applications, including treatments for cancer, rare genetic disorders, and infectious diseases. This review also discusses emerging RNA delivery systems, such as polymeric nanoparticles and viral vectors, which offer alternative strategies to overcome existing challenges related to stability, immune responses, and tissue-specific targeting. Additionally, we examine the pandemic's influence on regulatory processes, including the fast-tracked approvals for RNA therapies, and the surge in research funding that has spurred further innovation in the field. Public acceptance of RNA-based treatments has also grown, laying the groundwork for future developments in personalized medicine. By providing an in-depth analysis of these advancements, this review highlights the long-term impact of COVID-19 on the evolution of RNA therapeutics and the future of precision drug delivery technologies.

Dynamic factors associated with COVID-19 vaccine uptake in Cameroon between 2021 and 2022

Background

Little is known about attitudes towards COVID-19 vaccination in sub-Saharan Africa, where immunisation coverage is the lowest in the world.

Aim

The study aimed to identify factors associated with COVID-19 vaccine hesitancy and uptake in Cameroon, and assess changes in these factors over a period of time.

Setting

The study was conducted in the ten regions of Cameroon.

Methods

The authors conducted a two-phase cross-sectional survey in the 10 regions of Cameroon, from July 2021 to August 2021 (Phase one) and from August 2022 to September 2022 (Phase two). We analysed reasons for vaccine hesitancy descriptively and used logistic regression to assess factors associated with hesitancy.

Results

Overall, we enrolled 12 109 participants: 6567 (54.23%) in Phase one and 5542 (45.77%) in Phase two. Of these, 8009 (66.14%) were not interested in receiving the COVID-19 vaccine (n = 4176 in Phase one, n = 3833 in Phase two). The refusal rate increased significantly in the northern region from 27.00% in Phase 1 to 60.00% in Phase two. The leading contributor to COVID-19 vaccine hesitancy was fear that the vaccine was dangerous, which was significantly associated (95% confidence interval [CI], p < 0.05%) with vaccine refusal in both phases. Overall, 32.90% of participants (n = 2578) perceived the COVID-19 vaccine to be dangerous. Advanced age, male gender, Muslim religion and low level of education were associated with vaccine acceptance. Participants reported that healthcare workers were the most trusted source of information about the COVID-19 vaccine by 5005 (42.84%) participants.

Conclusion

Despite the investment of the Ministry of Health and its partners in community engagement, focussing on communication about the vaccine efficacy, tolerance and potential adverse events, fear of the vaccine remains high, likely leading to vaccine hesitancy in Cameroon between 2021 and 2022.

Contribution

The study highlight regional variations in COVID-19 vaccine acceptance in Cameroon, with factors age, gender, religion and education influencing willingness to vaccine. Trust in health workers was high, indicating that, tailored, community-led vaccination strategies are key for improving vaccine uptake, not only for COVID-19 but also for future epidemics.

The Ambivalence of Post COVID-19 Vaccination Responses in Humans

The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has prompted a massive global vaccination campaign, leading to the rapid development and deployment of several vaccines. Various COVID-19 vaccines are under different phases of clinical trials and include the whole virus or its parts like DNA, mRNA, or protein subunits administered directly or through vectors. Beginning in 2020, a few mRNA (Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273) and adenovirus-based (AstraZeneca ChAdOx1-S and the Janssen Ad26.COV2.S) vaccines were recommended by WHO for emergency use before the completion of the phase 3 and 4 trials. These vaccines were mostly administered in two or three doses at a defined frequency between the two doses. While these vaccines, mainly based on viral nucleic acids or protein conferred protection against the progression of SARS-CoV-2 infection into severe COVID-19, and prevented death due to the disease, their use has also been accompanied by a plethora of side effects. Common side effects include localized reactions such as pain at the injection site, as well as systemic reactions like fever, fatigue, and headache. These symptoms are generally mild to moderate and resolve within a few days. However, rare but more serious side effects have been reported, including allergic reactions such as anaphylaxis and, in some cases, myocarditis or pericarditis, particularly in younger males. Ongoing surveillance and research efforts continue to refine the understanding of these adverse effects, providing critical insights into the risk-benefit profile of COVID-19 vaccines. Nonetheless, the overall safety profile supports the continued use of these vaccines in combating the pandemic, with regulatory agencies and health organizations emphasizing the importance of vaccination in preventing COVID-19's severe outcomes. In this review, we describe different types of COVID-19 vaccines and summarize various adverse effects due to autoimmune and inflammatory response(s) manifesting predominantly as cardiac, hematological, neurological, and psychological dysfunctions. The incidence, clinical presentation, risk factors, diagnosis, and management of different adverse effects and possible mechanisms contributing to these effects are discussed. The review highlights the potential ambivalence of human response post-COVID-19 vaccination and necessitates the need to mitigate the adverse side effects.

Polypurine reverse hoogsteen hairpins as a therapeutic tool for SARS-CoV-2 infection

Although the COVID-19 pandemic was declared no longer a global emergency by the World Health Organization in May 2023, SARS-CoV-2 is still infecting people across the world. Many therapeutic oligonucleotides such as ASOs, siRNAs, or CRISPR-based systems emerged as promising antiviral strategies for the treatment of SARS-CoV-2. In this work, we explored the inhibitory potential on SARS-CoV-2 replication of Polypurine Reverse Hoogsteen Hairpins (PPRHs), CC1-PPRH, and CC3-PPRH, targeting specific polypyrimidine sequences within the replicase and Spike regions, respectively, and previously validated for COVID-19 diagnosis. Both PPRHs are bound to their target sequences in the viral genome with high affinity in the order of nM. In vitro, both PPRHs reduced viral replication by more than 92% when transfected into VERO-E6 cells 24 h prior to infection with SARS-CoV-2. In vivo intranasal administration of CC1-PPRH in K18-hACE2 mice expressing the human ACE receptor protected all the animals from SARS-CoV-2 infection. The properties of PPRHs position them as promising candidates for the development of novel therapeutics against SARS-CoV-2 and other viral infections.

Determinants of COVID-19 vaccine acceptance and hesitancy among adolescents and youths aged 10-35 years in sub-Saharan African countries: A systematic review and meta-analysis

The COVID-19 pandemic has overwhelmed health systems, especially in sub-Saharan African countries. Vaccination is one of the easily accessible interventions that can help reduce the burden on the health system. However, vaccination coverage remains low in sub-Saharan African countries. The determinants of vaccine acceptance and hesitancy among adolescents and youths remain unknown. Therefore, this study explored the pooled prevalence and determinants of COVID-19 vaccine acceptance and hesitancy among adolescents and youths in sub-Saharan African Countries. A systematic literature search of Scopus, PubMed Central, PubMed, Embase, African Journal Online, Research 4 Life, Embase, and Google Scholar was performed from 6th May to 31st December 2023, using developed keywords with a focus on sub-Saharan African countries. Twenty-three (N = 23) studies were finally selected for analysis. The pooled prevalence of vaccine acceptance among adolescents and youths was 38.7% (n = 23). The subgroup analysis of the pooled prevalence of acceptance among adolescents was 36.1% (n = 36.1) while youths were 42% (n = 10). At the region level, West Africa had 42.2% (n = 13), East Africa had 39.8% (n = 6), Central Africa had 33% (n = 1), and Southern Africa had 24.2% (n = 3). The determinants of vaccine acceptance were the desire for self-immunity (AOR = 1.97, 95%, CI, 1.083.47, I2 = 94.15%, p < 0.05), receiving Health Officers' information (AOR = 4.36, 95%, CI, 2.28-8.32, I2 = 97.74, p < 0.001), the effectiveness of COVID-19 vaccine (AOR = 2.14, 95%, CI, 1.14-4.05, I2 = 97.4%, p < 0.05). The odds of having an unconfirmed source of information (AOR = 0.22, 95% CI, 0.10-0.45, I2 = 94.09%, p< 0.001) was responsible for vaccine hesitancy. The findings indicate the low pooled prevalence of COVID-19 vaccine acceptance and high levels of hesitancy among adolescents and youths in sub-Saharan African countries. Therefore, there is a need to ensure that extensive research is undertaken into age-appropriate health promotion messages and strategies to encourage the uptake of vaccines. PROSPERO ID number CRD42023403071.

Modelling the impact of vaccination on COVID-19 in African countries

The rapid development of vaccines to combat the spread of COVID-19, caused by the SARS-CoV-2 virus, is a great scientific achievement. Before the development of the COVID-19 vaccines, most studies capitalized on the available data that did not include pharmaceutical measures. Such studies focused on the impact of non-pharmaceutical measures such as social distancing, sanitation, use of face masks, and lockdowns to study the spread of COVID-19. In this study, we used the SIDARTHE-V model, an extension of the SIDARTHE model, which includes vaccination rollouts. We studied the impact of vaccination on the severity of the virus, specifically focusing on death rates, in African countries. The SIRDATHE-V model parameters were extracted by simultaneously fitting the COVID-19 cumulative data of deaths, recoveries, active cases, and full vaccinations reported by the governments of Ghana, Kenya, Mozambique, Nigeria, South Africa, Togo, and Zambia. Using South Africa as a case study, our analysis showed that the cumulative death rates declined drastically with the increased extent of vaccination drives. Whilst the infection rates sometimes increased with the arrival of new coronavirus variants, the death rates did not increase as they did before vaccination.

Post-COVID pandemic: The new normal and aftermath

Background

The COVID-19 pandemic has brought about unparalleled worldwide transformations, impacting all facets of human existence, including health systems, economies, societal norms, and individual behaviors.

Aim

The goal is to comprehend the enduring alterations in public health strategies, economic recuperation processes, changes in work and education paradigms, and the psychological consequences for populations globally.

Methods and Materials

This analysis uses a multidisciplinary approach by incorporating data from healthcare studies, economic reports, educational research, and psychological assessments. It aims to offer a comprehensive perspective on the world after the pandemic.

Results

The findings suggest that the "New Normal" encompasses a wide range of changes, such as a greater dependence on digital technology, a transition toward remote work and learning, substantial modifications in global supply chains, and a revised outlook on health and wellness. The potential long-term consequences of these changes indicate that some may provide opportunities for innovation and expansion, whereas others present challenges that necessitate strategic planning and policy interventions.

Conclusion

The aftermath of the COVID-19 pandemic presents a critical moment for global leaders, policymakers, and individuals to navigate the complexities of a transformed world, emphasizing the need for resilience, adaptability, and a renewed commitment to collective well-being.

Influenza virus strains expressing SARS-CoV-2 receptor binding domain protein confer immunity in K18-hACE2 mice

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease (COVID-19), rapidly spread across the globe in 2019. With the emergence of the Omicron variant, COVID-19 shifted into an endemic phase. Given the anticipated rise in cases during the fall and winter seasons, the strategy of implementing seasonal booster vaccines for COVID-19 is becoming increasingly valuable to protect public health. This practice already exists for seasonal influenza vaccines to combat annual influenza seasons. Our goal was to investigate an easily modifiable vaccine platform for seasonal use against SARS-CoV-2. In this study, we evaluated the genetically modified influenza virus ΔNA(RBD) as an intranasal vaccine candidate for COVID-19. This modified virus was engineered to replace the coding sequence for the neuraminidase (NA) protein with a membrane-anchored form of the receptor binding domain (RBD) protein of SARS-CoV-2. We designed experiments to assess the protection of ΔNA(RBD) in K18-hACE2 mice using lethal (Delta) and non-lethal (Omicron) challenge models. Controls of COVID-19 mRNA vaccine and our lab's previously described intranasal virus like particle vaccine were used as comparisons. Immunization with ΔNA(RBD) expressing ancestral RBD elicited high anti-RBD IgG levels in the serum of mice, high anti-RBD IgA in lung tissue, and improved survival after Delta variant challenge. Modifying ΔNA(RBD) to express Omicron variant RBD shifted variant-specific antibody responses and limited viral burden in the lungs of mice after Omicron variant challenge. Overall, this data suggests that ΔNA(RBD) could be an effective intranasal vaccine platform that generates mucosal and systemic immunity towards SARS-CoV-2.

Impact of Vaccination on Intra-Host Genetic Diversity of Patients Infected with SARS-CoV-2 Gamma Lineage

The high transmissibility, rapid evolution, and immune escape of SARS-CoV-2 variants can influence the course of infection and, in turn, morbidity and mortality in COVID-19, posing a challenge in controlling transmission rates and contributing to the emergence and spread of new variants. Understanding the factors that shape viral genetic variation is essential for comprehending the evolution and transmission of SARS-CoV-2, especially in vaccinated individuals where immune response plays a role in the progression and spread of this disease. In this context, we evaluated the impact of immunity induced by the CoronaVac vaccine (Butantan/Sinovac) on intra-host genetic diversity, analyzing 118 whole-genome sequences of SARS-CoV-2 from unvaccinated and vaccinated patients infected with the Gamma variant. Vaccination with CoronaVac favors negative selection at the intra-host level in different genomic regions. It prevents greater genetic diversity of SARS-CoV-2, reinforcing the importance of vaccination in reducing the emergence of new mutations and virus transmission.

A Scoping Review of Factors Affecting COVID-19 Vaccination Uptake and Deployment in Global Healthcare Systems

Introduction: COVID-19 vaccines were rapidly developed and deployed on a large scale during a global crisis. A range of deployment strategies were used globally to maximize vaccine uptake. In this scoping review, we identify and analyze the main healthcare system and policy factors that guided and influenced COVID-19 vaccination deployment and uptake globally. Materials and Methods: JBI guidelines, Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), and the population, concept, and context (PCC) framework were applied. Studies on individual COVID-19 vaccination factors, such as vaccine hesitancy, were excluded. The search was last conducted in May 2024 yielding 26,686 articles from PubMed, Embase, CINAHL, Scopus, and COVID-19 websites. A total of 47 articles and 3 guidance documents were included. The results of the thematic analysis were mapped to the Consolidated Framework for Implementation Research (CFIR). Results: The results found the following healthcare system and policy factors as integral to COVID-19 vaccination: types of vaccine products, healthcare workforce capacity, procurement strategies, distribution and cold-chain capacity, partnership, coordination, and leadership, information, communication, and registration strategies, delivery models, organizations, the existing health systems and policies on prioritization of at-risk groups and deployment plans. Discussion: Globally, COVID-19 vaccination programs responded to the pandemic by leveraging and reforming the existing healthcare systems, relying on strong leadership and global cooperation (such as the COVID-19 Vaccines Global Access Initiative). Deployment was enabled by effective communication and adoption of innovative technologies using data-driven policies to create high vaccine demand while overcoming limited vaccine supply and rapidly adapting to uncertainties.

Development and Evaluation of Methotrexate and Baicalin-Loaded Nanolipid Carriers for Psoriasis Treatment

Objectives

Psoriasis is a chronic inflammatory, T-lymphocyte immune-mediated skin disease. In this study, skin-permeating nanolipid carriers (NLCs) of Methotrexate (MTX) and Baicalin (BL) were formulated. This further gave formulation of nano-lipid encapsulated carriers for dual-drug delivery of the hydrophilic and hydrophobic drugs through the liposomal gel.

Materials and Methods

Optimization of the formulation of NLCs was performed and characterized by determining their particle size, drug permeation, skin irritation, drug loading capacity, stability, in vitro drug release behavior, and in vitro cellular viability. Ex vivo skin permeation and in vivo psoriatic efficiency were also evaluated and compared.

Results

Results revealed that the amount of MTX permeating the skin was 2.4 to 4.4 fold greater for dual-drug s than for single NLCs. The optimized dual-drug loaded NLCs had an average particle size (150.20 ± 3.57 nm) and polydispersity index (0.301 ± 0.01) and high entrapment (86.32 ± 2.78% w/w). The MTX nanoparticles exhibit a positive Zeta potential of 38.6 mV. The psoriasis area and severity index scoring showed the lowest skin erythema, skin thickness and scaling. MTX-BL NLCs were inhibited the expression of inflammatory cytokines (tumor necrosis factor-alpha, and interleukin-17) .

Conclusion

It can be concluded that newer targeting strategies for NLCs for dual-drug delivery of nano-lipid carriers could be administered topically for the treatment of psoriasis.

Don't say it's over: The perceived epidemic stage and COVID preventive behaviour

Little is known about the perceptions of the COVID-19 pandemic's dynamic and its effect on self-protective behaviour. Using survey data from 1343 university students we explored how the perceived temporal distance to the COVID pandemic peak associates with risk perception and the adherence of preventive behaviours. Results show that individuals differ in their perception of the pandemic stage despite being in the same environment. The belief that the COVID peak is in the past was associated with less perceived risk and decreased self-protection. A high COVID-19 media involvement and trust in the authorities were associated with higher perceived risk and preventive behaviour implementation. Overall, the perception that the pandemic wave is in its final stages could be an independent predictor of more risky behaviour. Thus, the communication of the pandemic dynamic should be provided by policy makers with caution to avoid the possibility of discounting the risk.

Phytochemicals in antiviral drug development against human respiratory viruses

This review explores the potential antiviral properties of various plant-based compounds, including polyphenols, phytochemicals, and terpenoids. It emphasizes the diverse functionalities of compounds such as epigallocatechin-3-gallate (EGCG), quercetin, griffithsin (GRFT,) resveratrol, linalool, and carvacrol in the context of respiratory virus infections, including SARS-CoV-2. Emphasizing their effectiveness in modulating immune responses, disrupting viral envelopes, and influencing cellular signaling pathways, the review underlines the imperative for thorough research to establish safety and efficacy. Additionally, the review underscores the necessity of well-designed clinical trials to evaluate the efficacy and safety of these compounds as potential antiviral agents. This approach would establish a robust framework for future drug development efforts focused on bolstering host defense mechanisms against human respiratory viral infections.

Pfizer-BioNTech (BNT162b2) Vaccine Effectiveness against Symptomatic Laboratory-Confirmed COVID-19 Infection among Outpatients in Sentinel Sites, Lebanon, July-December 2021

On 14 February 2021, Lebanon implemented nationwide vaccination, offering the Pfizer-BioNTech (BNT162b2) vaccine to adults over 50 years of age. We estimated the effectiveness of the Pfizer-BioNTech vaccine in preventing symptomatic laboratory-confirmed COVID-19. We conducted a test-negative case-control (TND) study among symptomatic adults aged 50 years and older who presented with influenza-like illness (ILI) or COVID-19-like illness (CLI) in surveillance sentinel sites between 1 July and 31 December 2021. Unvaccinated participants did not receive any vaccine dose before symptom onset. Vaccinated participants received at least one dose within 14 days before onset of symptoms. We estimated vaccine effectiveness against symptomatic laboratory-confirmed COVID-19, adjusted for demographic and behavioral factors, using multivariable logistic regression. Out of 457 participants with symptoms, 150 (33%) were positive and 307 (67%) were negative for SARS-CoV-2. Adjusted vaccine effectiveness was 22% (95% CI: -70-65%) for those partially vaccinated and 44% (95% CI: 6-67%) for those fully vaccinated. Vaccination with two doses of the Pfizer-BioNTech vaccine was effective in preventing COVID-19 symptomatic illness in the older population. Vaccine effectiveness was lower for those partially vaccinated. We recommend enhancing vaccine uptake with at least one dose among risk groups for COVID-19 and keeping general recommendations on contact and droplet precautions in the general population.

Hybrid immunity after BNT162b2 Covid-19 vaccine administration in children aged 5 to 11 years

BACKGROUND

The immune response to coronavirus disease 2019 (COVID-19) vaccination is stronger among adults with prior infection (hybrid immunity). It is important to understand if children demonstrate a similar response to better inform vaccination strategies. Our study investigated the humoral response after BNT162b2 COVID-19 vaccine doses in SARS-CoV-2 naïve and recovered children (5-11 years).

METHODS

A multi-institutional, longitudinal, prospective cohort study was conducted. Children were enrolled in a case-ascertained antibody surveillance study in Ottawa, Ontario from September/2020-March/2021; at least one household member was severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive on RT-PCR. In November 2021, BNT162b2 COVID-19 vaccine was authorized for children aged 5-11 in Canada. Children enrolled in the surveillance study intending to receive two vaccine doses were invited to participate in this study from November 2021-April 2022. Main exposure was prior SARS-CoV-2 infection, defined by positive RT-PCR or SARS-CoV-2 anti-N IgG antibody presence. Primary outcome was spike IgG antibody levels measured following the first vaccine dose (2-3 weeks) and second vaccine dose (3-4 weeks).

RESULTS

Of the 153 eligible children, 75 participants (median age 8.9 IQR (7.4, 10.2) years; 38 (50.7 %) female; 59 (78.7 %) Caucasian) had complete follow-up. Fifty-four (72 %) children had prior SARS-COV-2 infection. Spike IgG antibody levels are significantly higher in SARS-CoV-2 recovered participants after receiving the first dose (p < 0.001) and the second (p = 0.01) compared to infection naïve children.

CONCLUSIONS AND RELEVANCE

SARS-CoV-2 recovered children (5-11 years) demonstrated higher antibody levels following first BNT162b2 vaccine dose compared with naïve children. Most reached antibody saturation two to three weeks after the first dose; a second dose didn't change the saturation level. A single vaccine dose in SARS-CoV-2 recovered children may be equivalent or superior to a 2-dose primary series in naïve children. Further research is needed on the durability and quality of a single vaccine dose in this population.

Preclinical Efficacy of Cap-Dependent and Independent mRNA Vaccines against Bovine Viral Diarrhea Virus-1

Bovine viral diarrhea virus (BVDV) is an RNA virus associated with severe economic losses in animal production. Effective vaccination and viral surveillance are urgent for the prevention and control of BVDV infection. However, the application of traditional modified live vaccines and inactivated vaccines is faced with tremendous challenges. In the present study, we describe the preclinical efficacy of two BVDV mRNA vaccines tested in mice and guinea pigs, followed by a field trial in goats, where they were compared to a commercial vaccine (formaldehyde inactivated). The two mRNAs were engineered to express the envelope protein E2 of BVDV-1, the most prevalent subtype across the world, through a 5' cap-dependent or independent fashion. Better titers of neutralizing antibodies against BVDV-1 were achieved using the capped RNA in the sera of mice and guinea pigs, with maximum values reaching 9.4 and 13.7 (by -log2), respectively, on the 35th day post-vaccination. At the same time point, the antibody levels in goats were 9.1 and 10.2 for the capped and capless RNAs, respectively, and there were no significant differences compared to the commercial vaccine. The animals remained healthy throughout the experiment, as reflected by their normal leukogram profiles. Collectively, our findings demonstrate that mRNA vaccines have good safety and immunogenicity, and we laid a strong foundation for the further exploitation of efficient and safe BVDV vaccines.

Cancer Nanovaccines: Nanomaterials and Clinical Perspectives

Cancer nanovaccines represent a promising frontier in cancer immunotherapy, utilizing nanotechnology to augment traditional vaccine efficacy. This review comprehensively examines the current state-of-the-art in cancer nanovaccine development, elucidating innovative strategies and technologies employed in their design. It explores both preclinical and clinical advancements, emphasizing key studies demonstrating their potential to elicit robust anti-tumor immune responses. The study encompasses various facets, including integrating biomaterial-based nanocarriers for antigen delivery, adjuvant selection, and the impact of nanoscale properties on vaccine performance. Detailed insights into the complex interplay between the tumor microenvironment and nanovaccine responses are provided, highlighting challenges and opportunities in optimizing therapeutic outcomes. Additionally, the study presents a thorough analysis of ongoing clinical trials, presenting a snapshot of the current clinical landscape. By curating the latest scientific findings and clinical developments, this study aims to serve as a comprehensive resource for researchers and clinicians engaged in advancing cancer immunotherapy. Integrating nanotechnology into vaccine design holds immense promise for revolutionizing cancer treatment paradigms, and this review provides a timely update on the evolving landscape of cancer nanovaccines.

Factors associated with acceleration of clinical development for infectious diseases: a cross-sectional analysis of 10-year EMA registration data

Background

Clinical trials feature centrally in the development of drugs and vaccines to determine safety and efficacy. Clinical development can be slow and may have a duration of more than ten years. Global public health threats such as Ebola virus disease (EVD) and COVID-19 have demonstrated that it is possible to accelerate clinical trials while maintaining safety and efficacy. We investigated acceleration in clinical trials over the past decade and identified factors associated with acceleration for drugs targeting infectious diseases.

Methods

A cross-sectional study was performed of all medicinal compounds targeting infectious diseases that received marketing authorisation by the European Medicines Agency (EMA) between 2012 and 2022. We calculated median clinical development time in years between the first phase 1 trial enrolment date and the authorisation date. Multivariable linear regression analysis was performed to identify factors associated with shorter development times.

Findings

Eighty-one trajectories were included. The median clinical development time was 7.3 years (IQR 4.4-12.3). The fastest times belonged to drugs and vaccines targeting COVID-19 (1.3 years, IQR 0.8-1.6), EVD (5.5 years, IQR 5.1-5.8), and Hepatitis A-E (5.5 years, IQR 3.9-8.2). Factors associated with shorter development times were outbreak setting (-5.4 years [95% CI, -8.2 to -2.6]), accelerated assessment status (-4.0 years [95% CI, -7.6 to -0.5]), and drugs with combined compounds (-2.7 years [95% CI, -4.9 to -0.4]).

Interpretation

Clinical development time for infectious disease-related drugs and vaccines was relatively short, and outbreak setting and accelerated EMA assessment were associated with shorter development times.

Funding

Amsterdam Public Health research institute.

Awareness and Uptake of COVID-19 Vaccines Among the Residents of Bisha in Saudi Arabia

OBJECTIVE

 Even though COVID-19 is no longer in an acute pandemic phase, sustaining awareness and promoting the uptake of COVID-19 vaccines are crucial for preventing future outbreaks and protecting public health. This study explores the awareness and uptake of COVID-19 vaccines among residents of Bisha, Asir province. It examines sources of information, healthcare providers' influence, and community engagement initiatives. The findings can inform future public health policies and strategies, supporting efforts to control the spread of the pandemic and enhance community resilience.

METHODS

 The cross-sectional study was administered to the adult population in Bisha. The study involved a total of 220 respondents. Data were collected using a questionnaire and analyzed using SPSS version 27 to obtain essential insights.

RESULTS

Most respondents (n = 204, 92.73%) reported receiving information about COVID-19 vaccines from healthcare professionals, other people, and family members. The study also revealed that only 46 (20.9%) individuals had exposure to COVID-19, with 36 (78.26%) reporting infection before vaccination and only 10 (21.74%) reporting infection after vaccination. Regarding COVID-19 vaccine first-dose uptake, less than half (27.73%) of the respondents had received the first dose. Among those who took the first dose, 29 (47.54%) took the second dose, while 32 (52.46%) did not. It also shows a statistically significant difference in COVID-19 vaccine uptake based on the participant's age, gender, education level, comorbidity, smoking status, and place of residence (P < 0.05).

CONCLUSION

There was a significantly high level of awareness about the vaccine, with significant proportions of respondents indicating their willingness to take preventive measures even after vaccination. However, vaccine uptake remains below optimal levels, with various reasons cited for non-vaccination, including concerns about vaccine availability, efficacy, and side effects. Healthcare professionals should intensify public education efforts and ensure the availability of vaccines in various forms at hospitals to address this issue.

COVID-19 Vaccines Breakthrough Infections and Adverse Effects Reported by the Birzeit University Community in Palestine

Background

Coronavirus disease (COVID-19) vaccines play an essential role in boosting immunity, preventing severe diseases, and alleviating the Covid-19 health crisis.

Objective

This study aimed to explore the type and severity of short-term adverse reactions associated with BNT162 (Pfizer-BioNTech), mRNA 1273 (Moderna), and viral vector vaccines and to compare the incidence of post-vaccination Covid-19 infection among the Birzeit University community in Palestine.

Methods

This questionnaire-based retrospective cross-sectional study was conducted among individuals who were vaccinated with at least one dose of any COVID-19 vaccine offered in Palestine during the COVID-19 pandemic. The study included participants aged 18 years and older who were vaccinated with Pfizer, Moderna, Sputnik Light, or Sputnik v.

Results

A total of 558 participants who were administered COVID-19 vaccine were included in the study. Sputnik (239), Pfizer vaccine recipients (236), and Moderna vaccine recipients (83). Of the viral vector vaccine recipients, 57 (23.8%) had a post-vaccination infection, compared to 30 (12.7%) for Pfizer and seven (8.4%) for Moderna. Furthermore, the reported adverse effects in the viral victor group were higher than those in the Moderna and Pfizer groups (71.7, 66.3, and 61.9%, respectively). Chills, headache, fatigue, abdominal pain, and joint pain were significantly higher in the Viral Vector vaccine group than the Moderna and Pfizer vaccine. Vomiting, tiredness, and fatigue were significantly less likely to be complained of by Pfizer vaccine recipients compared to Moderna and Viral Vector vaccine recipients (p < 0.05).

Conclusions

Breakthrough infections were associated with both viral vectors and mRNA; however, the mRNA vaccine had less reported post-vaccine infection. Furthermore, the Pfizer/BioNTech COVID-19 vaccine group reported fewer commonly reported side effects (fever, chills, headache, fatigue, muscle pain, joint pain, nausea, and dizziness), followed by the Moderna and viral vector vaccines. Females and underweight participants experienced more adverse effects with both vaccines, and fewer common side effects were reported by all participants.

From bench to bedside: potential of translational research in COVID-19 and beyond

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) have been around for more than 3 years now. However, due to constant viral evolution, novel variants are emerging, leaving old treatment protocols redundant. As treatment options dwindle, infection rates continue to rise and seasonal infection surges become progressively common across the world, rapid solutions are required. With genomic and proteomic methods generating enormous amounts of data to expand our understanding of SARS-CoV-2 biology, there is an urgent requirement for the development of novel therapeutic methods that can allow translational research to flourish. In this review, we highlight the current state of COVID-19 in the world and the effects of post-infection sequelae. We present the contribution of translational research in COVID-19, with various current and novel therapeutic approaches, including antivirals, monoclonal antibodies and vaccines, as well as alternate treatment methods such as immunomodulators, currently being studied and reiterate the importance of translational research in the development of various strategies to contain COVID-19.

Understanding COVID-19 Vaccine Hesitancy in the United States: A Systematic Review

The COVID-19 pandemic has presented the importance of vaccination as a pivotal strategy for controlling its spread. However, vaccine hesitancy poses a significant barrier to achieving widespread immunization in the United States. This systematic review utilizes the 5C model to examine the factors contributing to hesitancy, which include confidence in vaccines, complacency about disease risk, calculations of individual benefit, convenience of vaccination, and collective responsibility for the protection of others.

METHODS

We conducted a comprehensive search across several relevant databases and the gray literature, identifying 544 studies that used quantitative and qualitative methods to explore COVID-19 vaccine hesitancy in the general U.S.

POPULATION

RESULTS

This review identifies a complex interplay of factors affecting hesitancy, such as concerns over vaccine safety and efficacy, misinformation and conspiracy theories, demographic variables, and socioeconomic conditions. Key strategies for increasing vaccine uptake include transparent and effective communication along with proactive community engagement.

CONCLUSIONS

To effectively mitigate vaccine hesitancy, it is crucial to understand its multifaceted causes. Tailored interventions that consider socioeconomic and cultural contexts and prioritize clear communication, community involvement, and specific strategies to address unique concerns can enhance vaccine acceptance.

The negative impact of misinformation and vaccine conspiracy on COVID-19 vaccine uptake and attitudes among the general public in Iraq

BACKGROUND

Vaccine hesitancy is a major barrier to infectious disease control. Previous studies showed high rates of COVID-19 vaccine hesitancy in the Middle East. The current study aimed to investigate the attitudes towards COVID-19 vaccination and COVID-19 vaccine uptake among adult population in Iraq.

METHODS

This self-administered survey-based study was conducted in August-September 2022. The survey instrument assessed participants' demographics, attitudes to COVID-19 vaccination, beliefs in COVID-19 misinformation, vaccine conspiracy beliefs, and sources of information regarding the vaccine.

RESULTS

The study sample comprised a total of 2544 individuals, with the majority reporting the uptake of at least one dose of COVID-19 vaccination (n = 2226, 87.5 %). Positive attitudes towards COVID-19 vaccination were expressed by the majority of participants (n = 1966, 77.3 %), while neutral and negative attitudes were expressed by 345 (13.6 %) and 233 (9.2 %) participants, respectively. Factors associated with positive attitudes towards COVID-19 vaccination in multivariate analysis included disbelief in COVID-19 misinformation and disagreement with vaccine conspiracies. Higher COVID-19 vaccine uptake was significantly associated with previous history of COVID-19 infection, higher income, residence outside the Capital, disbelief in COVID-19 misinformation, disagreement with vaccine conspiracies, and reliance on reputable information sources.

CONCLUSION

COVID-19 vaccine coverage was high among the participants, with a majority having positive attitudes towards COVID-19 vaccination. Disbelief in COVID-19 misinformation and disagreement with vaccine conspiracies were correlated with positive vaccine attitudes and higher vaccine uptake. These insights can inform targeted interventions to enhance vaccination campaigns.

A Rapid Review of the Effects of the COVID-19 Vaccine Among Individuals Taking Clozapine

BACKGROUND

The COVID-19 pandemic prompted the rapid development of vaccines to combat the virus. Several COVID-19 vaccines have proven effective in preventing infection, hospitalization, and death. Vaccination has been especially recommended for vulnerable populations, such as individuals with psychiatric illnesses who face increased risks due to comorbidities and socioeconomic factors. This rapid review identifies and analyzes the effects of COVID-19 vaccines among individuals taking clozapine.

METHODS

The review included articles from PubMed, OVID, Clinical Key, Web of Science, and Google Scholar, published between September 2020 and December 2023. Inclusion criteria were peer-reviewed journals, English language, patients on clozapine receiving a COVID-19 vaccine, and documented vaccine-related adverse effects.

RESULTS

Twelve articles were included, consisting of 8 case reports, 1 cross-sectional study, and 3 prospective observational studies, involving 298 subjects, with 9 subjects from case reports. After the first vaccine dose, 27 of 248 subjects experienced adverse effects, with 1 case report advising a temporary halt and dose reduction of clozapine. The subject in this case was admitted in a delirious state 4 days after vaccination with repeated falls and urinary incontinence; active infectious and neurologic etiologies were ruled out. Second dose data were available for 261 subjects, with 31 reporting adverse effects. Adverse effects included hematological changes, delirious state, seizures, and fever.

CONCLUSIONS

The review suggests that individuals on clozapine receiving COVID-19 vaccines may experience adverse effects. Clozapine levels and immune system interactions should be monitored in these cases.

Urinary incontinence after COVID-19 vaccination: a case study in an 8-year-old boy

There have been many studies on the adverse effects of coronavirus disease 2019 (COVID-19) vaccines but the urinary incontinence after COVID-19 vaccination is rare. Here, we report an 8-year-old boy presented to outpatient department, Thai Binh University of Medicine Hospital, Thai Binh, Vietnam with complaints of urinary incontinence for the past 2 weeks, following the first dose of the messenger RNA vaccine. He had no other abnormalities in clinical and laboratory exams. This clinical situation suggested vaccine side effects. No specific treatment was administered upon diagnosis without toilet and bladder training. Subsequent monitoring revealed a gradual reduction in symptoms over 2 months, with complete recovery achieved at the 14th week from the onset of symptoms, without necessitating any medical intervention. This case highlights the need for thorough evaluation and assessment of potential adverse effects following vaccination, including uncommon presentations.

Efficacy and effectiveness of COVID-19 vaccines in Africa: A systematic review

BACKGROUND

Data on COVID-19 vaccine effectiveness to support regional vaccine policy and practice are limited in Africa. Thus, this review aimed to evaluate the efficacy and effectiveness of COVID-19 vaccines administered in Africa.

METHODS

We systematically searched peer-reviewed randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies that reported on VE in Africa. We carried out a risk of bias assessment, and the findings of this review were synthesized and presented in a narrative form, including tables and figures. The synthesis was focused on COVID-19 VE against various levels of the disease condition and outcomes (infection, hospitalization or critical, and death), time points, and variants of concern.

RESULTS

A total of 13 studies, with a total sample size of 913,285 participants, were included in this review. The majority (8/13) of studies were from South Africa and 38.5% (5/13) were randomized clinical trials. The studies reported that a full dose of Pfizer-BioNTech vaccine had a VE of 100% against COVID-19 infection by Beta (B.1.351) and Delta variants and 96.7% against hospitalization by Delta variant. The Johnson and Johnson vaccine had VE ranging from 38.1%-62.0% against hospitalization and 51.9%- 86% against critical disease by Beta (B 1.351) variant. The Oxford-AstraZeneca vaccine had a VE of 89.4% against hospitalization by the Omicron variant but was not effective against the B.1.351 variant (10.4%). The Sinopharm vaccine had a VE of 67% against infection and 46% against hospitalization by Delta variant.

CONCLUSIONS

COVID-19 vaccines administered in Africa were effective in preventing infections, hospitalization, and death. These review findings underscore the need for concerted efforts of all stakeholders to enhance the access and availability of COVID-19 vaccines and reinforce public awareness to reach the high-risk, unvaccinated group of the African population.

Detection of IgG antibodies against the receptor binding domain of the spike protein and nucleocapsid of SARS-CoV-2 at university students from Southern Mexico: a cross-sectional study

BACKGROUND

Natural infection and vaccination against SARS-CoV-2 is associated with the development of immunity against the structural proteins of the virus. Specifically, the two most immunogenic are the S (spike) and N (nucleocapsid) proteins. Seroprevalence studies performed in university students provide information to estimate the number of infected patients (symptomatic or asymptomatic) and generate knowledge about the viral spread, vaccine efficacy, and epidemiological control. Which, the aim of this study was to evaluate IgG antibodies against the S and N proteins of SARS-CoV-2 at university students from Southern Mexico.

METHODS

A total of 1418 serum samples were collected from eighteen work centers of the Autonomous University of Guerrero. Antibodies were detected by Indirect ELISA using as antigen peptides derived from the S and N proteins.

RESULTS

We reported a total seroprevalence of 39.9% anti-S/N (positive to both antigens), 14.1% anti-S and 0.5% anti-N. The highest seroprevalence was reported in the work centers from Costa Grande, Acapulco and Centro. Seroprevalence was associated with age, COVID-19, contact with infected patients, and vaccination.

CONCLUSION

University students could play an essential role in disseminating SARS-CoV-2. We reported a seroprevalence of 54.5% against the S and N proteins, which could be due to the high population rate and cultural resistance to safety measures against COVID-19 in the different regions of the state.

COVID-19 Vaccination Reporting and Adverse Event Analysis in Taiwan

The COVID-19 pandemic necessitated an urgent global response in vaccine deployment, achieving over 70.6% global vaccination coverage with at least one dose. This study focuses on Taiwan's vaccine administration and adverse event reporting, set against a global backdrop. Using data from Taiwan's Vaccine Adverse Event Reporting System (VAERS) and global vaccination data, this study investigates vaccine safety and the public health implications of vaccination strategies from local and global perspectives. Taiwan's proactive approach, resulting in high vaccination rates, provides a case study for the monitoring and management of vaccine-related adverse events. This study offers insights into the safety profiles of various COVID-19 vaccines and further explores the implications of adverse event reporting rates for vaccine policy and public health strategies. The comparative analysis reveals that, while vaccination has been effective in controlling the virus's spread, safety monitoring remains critical for maintaining public trust. It underscores the necessity of enhanced surveillance and the importance of transparent and tailored risk communication to support informed public health decisions. The findings aim to contribute to the global dialogue on vaccine safety, equitable distribution, evidence-based policy-making, and development of mitigation measures with consideration of local demographics in the ongoing fight against COVID-19.

Regional and temporal variations in COVID-19 cases and deaths in Ethiopia: Lessons learned from the COVID-19 enhanced surveillance and response

BACKGROUND

The COVID-19 pandemic is one of the most devastating public health emergencies of international concern to have occurred in the past century. To ensure a safe, scalable, and sustainable response, it is imperative to understand the burden of disease, epidemiological trends, and responses to activities that have already been implemented. We aimed to analyze how COVID-19 tests, cases, and deaths varied by time and region in the general population and healthcare workers (HCWs) in Ethiopia.

METHODS

COVID-19 data were captured between October 01, 2021, and September 30, 2022, in 64 systematically selected health facilities throughout Ethiopia. The number of health facilities included in the study was proportionally allocated to the regional states of Ethiopia. Data were captured by standardized tools and formats. Analysis of COVID-19 testing performed, cases detected, and deaths registered by region and time was carried out.

RESULTS

We analyzed 215,024 individuals' data that were captured through COVID-19 surveillance in Ethiopia. Of the 215,024 total tests, 18,964 COVID-19 cases (8.8%, 95% CI: 8.7%- 9.0%) were identified and 534 (2.8%, 95% CI: 2.6%- 3.1%) were deceased. The positivity rate ranged from 1% in the Afar region to 15% in the Sidama region. Eight (1.2%, 95% CI: 0.4%- 2.0%) HCWs died out of 664 infected HCWs, of which 81.5% were from Addis Ababa. Three waves of outbreaks were detected during the analysis period, with the highest positivity rate of 35% during the Omicron period and the highest rate of ICU beds and mechanical ventilators (38%) occupied by COVID-19 patients during the Delta period.

CONCLUSIONS

The temporal and regional variations in COVID-19 cases and deaths in Ethiopia underscore the need for concerted efforts to address the disparities in the COVID-19 surveillance and response system. These lessons should be critically considered during the integration of the COVID-19 surveillance system into the routine surveillance system.

Dysregulated Leukotriene Metabolism in Patients with COVID-19

This study aimed to examine the leukotriene metabolism during COVID-19. In total, 180 participants were included in this study, of which 60 were healthy controls, 60 required intensive care units (ICU), and 60 did not require intensive care (non-ICU). The serum levels of 5-lipoxygenase (5-LO), 5-LO activating protein (ALOX5AP), and cysteinyl leukotriene (CYSLT) were measured, and the mRNA expression levels of 5-LO, ALOX5AP, and cysteinyl leukotriene receptor 1 (CYSLTR1) were investigated. Compared with the control group, both the non-ICU and ICU groups had lower levels of 5-LO and mRNA expression. ICU patients had lower levels of 5-LO and mRNA expression than non-ICU patients. CYSLTR1 mRNA expression was highest in the ICU group, followed by the non-ICU group, and healthy controls had the lowest mRNA expression levels. CYSLT levels were higher in the control group than in the non-ICU and ICU groups. CYSLTR1 expression was higher in patients than in controls; therefore, selective leukotriene receptor blockers can be used as treatment options. CYSLTR1 expression was higher in the ICU group than in the non-ICU group. Furthermore, CYSLTR1 mRNA expression may be a promising biomarker of COVID-19 severity.