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Oh WO, Lee E, Heo YJ, Jung MJ, Han J. Understanding global research trends in the control and prevention of infectious diseases for children: Insights from text mining and topic modeling. J Nurs Scholarsh 2024. [PMID: 38380588 DOI: 10.1111/jnu.12963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION The emergence of novel infectious diseases has amplified the urgent need for effective prevention strategies, especially ones targeting vulnerable populations such as children. Factors such as the high incidence of both emerging and existing infectious diseases, delays in vaccinations, and routine exposure in communal settings heighten children's susceptibility to infections. Despite this pressing need, a comprehensive exploration of research trends in this domain remains lacking. This study aims to address this gap by employing text mining and modeling techniques to conduct a comprehensive analysis of the existing literature, thereby identifying emerging research trends in infectious disease prevention among children. METHODS A cross-sectional text mining approach was adopted, focusing on journal articles published between January 1, 2003, and August 31, 2022. These articles, related to infectious disease prevention in children, were sourced from databases such as PubMed, CINAHL, MEDLINE (Ovid), Scopus, and Korean RISS. The data underwent preprocessing using the Natural Language Toolkit (NLTK) in Python, with a semantic network analysis and topic modeling conducted using R software. RESULTS The final dataset comprised 509 journal articles extracted from multiple databases. The study began with a word frequency analysis to pinpoint relevant themes, subsequently visualized through a word cloud. Dominant terms encompassed "vaccination," "adolescent," "infant," "parent," "family," "school," "country," "household," "community," "HIV," "HPV," "COVID-19," "influenza," and "diarrhea." The semantic analysis identified "age" as a key term across infection, control, and intervention discussions. Notably, the relationship between "hand" and "handwashing" was prominent, especially in educational contexts linked with "school" and "absence." Latent Dirichlet Allocation (LDA) topic modeling further delineated seven topics related to infectious disease prevention for children, encompassing (1) educational programs, (2) vaccination efforts, (3) family-level responses, (4) care for immunocompromised individuals, (5) country-specific responses, (6) school-based strategies, and (7) persistent threats from established infectious diseases. CONCLUSION The study emphasizes the indispensable role of personalized interventions tailored for various child demographics, highlighting the pivotal contributions of both parental guidance and school participation. CLINICAL RELEVANCE The study provides insights into the complex public health challenges associated with preventing and managing infectious diseases in children. The insights derived could inform the formulation of evidence-based public health policies, steering practical interventions and fostering interdisciplinary synergy for holistic prevention strategies.
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Affiliation(s)
- Won-Oak Oh
- College of Nursing, Korea University, Seoul, South Korea
| | - Eunji Lee
- College of Nursing, Korea University, Seoul, South Korea
| | - Yoo-Jin Heo
- College of Nursing, Korea University, Seoul, South Korea
| | - Myung-Jin Jung
- College of Nursing, Korea University, Seoul, South Korea
| | - Jihee Han
- College of Nursing, Korea University, Seoul, South Korea
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Bianchi FP, Stefanizzi P, Cuscianna E, Riformato G, Di Lorenzo A, Giordano P, Germinario CA, Tafuri S. COVID-19 vaccination hesitancy among Italian parents: A systematic review and meta-analysis. Hum Vaccin Immunother 2023; 19:2171185. [PMID: 36698309 PMCID: PMC10012888 DOI: 10.1080/21645515.2023.2171185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
In May 2021, the Italian government extended the COVID-19 vaccination campaign to 12- to 18-year-old subjects and, starting December 2021, vaccines were also offered to children between 5 and 11 years-old. Despite these efforts, suboptimal vaccination coverages are reported. The purpose of this review is to estimate the proportion of parents/caregivers of children and adolescents expressing COVID-19 vaccine hesitancy in Italy. The vaccine hesitation rate among parents of minors was 55.1% (95%CI: 43.8-66.1%). A higher value was evidenced in studies focusing on children (59.9%; 95%CI = 43.7-75.1%) compared to the ones focusing on adolescents (51.3%; 95%CI = 34.5-68.0%). The main reasons for unwillingness were the belief that the vaccine was unsafe or ineffective, fear of adverse events, and considering COVID-19 a non-threatening disease. The implementation of effective communication campaigns and health educational programs on safe pediatric vaccinations is essential to support strategies to bolster vaccination confidence.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Eustachio Cuscianna
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Giacomo Riformato
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Paola Giordano
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
| | | | - Silvio Tafuri
- Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
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Ebrahim S, Blose N, Gloeck N, Hohlfeld A, Balakrishna Y, Muloiwa R, Gray A, Parrish A, Cohen K, Lancaster R, Kredo T. Effectiveness of the BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002676. [PMID: 38048340 PMCID: PMC10695397 DOI: 10.1371/journal.pgph.0002676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/06/2023] [Indexed: 12/06/2023]
Abstract
A rapid systematic review, based on Cochrane rapid review methodology was conducted to assess the effectiveness of two 10μg doses of BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years. We searched the Cochrane Library COVID-19 study register, the COVID-NMA living review database and the McMaster University Living Evidence Synthesis for pre-appraised trials and observational studies up to 7 December 2022. Records were screened independently in duplicate. Where appraisal was not available, these were done in duplicate. Meta-analysis was conducted using RevMan 5.3 presenting risk ratios/odds ratios/inverse vaccine efficacy with 95% confidence intervals (CI). GRADE for assessing the overall certainty of the evidence was done in Gradepro. We screened 403 records and assessed 52 full-text articles for eligibility. One randomised controlled trial (RCT) and 24 observational studies were included. The RCT reported that BNT162b2 was likely safe and 91% efficacious, RR 0.09 (95% CI 0.03 to 0.32) against incident COVID-19 infection (moderate certainty evidence). In absolute terms, this is 19 fewer cases per 1,000 vaccines delivered (ranging from 15 to 21 fewer cases). Observational studies reported vaccine effectiveness (VE) against incident COVID-19 infection of 65% (OR 0.35, 95% CI 0.26 to 0.47) and 76% against hospitalisation (OR 0.24, 95% CI 0.13 to 0.42) (moderate certainty evidence). The absolute effect is 167 fewer cases per 1,000 vaccines given (ranging from 130 fewer to 196 fewer cases) and 4 fewer hospitalisations per 10,000 children (from 3 fewer to 5 fewer hospitalisations). Adverse events following vaccination with BNT162b2 were mild or moderate and transient. The evidence demonstrated a reduction in incident COVID-19 cases and small absolute reduction in hospitalisation if a two-dose BNT162b2 vaccine regimen is offered to children aged 5 to 11 years, compared to placebo. PROSPERO registration: CRD42021286710.
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Affiliation(s)
- Sumayyah Ebrahim
- Department of Surgery, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Ntombifuthi Blose
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Natasha Gloeck
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Ameer Hohlfeld
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Yusentha Balakrishna
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Rudzani Muloiwa
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Andy Gray
- Division of Pharmacology, Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
- National Essential Medicines List Ministerial Advisory Committee on COVID-19 Therapeutics, National Department of Health, Pretoria, South Africa
| | - Andy Parrish
- National Essential Medicines List Ministerial Advisory Committee on COVID-19 Therapeutics, National Department of Health, Pretoria, South Africa
- Department of Internal Medicine, Walter Sisulu University, Mthatha, South Africa
| | - Karen Cohen
- National Essential Medicines List Ministerial Advisory Committee on COVID-19 Therapeutics, National Department of Health, Pretoria, South Africa
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Ruth Lancaster
- Affordable Medicines Directorate, National Department of Health, Pretoria, South Africa
| | - Tamara Kredo
- National Essential Medicines List Ministerial Advisory Committee on COVID-19 Therapeutics, National Department of Health, Pretoria, South Africa
- Division of Clinical Pharmacology, Department of Medicine, and Division of Biostatistics and Epidemiology, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
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Chen CC, Lee MH, Chen SY, Lu SC, Bai CH, Ko YL, Wang CY, Wang YH. Assessment of the detection accuracy of SARS-CoV-2 rapid antigen test in children and adolescents: An updated meta-analysis. J Chin Med Assoc 2023; 86:966-974. [PMID: 37683135 DOI: 10.1097/jcma.0000000000000987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Real-time and appropriate antigen tests play a pivotal role in preventing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, a previous meta-analysis reported that the antigen test had lower sensitivity for the detection of SARS-CoV-2 in children. To provide a comprehensive evaluation of diagnostic efficiency, we performed an updated meta-analysis to assess the detection accuracy of SARS-CoV-2 antigen tests stratified by days after symptom onset and specimen type in children and adolescents. METHODS We comprehensively searched for appropriate studies in the PubMed, Embase, and Cochrane Library databases. Studies on the diagnostic accuracy of antigen tests for SARS-CoV-2 in children and adolescents were included. The relevant data of the included studies were extracted to construct a 2 × 2 table on a per-patient basis. The overall sensitivity and specificity of the SARS-CoV-2 antigen tests were estimated using a bivariate random-effects model. RESULTS Seventeen studies enrolling 10 912 patients were included in the present meta-analysis. For the detection accuracy of SARS-CoV-2 antigen tests, the meta-analysis generated a pooled sensitivity of 77.9% (95% confidence interval [CI]: 67.3%-85.8%) and a pooled specificity of 99.6% (95% CI: 98.9%-99.8%). The subgroup analysis of studies that examined antigen tests in symptomatic participants ≦7 days after symptom onset generated a pooled sensitivity of 79.4% (95% CI: 47.6%-94.2%) and a pooled specificity of 99.4% (95% CI: 98.2%-99.8%). Another subgroup analysis of studies that evaluated nasal swab specimens demonstrated a pooled sensitivity of 80.1% (95% CI: 65.0%-89.7%) and a pooled specificity of 98.5% (95% CI: 97.3%-9.2%). CONCLUSION Our findings demonstrated that the antigen test performed using nasal swab specimens exhibited high sensitivity for the detection of SARS-CoV-2 within 7 days after symptom onset. Therefore, antigen testing using nasal swabs may be effective in blocking SARS-CoV-2 transmission in children.
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Affiliation(s)
- Cheng-Chieh Chen
- Department of Pathology and Laboratory Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC
| | - Mei-Hui Lee
- Division of Infectious Diseases, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Shih-Yen Chen
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Shou-Cheng Lu
- Department of Laboratory Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Chyi-Huey Bai
- Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Yu-Ling Ko
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chien-Ying Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Trauma, Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yuan-Hung Wang
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC
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Chighizola CB, Suardi I, Carrea G, Argolini L, Gattinara M, Marino A, Pontikaki I, Caporali R, Gerosa M. Anti-SARS-CoV-2 vaccination in adolescent and adult patients with juvenile-onset systemic lupus erythematosus: tolerability and impact on disease activity. Rheumatology (Oxford) 2023; 62:3146-3150. [PMID: 36702464 DOI: 10.1093/rheumatology/kead047] [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: 10/20/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES JSLE has a severe presentation and a remitting course. Patients with JSLE carry an increased vulnerability to infections, which also act as triggers of disease flare. Thus, vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important tool in JSLE. The objective of this study is to evaluate the tolerability and the safety of anti-SARS-CoV-2 vaccination, including the booster, in a monocentric cohort of JSLE patients. METHODS Clinical records of JSLE patients who received at least one dose of any anti-SARS-CoV-2 vaccine were retrospectively reviewed. Data about disease activity, treatment, anti-SARS-CoV-2 vaccination and COVID-19 infection were collected. RESULTS Sixty-five JSLE patients received at least one dose of anti-SARS-CoV-2 vaccination, while 46 patients completed the schedule with the booster. The rate of mild-moderate adverse events was 66%, mainly comprising fever, fatigue, arthromyalgias and pain at injection site. The rate of adverse events after the booster was similar to that registered after the first two doses. No significant changes after SARS-CoV-2 vaccination in BILAG and SLEDAI were observed. Disease flare rate (mainly LN) after immunization was 10.8%. Flares occurred predominantly in patients with moderate disease activity before immunization; accordingly, SLEDAI ≥4 identified patients at risk of flare while Lupus Low Disease Activity State (LLDAS) plays a protective role against post-vaccination flare. CONCLUSIONS This study confirms that anti-SARS-CoV-2 vaccination in JSLE is well tolerated; a strict clinical monitoring and a thoughtful choice of vaccination timing should be devoted to patients not in LLDAS due to the risk of post-vaccine flare.
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Affiliation(s)
- Cecilia Beatrice Chighizola
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Ilaria Suardi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Giulia Carrea
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | | | | | - Achille Marino
- Pediatric Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | | | - Roberto Caporali
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
| | - Maria Gerosa
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Clinical Rheumatology Unit, ASST Pini-CTO, Milan, Italy
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Funk T, Espenhain L, Møller FT, Ethelberg S. Factors associated with the formation of SARS-CoV-2 case-clusters in Danish schools: a nationwide register-based observational study. Epidemiol Infect 2023; 151:e168. [PMID: 37466091 PMCID: PMC10600729 DOI: 10.1017/s0950268823001188] [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: 03/31/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
A register-based retrospective observational study was conducted to describe SARS-CoV-2 cases and case-clusters in schoolchildren of Danish primary and lower secondary schools and identify which factors were associated with the occurrence of case-clusters in schools. The study period was the autumn school semester 2021. Clusters were defined as three or more cases in a school-class level within 14 days. Descriptive analysis was carried out and multivariable logistic regression analysis was performed to determine which factors were associated with case introductions (i.e., primary case) being linked to a cluster. More cases and clusters were identified in lower than in higher class levels. Out of 21,497 cases introduced into a school, 41.6% started a cluster. A higher assumed immunity level in a class level was significantly reducing the odds of a case introduction being linked to a cluster (e.g., assumed immunity of ≥80% vs <20%: OR: 0.28; 95%CI: 0.17-0.44). A previous infection (in the primary case) had a protective effect (OR: 0.58; 95%CI: 0.33-0.99). This study suggests that most cases appearing in schools did not induce clusters, but that once cluster occur sizes can be large. It further indicates that vaccination of children markedly reduces the risk of secondary infections.
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Affiliation(s)
- Tjede Funk
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Laura Espenhain
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Frederik Trier Møller
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
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Pagel C, Wilde H, Tomlinson C, Mateen B, Brown K. A Methodological Framework for Assessing the Benefit of SARS-CoV-2 Vaccination following Previous Infection: Case Study of Five- to Eleven-Year-Olds. Vaccines (Basel) 2023; 11:vaccines11050988. [PMID: 37243092 DOI: 10.3390/vaccines11050988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccination rates against SARS-CoV-2 in children aged five to eleven years remain low in many countries. The current benefit of vaccination in this age group has been questioned given that the large majority of children have now experienced at least one SARS-CoV-2 infection. However, protection from infection, vaccination or both wanes over time. National decisions on offering vaccines to this age group have tended to be made without considering time since infection. There is an urgent need to evaluate the additional benefits of vaccination in previously infected children and under what circumstances those benefits accrue. We present a novel methodological framework for estimating the potential benefits of COVID-19 vaccination in previously infected children aged five to eleven, accounting for waning. We apply this framework to the UK context and for two adverse outcomes: hospitalisation related to SARS-CoV-2 infection and Long Covid. We show that the most important drivers of benefit are: the degree of protection provided by previous infection; the protection provided by vaccination; the time since previous infection; and future attack rates. Vaccination can be very beneficial for previously infected children if future attack rates are high and several months have elapsed since the previous major wave in this group. Benefits are generally larger for Long Covid than hospitalisation, because Long Covid is both more common than hospitalisation and previous infection offers less protection against it. Our framework provides a structure for policy makers to explore the additional benefit of vaccination across a range of adverse outcomes and different parameter assumptions. It can be easily updated as new evidence emerges.
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Affiliation(s)
- Christina Pagel
- Clinical Operational Research Unit, Department of Mathematics, University College London (UCL), London WC1E 6BT, UK
| | - Harrison Wilde
- Department of Statistics, University of Warwick, Coventry CV4 7AL, UK
- UCL Institute of Health Informatics, University College London (UCL), London NW1 2DA, UK
| | - Christopher Tomlinson
- UCL Institute of Health Informatics, University College London (UCL), London NW1 2DA, UK
- UK Research and Innovation Centre for Doctoral Training in AI-enabled Healthcare Systems, University College London (UCL), London WC1E 6BT, UK
- University College London Hospitals Biomedical Research Centre, University College London (UCL), London W1T 7DN, UK
| | - Bilal Mateen
- UCL Institute of Health Informatics, University College London (UCL), London NW1 2DA, UK
- University College London Hospitals Biomedical Research Centre, University College London (UCL), London W1T 7DN, UK
- Wellcome Trust, London NW1 2BE, UK
| | - Katherine Brown
- Biomedical Research Centre, Great Ormond Street Hospital for Children, London WC1N 3JH, UK
- Institute of Cardiovascular Science, University College London (UCL), London WC1E 6DD, UK
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Yılmaz D, Üstündağ G, Büyükçam A, Salı E, Çelik Ü, Avcu G, Belet N, Çakmak Taşkın E, Öcal Demir S, Birbilen AZ, Kılıç Ö, Metin Akcan Ö, Tekin Yılmaz A, Aldemir Kocabaş B, Hatipoğlu N, Karbuz A, Çakır D, Sütçü M, Aygün FD, Çelik T, Bayturan Şen S, Dalgıç N, Ümit Z, Kara SS, Karadağ Öncel E, Bolat A, Kılıç Çil M, Turan C, Çakıl Güzin A, Topal S, Esen Besli G, Doğan G, Şahin S, Akın F, Bildirici Y, Timurtaş Dayar G, Ergül Sarı E, Kızmaz İşançlı D, Kara M, Önal P, Aylaç H, Lüleci D, Yaşar B, Dede E, Çağlar A, Akova S, Afat Turgut E, Yazıcı Özkaya P, Kandemir Gülmez T, Ulusoy E, Duyu M, Kara Y, Çeliktaş H, Tekeli O, Çağlar F, Gül D, Oral Cebeci S, Battal F, Bal A, Aygün E, Uysalol M, Arslan G, Özkavaklı A, Kızıl MC, Yazar A, Aygün F, Somer A, Kuyucu N, Dinleyici EÇ, Kara A. A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey. Eur J Pediatr 2023:10.1007/s00431-023-04982-6. [PMID: 37140703 PMCID: PMC10157577 DOI: 10.1007/s00431-023-04982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.
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Affiliation(s)
- Dilek Yılmaz
- Department of Pediatric Infectious Diseases, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Gülnihan Üstündağ
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey.
| | - Ayşe Büyükçam
- Pediatric Infectious Disease Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Enes Salı
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ümit Çelik
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Gülhadiye Avcu
- Department of Pediatric Infectious Diseases, Ege University Faculty of Medicine, İzmir, Turkey
| | - Nurşen Belet
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Esra Çakmak Taşkın
- Pediatric Infectious Disease Clinic, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Sevliya Öcal Demir
- Pediatric Infectious Disease Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Birbilen
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatric Emergency Clinic, Gaziantep, Turkey
| | - Ömer Kılıç
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Özge Metin Akcan
- Department of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ayşe Tekin Yılmaz
- Pediatric Infectious Disease Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Bilge Aldemir Kocabaş
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Nevin Hatipoğlu
- Pediatric Infectious Disease Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Adem Karbuz
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Deniz Çakır
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Sütçü
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Fatma Deniz Aygün
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Taylan Çelik
- Department of Pediatric Infectious Diseases, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Semra Bayturan Şen
- Department of Pediatric Infectious Diseases, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Nazan Dalgıç
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Zühal Ümit
- Pediatric Infectious Disease Clinic, Manisa City Hospital, Manisa, Turkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Eda Karadağ Öncel
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey
| | - Ahmet Bolat
- Pediatrics Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Merve Kılıç Çil
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Caner Turan
- Department of Pediatric Emergency Medicine, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Çakıl Güzin
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Sevgi Topal
- Pediatric Intensive Care Unit, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Gülser Esen Besli
- Pediatric Emergency Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Gizem Doğan
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatrics Clinic, Gaziantep, Turkey
| | - Sabiha Şahin
- Department of Pediatric Emergency Medicine, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Fatih Akın
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Yaşar Bildirici
- Pediatrics Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Gülperi Timurtaş Dayar
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Emine Ergül Sarı
- Pediatrics Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Didem Kızmaz İşançlı
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Pınar Önal
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Aylaç
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Duygu Lüleci
- Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Belma Yaşar
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Elif Dede
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Aykut Çağlar
- Department of Pediatric Emergency Medicine , Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Sevgi Akova
- Pediatric Emergency Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Elif Afat Turgut
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Pınar Yazıcı Özkaya
- Department of Pediatric Intensive Care, Ege University Faculty of Medicine, İzmir, Turkey
| | | | - Emel Ulusoy
- Department of Pediatric Emergency Medicine, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Muhterem Duyu
- Pediatric Intensive Care Unit, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Yalçın Kara
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Hüseyin Çeliktaş
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Onur Tekeli
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatma Çağlar
- Pediatric Emergency Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Doruk Gül
- Department of Pediatrics, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Sinem Oral Cebeci
- Department of Pediatric Emergency Medicine, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Fatih Battal
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Alkan Bal
- Department of Pediatric Emergency Medicine, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Emre Aygün
- Pediatrics Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Metin Uysalol
- Department of Pediatric Emergency Medicine, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Gazi Arslan
- Department of Pediatric Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayberk Özkavaklı
- Pediatrics Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Mahmut Can Kızıl
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Aygün
- Department of Pediatric Intensive Care, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Necdet Kuyucu
- Department of Pediatric Infectious Diseases, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatric Intensive Care, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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9
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Parental COVID-19 Vaccine Hesitancy for Children and Its Influencing Factors: A Riyadh-Based Cross-Sectional Study. Vaccines (Basel) 2023; 11:vaccines11030518. [PMID: 36992102 DOI: 10.3390/vaccines11030518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/12/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
It is well known that vaccination is the best clinical approach for successfully controlling COVID-19 infection. Understanding the disparities in COVID-19 vaccination apprehension among parents in different societies is crucial for effectively implementing COVID-19 vaccination programs. This observational cross-sectional study was carried out in the Riyadh region of Saudi Arabia between February and April 2022. The validated questionnaire was shared with parents who had children between the ages of five and eleven years. The collected data were analyzed using descriptive and inferential statistical methods. Multinomial regression analysis was conducted to determine the factors significantly affecting vaccine-use decisions. Of the 699 participants, 83% of the mothers were between the ages of 35 and 44 years, 67% were university educated, and only 14% were healthcare workers. A large proportion of parents, with an age range of 18–34 years (p = 0.001), and those with a higher income group (p = 0.014), demonstrated significant vaccine hesitancy. Further, parents who received one or two vaccination doses were significantly (p = 0.02) more hesitant than those who received more than two doses of the vaccine. Furthermore, a significantly (p = 0.002) high percentage of parents who follow the Ministry of Health (MOH) guidelines for personal preventive measures were hesitant about their children’s vaccination. Concerns about side effects (31.4%) and a lack of safety data (31.2%) on the COVID-19 vaccines were the two most significant reasons for parents to develop vaccine hesitancy. Social media (24.3%), poor perceived immunity (16.3 %), and news articles (15.5%) were the top three contributors to this hesitancy. Vaccinated parents were 8.21 times more likely to be vaccination-hesitant than non-vaccinated parents. Additionally, parents with less education and a COVID-19-positive child at home increased the odds of vaccine hesitancy by 1.66 and 1.48 times, respectively. Overall, one-third of the parents were not prepared to vaccinate their children, and one-quarter of the respondents had not decided about vaccination. This study shows that parents in Riyadh are generally reluctant to vaccinate their children against COVID-19. As social media is a primary source of information for parents, public health professionals should utilize the platform to encourage parents to support vaccine acceptance.
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Lau CS, Oh MLH, Phua SK, Liang YL, Aw TC. 210-Day Kinetics of Total, IgG, and Neutralizing Spike Antibodies across a Course of 3 Doses of BNT162b2 mRNA Vaccine. Vaccines (Basel) 2022; 10:vaccines10101703. [PMID: 36298568 PMCID: PMC9607129 DOI: 10.3390/vaccines10101703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction: We tested the total spike antibody (S-Ab), IgG/IgM S-Ab, and neutralizing antibody (N-Ab) responses of COVID-19-naïve subjects from before their first BNT162b2 vaccination up to 210 days after boosting. Methods: We studied 136 COVID-19-naïve subjects who received three doses of the Pfizer mRNA vaccine (39 males, 97 females, mean age 43.8 ± 13.5 years) from January 2021 to May 2022. Serum was assessed for total S-Ab (Roche), IgG/M (Abbott), and N-Ab (Snibe). Results: Peak antibody levels were measured 20-30 days after each dose, with booster dosing eliciting significantly higher peak antibodies than the second dose: total S-Ab 2219 vs. 19,551 BAU/mL (difference 16,667 BAU/mL, p < 0.0001); IgG 2270 vs. 2932 BAU/mL (difference 660 BAU/mL, p = 0.04); and N-Ab 3.52 vs. 26.4 µg/mL (difference 21.4 µg/mL, p < 0.0001). Only IgM showed a lower peak post-booster antibody titer (COI 2.11 vs. 0.23, difference 1.63, 95% CI 1.05 to 2.38, p < 0.0001). By 180−210 days after the second or third vaccination, total S-Ab/IgG/N-Ab had decreased by 68.7/93.8/73.6% vs. 82.8/86.3/79.5%. The half-lives of IgG and N-Ab antibodies were longer after the third vaccination (IgG: 65 vs. 34 days, N-Ab: 99 vs. 78 days). Conclusion: Total S-Ab/IgG/N-Ab showed a greater increase post-booster, with IgG/N-Ab having a longer half-life.
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Affiliation(s)
- Chin Shern Lau
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
- Correspondence: ; Tel.: +65-68504927; Fax: +65-64269507
| | - May Lin Helen Oh
- Department of Infectious Diseases, Changi General Hospital, Singapore 529889, Singapore
| | - Soon Kieng Phua
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
| | - Ya-Li Liang
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
| | - Tar Choon Aw
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
- Department of Medicine, National University of Singapore, Singapore 117599, Singapore
- Academic Pathology Program, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
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11
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COVID-19 Vaccine Effectiveness against Omicron Variant among Underage Subjects: The Veneto Region's Experience. Vaccines (Basel) 2022; 10:vaccines10081362. [PMID: 36016248 PMCID: PMC9413750 DOI: 10.3390/vaccines10081362] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/13/2022] [Accepted: 08/17/2022] [Indexed: 01/14/2023] Open
Abstract
Even if most of the complications due to COVID-19 are observed in the elderly, in Italy the impact of COVID-19 among young people has not been negligible. Furthermore, their contribution to SARS-CoV-2 circulation is still unclear. These reasons have driven policy makers to involve subjects aged 5 to 17 years in the COVID-19 vaccination campaign. However, the trade-off of vaccinating this age-group should be further investigated, especially in view of the rise of new immunologically evasive variants of concern (VOCs). We used regional databases to retrospectively estimate vaccine effectiveness over time of each approved vaccination schedule among children (5–11) and adolescents (12–17). Our findings suggest that COVID-19 vaccines were highly effective and their protection levels lasted longer during a period of Delta variant predominance, whereas they offered just mild to moderate levels of protection—apparently affected by a rapid waning effect—in a period of Omicron variant predominance. Considering these results, it is plausible to evaluate a reformulation of possible future COVID-19 vaccination campaigns among underage subjects. However, effectiveness against serious complications due to COVID-19, as well as indirect benefits of underage vaccinations, should first be addressed. Furthermore, vaccine effectiveness should be kept monitored, as new VOCs may arise, but also new adapted vaccines may start being administered.
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