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Gehring S, Kowalzik F, Okasha O, Engelmann T, Schreiner D, Jensen C, Mähringer-Kunz A, Hartig-Merkel W, Mai Phuong Tran T, Oostvogels C, Verstraeten T. A prospective cohort study of SARS-CoV-2 infection-induced seroconversion and disease incidence in German healthcare workers before and during the rollout of COVID-19 vaccines. PLoS One 2024; 19:e0294025. [PMID: 38289913 PMCID: PMC10826949 DOI: 10.1371/journal.pone.0294025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/22/2023] [Indexed: 02/01/2024] Open
Abstract
We assessed the seroepidemiology of SARS-CoV-2 infection and the incidence of coronavirus disease 2019 (COVID-19) before and during the rollout of COVID-19 vaccines, in a prospective observational cohort study on healthcare workers (HCWs) in a large tertiary hospital in Mainz, Germany. Antibody status was assessed during six visits between September 2020 and February 2022. Self-reported symptoms were collected using a smartphone application; symptomatic HCWs were tested using real-time polymerase chain reaction (RT-PCR) assays for SARS-CoV-2. Rates of virologically confirmed and severe COVID-19 were estimated using the U.S. Food and Drug Administration (FDA) and Coalition for Epidemic Preparedness Innovations (CEPI) case definitions, respectively, and were contrasted to background community transmission and circulating SARS-CoV-2 variants. A total of 3665 HCWs were enrolled (mean follow-up time: 18 months); 97 met the FDA definition of virologically confirmed COVID-19 (incidence rate (IR) 2.3/1000 person-months (PMs), one severe case). Most cases reported ≥2 symptoms, commonly, cough and anosmia or ageusia. Overall, 263 individuals seroconverted (IR 6.6/1000 PMs-2.9 times the estimated IR of COVID-19), indicating many cases were missed, either due to asymptomatic infections or to an atypical presentation of symptoms. A triphasic trend in anti-SARS-CoV-2 seroprevalence and seroconversion was observed, with an initial increase following the rollout of COVID-19 vaccines, a two-fold decline six months later, and finally a six-fold increase by the end of the study when Omicron was the dominant circulating variant. Despite the increase in infection rates at the end of the study due to the circulation of the Omicron variant, the infection and disease rates observed were lower than the published estimates in HCWs and rates in the general local population. Preferential vaccination of HCWs and the strict monitoring program for SARS-CoV-2 infection are the most likely reasons for the successful control of COVID-19 in this high-risk population.
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Affiliation(s)
- Stephan Gehring
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Frank Kowalzik
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Omar Okasha
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Tobias Engelmann
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Daniel Schreiner
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Christian Jensen
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
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Huang ST, Huang YS, Liu WD, Pan SC, Sun HY, Lien CE, Chen C, Hsieh SM. Immunogenicity and safety of heterologous mRNA-1273/MVC-COV1901 vaccination versus homologous mRNA1273 vaccination: A randomized, double-blind controlled study. J Formos Med Assoc 2023; 122:1165-1173. [PMID: 37321955 PMCID: PMC10264237 DOI: 10.1016/j.jfma.2023.05.030] [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: 01/10/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND/PURPOSE MVC-COV1901 is a protein vaccine based on the same SARS-CoV-2 strain used in mRNA vaccine mRNA-1273. Data are lacking on immunogenicity and safety of MVC-COV1901 as heterologous boost for people already received one dose of mRNA-1273. METHODS This is a randomized, double-blind trial that recruited adults aged 20-70 years who previously received a single dose of mRNA-1273 vaccine and were randomly assigned in a 1:1 ratio to receive a second dose with the homologous vaccine or protein-based MVC-COV1901 8-12 weeks after the first dose. The primary outcome was neutralizing antibody titers in terms of the geometric mean titer (GMT) 14 days after the second dose. Safety was assessed in all participants who received a dose of the study vaccine. The study is registered with ClinicalTrials.gov (NCT05079633). RESULTS From September 30 to November 5, 2021, 144 participants were enrolled and randomly assigned to the MVC-COV1901 boost group (n = 72) or the mRNA-1273 boost group (n = 72). The neutralizing antibodies on Day 15 and the anti-SARS-CoV-2 IgG titers on Day 15 and 29 of homologous mRNA-1273 were significantly higher than those of heterologous mRNA-1273/MVC-COV1901. Cellular immune responses were comparable in both groups. However, adverse events were much more frequent after the mRNA-1273 boost than after the MVC-COV1901 boost. CONCLUSION Our results show that heterologous boost with MVC-COV1901 yielded an inferior immunogenicity but significantly fewer adverse events, compared with homologous boost with mRNA-1273. In people experienced severe adverse events after prime dose of mRNA-1273, as well as in periods when the supply of mRNA-1273 is limited, MVC-COV1901 could serve as an acceptable alternative heterologous boost.
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Affiliation(s)
- Szu-Ting Huang
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Shan Huang
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wang-Da Liu
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Ching Pan
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsin-Yun Sun
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chia-En Lien
- Medigen Vaccine Biologics Corporation, Taipei, Taiwan; Institute of Public Health, National Yang-Ming Chiao Tung University, Taipei City, Taiwan
| | - Charles Chen
- Medigen Vaccine Biologics Corporation, Taipei, Taiwan
| | - Szu-Min Hsieh
- Division of Infectious Diseases, Department of Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Reynolds L, Dewey C, Asfour G, Little M. Vaccine efficacy against SARS-CoV-2 for Pfizer BioNTech, Moderna, and AstraZeneca vaccines: a systematic review. Front Public Health 2023; 11:1229716. [PMID: 37942238 PMCID: PMC10628441 DOI: 10.3389/fpubh.2023.1229716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/15/2023] [Indexed: 11/10/2023] Open
Abstract
The purpose of this systematic review was to report on the vaccine efficacy (VE) of three SARS-CoV-2 vaccines approved by Health Canada: Pfizer BioNTech, Moderna, and AstraZeneca. Four databases were searched for primary publications on population-level VE. Ninety-two publications matched the inclusion criteria, and the extracted data were separated by vaccine type: mRNA vaccines (Pfizer and Moderna) and the AstraZeneca vaccine. The median VE for PCR-positive patients and various levels of clinical disease was determined for the first and second doses of both vaccine types against multiple SARS-CoV-2 variants. The median VE for PCR-positive infections against unidentified variants from an mRNA vaccine was 64.5 and 89%, respectively, after one or two doses. The median VE for PCR-positive infections against unidentified variants from the AstraZeneca vaccine was 53.4 and 69.6%, respectively, after one or two doses. The median VE for two doses of mRNA for asymptomatic, symptomatic, and severe infection against unidentified variants was 85.5, 93.2, and 92.2%, respectively. The median VE for two doses of AstraZeneca for asymptomatic, symptomatic, and severe infection against unidentified variants was 69.7, 71, and 90.2%, respectively. Vaccine efficacy numerically increased from the first to the second dose, increased from the first 2 weeks to the second 2 weeks post-vaccination for both doses, but decreased after 4 months from the second dose. Vaccine efficacy did not differ by person's age.
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Affiliation(s)
- Lia Reynolds
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Cate Dewey
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Ghaid Asfour
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Matthew Little
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, BC, Canada
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Kääriäinen S, Harjunmaa U, Hannila-Handelberg T, Ollgren J, Lyytikäinen O. Risk of COVID-19 in different groups of healthcare professionals between February 2020 and June 2021 in Finland: a register-based cohort study. Infect Prev Pract 2023; 5:100297. [PMID: 37560347 PMCID: PMC10406617 DOI: 10.1016/j.infpip.2023.100297] [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: 05/03/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND During the Coronavirus Disease 2019 (COVID-19) pandemic, healthcare workers (HCWs) have been a risk group for COVID-19. AIM To assess the cumulative incidence in different groups of HCWs and the risk factors and outcomes of COVID-19 in HCWs between February 2020 and June 2021 in Finland. METHODS We linked two national registers, National Infectious Diseases Register (NIDR) and Register of Social Welfare and Healthcare Professionals (Terhikki), using national identity codes. COVID-19 cases were identified from NIDR notifications made by laboratories and physicians, and their healthcare professions from Terhikki. We categorized healthcare professions into seven groups and calculated cumulative incidences using Kaplan-Meier estimate during three periods (1/2/2020-30/6/2020, 1/7/2020-31/12/2020, 1/1/2021-30/6/2021). We identified risk factors in a multivariable model using Cox's regression. FINDINGS We identified 8,009 COVID-19-cases among HCWs, with cumulative incidence of 1.79%; 83% were female, median age was 40.9 years (interquartile range, 31.2-51.6). Most COVID-19-cases occurred in nursing assistants (53%) and nurses (17%), with the highest cumulative incidences 2.07% (95%CI, 2.01-2.13%) and 1.82% (95%CI, 1.73-1.91%), respectively. Risk factors were male sex (hazard ratio (HR) 1.2; 95%CI, 1.1-1.3), foreign native language (HR 2.5; 95%CI, 2.2-2.9) and foreign country of birth (HR 1.2; 95%CI, 1.1-1.4). Physician notification data was available for 6,113/8,009 cases (76.3%); 244/6,113 (4.0%) were hospitalized and 37/6,113 (0.6%) in intensive care. CONCLUSION Nurses and nursing assistant, especially men and professionals with foreign background, were at higher risk of COVID-19. This should be specifically addressed during training and implementing infection control measures to protect themselves and patients.
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Affiliation(s)
- Sohvi Kääriäinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Ulla Harjunmaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Jukka Ollgren
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Cromer D, Steain M, Reynaldi A, Schlub TE, Khan SR, Sasson SC, Kent SJ, Khoury DS, Davenport MP. Predicting vaccine effectiveness against severe COVID-19 over time and against variants: a meta-analysis. Nat Commun 2023; 14:1633. [PMID: 36964146 PMCID: PMC10036966 DOI: 10.1038/s41467-023-37176-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/06/2023] [Indexed: 03/26/2023] Open
Abstract
Vaccine protection from symptomatic SARS-CoV-2 infection has been shown to be strongly correlated with neutralising antibody titres; however, this has not yet been demonstrated for severe COVID-19. To explore whether this relationship also holds for severe COVID-19, we performed a systematic search for studies reporting on protection against different SARS-CoV-2 clinical endpoints and extracted data from 15 studies. Since matched neutralising antibody titres were not available, we used the vaccine regimen, time since vaccination and variant of concern to predict corresponding neutralising antibody titres. We then compared the observed vaccine effectiveness reported in these studies to the protection predicted by a previously published model of the relationship between neutralising antibody titre and vaccine effectiveness against severe COVID-19. We find that predicted neutralising antibody titres are strongly correlated with observed vaccine effectiveness against symptomatic (Spearman [Formula: see text] = 0.95, p < 0.001) and severe (Spearman [Formula: see text] = 0.72, p < 0.001 for both) COVID-19 and that the loss of neutralising antibodies over time and to new variants are strongly predictive of observed vaccine protection against severe COVID-19.
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Affiliation(s)
- Deborah Cromer
- Kirby Institute, University of New South Wales, Sydney, Australia.
| | - Megan Steain
- Sydney Institute of Infectious Diseases and Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Arnold Reynaldi
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Timothy E Schlub
- Kirby Institute, University of New South Wales, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Shanchita R Khan
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sarah C Sasson
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Melbourne Sexual Health Centre and Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, Australia
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Wu N, Joyal-Desmarais K, Ribeiro PAB, Vieira AM, Stojanovic J, Sanuade C, Yip D, Bacon SL. Long-term effectiveness of COVID-19 vaccines against infections, hospitalisations, and mortality in adults: findings from a rapid living systematic evidence synthesis and meta-analysis up to December, 2022. THE LANCET. RESPIRATORY MEDICINE 2023; 11:439-452. [PMID: 36780914 PMCID: PMC9917454 DOI: 10.1016/s2213-2600(23)00015-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Synthesising evidence on the long-term vaccine effectiveness of COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna], ChAdOx1 nCoV-19 [AZD1222; Oxford-AstraZeneca], and Ad26.COV2.S [Janssen]) against infections, hospitalisations, and mortality is crucial to making evidence-based pandemic policy decisions. METHODS In this rapid living systematic evidence synthesis and meta-analysis, we searched EMBASE and the US National Institutes of Health's iSearch COVID-19 Portfolio, supplemented by manual searches of COVID-19-specific sources, until Dec 1, 2022, for studies that reported vaccine effectiveness immediately and at least 112 days after a primary vaccine series or at least 84 days after a booster dose. Single reviewers assessed titles, abstracts, and full-text articles, and extracted data, with a second reviewer verifying included studies. The primary outcomes were vaccine effectiveness against SARS-CoV-2 infections, hospitalisations, and mortality, which were assessed using three-level meta-analytic models. This study is registered with the National Collaborating Centre for Methods and Tools, review 473. FINDINGS We screened 16 696 records at the title and abstract level, appraised 832 (5·0%) full texts, and initially included 73 (0·4%) studies. Of these, we excluded five (7%) studies because of critical risk of bias, leaving 68 (93%) studies that were extracted for analysis. For infections caused by any SARS-CoV-2 strain, vaccine effectiveness for the primary series reduced from 83% (95% CI 80-86) at baseline (14-42 days) to 62% (53-69) by 112-139 days. Vaccine effectiveness at baseline was 92% (88-94) for hospitalisations and 91% (85-95) for mortality, and reduced to 79% (65-87) at 224-251 days for hospitalisations and 86% (73-93) at 168-195 days for mortality. Estimated vaccine effectiveness was lower for the omicron variant for infections, hospitalisations, and mortality at baseline compared with that of other variants, but subsequent reductions occurred at a similar rate across variants. For booster doses, which covered mostly omicron studies, vaccine effectiveness at baseline was 70% (56-80) against infections and 89% (82-93) against hospitalisations, and reduced to 43% (14-62) against infections and 71% (51-83) against hospitalisations at 112 days or later. Not enough studies were available to report on booster vaccine effectiveness against mortality. INTERPRETATION Our analyses indicate that vaccine effectiveness generally decreases over time against SARS-CoV-2 infections, hospitalisations, and mortality. The baseline vaccine effectiveness levels for the omicron variant were notably lower than for other variants. Therefore, other preventive measures (eg, face-mask wearing and physical distancing) might be necessary to manage the pandemic in the long term. FUNDING Canadian Institutes of Health Research and the Public Health Agency of Canada.
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Affiliation(s)
- Nana Wu
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Keven Joyal-Desmarais
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Paula A B Ribeiro
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Ariany Marques Vieira
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jovana Stojanovic
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Comfort Sanuade
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Doro Yip
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Simon L Bacon
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada.
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Shishido AA, Barnes AH, Narayanan S, Chua JV. COVID-19 Vaccines-All You Want to Know. Semin Respir Crit Care Med 2023; 44:143-172. [PMID: 36646092 DOI: 10.1055/s-0042-1759779] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic has led to an unprecedented public health crisis. The collective global response has led to production of multiple safe and effective vaccines utilizing novel platforms to combat the virus that have propelled the field of vaccinology forward. Significant challenges to universal vaccine effectiveness remain, including immune evasion by SARS-CoV-2 variants, waning of immune response, inadequate knowledge of correlates of protection, and dosing in special populations. This review serves as a detailed evaluation of the development of the current SARS-CoV-2 vaccines, their effectiveness, and challenges to their deployment as a preventive tool.
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Affiliation(s)
- Akira A Shishido
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland.,Division of Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia
| | - Ashley H Barnes
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Shivakumar Narayanan
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Joel V Chua
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland
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Nienhaus A, Stranzinger J, Kozak A. COVID-19 as an Occupational Disease-Temporal Trends in the Number and Severity of Claims in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1182. [PMID: 36673937 PMCID: PMC9858689 DOI: 10.3390/ijerph20021182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/29/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
COVID-19 is considered an occupational disease (OD), when infection occurs at the workplace for health workers (HW). Because of the increased infection risk of these workers, they were deemed to be a priority group when the vaccination campaign started in Germany in December 2020. By December 2021, more than 90% of HW had been vaccinated twice. We studied the number and the time trend concerning the severity of OD claims related to COVID-19. Workers' compensation claims for OD are recorded in a standardized database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). We analyzed all notifiable COVID-19 related claims filed between 1 March 2020 and 30 September 2022. The proportion of severe cases was estimated by inpatient stays, injury benefit payments, rehabilitation measures, and deaths. The data analysis was descriptive. Due to COVID-19, 317,403 notifiable cases were reported to the BGW. Of these, 200,505 (63.2%) had thus far been recognized as OD. The number of notifiable cases was highest in 2022 and lowest in 2020. In total, 3289 insured individuals were admitted to rehabilitation management. This represented 1.6% of all recognized ODs due to COVID-19 at the BGW. The proportion of cases admitted to rehabilitation management decreased from 4.5% of all recognized ODs in 2020 to 3.2% in 2021 and to 0.1% of all recognized cases in 2022. For inpatient stays, injury benefit payment, and death, a similar trend was observed. Therefore, it might be concluded that the successful vaccination campaign mitigated the negative health effects of COVID-19 on HW. Even with vaccination, severe cases can occur. Therefore, infection prevention at the workplace remains paramount.
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Affiliation(s)
- Albert Nienhaus
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
- Department for Occupational Medicine, Hazardous Substances and Health Sciences (AGG), Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
| | - Johanna Stranzinger
- Department for Occupational Medicine, Hazardous Substances and Health Sciences (AGG), Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
| | - Agnessa Kozak
- Department for Occupational Medicine, Hazardous Substances and Health Sciences (AGG), Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
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9
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Alyahya MS, Momani S, Alolayyan MN, Khader YS. Workplace policies and quality of working life (QoWL) during the COVID-19 pandemic in Jordanian hospitals. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2023; 34:101-119. [PMID: 37154188 DOI: 10.3233/jrs-220039] [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: 05/10/2023]
Abstract
BACKGROUND Many healthcare organizations place a high value on quality of work-life (QoWL). The healthcare system's long-term sustainability and capability to offer high-quality services to patients depend on improving QoWL for their healthcare workers. OBJECTIVE The study aimed to explore the impact of Jordanian hospitals' workplace policies and measures in three main domains: (I) Infection prevention and control (IPC) measures, (II) Supply of personal protective equipment (PPE), and (III) COVID-19 precautionary measures on the QoWL among healthcare workers during the COVID-19 pandemic. METHODS A cross-sectional survey was conducted from May to June 2021 through an online self-reported questionnaire (Google Form) targeting hospital healthcare professionals working at Jordanian hospitals (public, private, military, and university). The study used a valid work-related quality of life (WRQoL) scale to study the QoWL. RESULTS A total of 484 HCWs in Jordanian hospitals participated in the study with a mean age of (34.8 ± 8.28 years). 57.6% of the respondents were females. 66.1% were married, with 61.6% having children at home. An average QoWL among healthcare workers in Jordanian hospitals during the pandemic was observed. The study results also showed a significant positive correlation between workplace policies (IPC measures, supply of PPE, and COVID-19 preventive measures) and the WRQoL among healthcare workers. CONCLUSION Our findings highlighted the vital need for QoWL and psychological well-being support services for healthcare staff during pandemics. Improved IPC systems and other precautionary measures at the national and hospital management levels are required to help minimize the stress and fear that healthcare workers experience and lower the risk of COVID-19 and future pandemics.
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Affiliation(s)
- Mohammad S Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Salam Momani
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Main Naser Alolayyan
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Risk of Infection and Duration of Protection after the Booster Dose of the Anti-SARS-CoV-2 Vaccine BNT162b2 among Healthcare Workers in a Large Teaching Hospital in Italy: Results of an Observational Study. Vaccines (Basel) 2022; 11:vaccines11010025. [PMID: 36679868 PMCID: PMC9863759 DOI: 10.3390/vaccines11010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
The efficacy of the first schedule of COVID-19 mRNA vaccines has decreased after the surge of the Delta variant, posing the need to administer a booster dose to enhance the neutralising immune response. This study aims at evaluating the duration of protection given by the booster dose of Pfizer-BioNTech BNT162b2 mRNA vaccine in healthcare workers (HCWs) of a large teaching hospital in Rome and to analyse the factors associated with post-booster vaccination infections. Data about vaccinations of HCWs with the BNT162b2 vaccine and nasal swabs positive for SARS-CoV-2 were extracted from the digital archives of the hospital from 27 September 2021 to 31 May 2022. In total, 5770 HCWs were observed. The cumulative risk of becoming infected by SARS-CoV-2 increased with time (2.5% at 4 weeks, 17% at 12 weeks and 40% at 24 weeks) and was significantly higher for females, younger classes of patients and for those who had developed a hybrid immunity (natural infection plus one dose, namely the primary schedule, added to the booster dose) compared to those who had completed the three doses. This study describes the duration and the determinants of the protection against infections after the booster dose of COVID-19 vaccine, highlighting the need for continuous monitoring of vaccine-induced immunogenicity.
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Baum U, Poukka E, Leino T, Kilpi T, Nohynek H, Palmu AA. High vaccine effectiveness against severe COVID-19 in the elderly in Finland before and after the emergence of Omicron. BMC Infect Dis 2022; 22:816. [PMID: 36335289 PMCID: PMC9636823 DOI: 10.1186/s12879-022-07814-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background The elderly are highly vulnerable to severe COVID-19. Waning immunity and emergence of Omicron have caused concerns about reduced effectiveness of COVID-19 vaccines. The objective was to estimate vaccine effectiveness (VE) against severe COVID-19 among the elderly. Methods This nationwide, register-based cohort analysis included all residents aged 70 years and over in Finland. The follow-up started on December 27, 2020, and ended on March 31, 2022. The outcomes of interest were COVID-19-related hospitalization and intensive care unit (ICU) admission timely associated with SARS-CoV-2 infection. VE was estimated as one minus the hazard ratio comparing the vaccinated and unvaccinated and taking into account time since vaccination. Omicron-specific VE was evaluated as the effectiveness observed since January 1, 2022. Results The cohort included 896,220 individuals. Comirnaty (BioNTech/Pfizer) VE against COVID-19-related hospitalization was 93% (95% CI 89–95%) and 85% (95% CI 82–87%) 14–90 and 91–180 days after the second dose; VE increased to 95% (95% CI 94–96%) 14–60 days after the third dose. VE of other homologous and heterologous three dose series was similar. Protection against severe COVID-19 requiring ICU treatment was even better. Since January 1, 2022, Comirnaty VE was 98% (95% CI 92–99%) and 92% (95% CI 87–95%) 14–90 and 91–180 days after the second and 98% (95% CI 95–99%) 14–60 days after the third dose. Conclusions VE against severe COVID-19 is high among the elderly. It waned slightly after two doses, but a third restored the protection. VE against severe COVID-19 remained high even after the emergence of Omicron. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07814-4.
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Jiménez-Sepúlveda N, Chico-Sánchez P, Castro-García JM, Escribano-Cañadas I, Merino-Lucas E, Ronda-Pérez E, Sánchez-Payá J, Gras-Valentí P. The Waning of BNT162b2 Vaccine Effectiveness for SARS-CoV-2 Infection Prevention over Time: A Test-Negative Study in Health Care Professionals of a Health Department from January 2021 to December 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113884. [PMID: 36360764 PMCID: PMC9653695 DOI: 10.3390/ijerph192113884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/01/2023]
Abstract
The duration of protection of vaccines against SARS-CoV-2 infection has been evaluated in previous studies, but uncertainty remains about the persistence of effectiveness over time and the ideal timing for booster doses. Therefore, the aim of this study was to evaluate BNT162b2 vaccine effectiveness against SARS-CoV-2 infection in health care workers (HCWs) at a tertiary hospital depending on time elapsed since the completion of a two-dose vaccination regimen. We conducted a case-control with negative test study between 25 January and 12 December 2021 that included 1404 HCWs who underwent an active infection diagnostic test (AIDT) to rule out SARS-CoV-2 infection due to COVID-19 suspicion or prior close contact with patients diagnosed with COVID-19. The adjusted vaccine effectiveness (aVE) for the prevention of SARS-CoV-2 infection 12 to 120 days after completing the full two-dose vaccination regimen was 91.9%. Then, aVE decreased to 63.7% between 121 to 240 days after completing the full two-dose regimen and to 37.2% after 241 days since the second dose. Vaccination against SARS-CoV-2 infection in HCWs remains highly effective after 12 to 120 days have elapsed since the administration of two doses of the BNT162b2 vaccine; however, effectiveness decreases as time elapses since its administration.
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Affiliation(s)
- Natali Jiménez-Sepúlveda
- Epidemiology Unit, Department of Preventive Medicine, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital Dr. Balmis, 03010 Alicante, Spain
| | - Pablo Chico-Sánchez
- Epidemiology Unit, Department of Preventive Medicine, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital Dr. Balmis, 03010 Alicante, Spain
| | | | - Isabel Escribano-Cañadas
- Department of Microbiology, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital Dr. Balmis, 03010 Alicante, Spain
| | - Esperanza Merino-Lucas
- Unit of Infectious Diseases, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital Dr. Balmis, 03010 Alicante, Spain
| | - Elena Ronda-Pérez
- Preventive Medicine and Public Health Area, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
- Centre of Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - José Sánchez-Payá
- Epidemiology Unit, Department of Preventive Medicine, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital Dr. Balmis, 03010 Alicante, Spain
| | - Paula Gras-Valentí
- Epidemiology Unit, Department of Preventive Medicine, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital Dr. Balmis, 03010 Alicante, Spain
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13
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Diani S, Leonardi E, Cavezzi A, Ferrari S, Iacono O, Limoli A, Bouslenko Z, Natalini D, Conti S, Mantovani M, Tramonte S, Donzelli A, Serravalle E. SARS-CoV-2-The Role of Natural Immunity: A Narrative Review. J Clin Med 2022; 11:6272. [PMID: 36362500 PMCID: PMC9655392 DOI: 10.3390/jcm11216272] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Both natural immunity and vaccine-induced immunity to COVID-19 may be useful to reduce the mortality/morbidity of this disease, but still a lot of controversy exists. AIMS This narrative review analyzes the literature regarding these two immunitary processes and more specifically: (a) the duration of natural immunity; (b) cellular immunity; (c) cross-reactivity; (d) the duration of post-vaccination immune protection; (e) the probability of reinfection and its clinical manifestations in the recovered patients; (f) the comparisons between vaccinated and unvaccinated as to the possible reinfections; (g) the role of hybrid immunity; (h) the effectiveness of natural and vaccine-induced immunity against Omicron variant; (i) the comparative incidence of adverse effects after vaccination in recovered individuals vs. COVID-19-naïve subjects. MATERIAL AND METHODS through multiple search engines we investigated COVID-19 literature related to the aims of the review, published since April 2020 through July 2022, including also the previous articles pertinent to the investigated topics. RESULTS nearly 900 studies were collected, and 246 pertinent articles were included. It was highlighted that the vast majority of the individuals after suffering from COVID-19 develop a natural immunity both of cell-mediated and humoral type, which is effective over time and provides protection against both reinfection and serious illness. Vaccine-induced immunity was shown to decay faster than natural immunity. In general, the severity of the symptoms of reinfection is significantly lower than in the primary infection, with a lower degree of hospitalizations (0.06%) and an extremely low mortality. CONCLUSIONS this extensive narrative review regarding a vast number of articles highlighted the valuable protection induced by the natural immunity after COVID-19, which seems comparable or superior to the one induced by anti-SARS-CoV-2 vaccination. Consequently, vaccination of the unvaccinated COVID-19-recovered subjects may not be indicated. Further research is needed in order to: (a) measure the durability of immunity over time; (b) evaluate both the impacts of Omicron BA.5 on vaccinated and healed subjects and the role of hybrid immunity.
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Affiliation(s)
- Sara Diani
- School of Musictherapy, Université Européenne Jean Monnet, 35129 Padova, Italy
| | | | | | | | - Oriana Iacono
- Physical Medicine and Rehabilitation Department, Mirandola Hospital, 41037 Mirandola, Italy
| | - Alice Limoli
- ARPAV (Regional Agency for the Environment Protection), 31100 Treviso, Italy
| | - Zoe Bouslenko
- Cardiology Department, Valdese Hospital, 10100 Torino, Italy
| | | | | | | | - Silvano Tramonte
- Environment and Health Commission, National Bioarchitecture Institute, 20121 Milano, Italy
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14
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Law TH, Ng CP, Poi AWH. The sources of the Kuznets relationship between the COVID-19 mortality rate and economic performance. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 81:103233. [PMID: 36093278 PMCID: PMC9444851 DOI: 10.1016/j.ijdrr.2022.103233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/11/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
This paper discusses the findings of an empirical analysis of the Kuznets, or reverse U-shaped relationship, between the COVID-19 mortality rate and economic performance. In the early stages of economic development, the COVID-19 mortality rate is anticipated to rise with rising economic activity and urbanization. Eventually, the mortality rate decreases at higher economic development levels as people and the government are more capable of investing in disease abatement measures. The quality of political institutions, wealth distribution, urbanization, vaccination rate, and improvements in healthcare systems are hypothesized to affect the COVID-19 mortality rate. Examining this relationship can be effective in understanding the change in the COVID-19 mortality rate at different economic performance stages and in identifying appropriate preventive measures. This study employed the negative binomial regression to model a cross-sectional dataset of 137 countries. Results indicated that the relationship between the per-head gross domestic product (GDP) level and the COVID-19 mortality rate appeared to follow a pattern like the Kuznets curve, implying that changes in institutional quality, healthcare advancements, wealth distribution, urbanization, vaccination rate, and the percentage of the elderly population were significant in explaining the relationship. Improvement of the healthcare system has a notable effect on lowering the COVID-19 mortality rate under more effective government conditions. Additionally, the results suggested that a higher per-head GDP is required to reverse the rising trend of the mortality rate under higher income inequality. Based on these results, preventive measures, and policies to reduce COVID-19 mortalities were recommended in the conclusion section.
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Affiliation(s)
- Teik Hua Law
- Road Safety Research Center, Faculty of Engineering, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Choy Peng Ng
- Civil Engineering Department, Faculty of Engineering, Universiti Pertahanan Nasional Malaysia, 57000 Kuala Lumpur, Malaysia
| | - Alvin Wai Hoong Poi
- Road Safety Engineering and Environment Research Center, Malaysian Institute of Road Safety Research, 43000 Kajang, Selangor, Malaysia
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15
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Grasselli G, Zanella A, Carlesso E, Florio G, Canakoglu A, Bellani G, Bottino N, Cabrini L, Castelli GP, Catena E, Cecconi M, Cereda D, Chiumello D, Forastieri A, Foti G, Gemma M, Giudici R, Grazioli L, Lombardo A, Lorini FL, Madotto F, Mantovani A, Mistraletti G, Mojoli F, Mongodi S, Monti G, Muttini S, Piva S, Protti A, Rasulo F, Scandroglio AM, Severgnini P, Storti E, Fumagalli R, Pesenti A. Association of COVID-19 Vaccinations With Intensive Care Unit Admissions and Outcome of Critically Ill Patients With COVID-19 Pneumonia in Lombardy, Italy. JAMA Netw Open 2022; 5:e2238871. [PMID: 36301541 PMCID: PMC9614574 DOI: 10.1001/jamanetworkopen.2022.38871] [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] [Received: 06/20/2022] [Accepted: 09/08/2022] [Indexed: 11/14/2022] Open
Abstract
Importance Data on the association of COVID-19 vaccination with intensive care unit (ICU) admission and outcomes of patients with SARS-CoV-2-related pneumonia are scarce. Objective To evaluate whether COVID-19 vaccination is associated with preventing ICU admission for COVID-19 pneumonia and to compare baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU. Design, Setting, and Participants This retrospective cohort study on regional data sets reports: (1) daily number of administered vaccines and (2) data of all consecutive patients admitted to an ICU in Lombardy, Italy, from August 1 to December 15, 2021 (Delta variant predominant). Vaccinated patients received either mRNA vaccines (BNT162b2 or mRNA-1273) or adenoviral vector vaccines (ChAdOx1-S or Ad26.COV2). Incident rate ratios (IRRs) were computed from August 1, 2021, to January 31, 2022; ICU and baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU were analyzed from August 1 to December 15, 2021. Exposures COVID-19 vaccination status (no vaccination, mRNA vaccine, adenoviral vector vaccine). Main Outcomes and Measures The incidence IRR of ICU admission was evaluated, comparing vaccinated people with unvaccinated, adjusted for age and sex. The baseline characteristics at ICU admission of vaccinated and unvaccinated patients were investigated. The association between vaccination status at ICU admission and mortality at ICU and hospital discharge were also studied, adjusting for possible confounders. Results Among the 10 107 674 inhabitants of Lombardy, Italy, at the time of this study, the median [IQR] age was 48 [28-64] years and 5 154 914 (51.0%) were female. Of the 7 863 417 individuals who were vaccinated (median [IQR] age: 53 [33-68] years; 4 010 343 [51.4%] female), 6 251 417 (79.5%) received an mRNA vaccine, 550 439 (7.0%) received an adenoviral vector vaccine, and 1 061 561 (13.5%) received a mix of vaccines and 4 497 875 (57.2%) were boosted. Compared with unvaccinated people, IRR of individuals who received an mRNA vaccine within 120 days from the last dose was 0.03 (95% CI, 0.03-0.04; P < .001), whereas IRR of individuals who received an adenoviral vector vaccine after 120 days was 0.21 (95% CI, 0.19-0.24; P < .001). There were 553 patients admitted to an ICU for COVID-19 pneumonia during the study period: 139 patients (25.1%) were vaccinated and 414 (74.9%) were unvaccinated. Compared with unvaccinated patients, vaccinated patients were older (median [IQR]: 72 [66-76] vs 60 [51-69] years; P < .001), primarily male individuals (110 patients [79.1%] vs 252 patients [60.9%]; P < .001), with more comorbidities (median [IQR]: 2 [1-3] vs 0 [0-1] comorbidities; P < .001) and had higher ratio of arterial partial pressure of oxygen (Pao2) and fraction of inspiratory oxygen (FiO2) at ICU admission (median [IQR]: 138 [100-180] vs 120 [90-158] mm Hg; P = .007). Factors associated with ICU and hospital mortality were higher age, premorbid heart disease, lower Pao2/FiO2 at ICU admission, and female sex (this factor only for ICU mortality). ICU and hospital mortality were similar between vaccinated and unvaccinated patients. Conclusions and Relevance In this cohort study, mRNA and adenoviral vector vaccines were associated with significantly lower risk of ICU admission for COVID-19 pneumonia. ICU and hospital mortality were not associated with vaccinated status. These findings suggest a substantial reduction of the risk of developing COVID-19-related severe acute respiratory failure requiring ICU admission among vaccinated people.
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Affiliation(s)
- Giacomo Grasselli
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alberto Zanella
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Carlesso
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gaetano Florio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Arif Canakoglu
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Bellani
- Department of Anesthesia and Intensive Care Medicine, ASST Monza Ospedale San Gerardo, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nicola Bottino
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Cabrini
- Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Università degli Studi dell'Insubria, Varese, Italy
| | - Gian Paolo Castelli
- Dipartimento di Anestesia e Rianimazione, ASST Mantova Ospedale Carlo Poma, Mantova Italy
| | - Emanuele Catena
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco Luigi Sacco Hospital, Polo Universitario, Milan, Italy
| | - Maurizio Cecconi
- Department of Anaesthesia and Intensive Care Medicine, IRCCS Humanitas Clinical and Research Centre, Rozzano, Italy
- Humanitas University, Pieve Emanuele, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milano, Italy
| | - Davide Chiumello
- Department of Anesthesia and Intensive Care, San Paolo Hospital, Milano, Italy
- Department of Health Sciences, University of Milan, Milano, Italy
| | - Andrea Forastieri
- Dipartimento di Anestesia e Rianimazione ASST Lecco Ospedale di Lecco, Lecco, Italy
| | - Giuseppe Foti
- Department of Anesthesia and Intensive Care Medicine, ASST Monza Ospedale San Gerardo, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Gemma
- Terapia Intensiva–Neuroanestesia e Rianimazione. Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Riccardo Giudici
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Grazioli
- Department of Anaesthesia and Intensive Care, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Lombardo
- Dipartimento Di Emergenza, Rianimazione, Anestesia–UO Anestesia e Rianimazione 2–ASST Lariana Ospedale Sant'Anna, Como, Italy
| | | | - Fabiana Madotto
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giovanni Mistraletti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Anesthesia and critical care, ASST Ovest Milanese Ospedale Nuovo di Legnano, Legnano, Italy
| | - Francesco Mojoli
- Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Clinico-Chirurgiche Diagnostiche e Pediatriche, Università degli Studi di Pavia, Pavia, Italy
| | - Silvia Mongodi
- Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianpaola Monti
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Stefano Muttini
- SC Anestesia e Rianimazione II, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo–Polo Universitario, Milano, Italy
| | - Simone Piva
- Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
| | - Alessandro Protti
- Department of Anaesthesia and Intensive Care Medicine, IRCCS Humanitas Clinical and Research Centre, Rozzano, Italy
- Humanitas University, Pieve Emanuele, Italy
| | - Frank Rasulo
- Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Anna Mara Scandroglio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Paolo Severgnini
- Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Università degli Studi dell'Insubria, Varese, Italy
| | - Enrico Storti
- Dipartimento di Anestesia e Rianimazione ASST Cremona Ospedale di Cremona, Cremona, Italy
| | - Roberto Fumagalli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Antonio Pesenti
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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16
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Wolfensberger A, Kufner V, Zaheri M, Zeeb M, Nortes I, Schreiber PW, Vazquez M, Schärer V, Scheier T, Schmutz S, Probst E, Saleschus D, Huber M, Rampini SK, Zingg W. Nosocomial COVID-19 Incidence and Secondary Attack Rates among Patients of Tertiary Care Center, Zurich, Switzerland. Emerg Infect Dis 2022; 28:2087-2090. [PMID: 36048771 PMCID: PMC9514341 DOI: 10.3201/eid2810.220321] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Of 1,118 patients with COVID-19 at a university hospital in Switzerland during October 2020-June 2021, we found 83 (7.4%) had probable or definite healthcare-associated COVID-19. After in-hospital exposure, we estimated secondary attack rate at 23.3%. Transmission was associated with longer contact times and with lower cycle threshold values among index patients.
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17
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Investigation of Possible Factors Influencing the Neutralizing Anti-SARS-CoV-2 Antibody Titer after Six Months from the Second Vaccination Dose in a Sample of Italian Nursing Home Personnel. Antibodies (Basel) 2022; 11:antib11030059. [PMID: 36134955 PMCID: PMC9495803 DOI: 10.3390/antib11030059] [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: 07/13/2022] [Revised: 08/27/2022] [Accepted: 09/07/2022] [Indexed: 11/22/2022] Open
Abstract
The titer of the anti-SARS-CoV-2 antibodies produced after vaccination shows a relevant decay over time, as demonstrated in several studies. However, less is known on the possible factors affecting the entity of this decay. The aim of this study is to analyze a group of individual factors which are possibly associated with anti-SARS-CoV-2 antibody titer decay six months after the second vaccine dose. We report here the results of a follow-up serological analysis and a questionnaire-based evaluation of a sample of workers from an Italian nursing home, vaccinated with two doses of BNT162b2 vaccine in early 2021. The baseline data were collected one month after the vaccine, while in the present analysis we report the data collected six months later. Our data show a relevant decay of the neutralizing antibody titer, even if for all the workers a largely positive response was detected. Moreover, our results demonstrate a possible association between younger age and the absence of previous COVID-19 infection, and a higher decay rate of the anti-SARS-CoV-2 antibodies titer.
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18
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Zheutlin A, Ott M, Sun R, Zemlianskaia N, Meyer CS, Rubel M, Hayden J, Neri B, Kamath T, Khan N, Schneeweiss S, Sarsour K. Durability of Protection Post-Primary COVID-19 Vaccination in the United States. Vaccines (Basel) 2022; 10:vaccines10091458. [PMID: 36146536 PMCID: PMC9505933 DOI: 10.3390/vaccines10091458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 12/27/2022] Open
Abstract
The durability of immune responses after COVID-19 vaccination will drive long-term vaccine effectiveness across settings and may differ by vaccine type. To determine durability of protection of COVID-19 vaccines (BNT162b2, mRNA-1273, and Ad26.COV2.S) following primary vaccination in the United States, a matched case-control study was conducted in three cohorts between 1 January and 7 September 2021 using de-identified data from a database covering 168 million lives. Odds ratios (ORs) for developing outcomes of interest (breakthrough SARS-CoV-2 infection, hospitalization, or intensive care unit admission) were determined for each vaccine (no direct comparisons). In total, 17,017,435 individuals were identified. Relative to the baseline, stable protection was observed for Ad26.COV2.S against infections (OR [95% confidence interval (CI)], 1.31 [1.18–1.47]) and hospitalizations (OR [95% CI], 1.25 [0.86–1.80]). Relative to the baseline, protection waned over time against infections for BNT162b2 (OR [95% CI], 2.20 [2.01–2.40]) and mRNA-1273 (OR [95% CI], 2.07 [1.87–2.29]) and against hospitalizations for BNT162b2 (OR [95% CI], 2.38 [1.79–3.17]). Baseline protection remained stable for intensive care unit admissions for all three vaccines. Calculated baseline VE was consistent with published literature. This study suggests that the three vaccines in three separate populations may have different durability profiles.
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Affiliation(s)
- Amanda Zheutlin
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Miles Ott
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Ran Sun
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Natalia Zemlianskaia
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Craig S. Meyer
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Meagan Rubel
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Jennifer Hayden
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Breno Neri
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Tripthi Kamath
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Najat Khan
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02120, USA
| | - Khaled Sarsour
- Data Sciences, Research & Development, Janssen Pharmaceuticals, Titusville, NJ 08560, USA
- Correspondence: ; Tel.: +1-650-296-0719
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Starrfelt J, Danielsen AS, Buanes EA, Juvet LK, Lyngstad TM, Rø GØI, Veneti L, Watle SV, Meijerink H. Age and product dependent vaccine effectiveness against SARS-CoV-2 infection and hospitalisation among adults in Norway: a national cohort study, July-November 2021. BMC Med 2022; 20:278. [PMID: 36050718 PMCID: PMC9436448 DOI: 10.1186/s12916-022-02480-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/14/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND COVID-19 vaccines have been crucial in the pandemic response and understanding changes in vaccines effectiveness is essential to guide vaccine policies. Although the Delta variant is no longer dominant, understanding vaccine effectiveness properties will provide essential knowledge to comprehend the development of the pandemic and estimate potential changes over time. METHODS In this population-based cohort study, we estimated the vaccine effectiveness of Comirnaty (Pfizer/BioNTech; BNT162b2), Spikevax (Moderna; mRNA-1273), Vaxzevria (AstraZeneca; ChAdOx nCoV-19; AZD1222), or a combination against SARS-CoV-2 infections, hospitalisations, intensive care admissions, and death using Cox proportional hazard models, across different vaccine product regimens and age groups, between 15 July and 31 November 2021 (Delta variant period). Vaccine status is included as a time-varying covariate and all models were adjusted for age, sex, comorbidities, county of residence, country of birth, and living conditions. Data from the entire adult Norwegian population were collated from the National Preparedness Register for COVID-19 (Beredt C19). RESULTS The overall adjusted vaccine effectiveness against infection decreased from 81.3% (confidence interval (CI): 80.7 to 81.9) in the first 2 to 9 weeks after receiving a second dose to 8.6% (CI: 4.0 to 13.1) after more than 33 weeks, compared to 98.6% (CI: 97.5 to 99.2) and 66.6% (CI: 57.9 to 73.6) against hospitalisation respectively. After the third dose (booster), the effectiveness was 75.9% (CI: 73.4 to 78.1) against infection and 95.0% (CI: 92.6 to 96.6) against hospitalisation. Spikevax or a combination of mRNA products provided the highest protection, but the vaccine effectiveness decreased with time since vaccination for all vaccine regimens. CONCLUSIONS Even though the vaccine effectiveness against infection waned over time, all vaccine regimens remained effective against hospitalisation after the second vaccine dose. For all vaccine regimens, a booster facilitated recovery of effectiveness. The results from this support the use of heterologous schedules, increasing flexibility in vaccination policy.
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Affiliation(s)
- Jostein Starrfelt
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway.
| | - Anders Skyrud Danielsen
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Eirik Alnes Buanes
- Norwegian Intensive Care and Pandemic Registry (NIPaR), Helse Bergen Health Trust, Bergen, Norway.,Department of Anaesthesiology and Intensive Care Haukeland University Hospital, Bergen, Norway
| | - Lene Kristine Juvet
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Trude Marie Lyngstad
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway
| | | | - Lamprini Veneti
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway
| | - Sara Viksmoen Watle
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Hinta Meijerink
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
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20
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He X, Su J, Ma Y, Zhang W, Tang S. A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines. Front Immunol 2022; 13:945930. [PMID: 36090988 PMCID: PMC9459021 DOI: 10.3389/fimmu.2022.945930] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
It is urgently needed to update the comprehensive analysis about the efficacy or effectiveness of COVID-19 vaccines especially during the COVID-19 pandemic caused by SARS-CoV-2 Delta and Omicron variants. In general, the current COVID-19 vaccines showed a cumulative efficacy of 66.4%, 79.7%, and 93.6% to prevent SARS-CoV-2 infection, symptomatic COVID-19, and severe COVID-19, respectively, but could not prevent the asymptomatic infection of SARS-CoV-2. Furthermore, the current COVID-19 vaccines could effectively prevent COVID-19 caused by the Delta variant although the incidence of breakthrough infection of the SARS-CoV-2 Delta variant increased when the intervals post full vaccination extended, suggesting the waning effectiveness of COVID-19 vaccines. In addition, one-dose booster immunization showed an effectiveness of 74.5% to prevent COVID-19 caused by the Delta variant. However, current COVID-19 vaccines could not prevent the infection of Omicron sub-lineage BA.1.1.529 and had about 50% effectiveness to prevent COVID-19 caused by Omicron sub-lineage BA.1.1.529. Furthermore, the effectiveness was 87.6% and 90.1% to prevent severe COVID-19 and COVID-19-related death caused by Omicron sub-lineage BA.2, respectively, while one-dose booster immunization could enhance the effectiveness of COVID-19 vaccines to prevent the infection and COVID-19 caused by Omicron sub-lineage BA.1.1.529 and sub-lineage BA.2. Two-dose booster immunization showed an increased effectiveness of 81.8% against severe COVID-19 caused by the Omicron sub-lineage BA.1.1.529 variant compared with one-dose booster immunization. The effectiveness of the booster immunization with RNA-based vaccine BNT162b2 or mRNA-1273 was over 75% against severe COVID-19 more than 17 weeks after booster immunization whereas the heterogenous booster immunization showed better effectiveness than homologous booster immunization. In summary, the current COVID-19 vaccines could effectively protect COVID-19 caused by Delta and Omicron variants but was less effective against Omicron variant infection. One-dose booster immunization could enhance protection capability, and two-dose booster immunization could provide additional protection against severe COVID-19.
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Affiliation(s)
- Xiaofeng He
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Institute of Evidence-Based Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Jiao Su
- Department of biochemistry, Changzhi Medical College, Changzhi, China
| | - Yu’nan Ma
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenping Zhang
- Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Shixing Tang,
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21
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Promotion of neutralizing antibody-independent immunity to wild-type and SARS-CoV-2 variants of concern using an RBD-Nucleocapsid fusion protein. Nat Commun 2022; 13:4831. [PMID: 35977933 PMCID: PMC9382605 DOI: 10.1038/s41467-022-32547-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/05/2022] [Indexed: 11/20/2022] Open
Abstract
Both T cells and B cells have been shown to be generated after infection with SARS-CoV-2 yet protocols or experimental models to study one or the other are less common. Here, we generate a chimeric protein (SpiN) that comprises the receptor binding domain (RBD) from Spike (S) and the nucleocapsid (N) antigens from SARS-CoV-2. Memory CD4+ and CD8+ T cells specific for SpiN could be detected in the blood of both individuals vaccinated with Coronavac SARS-CoV-2 vaccine and COVID-19 convalescent donors. In mice, SpiN elicited a strong IFN-γ response by T cells and high levels of antibodies to the inactivated virus, but not detectable neutralizing antibodies (nAbs). Importantly, immunization of Syrian hamsters and the human Angiotensin Convertase Enzyme-2-transgenic (K18-ACE-2) mice with Poly ICLC-adjuvanted SpiN promotes robust resistance to the wild type SARS-CoV-2, as indicated by viral load, lung inflammation, clinical outcome and reduction of lethality. The protection induced by SpiN was ablated by depletion of CD4+ and CD8+ T cells and not transferred by antibodies from vaccinated mice. Finally, vaccination with SpiN also protects the K18-ACE-2 mice against infection with Delta and Omicron SARS-CoV-2 isolates. Hence, vaccine formulations that elicit effector T cells specific for the N and RBD proteins may be used to improve COVID-19 vaccines and potentially circumvent the immune escape by variants of concern. Protection against SARS-CoV-2 infection involves T cell and B cell responses but only studying one or the other has proved difficult. Here the authors immunise with a fusion protein construct of N and RBD proteins from SARS-CoV-2 and find that this promotes protection in animal models preferentially via T cells.
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22
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Zurac S, Vladan C, Dinca O, Constantin C, Neagu M. Immunogenicity evaluation after BNT162b2 booster vaccination in healthcare workers. Sci Rep 2022; 12:12716. [PMID: 35882871 PMCID: PMC9321272 DOI: 10.1038/s41598-022-16759-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/14/2022] [Indexed: 12/21/2022] Open
Abstract
Waning of the immune response upon vaccination in SARS-CoV-2 infection is an important subject of evaluation in this pandemic, mostly in healthcare workers (HCW) that are constantly in contact with infected samples and patients. Therefore, our study aimed to establish the specific humoral response of specific IgG and IgA antibodies upon vaccination, during the second year of pandemic and evaluating the booster shot with the same vaccine type. A group of 103 HCW with documented exposure to the virus were monitored for specific IgG and IgA levels prior to vaccination, after the first vaccination round, during the following 8 months and after the booster shot with the same vaccine type. After 8 months post-vaccination the humoral response in both IgG and IgA decreased, 2.4 times for IgG, and 2.7 times for IgA. Although the antibodies levels significantly decreased, no documented infection was registered in the group. After the booster shot, the entire group, displayed IgG increased levels, immediately after booster followed by the increase in specific IgA. IgG levels post-second round of vaccination are statistically higher compared to the first round, while IgA is restored at the same levels. Within the vaccination or booster routine for a multiple waves' pandemic that is generating new virus variants, populational immunity remains an important issue for future implementation of prevention/control measures.
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Affiliation(s)
- Sabina Zurac
- Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania
| | - Cristian Vladan
- Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Prof. Dr. Dan Theodorescu" Clinical Hospital for Oro-Maxillo-Facial Surgery, Bucharest, Romania
| | - Octavian Dinca
- Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Prof. Dr. Dan Theodorescu" Clinical Hospital for Oro-Maxillo-Facial Surgery, Bucharest, Romania
| | - Carolina Constantin
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania.
- Department of Immunology, Victor Babes National Institute of Pathology, Bucharest, Romania.
| | - Monica Neagu
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania
- "Prof. Dr. Dan Theodorescu" Clinical Hospital for Oro-Maxillo-Facial Surgery, Bucharest, Romania
- Doctoral School, Faculty of Biology, University of Bucharest, Bucharest, Romania
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23
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Olivier E, Sophie A, Maeva L, Jean-François F, Jocelyn M, Emilia F, Sophie B, Cécile J, Gabrielle C, Audrey F, Simon L, Lena S, Pierre C, Aba M, Guillaume B. Impact of vaccination on the symptoms of hospitalised patients with SARS-CoV-2 delta variant (B.1.617.1) infection. Clin Microbiol Infect 2022; 28:1629-1635. [PMID: 35779764 PMCID: PMC9242694 DOI: 10.1016/j.cmi.2022.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The diffusion of the SARS-CoV-2 delta (B.1.617.2) variant and the waning of immune response after primary Covid-19 vaccination favoured the breakthrough SARS-CoV-2 infections in vaccinated subjects. To assess the impact of vaccination, we determined the severity of infection in hospitalised patients according to vaccine status. METHODS We performed a retrospectiveobservational study on patients hospitalised in 10 centres with a SARS-CoV-2 infection (delta variant) from July to November 2021 by including all patients who had completed their primary vaccination at least 14 days before hospital admission and the same number of completely unvaccinated patients. We assessed the impact of vaccination and other risk factors through logistic regression. RESULTS We included 955 patients (474 vaccinated and 481 unvaccinated). Vaccinated patients were significantly older (75.0 [63.25-84.0] vs. 55.0 [38.0-73.0]; p<0.001), more frequently males (55.1% (261/474) vs. 46.4% (223/481); p=0.009), and had more comorbidities (2.0 [1.0-3.0] vs. 1.0 [0.0-2.0]; p<0.001). Vaccinated patients were less often admitted for Covid-19 (59.3% (281/474) vs. 75.1% (361/481); p<0.001), had less extended lung lesions (≤25%: 64.3% (117/182) vs. 38.4% (88/229); p<0.001), required oxygen less frequently (57.5% (229/398) vs. 73.0% (270/370); p<0.001), at a lower flow (3.0 [0.0-8.7] vs. 6.0 [2.0-50.0] L/min, p<0.001), and for a shorter duration (3 [0.0-8.0] vs. 6 [2.0-12.0] days, p<0.001)., and required less frequently intensive care unit admission (16.2% (60/370) vs. 36.0% (133/369); p<0.001) but had comparable mortality in bivariate analysis (16.7% (74/443) vs. 12.2% (53/433); p=0.075). Multivariate logistic regression showed that vaccination significantly decreased the risk of death (0.38 [0.20-0.70](p=0.002), ICU admission (0.31 [0.21-0.47](p<0.001) and oxygen requirement (0.16 [0.10-0.26](p<0.001), even among older patients or with comorbidities. CONCLUSIONS Among patients hospitalised with a delta variant SARS-CoV-2 infection, vaccination was associated with less severe forms, even in the presence of comorbidities.
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Affiliation(s)
- Epaulard Olivier
- infectious diseases, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC-1406, Inserm-CHUGA-UGA, Grenoble, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF).
| | - Abgrall Sophie
- Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF); APHP, Hôpital Antoine Béclère, Service de Médecine Interne, Clamart; Université Paris-Saclay, UVSQ, INSERM U1018, CESP, Le Kremlin-Bicêtre, France
| | - Lefebvre Maeva
- Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF); Infectious Diseases Department, Centre for Prevention of Infectious and Transmissible Diseases, CHU Nantes and INSERM UIC 1413 Nantes University, Nantes, France
| | - Faucher Jean-François
- CHU Limoges, Department of Infectious Diseases and Tropical Medicine, Limoges, France; Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Michon Jocelyn
- Department of Infectious diseases, University Hospital of Caen, Caen, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Frentiu Emilia
- Infectious diseases department, Centre Hospitalier Universitaire de Nancy, Nancy, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Blanchi Sophie
- Infectious diseases department, Centre Hospitalier, Le Mans, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Janssen Cécile
- Infectious Disease Unit, Centre Hospitalier Annecy Genevois, Annecy, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Charbonnier Gabrielle
- Infectious diseases department, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Fresse Audrey
- Pharmacovigilance, Centre Hospitalier Universitaire de Nancy, Nancy, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Laurent Simon
- Department of Infectious diseases, University Hospital of Caen, Caen, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Sandjakian Lena
- CHU Limoges, Department of Infectious Diseases and Tropical Medicine, Limoges, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Casez Pierre
- Infectious Disease Unit, Centre Hospitalier Annecy Genevois, Annecy, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Mahamat Aba
- Regional Centre for Prevention of Infectious Diseases and Healthcare-Associated Infections, General Hospital of Ajaccio; Ajaccio, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
| | - Beraud Guillaume
- Department of Internal Medicine and Infectious Diseases, University Hospital of Poitiers; Poitiers, France; Groupe Vaccination-Prévention de la Société de Pathologie Infectieuse de Langue Française (SPILF)
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24
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Higdon MM, Wahl B, Jones CB, Rosen JG, Truelove SA, Baidya A, Nande AA, ShamaeiZadeh PA, Walter KK, Feikin DR, Patel MK, Deloria Knoll M, Hill AL. A Systematic Review of Coronavirus Disease 2019 Vaccine Efficacy and Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Disease. Open Forum Infect Dis 2022; 9:ofac138. [PMID: 35611346 PMCID: PMC9047227 DOI: 10.1093/ofid/ofac138] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/17/2022] [Indexed: 01/13/2023] Open
Abstract
Billions of doses of coronavirus disease 2019 (COVID-19) vaccines have been administered globally, dramatically reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidence and severity in some settings. Many studies suggest vaccines provide a high degree of protection against infection and disease, but precise estimates vary and studies differ in design, outcomes measured, dosing regime, location, and circulating virus strains. In this study, we conduct a systematic review of COVID-19 vaccines through February 2022. We included efficacy data from Phase 3 clinical trials for 15 vaccines undergoing World Health Organization Emergency Use Listing evaluation and real-world effectiveness for 8 vaccines with observational studies meeting inclusion criteria. Vaccine metrics collected include protection against asymptomatic infection, any infection, symptomatic COVID-19, and severe outcomes including hospitalization and death, for partial or complete vaccination, and against variants of concern Alpha, Beta, Gamma, Delta, and Omicron. We additionally review the epidemiological principles behind the design and interpretation of vaccine efficacy and effectiveness studies, including important sources of heterogeneity.
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Affiliation(s)
- Melissa M Higdon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brian Wahl
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carli B Jones
- Department of Pathology Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph G Rosen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shaun A Truelove
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anurima Baidya
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anjalika A Nande
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Parisa A ShamaeiZadeh
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Karoline K Walter
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Daniel R Feikin
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Minal K Patel
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Maria Deloria Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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25
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Kissling E, Hooiveld M, Martínez-Baz I, Mazagatos C, William N, Vilcu AM, Kooijman MN, Ilić M, Domegan L, Machado A, de Lusignan S, Lazar M, Meijer A, Brytting M, Casado I, Larrauri A, Murray JLK, Behillil S, de Gier B, Mlinarić I, O’Donnell J, Rodrigues AP, Tsang R, Timnea O, de Lange M, Riess M, Castilla J, Pozo F, Hamilton M, Falchi A, Knol MJ, Kurečić Filipović S, Dunford L, Guiomar R, Cogdale J, Cherciu C, Jansen T, Enkirch T, Basile L, Connell J, Gomez V, Sandonis Martín V, Bacci S, Rose AMC, Pastore Celentano L, Valenciano M. Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre analysis, I-MOVE-COVID-19 and ECDC networks, July to August 2021. Euro Surveill 2022; 27:2101104. [PMID: 35620997 PMCID: PMC9137272 DOI: 10.2807/1560-7917.es.2022.27.21.2101104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe.AimUsing a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection.MethodsIndividuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-CoV-2. We measured complete primary course overall VE by vaccine brand and by time since vaccination.ResultsOverall VE was 74% (95% CI: 69-79), 76% (95% CI: 71-80), 63% (95% CI: 48-75) and 63% (95% CI: 16-83) among those aged 30-44, 45-59, 60-74 and ≥ 75 years, respectively. VE among those aged 30-59 years was 78% (95% CI: 75-81), 66% (95% CI: 58-73), 91% (95% CI: 87-94) and 52% (95% CI: 40-61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among people 60 years and older was 67% (95% CI: 52-77), 65% (95% CI: 48-76) and 83% (95% CI: 64-92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30-59 years was 87% (95% CI: 83-89) at 14-29 days and 65% (95% CI: 56-71%) at ≥ 90 days between vaccination and onset of symptoms.ConclusionsVE against symptomatic infection with the SARS-CoV-2 Delta variant varied among brands, ranging from 52% to 91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% at 90 days or more between vaccination and onset.
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Affiliation(s)
| | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marjolein N Kooijman
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maja Ilić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Behillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Olivia Timnea
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | | | - Mirjam J Knol
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Carmen Cherciu
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | | | | | - Luca Basile
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalunya, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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26
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Zeng B, Gao L, Zhou Q, Yu K, Sun F. Effectiveness of COVID-19 vaccines against SARS-CoV-2 variants of concern: a systematic review and meta-analysis. BMC Med 2022; 20:200. [PMID: 35606843 PMCID: PMC9126103 DOI: 10.1186/s12916-022-02397-y] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND It was urgent and necessary to synthesize the evidence for vaccine effectiveness (VE) against SARS-CoV-2 variants of concern (VOC). We conducted a systematic review and meta-analysis to provide a comprehensive overview of the effectiveness profile of COVID-19 vaccines against VOC. METHODS Published randomized controlled trials (RCTs), cohort studies, and case-control studies that evaluated the VE against VOC (Alpha, Beta, Gamma, Delta, or Omicron) were searched until 4 March 2022. Pooled estimates and 95% confidence intervals (CIs) were calculated using random-effects meta-analysis. VE was defined as (1-estimate). RESULTS Eleven RCTs (161,388 participants), 20 cohort studies (52,782,321 participants), and 26 case-control studies (2,584,732 cases) were included. Eleven COVID-19 vaccines (mRNA-1273, BNT162b2, ChAdOx1, Ad26.COV2.S, NVX-CoV2373, BBV152, CoronaVac, BBIBP-CorV, SCB-2019, CVnCoV, and HB02) were included in this analysis. Full vaccination was effective against Alpha, Beta, Gamma, Delta, and Omicron variants, with VE of 88.0% (95% CI, 83.0-91.5), 73.0% (95% CI, 64.3-79.5), 63.0% (95% CI, 47.9-73.7), 77.8% (95% CI, 72.7-82.0), and 55.9% (95% CI, 40.9-67.0), respectively. Booster vaccination was more effective against Delta and Omicron variants, with VE of 95.5% (95% CI, 94.2-96.5) and 80.8% (95% CI, 58.6-91.1), respectively. mRNA vaccines (mRNA-1273/BNT162b2) seemed to have higher VE against VOC over others; significant interactions (pinteraction < 0.10) were observed between VE and vaccine type (mRNA vaccines vs. not mRNA vaccines). CONCLUSIONS Full vaccination of COVID-19 vaccines is highly effective against Alpha variant, and moderate effective against Beta, Gamma, and Delta variants. Booster vaccination is more effective against Delta and Omicron variants. mRNA vaccines seem to have higher VE against Alpha, Beta, Gamma, and Delta variants over others.
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Affiliation(s)
- Baoqi Zeng
- Department of Science and Education, Peking University Binhai Hospital, Tianjin, China
| | - Le Gao
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Qingxin Zhou
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Kai Yu
- Department of Science and Education, Peking University Binhai Hospital, Tianjin, China.
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China.
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27
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Saade A, Cha L, Tadié E, Jurado B, Le Bihan A, Baron-Latouche P, Febreau C, Thibault V, Garlantezec R, Tattevin P, Paris C. Delay between COVID-19 complete vaccination and SARS-CoV-2 infection among healthcare workers. Vaccine 2022; 40:3159-3164. [PMID: 35465980 PMCID: PMC9013627 DOI: 10.1016/j.vaccine.2022.04.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/21/2022] [Accepted: 04/11/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Healthcare workers (HCWs), at increased risk of coronavirus disease 2019 (COVID-19) were among the primary targets for vaccination, which became mandatory for them on September 15th, 2021 in France. In November they were confronted to the fifth COVID-19 wave despite excellent vaccine coverage. We aimed to estimate the incidence of SARS-CoV-2 infection after complete vaccination among HCWs with different vaccination schemes, and its determinants. METHODS We enrolled all HCWs in the university hospital of Rennes, France who had received complete vaccination (two doses of COVID-19 vaccine). The delay from last vaccination dose to SARS-CoV-2 infection was computed.Fitted mixed Cox survival model with a random effect applied to exposure risk periods to account for epidemic variation was used to estimate the determinants of SARS-CoV-2 infection after complete vaccination. RESULTS Of the 6674 (82%) HCWs who received complete vaccination (36% BNT162b2, 29% mRNA-1273, and 34% mixed with ChAdOx1 nCoV-19) and were prospectively followed-up for a median of 7.0 [6.3-8.0] months, 160 (2.4%) tested positive for SARS-CoV-2 by RT-PCR. Incidence density of SARS-CoV-2 infection after complete vaccination was 3.39 [2.89-3.96] infections per 1000 person-month. Median time from vaccine completion to SARS-CoV-2 infection was 5.5 [3.2-6.6] months. Using fitted mixed Cox regression with the delay as a time-dependent variable and random effect applied to exposure risk periods, age (P < 0.001) was independently associated with the incidence of SARS-CoV-2 infection. Vaccine schemes were not associated with SARS-CoV-2 infection (P = 0.068). A period effect was significantly associated with the incidence of SARS-CoV-2 infection (P < 0.001). CONCLUSIONS In this real-world study, incidence of SARS-CoV-2 infection increases with time in fully vaccinated HCWs with no differences according to the vaccination scheme. The short delay between complete vaccination and incident SARS-CoV-2 infection highlights the need for sustained barrier measures even in fully vaccinated HCWs.
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Affiliation(s)
- Anastasia Saade
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France,CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Université de Rennes, Rennes 35000, France,Corresponding author at: Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France. CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) – UMR_S 1085, Université de Rennes 35000 Rennes, France
| | - Leo Cha
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Emilie Tadié
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Bruno Jurado
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Alix Le Bihan
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Pauline Baron-Latouche
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Christine Febreau
- Laboratoire de Virologie, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Vincent Thibault
- Laboratoire de Virologie, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Ronan Garlantezec
- Service d’épidémiologie et de Santé Publique, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Pierre Tattevin
- Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France
| | - Christophe Paris
- Service de Santé au Travail, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes 35033, France,CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Université de Rennes, Rennes 35000, France
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28
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The Beneficial Effect of the COVID-19 Vaccine Booster Dose among Healthcare Workers in an Infectious Diseases Center. Vaccines (Basel) 2022; 10:vaccines10040552. [PMID: 35455301 PMCID: PMC9029317 DOI: 10.3390/vaccines10040552] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 12/20/2022] Open
Abstract
Introduction: Healthcare workers in Poland received a booster dose of the BNT162b2 mRNA vaccine (Pfizer-BioNTech, Manufacturer: Pfizer, Inc., and BioNTech; Moguncja, Germany) at the beginning of October 2021. Here, we report on the preliminary results of an ongoing clinical study into the antibody response to SARS-CoV-2 of healthcare workers previously exposed to the virus, with or without evidence of past infection, in the Hospital for Infectious Diseases in Warsaw before and after the vaccine booster dose. Methods: Blood samples were collected on the day the vaccine booster dose was administered and again 14 days later. The levels of SARS-CoV-2 IgG antibodies (against the n-protein, indicative of disease) and S-RBD (indicative of a response to vaccination) were measured. Results: One hundred and ten health care workers from the Hospital for Infectious Diseases were included in the study. The percentage of subjects with a positive test for anti-n-protein IgG antibodies at both time points remained unchanged (16, 14%), while a statistically significant increase in the percentage of subjects producing high levels of S-RBD antibodies (i.e., >433 BAU/mL) was observed (from 23, 21% to 109, 99%; p = 0.00001). Conclusions: The results of the study indicate that the booster dose of the vaccine significantly increases the percentage of people with high levels of S-RBD antibodies, regardless of previous contact with the virus, which may indicate greater protection against both the disease and a severe course of COVID-19.
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29
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Mahasirimongkol S, Khunphon A, Kwangsukstid O, Sapsutthipas S, Wichaidit M, Rojanawiwat A, Wichuckchinda N, Puangtubtim W, Pimpapai W, Soonthorncharttrawat S, Wanitchang A, Jongkaewwattana A, Srisutthisamphan K, Phainupong D, Thawong N, Piboonsiri P, Sawaengdee W, Somsaard T, Ritthitham K, Chumpol S, Pinyosukhee N, Wichajarn R, Dhepakson P, Iamsirithaworn S, Phumiamorn S. The Pilot Study of Immunogenicity and Adverse Events of a COVID-19 Vaccine Regimen: Priming with Inactivated Whole SARS-CoV-2 Vaccine (CoronaVac) and Boosting with the Adenoviral Vector (ChAdOx1 nCoV-19) Vaccine. Vaccines (Basel) 2022; 10:vaccines10040536. [PMID: 35455285 PMCID: PMC9028748 DOI: 10.3390/vaccines10040536] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/28/2022] Open
Abstract
In response to the SARS-CoV-2 Delta variant, which partially escaped the vaccine-induced immunity provided by two doses of vaccination with CoronaVac (Sinovac), the National Vaccine Committee recommended the heterologous CoronaVac-ChAdOx1 (Oxford−AstraZeneca), a prime−boost vaccine regimen. This pilot study aimed to describe the immunogenicity and adverse events of the heterologous CoronaVac-ChAdOx1 regimen, in comparison with homologous CoronaVac, and homologous ChAdOx1. Between May and August 2021, we recruited a total of 354 participants from four vaccination groups: the CoronaVac-ChAdOx1 vaccinee (n = 155), the homologous CoronaVac vaccinee (n = 32), the homologous ChAdOx1 vaccinee (n = 47), and control group of COVID-19 patients (n = 120). Immunogenicity was evaluated by measuring the level of IgG antibodies against the receptor-binding domain (anti-SRBD) of the SARS-CoV-2 spike protein S1 subunit and the level of neutralizing antibodies (NAbs) against variants of concern (VOCs) using the plaque reduction neutralization test (PRNT) and pseudovirus neutralization test (pVNT). The safety profile was recorded by interviewing at the 1-month visit after vaccination. The anti-SRBD level after the second booster dose of the CoronaVac-ChAdOx1 group at 2 weeks was higher than 4 weeks. At 4 weeks after the second booster dose, the anti-SRBD level in the CoronaVac-ChAdOx1 group was significantly higher than either homologous CoronaVac, the homologous ChAdOx1 group, and Control group (p < 0.001). In the CoronaVac-ChAdOx1 group, the PRNT50 level against the wild-type (434.5 BAU/mL) was the highest; followed by Alpha variant (80.4), Delta variant (67.4), and Beta variant (19.8). The PVNT50 level was also found to be at its highest against the wild-type (432.1); followed by Delta variants (178.3), Alpha variants (163.9), and Beta variant (42.2), respectively. The AEs in the CoronaVac-ChAdOx1 group were well tolerated and generally unremarkable. The CoronaVac-ChAdOx1 heterologous regimen induced higher immunogenicity and a tolerable safety profile. In a situation when only CoronaVac-ChAdOx1 vaccines are available, they should be considered for use in responding to the Delta variant.
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Affiliation(s)
- Surakameth Mahasirimongkol
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
- Correspondence:
| | - Athiwat Khunphon
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Oraya Kwangsukstid
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok 10400, Thailand; (O.K.); (M.W.); (D.P.)
| | - Sompong Sapsutthipas
- Institute of Biological Products, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.S.); (T.S.); (K.R.); (S.C.); (S.P.)
| | - Mingkwan Wichaidit
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok 10400, Thailand; (O.K.); (M.W.); (D.P.)
| | - Archawin Rojanawiwat
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand;
| | - Nuanjun Wichuckchinda
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Wiroj Puangtubtim
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Warangluk Pimpapai
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Sakulrat Soonthorncharttrawat
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Asawin Wanitchang
- Virology and Cell Technology Research Team, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand; (A.W.); (A.J.)
| | - Anan Jongkaewwattana
- Virology and Cell Technology Research Team, National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand; (A.W.); (A.J.)
| | - Kanjana Srisutthisamphan
- Epidemiology Division, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (K.S.); (S.I.)
| | - Daraka Phainupong
- Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok 10400, Thailand; (O.K.); (M.W.); (D.P.)
| | - Naphatcha Thawong
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Pundharika Piboonsiri
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Waritta Sawaengdee
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Thitiporn Somsaard
- Institute of Biological Products, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.S.); (T.S.); (K.R.); (S.C.); (S.P.)
| | - Kanokphon Ritthitham
- Institute of Biological Products, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.S.); (T.S.); (K.R.); (S.C.); (S.P.)
| | - Supaporn Chumpol
- Institute of Biological Products, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.S.); (T.S.); (K.R.); (S.C.); (S.P.)
| | - Nadthanan Pinyosukhee
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Rattanawadee Wichajarn
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Panadda Dhepakson
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (A.K.); (N.W.); (W.P.); (W.P.); (S.S.); (N.T.); (P.P.); (W.S.); (N.P.); (R.W.); (P.D.)
| | - Sopon Iamsirithaworn
- Epidemiology Division, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (K.S.); (S.I.)
| | - Supaporn Phumiamorn
- Institute of Biological Products, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.S.); (T.S.); (K.R.); (S.C.); (S.P.)
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Duration of SARS-CoV-2 Immune Responses Up to Six Months Following Homologous or Heterologous Primary Immunization with ChAdOx1 nCoV-19 and BNT162b2 mRNA Vaccines. Vaccines (Basel) 2022; 10:vaccines10030359. [PMID: 35334989 PMCID: PMC8953845 DOI: 10.3390/vaccines10030359] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 01/10/2023] Open
Abstract
Heterologous primary immunization against SARS-CoV-2 is part of applied recommendations. However, little is known about duration of immune responses after heterologous vaccine regimens. To evaluate duration of immune responses after primary vaccination with homologous adeno-vectored ChAdOx1 nCoV-19 vaccine (ChAd) or heterologous ChAd/BNT162b2 mRNA vaccine (BNT), anti-spike-IgG and SARS-CoV-2 VOC-neutralizing antibody responses were measured in 354 healthcare workers (HCW) at 2 weeks, 3 months, 5 months and 6 months after the second vaccine dose. T-cell responses were investigated using a whole blood interferon gamma (IFN-γ) release assay 2 weeks and 3 months post second vaccine dose. Two hundred and ten HCW immunized with homologous BNT were enrolled for comparison of antibody responses. In study participants naïve to SARS-CoV-2 prior to vaccination, heterologous ChAd/BNT resulted in 6-fold higher peak anti-spike IgG antibody titers compared to homologous ChAd vaccination. The half-life of antibody titers was 3.1 months (95% CI 2.8–3.6) following homologous ChAd vaccination and 1.9 months (95% CI 1.7–2.1) after heterologous vaccination, reducing the GMT difference between the groups to 3-fold 6 months post vaccination. Peak T-cell responses were stronger in ChAd/BNT vaccinees, but no significant difference was observed 3 months post vaccination. SARS-CoV-2 infection prior to vaccination resulted in substantially higher peak GMTs and IFN-γ levels and enhanced SARS-CoV-2 specific antibody and T cell responses over time. Heterologous primary SARS-CoV-2 immunization with ChAd and BNT elicits a stronger initial immune response compared to homologous vaccination with ChAd. However, although the differences in humoral responses remain over 6 months, the difference in SARS-CoV-2 specific T cell responses are no longer significant three months after vaccination.
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