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Mwendwa F, Kanji A, Bukhari AR, Khan U, Sadiqa A, Mushtaq Z, Nasir N, Mahmood SF, Aamir UB, Hasan Z. Shift in SARS-CoV-2 variants of concern from Delta to Omicron was associated with reduced hospitalizations, increased risk of breakthrough infections but lesser disease severity. J Infect Public Health 2024; 17:1100-1107. [PMID: 38714122 PMCID: PMC11142923 DOI: 10.1016/j.jiph.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND COVID-19 epidemiology changed with the emergence of SARS-CoV-2 variants of concern (VOC). Pakistan administered mostly inactivated vaccines. We investigated the association between VOC and breakthrough infections in a mixed-vaccination-status population of Karachi. METHODS We investigated SARS-CoV-2 VOC tested in 392 respiratory specimens collected between May and December 2021. Data for age, sex, hospital admission, vaccinations, together with CT values of the diagnostic PCR test were analyzed. RESULTS The median age of COVID-19 cases tested was 40 (27-57) years and 43.4% were female. Delta variants were most common (56.4%) followed by Alpha (15.9%), Omicron (12.2%), Beta/Gamma (11.3%), and others (4.3%). Eighteen percent of cases were hospitalized whereby, predominant VOC were Beta/Gamma (40.8%), Alpha (35.2%) and Delta (22.5%). Overall, 55.4% of individuals were fully vaccinated, 7.4% were partially vaccinated and 37.2% were unvaccinated. Most (74.6%) inpatients were unvaccinated. Vaccines comprised inactivated (85.34%), single-shot vector (8.62%), two-shot vector (3.02%) and mRNA (3.02%) types. Omicron variants showed lower viral loads as compared to Alpha, Beta/Gamma, and Delta (p = 0.017). The risk of infection with Delta and Omicron variants was higher, 8 weeks after vaccination. The majority of those with breakthrough infections after receiving inactivated vaccines acquired COVID-19 within 4 months of vaccination. CONCLUSION Our data highlights the shifting of VOC from Delta to Omicron during 2021 and that COVID-19 vaccinations reduced both hospitalizations and viral transmission. It informs on the increased risk of breakthrough infection within 8 weeks of vaccination, indicating the need for booster vaccinations.
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Affiliation(s)
- Fridah Mwendwa
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Akbar Kanji
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Ali Raza Bukhari
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Unab Khan
- Department of Family Medicine, The Aga Khan University, Karachi, Pakistan
| | - Ayesha Sadiqa
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Zain Mushtaq
- Department of Family Medicine, The Aga Khan University, Karachi, Pakistan
| | - Nosheen Nasir
- Department of Family Medicine, The Aga Khan University, Karachi, Pakistan
| | | | | | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan.
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Mushtaq MZ, Nasir N, Mahmood SF, Khan S, Kanji A, Nasir A, Syed MA, Aamir UB, Hasan Z. Exploring the relationship between SARS-CoV-2 variants, illness severity at presentation, in-hospital mortality and COVID-19 vaccination in a low middle-income country: A retrospective cross-sectional study. Health Sci Rep 2023; 6:e1703. [PMID: 38045627 PMCID: PMC10690835 DOI: 10.1002/hsr2.1703] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 12/05/2023] Open
Abstract
Background and Aims COVID-19 morbidity and mortality varied globally through the pandemic. We studied the relationship of SARS-CoV-2 variants of concern (VOC) with COVID-19 severity and mortality among hospitalized patients in Pakistan. Methods A retrospective review of clinical, laboratory, and vaccination data of 197 COVID-19 adult patients at the Aga Khan University Hospital, Karachi between April 2021, and February 2022 was performed. SARS-CoV-2 VOC identified in respiratory samples were analyzed. Univariate and multivariate analysis was conducted to identify factors associated with COVID-19 outcomes. Results The median age of cases was 55 years and 51.8% were males. Twenty-four percent of females were pregnant. Of COVID-19 cases, 48.2% had nonsevere disease, while 52.8% had severe/critical disease. Hypertension (48%) and diabetes mellitus (41%) were common comorbids. SARS-CoV-2 VOC identified comprised; Omicron (55.3%), Beta (14.7%), Alpha (13.7%), Delta (12.7%), and Gamma (3.6%) variants. Most (59.7%) study subjects were unvaccinated. Of vaccines, 88% had received inactivated virus COVID-19 vaccines. Increased risk of severe disease was associated with age ≥50 years (odds ratio [OR]: 5.73; 95% confidence interval [CI]: [2.45-13.7]), as well as with diabetes mellitus (OR: 4.24; 95% CI: [1.82-9.85]). Full vaccination (OR: 0.25; 95% CI: [0.11-0.58]) or infection with Omicron (OR: 0.42; 95% CI: [0.23-0.74]) was associated with reduced disease severity. The risk of mortality increased with age ≥50 years (OR: 5.07; 95% CI: [1.92-13.42]) and a history of myocardial infarction (OR: 5.11; 95% CI: [1.45-17.93]) whilst, infection with Omicron was found to reduce the risk (OR: 0.22; 95% CI: [0.10-0.53]). Conclusion Our study describes the relationship between the severity of COVID-19, in-hospital mortality in relation to SARS-CoV-2 variants, and the impact of COVID-19 vaccination in Pakistan. Outcomes were more favorable in younger individuals, after vaccinations and with Omicron variant infections. Most cases received inactivated virus vaccines therefore these data highlight the protection provided against severe COVID-19.
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Affiliation(s)
| | - Nosheen Nasir
- Department of MedicineThe Aga Khan UniversityKarachiPakistan
| | | | - Sara Khan
- Department of MedicineThe Aga Khan UniversityKarachiPakistan
| | - Akbar Kanji
- Department of Pathology and Laboratory MedicineThe Aga Khan UniversityKarachiPakistan
| | - Asghar Nasir
- Department of Pathology and Laboratory MedicineThe Aga Khan UniversityKarachiPakistan
| | - M. Asif Syed
- Department of HealthGovernment of SindhHyderabadPakistan
| | | | - Zahra Hasan
- Department of Pathology and Laboratory MedicineThe Aga Khan UniversityKarachiPakistan
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Ashraf J, Bukhari SARS, Kanji A, Iqbal T, Yameen M, Nisar MI, Khan W, Hasan Z. Substitution spectra of SARS-CoV-2 genome from Pakistan reveals insights into the evolution of variants across the pandemic. Sci Rep 2023; 13:20955. [PMID: 38017265 PMCID: PMC10684861 DOI: 10.1038/s41598-023-48272-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
Changing morbidity and mortality due to COVID-19 across the pandemic has been linked with factors such as the emergence of SARS-CoV-2 variants and vaccination. Mutations in the Spike glycoprotein enhanced viral transmission and virulence. We investigated whether SARS-CoV-2 mutation rates and entropy were associated COVID-19 in Pakistan, before and after the introduction of vaccinations. We analyzed 1,705 SARS-CoV-2 genomes using the Augur phylogenetic pipeline. Substitution rates and entropy across the genome, and in the Spike glycoprotein were compared between 2020, 2021 and 2022 (as periods A, B and C). Mortality was greatest in B whilst cases were highest during C. In period A, G clades were predominant, and substitution rate was 5.25 × 10-4 per site per year. In B, Delta variants dominated, and substitution rates increased to 9.74 × 10-4. In C, Omicron variants led to substitution rates of 5.02 × 10-4. Genome-wide entropy was the highest during B particularly, at Spike E484K and K417N. During C, genome-wide mutations increased whilst entropy was reduced. Enhanced SARS-CoV-2 genome substitution rates were associated with a period when more virulent SARS-CoV-2 variants were prevalent. Reduced substitution rates and stabilization of genome entropy was subsequently evident when vaccinations were introduced. Whole genome entropy analysis can help predict virus evolution to guide public health interventions.
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Affiliation(s)
- Javaria Ashraf
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
| | - Sayed Ali Raza Shah Bukhari
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
| | - Akbar Kanji
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
| | - Tulaib Iqbal
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
| | - Maliha Yameen
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
| | - Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, CITRIC Center for Bioinformatics and Computational Biology, Aga Khan University, Karachi, Pakistan
| | - Waqasuddin Khan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, CITRIC Center for Bioinformatics and Computational Biology, Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan.
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Yao T, Guo Y, Xu X, Zhang X, Mu S, Huo J, Wei Z, Liu L, Li X, Li H, Xing R, Feng Y, Chen J, Feng L, Wang S. Predictors of immune persistence induced by two-dose BBIBP-CorV vaccine in high-risk occupational population. Vaccine 2023; 41:5910-5917. [PMID: 37604725 DOI: 10.1016/j.vaccine.2023.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND The immune protection from infection may wane over time as neutralizing antibody levels decline. We aimed to develop a nomogram to predict long-term immune persistence induced by two-dose BBIBP-CorV vaccine and calculate the neutralizing antibody decline probability of individuals. METHODS In the initial study, a total of 809 participants were recruited and randomly allocated (1:1:1) to vaccination group with three two-dose schedules on days 0 and 14, 0 and 21, or 0 and 28. The participants with neutralizing antibody titers of 16 or above on day 28 after the second dose were followed up at month 3, 6 and 10. Multivariable Cox proportional hazards regression model and nomogram model were used to identify predictors associated with maintaining of neutralizing antibody levels during 10 months after the second dose. RESULTS A total of 744 participants followed up at day 28 after the second dose. The participants with age ≥ 50 (aHR = 3.556, 95 %CI: 1.141-4.884, P = 0.028) were associated with a high risk of response loss (titers < 16). The participants who were in 0-28 d group (aHR = 0.403, 95 %CI: 0.177-0.919, P = 0.031), had an influenza vaccination history (aHR = 0.468, 95 %CI: 0.267-0.921, P = 0.033) or were female (aHR = 0.542, 95 %CI: 0.269-0.935, P = 0.035) tended to maintain immune persistence during 10 months after the second dose. The nomogram was constructed and showed moderate discrimination[C-index:0.711 (95 %CI: 0.652-0.770); AUC: 0.731 (95 %CI: 0.663-0.792)] and good calibration. CONCLUSIONS From 28 days to 10 months after receipt of the second dose of the BBIBP-CorV vaccine, neutralizing antibody levels were substantially decreased, especially among men, among persons 50 years of age or older, among persons with the 0-14 d group, and among persons without history of influenza vaccination. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2100041705, ChiCTR2100041706.
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Affiliation(s)
- Tian Yao
- First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Yana Guo
- School of Public Health, Shanxi Medical University, Taiyuan, China; Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Xiuyang Xu
- School of Public Health, Shanxi Medical University, Taiyuan, China; Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Xiaohong Zhang
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Shengcai Mu
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Junfeng Huo
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Zhiyun Wei
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Ling Liu
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Xiaoqing Li
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Hong Li
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Rongqin Xing
- Outpatient Department of Shanxi Aviation Industry Group Co. LTD, Taiyuan, China
| | - Yongliang Feng
- School of Public Health, Shanxi Medical University, Taiyuan, China; Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Jing Chen
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China
| | - Lizhong Feng
- Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China; Shanxi Provincial Key Laboratory for Major Infectious Disease Response, Taiyuan, China.
| | - Suping Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China; Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China.
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Hasan Z, Masood KI, Qaiser S, Khan E, Hussain A, Ghous Z, Khan U, Yameen M, Hassan I, Nasir MI, Qazi MF, Memon HA, Ali S, Baloch S, Bhutta ZA, Veldhoen M, Pedro Simas J, Mahmood SF, Ghias K, Hussain R. Investigating the impact of prior COVID-19 on IgG antibody and interferon γ responses after BBIBP-CorV vaccination in a disease endemic population: A prospective observational study. Health Sci Rep 2023; 6:e1521. [PMID: 37692793 PMCID: PMC10486204 DOI: 10.1002/hsr2.1521] [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: 04/08/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Background and Aims COVID-19 vaccinations have reduced morbidity and mortality from the disease. Antibodies against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) have been associated with immune protection. Seroprevalence studies revealed high immunoglobulin G (IgG) antibody levels to SARS-CoV-2 in the Pakistani population before vaccinations. We investigated the effect of BBIBP-CorV vaccination on circulating IgG antibodies and interferon (IFN)-γ from T cells measured in a cohort of healthy individuals, with respect to age, gender, and history of COVID-19. Methods The study was conducted between April and October 2021. BBIBP-CorV vaccinated participants were followed up to 24 weeks. Antibodies to SARS-CoV-2 Spike protein and its receptor-binding domain (RBD) were measured. IFNγ secreted by whole blood stimulation of Spike protein and extended genome antigens was determined. Results Study participants with a history of prior COVID-19 displayed a higher magnitude of IgG antibodies to Spike and RBD. IgG seropositivity was greater in those with prior COVID-19, aged 50 years or younger and in females. At 24 weeks after vaccination, 37.4% of participants showed IFN-γ responses to SARS-CoV-2 antigens. T cell IFN-γ release was higher in those with prior COVID-19 and those aged 50 years or less. Highest IFN-γ release was observed to extended genome antigens in individuals both with and without prior COVID-19. Conclusion We found that IgG seropositivity to both Spike and RBD was affected by prior COVID-19, age and gender. Importantly, seropositive responses persisted up to 24 weeks after vaccination. Persistence of vaccine induced IgG antibodies may be linked to the high seroprevalence observed earlier in unvaccinated individuals. Increased T cell reactivity to Spike and extended genome antigens reflects cellular activation induced by BBIBP-CorV. COVID-19 vaccination may have longer lasting immune responses in populations with a higher seroprevalence. These data inform on vaccination booster policies for high-risk groups.
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Affiliation(s)
- Zahra Hasan
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Kiran Iqbal Masood
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Shama Qaiser
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Erum Khan
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Areeba Hussain
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Zara Ghous
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Unab Khan
- Department of Family MedicineAga Khan UniversityKarachiPakistan
| | - Maliha Yameen
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Imran Hassan
- Department of Family MedicineAga Khan UniversityKarachiPakistan
| | | | | | - Haris Ali Memon
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Shiza Ali
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Sadaf Baloch
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
| | - Zulfiqar A. Bhutta
- Center of Excellence in Women and Child HealthAga Khan UniversityKarachiPakistan
- Center for Global Child HealthHospital for Sick ChildrenTorontoCanada
| | - Marc Veldhoen
- Instituto de Medicina Molecular, João Lobo Antunes, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
| | - J. Pedro Simas
- Católica Biomedical Research Center, Católica Medical SchoolUniversidade Católica PortuguesaLisboaPortugal
| | | | - Kulsoom Ghias
- Department of Biological and Biomedical SciencesAga Khan UniversityKarachiPakistan
| | - Rabia Hussain
- Department of Pathology and Laboratory MedicineAga Khan UniversityKarachiPakistan
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6
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Bukhari AR, Ashraf J, Kanji A, Rahman YA, Trovão NS, Thielen PM, Yameen M, Kanwar S, Khan W, Kabir F, Nisar MI, Merritt B, Hasan R, Spiro D, Rasmussen Z, Aamir UB, Hasan Z. Sequential viral introductions and spread of BA.1 across Pakistan provinces during the Omicron wave. BMC Genomics 2023; 24:432. [PMID: 37532989 PMCID: PMC10399012 DOI: 10.1186/s12864-023-09539-3] [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: 04/30/2023] [Accepted: 07/27/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND COVID-19 waves caused by specific SARS-CoV-2 variants have occurred globally at different times. We focused on Omicron variants to understand the genomic diversity and phylogenetic relatedness of SARS-CoV-2 strains in various regions of Pakistan. METHODS We studied 276,525 COVID-19 cases and 1,031 genomes sequenced from December 2021 to August 2022. Sequences were analyzed and visualized using phylogenetic trees. RESULTS The highest case numbers and deaths were recorded in Sindh and Punjab, the most populous provinces in Pakistan. Omicron variants comprised 93% of all genomes, with BA.2 (32.6%) and BA.5 (38.4%) predominating. The first Omicron wave was associated with the sequential identification of BA.1 in Sindh, then Islamabad Capital Territory, Punjab, Khyber Pakhtunkhwa (KP), Azad Jammu Kashmir (AJK), Gilgit-Baltistan (GB) and Balochistan. Phylogenetic analysis revealed Sindh to be the source of BA.1 and BA.2 introductions into Punjab and Balochistan during early 2022. BA.4 was first introduced in AJK and BA.5 in Punjab. Most recent common ancestor (MRCA) analysis revealed relatedness between the earliest BA.1 genome from Sindh with Balochistan, AJK, Punjab and ICT, and that of first BA.1 from Punjab with strains from KPK and GB. CONCLUSIONS Phylogenetic analysis provides insights into the introduction and transmission dynamics of the Omicron variant in Pakistan, identifying Sindh as a hotspot for viral dissemination. Such data linked with public health efforts can help limit surges of new infections.
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Affiliation(s)
- Ali Raza Bukhari
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Javaria Ashraf
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Akbar Kanji
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Yusra Abdul Rahman
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Nídia S Trovão
- Fogarty International Center, U.S. National Institutes of Health, 16 Center Drive, Bethesda, MD, 20892, USA
| | - Peter M Thielen
- Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD, 20723, USA
| | - Maliha Yameen
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - Samiah Kanwar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, 74800, Pakistan
| | - Waqasuddin Khan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, 74800, Pakistan
| | - Furqan Kabir
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, 74800, Pakistan
| | - Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, 74800, Pakistan
| | - Brian Merritt
- Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD, 20723, USA
| | - Rumina Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan
| | - David Spiro
- Fogarty International Center, U.S. National Institutes of Health, 16 Center Drive, Bethesda, MD, 20892, USA
| | - Zeba Rasmussen
- Fogarty International Center, U.S. National Institutes of Health, 16 Center Drive, Bethesda, MD, 20892, USA
| | - Uzma Bashir Aamir
- World Health Organization Country Office, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, 74800, Pakistan.
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7
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Shava E, Izu A, Gaolathe T, Walker A, Carty L, Georgiou P, Kuate L, Kgathi C, Sekoto T, Seonyatseng N, Mogashoa T, Maphorisa C, Mohammed T, Ntalabgwe T, Frank TT, Matlhaku B, Diphoko A, Phindela T, Kaunda A, Kgari P, Kanyakula T, Palalani G, Phakedi I, Taylor S, Mmalane M, Moyo S, Makhema J. Safety and incidence of COVID-19 following ChAdOx1(AZD1222) COVID-19 vaccination in Botswana. J Infect 2023; 86:603-606. [PMID: 36863535 PMCID: PMC9974206 DOI: 10.1016/j.jinf.2023.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Emily Shava
- Botswana Harvard AIDS Institute Partnership, Botswana.
| | - Alane Izu
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Innovation/National Research Foundation South African Research Chair Initiative in Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.
| | - Tendani Gaolathe
- Harvard T.H. Chan School of Public Health, Department of Immunology and Infectious Diseases, Boston, United States; University of Botswana, Gaborone, Botswana.
| | - Adam Walker
- Medical Evidence, Vaccine and Immune Therapies, BioPharmaceuticals Medicine, AstraZeneca, Cambridge, UK.
| | - Lucy Carty
- Medical and Payer Evidence Statistics, BioPharmaceuticals Medicine, AstraZeneca, Cambridge, UK.
| | - Panayiotis Georgiou
- Late Development, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
| | | | | | | | | | | | | | | | | | | | | | - Ame Diphoko
- Botswana Harvard AIDS Institute Partnership, Botswana.
| | | | - Agripa Kaunda
- Botswana Harvard AIDS Institute Partnership, Botswana.
| | - Poloko Kgari
- Botswana Harvard AIDS Institute Partnership, Botswana.
| | | | - Gape Palalani
- Botswana Harvard AIDS Institute Partnership, Botswana.
| | | | - Sylvia Taylor
- Infection Evidence Strategy, Vaccine and Immune Therapies, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
| | | | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Botswana; Harvard T.H. Chan School of Public Health, Department of Immunology and Infectious Diseases, Boston, United States.
| | - Joseph Makhema
- Botswana Harvard AIDS Institute Partnership, Botswana; Harvard T.H. Chan School of Public Health, Department of Immunology and Infectious Diseases, Boston, United States.
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