Efficacy and safety of a fourth dose of the COVID-19 vaccine in kidney transplant recipients: A systematic review and meta-analysis

Consensus on COVID-19 vaccine recommendations: Challenges and strategies for high-risk populations in Taiwan

The COVID-19 pandemic has had a profound impact globally, particularly in high-risk populations such as those with underlying health conditions. In response to the evolving pandemic landscape and the recent surge in confirmed cases in Taiwan, the Taiwan Association of Family Medicine (TAFM) established a consensus on COVID-19 vaccine recommendations for vulnerable groups through a comprehensive literature review, expert panel discussions, and a practice-oriented formulation procedure to develop evidence-based guidance. Its key findings highlight the increased risk of severe COVID-19 outcomes among individuals with disorders such as diabetes, obesity, chronic kidney disease, cardiovascular disease, and respiratory illness. It emphasizes the safety and effectiveness of COVID-19 vaccines, particularly mRNA vaccines, in these high-risk populations. It particularly underscores the critical role of family medicine physicians in the COVID-19 response, including routine screening, health education, vaccination delivery, and continuous research to optimize strategies. Ongoing monitoring, adaptation, and collaborative efforts will be essential to ensure the continued effectiveness of these recommendations in the evolving COVID-19 landscape. In conclusion, the TAFM consensus recommendations provide a robust framework to guide healthcare providers and policymakers in tailoring vaccination efforts to address the unique needs of vulnerable groups in Taiwan and are an applicable template for neighboring countries.

Coronavirus Disease 2019 in Kidney Transplantation - A 2024 Update

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 has led to the death of about 7 million people worldwide. When infected, older individuals and those with diabetes, hypertension, cardiovascular disease, and compromised immune system are at higher risk for unfavorable outcomes. These comorbidities are prevalent in kidney transplant candidates and recipients making them inherently vulnerable to severe acute respiratory syndrome coronavirus 2 infection, hence, the significant burden the pandemic has exerted on kidney transplant programs. With the swift discovery and wide-scale availability of vaccines and therapeutics against severe acute respiratory syndrome coronavirus 2, the pandemic is currently behind us allowing transplant programs to relieve their restrictions and resume normal pre-COVID-19 operations. In the aftermath of the pandemic, we discuss the implications for immunosuppression and vaccination, COVID-19-induced kidney injury phenotypes and long COVID-19 symptoms. We also discuss some of the operational aspects the pandemic brought about - mainly the utilization of telemedicine - that are now here to stay.

Safety and immunogenicity of homologous prime-boost CoronaVac vaccine in people living with HIV in China: A multicenter prospective cohort study

People living with HIV (PLWH) are particularly vulnerable to SARS-CoV-2. This multicentre prospective cohort study evaluated the long-term immunogenicity and safety of a third homologous dose of Sinovac CoronaVac in PLWH in China. A total of 228 PLWH and 127 HIV-negative controls were finally included and followed up for 6 months. Fewer participants reported mild or moderate adverse reactions, and no serious adverse events were observed. The median levels of neutralizing antibodies (nAbs) and immunoglobulin G against the receptor-binding domain of the spike protein (S-IgG) in PLWH (655.92 IU/mL, IQR: 175.76-1663.55; 206.83 IU/mL, IQR: 85.20-397.82) were comparable to those in control group (1067.16 IU/mL, IQR: 239.85-1670.83; 261.70 IU/mL, IQR: 77.13-400.75), and reached their peak at 4 weeks, exhibiting a delayed peak pattern compared to the 2-week peak in control group. After then, the immune titres gradually decreased over time, but most participants still maintained positive seroconversion at the 6-month mark. Multivariable generalized estimating equation analysis indicated that CD4+T cell count, HIV viral load, and antiretroviral therapy (ART) were independent factors strongly associated with immune response (each p < 0.05). We suggested that PLWH should maintain well-controlled HIV status through ART and receive timely administration of the second booster dose for optimal protection.