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Liu H, Xu X, Deng X, Hu Z, Sun R, Zou J, Dong J, Wu Q, Chen X, Yi L, Cai J, Zhang J, Ajelli M, Yu H. Counterfactual analysis of the 2023 Omicron XBB wave in China. Infect Dis Model 2024; 9:195-203. [PMID: 38293688 PMCID: PMC10824770 DOI: 10.1016/j.idm.2023.12.006] [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: 09/22/2023] [Revised: 11/26/2023] [Accepted: 12/25/2023] [Indexed: 02/01/2024] Open
Abstract
Background China has experienced a COVID-19 wave caused by Omicron XBB variant starting in April 2023. Our aim is to conduct a retrospective analysis exploring the dynamics of the outbreak under counterfactual scenarios that combine the use of vaccines, antiviral drugs, and nonpharmaceutical interventions. Methods We developed a mathematical model of XBB transmission in China, which has been calibrated using SARS-CoV-2 positive rates per week. Intrinsic age-specific infection-hospitalization risk, infection-ICU risk, and infection-fatality risk were used to estimate disease burdens, characterized as number of hospital admissions, ICU admissions, and deaths. Results We estimated that in absence of behavioral change, the XBB outbreak in spring 2023 would have resulted in 0.86 billion infections (∼61% of the total population). Our counterfactual analysis shows that the synergetic effect of vaccination (70% vaccination coverage), antiviral treatment (20% receiving antiviral treatment), and moderate nonpharmaceutical interventions (20% isolation and L1 PHSMs) could reduce the number of deaths to levels close to seasonal influenza (1.17 vs. 0.65 per 10,000 individuals and 5.85 vs. 3.85 per 10,000 individuals aged 60+, respectively). The maximum peak prevalence of hospital and ICU admissions are estimated to be lower than the corresponding capacities (8.6 vs. 10.4 per 10,000 individuals and 1.2 vs. 2.1 per 10,000 individuals, respectively). Conclusion Our findings suggest that the capacity of the Chinese healthcare system was adequate to face the Omicron XBB wave in spring 2023 but, at the same time, supports the importance of administering highly effective vaccine with long-lasting immune response, and the use of antiviral treatments.
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Affiliation(s)
- Hengcong Liu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xiangyanyu Xu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xiaowei Deng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Zexin Hu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Ruijia Sun
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Junyi Zou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiayi Dong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Qianhui Wu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xinhua Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lan Yi
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jun Cai
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Juanjuan Zhang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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Giles ML, Flanagan KL. COVID-19 vaccination: are more jabs needed or are we now immune? Intern Med J 2024; 54:368-373. [PMID: 38414215 DOI: 10.1111/imj.16341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024]
Abstract
As the COVID-19 pandemic has progressed, it has become apparent that COVID-19 vaccination has limited impact on SAR-CoV-2 transmission and provides only short-term protection against acquiring infection, but more robust protection against severe disease and death. As a result, vaccinated people remain susceptible to SARS-CoV-2 infection but are less likely to experience severe outcomes. Studies show that immunity derived from the combination of vaccination and natural infection, so-called hybrid immunity, is superior to that provided by vaccination or natural infection alone. Since most Australian adults have received three or more doses of COVID-19 vaccines and >70% have also been infected with SARS-CoV-2, we now have a population with high levels of hybrid immunity. This was mostly achieved by receiving original Wuhan strain vaccines and then experiencing Omicron strain infections. The original Wuhan strain of SARS-CoV-2 has now disappeared and been replaced with Omicron-lineage variants globally. The predominance of the Omicron strain initially led to the development of bivalent vaccines containing both the Wuhan strain and Omicron variants. Currently, vaccines containing the original Wuhan strain of spike protein are being phased out, and new COVID-19 vaccines based exclusively on the Omicron strain XBB have become available in Australia. This article explores the question of whether further doses will be required from 2024 onwards and, if so, who should receive them?
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Affiliation(s)
- Michelle L Giles
- Department of Infectious Diseases, University of Melbourne, Melbourne, Victoria, Australia
- Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Katie L Flanagan
- Department of Medicine, Launceston General Hospital, Launceston, Tasmania, Australia
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, Tasmania, Australia
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
- School of Health and Biomedical Science, RMIT University, Melbourne, Victoria, Australia
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Zhan H, Xie Y, Liu Y, Cheng L, Xu Y, Qu X, Li C, Guo X, Li H, Wang Y, Dai E, Wang L, Gao H, Li Y. Omicron BA.4/5 neutralization and cell-mediated immune responses in relation to baseline immune status and breakthrough infection among PLWH: A follow-up cohort study. J Med Virol 2024; 96:e29446. [PMID: 38345110 DOI: 10.1002/jmv.29446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/04/2024] [Accepted: 01/21/2024] [Indexed: 02/15/2024]
Abstract
There is a paucity of data on hybrid immunity (vaccination plus breakthrough infection [BI]), especially cell-mediated responses to Omicron among immunosuppressed patients. We aim to investigate humoral and cellular responses to Omicron BA.4/5 among people living with HIV (PLWH) with/without BIs, the most prevalent variant of concern after the reopening of China. Based on our previous study, we enrolled 77 PLWH with baseline immune status of severe acute respiratory syndrome coronavirus 2 specific antibodies after inactivated vaccination. "Correlates of protection," including serological immunoassays, T cell phenotypes and memory B cells (MBC) were determined in PLWH without and with BI, together with 16 PLWH with reinfections. Higher inhibition rate of neutralizing antibodies (NAb) against BA.4/5 was elicited among PLWH with BI than those without. Omicron-reactive IL4+ CD8+ T cells were significantly elevated in PLWH experienced postvaccine infection contrasting with those did not. NAb towards wild type at baseline was associated with prolonged negative conversion time for PLWH whereas intermediate MBCs serve as protecting effectors. We uncovered that hybrid immunity intensified more protection on BA.4/5 than vaccination did. Strengthened surveillance on immunological parameters and timely clinical intervention on PLWH deficient in protection would reduce the severity and mortality in the context of coexistence with new Omicron subvariants.
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Affiliation(s)
- Haoting Zhan
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuchen Xie
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Yongmei Liu
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Linlin Cheng
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yi Xu
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Xiaojing Qu
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Chen Li
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Xinru Guo
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Haolong Li
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuling Wang
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Erhei Dai
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Lijing Wang
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Huixia Gao
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Lee S, Zabinsky ZB, Wasserheit JN, Ross JM, Chen S, Liu S. Impact of Vaccination and Nonpharmaceutical Interventions With Possible COVID-19 Viral Evolutions Using an Agent-Based Simulation. AJPM FOCUS 2024; 3:100155. [PMID: 38130803 PMCID: PMC10733698 DOI: 10.1016/j.focus.2023.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Introduction The COVID-19 pandemic continues with highly contagious variants and waning immunity. As the virus keeps evolving to be more infectious and immune evasive, some question whether the COVID-19 pandemic can be managed through sustainable public health measures. Methods We developed an agent-based simulation to explore the impact of COVID-19 mutations, periodic vaccinations, and nonpharmaceutical interventions on reducing COVID-19 deaths. The model is calibrated to the greater Seattle area by observing local epidemic data. We perform scenario analyses on viral mutations that change infectiousness, disease severity, and immune evasiveness from previous infections and vaccination every 6 months. The simulation is run until the end of year 2023. Results Variants with increased infectivity or increased immune evasion dominate previous strains. With enhanced immune protection from a pancoronavirus vaccine, the most optimistic periodic vaccination rate reduces average total deaths by 44.6% compared with the most pessimistic periodic vaccination rate. A strict threshold nonpharmaceutical intervention policy reduces average total deaths by 71.3% compared with an open society, whereas a moderate nonpharmaceutical intervention policy results in a 33.6% reduction. Conclusions Our findings highlight the potential benefits of pancoronavirus vaccines that offer enhanced and longer-lasting immunity. We emphasize the crucial role of nonpharmaceutical interventions in reducing COVID-19 deaths regardless of virus mutation scenarios. Owing to highly immune evasive and contagious SARS-CoV-2 variants, most scenarios in this study fail to reduce the mortality of COVID-19 to the level of influenza and pneumonia. However, our findings indicate that periodic vaccinations and a threshold nonpharmaceutical intervention policy may succeed in achieving this goal. This indicates the need for caution and vigilance in managing a continuing COVID-19 epidemic.
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Affiliation(s)
- Serin Lee
- Department of Industrial & Systems Engineering, University of Washington, Seattle, Washington
| | - Zelda B. Zabinsky
- Department of Industrial & Systems Engineering, University of Washington, Seattle, Washington
| | - Judith N. Wasserheit
- Department of Global Health, University of Washington, Seattle, Washington
- Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
| | - Jennifer M. Ross
- Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington
| | - Shi Chen
- Department of Information Systems and Operations Management, Foster School of Business, University of Washington, Seattle, Washington
| | - Shan Liu
- Department of Industrial & Systems Engineering, University of Washington, Seattle, Washington
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5
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Kassanjee R, Davies MA, Heekes A, Mahomed H, Hawkridge AJ, Wolmarans M, Morden E, Jacobs T, Cohen C, Moultrie H, Lessells RJ, Van Der Walt N, Arendse JO, Goeiman H, Mudaly V, Wolter N, Walaza S, Jassat W, von Gottberg A, Hannan PL, Rousseau P, Feikin D, Cloete K, Boulle A. COVID-19 vaccine uptake and effectiveness by time since vaccination in the Western Cape province, South Africa: An observational cohort study during 2020-2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.24.24301721. [PMID: 38343866 PMCID: PMC10854330 DOI: 10.1101/2024.01.24.24301721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Background There are few data on the real-world effectiveness of COVID-19 vaccines and boosting in Africa, which experienced high levels of SARS-CoV-2 infection in a mostly vaccine-naïve population, and has limited vaccine coverage and competing health service priorities. We assessed the association between vaccination and severe COVID-19 in the Western Cape, South Africa. Methods We performed an observational cohort study of >2 million adults during 2020-2022. We described SARS-CoV-2 testing, COVID-19 outcomes, and vaccine uptake over time. We used multivariable cox models to estimate the association of BNT162b2 and Ad26.COV2.S vaccination with COVID-19-related hospitalisation and death, adjusting for demographic characteristics, underlying health conditions, socioeconomic status proxies and healthcare utilisation. Results By end 2022, only 41% of surviving adults had completed vaccination and 8% a booster dose, despite several waves of severe COVID-19. Recent vaccination was associated with notable reductions in severe COVID-19 during distinct analysis periods dominated by Delta, Omicron BA.1/2 and BA.4/5 (sub)lineages: within 6 months of completing vaccination or boosting, vaccine effectiveness was 46-92% for death (range across periods), 45-92% for admission with severe disease or death, and 25-90% for any admission or death. During the Omicron BA.4/5 wave, within 3 months of vaccination or boosting, BNT162b2 and Ad26.COV2.S were each 84% effective against death (95% CIs: 57-94 and 49-95, respectively). However, there were distinct reductions of VE at larger times post completing or boosting vaccination. Conclusions Continued emphasis on regular COVID-19 vaccination including boosting is important for those at high risk of severe COVID-19 even in settings with widespread infection-induced immunity.
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Affiliation(s)
- Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Mary-Ann Davies
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
| | - Alexa Heekes
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
| | - Hassan Mahomed
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- Metro Health Services, Western Cape Government Department of Health and Wellness, South Africa
| | - Anthony J Hawkridge
- Rural Health Services, Western Cape Government Department of Health and Wellness, South Africa
| | | | - Erna Morden
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
- School of Public Health, University of Cape Town, South Africa
| | - Theuns Jacobs
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Public Health, University of the Witwatersrand, South Africa
| | - Harry Moultrie
- Centre for Tuberculosis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
| | - Richard J Lessells
- KwaZulu-Natal Research Innovation & Sequencing Platform, University of KwaZulu-Natal, South Africa
| | - Nicolette Van Der Walt
- Emergency & Clinical Services Support, Western Cape Government Department of Health and Wellness, South Africa
| | - Juanita O Arendse
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- Emergency & Clinical Services Support, Western Cape Government Department of Health and Wellness, South Africa
| | - Hilary Goeiman
- Western Cape Government Department of Health and Wellness, South Africa
| | - Vanessa Mudaly
- Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
- Western Cape Government Department of Health and Wellness, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Pathology, University of the Witwatersrand, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Public Health, University of the Witwatersrand, South Africa
| | - Waasila Jassat
- Health Practice, Genesis Analytics, South Africa
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, South Africa
- School of Pathology, University of the Witwatersrand, South Africa
| | - Patrick L Hannan
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, South Africa
| | - Petro Rousseau
- South African National Department of Health, South Africa
| | - Daniel Feikin
- Department of Immunizations, Vaccines, and Biologicals, World Health Organization, Switzerland
| | - Keith Cloete
- Western Cape Government Department of Health and Wellness, South Africa
| | - Andrew Boulle
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
- Health Intelligence, Western Cape Government Department of Health and Wellness, South Africa
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Walmsley S, Nabipoor M, Lovblom LE, Ravindran R, Colwill K, McGeer A, Dayam RM, Manase D, Gingras AC. Predictors of Breakthrough SARS-CoV-2 Infection after Vaccination. Vaccines (Basel) 2023; 12:36. [PMID: 38250849 PMCID: PMC10820583 DOI: 10.3390/vaccines12010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
The initial two-dose vaccine series and subsequent booster vaccine doses have been effective in modulating SARS-CoV-2 disease severity and death but do not completely prevent infection. The correlates of infection despite vaccination continue to be under investigation. In this prospective decentralized study (n = 1286) comparing antibody responses in an older- (≥70 years) to a younger-aged cohort (aged 30-50 years), we explored the correlates of breakthrough infection in 983 eligible subjects. Participants self-reported data on initial vaccine series, subsequent booster doses and COVID-19 infections in an online portal and provided self-collected dried blood spots for antibody testing by ELISA. Multivariable survival analysis explored the correlates of breakthrough infection. An association between higher antibody levels and protection from breakthrough infection observed during the Delta and Omicron BA.1/2 waves of infection no longer existed during the Omicron BA.4/5 wave. The older-aged cohort was less likely to have a breakthrough infection at all time-points. Receipt of an original/Omicron vaccine and the presence of hybrid immunity were associated with protection of infection during the later Omicron BA.4/5 and XBB waves. We were unable to determine a threshold antibody to define protection from infection or to guide vaccine booster schedules.
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Affiliation(s)
- Sharon Walmsley
- Division of Infectious Diseases, Department of Medicine, University Health Network, Toronto, ON M5G1L7, Canada;
- Department of Medicine, University of Toronto, Toronto, ON M5S1A1, Canada
| | - Majid Nabipoor
- Biostatistics Department, University Health Network, Toronto, ON M5G1L7, Canada; (M.N.); (L.E.L.)
| | - Leif Erik Lovblom
- Biostatistics Department, University Health Network, Toronto, ON M5G1L7, Canada; (M.N.); (L.E.L.)
| | - Rizani Ravindran
- Division of Infectious Diseases, Department of Medicine, University Health Network, Toronto, ON M5G1L7, Canada;
| | - Karen Colwill
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G1X5, Canada; (K.C.); (R.M.D.); (A.-C.G.)
| | - Alison McGeer
- Mount Sinai Hospital, Sinai Health, Toronto, ON M5G1X5, Canada;
| | - Roya Monica Dayam
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G1X5, Canada; (K.C.); (R.M.D.); (A.-C.G.)
| | - Dorin Manase
- DATA Team, University Health Network, Toronto, ON M5G1L7, Canada;
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health, Toronto, ON M5G1X5, Canada; (K.C.); (R.M.D.); (A.-C.G.)
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S1A1, Canada
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7
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Liu R, Zhang Y, Ma J, Wang H, Lan Y, Tang X. Epidemiological features of SARS-CoV-2 Omicron infection under new control strategy: a cross-sectional study of the outbreak since December 2022 in Sichuan, China. BMC Public Health 2023; 23:2463. [PMID: 38066518 PMCID: PMC10709916 DOI: 10.1186/s12889-023-17361-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A major shift in the "dynamic zero-COVID" policy was announced by China's National Health Commission on December 7, 2022, and the subsequent immediate large-scale outbreak of SARS-CoV-2 infections in the entire country has caused worldwide concern. This observational cross-sectional study aimed to describe the epidemiological characteristics of this outbreak in Sichuan, China. METHODS All data were self-reported online by volunteers. We described the epidemic by characterizing the infection, symptoms, clinical duration, severity, spatiotemporal clustering, and dynamic features of the disease. Prevalence ratio (PR), Odds ratios (ORs) and adjusted ORs were calculated to analyze the associations between risk factors and infection and the associations of risk factors with clinical severity using log-binomial and multivariable logistic regression models; 95% confidence intervals (CIs) and Wald test results were reported. The prevalence rates and clinical severity among different subgroups were compared using the Chi-square and trend Chi-square tests. RESULTS Between January 6 and 12, 2023, 138,073 volunteers were enrolled in this survey, and 102,645 were infected with COVID-19, holding a prevalence rate of 74.34%; the proportion of asymptomatic infections was 1.58%. Log-binomial regression revealed that the risk of infection increased among those living in urban areas. Multivariable logistic regression analysis showed that female sex, chronic diseases, older age and the fewer doses of vaccine received were associated with an increased risk of severe clinical outcomes after infection. We estimated the mean reproduction number during this pandemic was 1.83. The highest time-dependent reproduction number was 4.15; this number decreased below 1 after 11 days from December 7, 2022. Temporal trends revealed a single peak curve with a plateau pattern of incidence during the outbreak, whereas spatiotemporal clustering analysis showed that the onset in 21 cities in the Sichuan province had four-wave peaks. CONCLUSIONS The peak of the first wave of Omicron infection in Sichuan Province had passed and could be considered a snapshot of China under the new control strategy. There were significant increases in the risk of severe clinical outcomes after infection among females, with chronic diseases, and the elderly. The vaccines have been effective in reducing poor clinical outcomes.
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Affiliation(s)
- Runyou Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, 610041, P.R. China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
- West China Hospital, Chinese Evidence-Based Medicine Center, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Jingxuan Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Hongjian Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Yajia Lan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China.
| | - Xuefeng Tang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, 610041, P.R. China.
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8
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Irala S, Hamid S, Penayo E, Michel F, Couto P, Vazquez C, Ortega MJ, Domínguez C, Battaglia S, Von Horoch M, Montoya R, Sequera G, Nogareda F. COVID-19 vaccine effectiveness against hospitalizations in Paraguay, May 2021-April 2022: A test-negative design. Vaccine 2023; 41:6453-6460. [PMID: 37716830 DOI: 10.1016/j.vaccine.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Vaccine effectiveness (VE) estimates vary by population characteristics and circulating variants. North America and Europe have generated many COVID-19 VE estimates but relied heavily on mRNA vaccines. Fewer estimates are available for non-mRNA vaccines and from Latin America. We aimed to estimate the effectiveness of several COVID-19 vaccines in preventing SARS-CoV-2-associated severe acute respiratory infection (SARI) in Paraguay from May 2021 to April 2022. METHODS Using sentinel surveillance data from four hospitals in Paraguay, we conducted a test-negative case-control study to estimate COVID-19 vaccine effectiveness against SARI by vaccine type/brand and period of SARS-CoV-2 variant predominance (Gamma, Delta, Omicron). We used multivariable logistic regression adjusting for month of symptom onset, age group, and presence of ≥1 comorbidity to estimate the odds of COVID-19 vaccination in SARS-CoV-2 test-positive SARI case-patients compared to SARS-CoV-2 test-negative SARI control-patients. RESULTS Of 4,229 SARI patients, 2,381 (56%) were SARS-CoV-2-positive case-patients and 1,848 (44%) were SARS-CoV-2-negative control-patients. A greater proportion of case-patients (73%; 95% CI: 71-75) than of control-patients (40%; 95% CI: 38-42) were unvaccinated. During the Gamma variant-predominant period, VE estimates for partial vaccination with mRNA vaccines and Oxford/AstraZeneca Vaxzevria were 90.4% (95% CI: 66.4-97.6) and 52.2% (95% CI: 25.0-69.0), respectively. During the Delta variant-predominant period, VE estimates for complete vaccination with mRNA vaccines, Oxford/AstraZeneca Vaxzevria, or Gamaleya Sputnik V were 90.4% (95% CI: 74.3-97.3), 83.2% (95% CI: 67.8-91.9), and 82.9% (95% CI: 53.0-95.2), respectively. The effectiveness of all vaccines declined substantially during the Omicron variant-predominant period. CONCLUSIONS This study contributes to our understanding of COVID-19 VE in Latin America and to global understanding of vaccines that have not been widely used in North America and Europe. VE estimates from Paraguay can parameterize models to estimate the impact of the national COVID-19 vaccination campaign in Paraguay and similar settings.
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Affiliation(s)
- Sandra Irala
- Directorate General for Health Surveillance, Ministry of Public Health and Social Welfare, Paraguay
| | - Sarah Hamid
- National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Elena Penayo
- Directorate General for Health Surveillance, Ministry of Public Health and Social Welfare, Paraguay.
| | | | - Paula Couto
- Pan American Health Organization, Washington, DC, USA
| | - Cynthia Vazquez
- Department of Virology, Central Laboratory for Public Health, Asunción, Paraguay
| | - María José Ortega
- Department of Virology, Central Laboratory for Public Health, Asunción, Paraguay
| | - Chavely Domínguez
- Directorate General for Health Surveillance, Ministry of Public Health and Social Welfare, Paraguay
| | - Silvia Battaglia
- National Program for Vaccine Preventable Diseases and Expanded Program on Immunization, Asunción, Paraguay
| | - Marta Von Horoch
- National Program for Vaccine Preventable Diseases and Expanded Program on Immunization, Asunción, Paraguay
| | - Romeo Montoya
- Pan American Health Organization, Asunción, Paraguay
| | - Guillermo Sequera
- Directorate General for Health Surveillance, Ministry of Public Health and Social Welfare, Paraguay
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Drummond PD, de Salles DB, de Souza NSH, Oliveira DCR, Guidoni DL, de Souza FSH. Profile and Outcomes of Hospitalized COVID-19 Patients during the Prevalence of the Omicron Variant According to the Brazilian Regions: A Retrospective Cohort Study from 2022. Vaccines (Basel) 2023; 11:1568. [PMID: 37896971 PMCID: PMC10610688 DOI: 10.3390/vaccines11101568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/29/2023] Open
Abstract
We investigated the clinical-epidemiological profile and outcomes of COVID-19 patients hospitalized in 2022, during the Omicron variant/subvariant prevalence, in different Brazilian regions to identify the most vulnerable subgroups requiring special attention. Data from COVID-19 patients were extracted from the national Information System for Epidemiological Surveillance of Influenza (SIVEP-Gripe database), and analyses stratified by region and age group were conducted. The constructed dataset encompassed clinical-epidemiological information, intensive care unit admission, invasive and non-invasive ventilation requirements, vaccination status, and evolution (cure or death). It was observed that there were significant differences in the vaccination rates between regions, in the occurrence of unfavorable outcomes, and in the pattern of comorbidities in young patients. The north region had higher rates of unvaccinated patients and a lower percentage of those vaccinated with three doses in all age groups compared to other regions. The northeast region had the highest rates of patients admitted to the ICU for all age groups, while the north and northeast were the most affected by IMV requirements and in-hospital death in all age groups. This study showed that extended vaccination coverage, especially booster doses, can protect different population segments from developing severe disease since lower vaccination coverage was observed in regions with higher fatality rates.
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Affiliation(s)
- Pedro Dutra Drummond
- Department of Computing, Federal University of Ouro Preto, Morro do Cruzeiro Campus, Ouro Preto 35400-000, MG, Brazil
| | - Daniel Bortot de Salles
- Department of Computing, Federal University of Ouro Preto, Morro do Cruzeiro Campus, Ouro Preto 35400-000, MG, Brazil
| | - Natália Satchiko Hojo de Souza
- Laboratory of Immunopathology, Oswaldo Cruz Foundation—Minas, Av. Augusto de Lima 1715, Belo Horizonte 30190-002, MG, Brazil
| | - Daniela Carine Ramires Oliveira
- Department of Mathematics and Statistics, Federal University of São João del-Rei, Praça Frei Orlando 170, São João del Rei 36307-352, MG, Brazil
| | - Daniel Ludovico Guidoni
- Department of Computing, Federal University of Ouro Preto, Morro do Cruzeiro Campus, Ouro Preto 35400-000, MG, Brazil
| | - Fernanda Sumika Hojo de Souza
- Department of Computing, Federal University of Ouro Preto, Morro do Cruzeiro Campus, Ouro Preto 35400-000, MG, Brazil
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10
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Lo CKL, Kumar D. SARS-CoV-2 mRNA vaccine: Sometimes life needs a boost. Transpl Infect Dis 2023; 25:e14135. [PMID: 37616274 DOI: 10.1111/tid.14135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Carson Ka-Lok Lo
- Transplant Infectious Diseases, Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, Canada
| | - Deepali Kumar
- Transplant Infectious Diseases, Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, Canada
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11
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Spicer KB, Glick C, Thoroughman DA. Adolescent COVID-19 Cases During the SARS-CoV-2 Delta and Omicron Variant Surges in Kentucky: Association With Vaccination and Prior Infection. J Adolesc Health 2023; 73:536-542. [PMID: 37318408 PMCID: PMC10176104 DOI: 10.1016/j.jadohealth.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/24/2023] [Accepted: 04/29/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Effectiveness of COVID-19 mRNA vaccines is influenced by SARS-CoV-2 variant and history of prior infection. Data regarding protection against SARS-CoV-2 infection among adolescents, accounting for prior infection and time since vaccination, are limited. METHODS SARS-CoV-2 testing and immunization data from the Kentucky Electronic Disease Surveillance System and the Kentucky Immunization Registry, August-September 2021 (Delta predominance) and January 2022 (Omicron Predominance) among adolescents aged 12-17 years, were used to assess association of SARS-CoV-2 infection with mRNA vaccination and prior SARS-CoV-2 infection. Estimated protection was derived from prevalence ratios ([1-PR] × 100%). RESULTS During Delta predominance, 89,736 tested adolescents were evaluated. Completion of primary series (second dose of mRNA vaccine ≥ 14 days prior to testing) and history of prior infection (> 90 days prior to testing) were both protective against SARS-CoV-2 infection (primary series: 81%, 95% confidence interval [CI] 79.7-82.3; prior infection: 66%, 95% CI 62.0-69.6). Prior infection plus primary series provided the greatest protection (92.3%, 95% CI 88.0-95.1). During Omicron predominance, 67,331 tested adolescents were evaluated. Primary series alone provided no benefit against SARS-CoV-2 infection after 90 days; prior infection was protective for up to one year (24.2%, 95% CI 17.2-30.7). Prior infection plus booster vaccination provided the greatest protection against infection (82.4%, 95% CI 62.1-91.8). DISCUSSION Strength and duration of protection against infection provided by COVID-19 vaccination and prior SARS-CoV-2 infection differed by variant. Vaccination provided additional benefit to the protection offered by prior infection alone. Remaining up to date with vaccination is recommended for all adolescents regardless of infection history.
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Affiliation(s)
- Kevin B Spicer
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, Kentucky.
| | - Connor Glick
- Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, Kentucky
| | - Douglas A Thoroughman
- Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, Kentucky; Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness and Response, CDC, Atlanta, Georgia
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12
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Violán C, Carrasco-Ribelles LA, Collatuzzo G, Ditano G, Abedini M, Janke C, Reinkemeyer C, Giang LTT, Liviero F, Scapellato ML, Mauro M, Rui F, Porru S, Spiteri G, Monaco MGL, Carta A, Otelea M, Rascu A, Fabiánová E, Klöslová Z, Boffetta P, Torán-Monserrat P. Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers-Orchestra Project. Vaccines (Basel) 2023; 11:1340. [PMID: 37631908 PMCID: PMC10459685 DOI: 10.3390/vaccines11081340] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023] Open
Abstract
Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92-3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15-2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91-0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94-0.96), and multimorbidity (RR = 0.89, CI = 0.80-1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80-0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.
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Affiliation(s)
- Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Grup de REcerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra) (2021 SGR 01537), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Universitat Autónoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Spain
| | - Lucía A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Grup de REcerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra) (2021 SGR 01537), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, Leopoldstraße 5, 80802 Munich, Germany; (C.J.); (C.R.)
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, Leopoldstraße 5, 80802 Munich, Germany; (C.J.); (C.R.)
| | - Le Thi Thu Giang
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Lindwurmstrasse 4, 80337 Munich, Germany;
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | | | - Marcella Mauro
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (F.R.)
| | - Francesca Rui
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (F.R.)
| | - Stefano Porru
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
| | - Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
| | - Angela Carta
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Marina Otelea
- University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (M.O.); (A.R.)
| | - Agripina Rascu
- University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (M.O.); (A.R.)
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia; (E.F.); (Z.K.)
- Public Health Department, Faculty of Health, Catholic University, 03401 Ružomberok, Slovakia
| | - Zuzana Klöslová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia; (E.F.); (Z.K.)
- Public Health Department, Faculty of Health, Catholic University, 03401 Ružomberok, Slovakia
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Girona, 17001 Girona, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS) (2021 SGR 01484), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
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13
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Meeraus W, de Munter L, Gray CM, Dwivedi A, Wyndham-Thomas C, Ouwens M, Hartig-Merkel W, Drikite L, Rebry G, Carmona A, Stuurman AL, Chi Nguyen TY, Mena G, Mira-Iglesias A, Icardi G, Otero-Romero S, Baumgartner S, Martin C, Taylor S, Bollaerts K. Protection against COVID-19 hospitalisation conferred by primary-series vaccination with AZD1222 in non-boosted individuals: first vaccine effectiveness results of the European COVIDRIVE study and meta-regression analysis. THE LANCET REGIONAL HEALTH. EUROPE 2023; 31:100675. [PMID: 37547274 PMCID: PMC10398604 DOI: 10.1016/j.lanepe.2023.100675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/30/2023] [Accepted: 06/14/2023] [Indexed: 08/08/2023]
Abstract
Background Vaccine effectiveness (VE) studies with long-term follow-up are needed to understand durability of protection against severe COVID-19 outcomes conferred by primary-series vaccination in individuals not receiving boosters. COVIDRIVE is a European public-private partnership evaluating brand-specific vaccine effectiveness (VE). We report a prespecified interim analysis of primary-series AZD1222 (ChAdOx1 nCoV-19) VE. Methods Seven Study Contributors in Europe collected data on individuals aged ≥18 years who were hospitalised with severe acute respiratory infection (June 1st, 2021-September 5th, 2022) and eligible for COVID-19 vaccination prior to hospitalisation. In this test-negative case-control study, individuals were defined as test-positive cases or test-negative controls (SARS-CoV-2 RT-PCR) and were either fully vaccinated (two AZD1222 doses, 4-12 weeks apart, completed ≥14 days prior to symptom onset; no booster doses) or unvaccinated (no COVID-19 vaccine prior to hospitalisation). The primary objective was to estimate AZD1222 VE against COVID-19 hospitalisation. A literature review and meta-regression were conducted to contextualise findings on durability of protection. Findings 761 individuals were included during the 15-month analysis period. Overall AZD1222 VE estimate was 72.8% (95% CI, 53.4-84.1). VE was 93.8% (48.6-99.3) in participants who received second AZD1222 doses ≤8 weeks prior to hospitalisation, with spline-based VE estimates demonstrating protection (VE ≥ 50%) 30 weeks post-second dose. Meta-regression analysis (data from seven publications) showed consistent results, with ≥80% protection against COVID-19 hospitalisation through ∼43 weeks post-second dose, with some degree of waning. Interpretation Primary-series AZD1222 vaccination confers protection against COVID-19 hospitalisation with enduring levels of VE through ≥6 months. Funding AstraZeneca.
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Affiliation(s)
- Wilhelmine Meeraus
- Medical Evidence, Vaccines & Immune Therapies, AstraZeneca, Cambridge, UK
| | | | - Christen M. Gray
- Real World Science, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
| | | | | | - Mario Ouwens
- Medical and Payor Statistics, BioPharmaceutical Business Unit, AstraZeneca, Mölndal, Sweden
| | | | - Laura Drikite
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Griet Rebry
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Antonio Carmona
- Vaccine Research Department, Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO) de la Comunitat Valenciana, Salud Pública, Valencia, Spain
- Biomedical Research Consortium of Epidemiology and Public Health (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Anke L. Stuurman
- Medical Evidence, Vaccines & Immune Therapies, AstraZeneca, Cambridge, UK
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Thi Yen Chi Nguyen
- Medical Evidence, Vaccines & Immune Therapies, AstraZeneca, Cambridge, UK
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Guillermo Mena
- Preventive Medicine Department - Germans Trias i Pujol University Hospital, Badalona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
- Germans Trias I Pujol Research Institute (IGTP), Badalona, Spain
| | - Ainara Mira-Iglesias
- Vaccine Research Department, Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO) de la Comunitat Valenciana, Salud Pública, Valencia, Spain
- Biomedical Research Consortium of Epidemiology and Public Health (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Giancarlo Icardi
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- Department of Health Sciences, University of Genoa, Italy
| | - Susana Otero-Romero
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
| | - Sebastian Baumgartner
- Fourth Medical Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten/Kaiser-Franz-Josef Hospital, Vienna, Austria
| | - Charlotte Martin
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | - Sylvia Taylor
- Medical Evidence, Vaccines & Immune Therapies, AstraZeneca, Cambridge, UK
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Silva MFS, de Oliveira FDCE, Pinto ACMD, Luciano MCDS, Garcia MML, Araújo FMDC, Fonseca MHG. Antibody response following the fourth SARS-CoV-2 vaccine dose during the Omicron wave in Brazil. J Med Virol 2023; 95:e29055. [PMID: 37641396 DOI: 10.1002/jmv.29055] [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: 04/04/2023] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
We investigated the impact of the fourth dose with ChAdOx1 nCoV-19 (AstraZeneca) in the humoral immune response to SARS-CoV-2 during a 9-month follow-up period in which Omicron was the predominant variant in Brazil. IgG for the SARS-CoV-2 spike protein (S) and nucleocapsid (N) proteins were analyzed in samples collected before and after the fourth dose. All participants were tested monthly for SARS-CoV-2 infection by RT-qPCR. The antibody response induced by the fourth dose of the coronavirus disease 2019 vaccine was evaluated and compared with the response induced by the second and third doses. The additional antibody response to the viral S protein after the fourth dose was smaller than those after the third vaccine dose. In contrast, an increase in the N IgG levels could be observed after the fourth dose compared to other vaccine doses. In the comparison of the antibody response before and after the fourth dose, an increase in both S-and-N IgG was noted, mainly in the positive qPCR group. We did not observe a significant decline in IgG levels after the fourth dose, as observed after the second and third doses, therefore, a sustained humoral response to both S and N proteins seems to be achieved.
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15
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Xu S, Li J, Wang H, Wang F, Yin Z, Wang Z. Real-world effectiveness and factors associated with effectiveness of inactivated SARS-CoV-2 vaccines: a systematic review and meta-regression analysis. BMC Med 2023; 21:160. [PMID: 37106390 PMCID: PMC10134725 DOI: 10.1186/s12916-023-02861-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The two inactivated SARS-CoV-2 vaccines, CoronaVac and BBIBP-CorV, have been widely used to control the COVID-19 pandemic. The influence of multiple factors on inactivated vaccine effectiveness (VE) during long-term use and against variants is not well understood. METHODS We selected published or preprinted articles from PubMed, Embase, Scopus, Web of Science, medRxiv, BioRxiv, and the WHO COVID-19 database by 31 August 2022. We included observational studies that assessed the VE of completed primary series or homologous booster against SARS-CoV-2 infection or severe COVID-19. We used DerSimonian and Laird random-effects models to calculate pooled estimates and conducted multiple meta-regression with an information theoretic approach based on Akaike's Information Criterion to select the model and identify the factors associated with VE. RESULTS Fifty-one eligible studies with 151 estimates were included. For prevention of infection, VE associated with study region, variants, and time since vaccination; VE was significantly decreased against Omicron compared to Alpha (P = 0.021), primary series VE was 52.8% (95% CI, 43.3 to 60.7%) against Delta and 16.4% (95% CI, 9.5 to 22.8%) against Omicron, and booster dose VE was 65.2% (95% CI, 48.3 to 76.6%) against Delta and 20.3% (95% CI, 10.5 to 28.0%) against Omicron; primary VE decreased significantly after 180 days (P = 0.022). For the prevention of severe COVID-19, VE associated with vaccine doses, age, study region, variants, study design, and study population type; booster VE increased significantly (P = 0.001) compared to primary; though VE decreased significantly against Gamma (P = 0.034), Delta (P = 0.001), and Omicron (P = 0.001) compared to Alpha, primary and booster VEs were all above 60% against each variant. CONCLUSIONS Inactivated vaccine protection against SARS-CoV-2 infection was moderate, decreased significantly after 6 months following primary vaccination, and was restored by booster vaccination. VE against severe COVID-19 was greatest after boosting and did not decrease over time, sustained for over 6 months after the primary series, and more evidence is needed to assess the duration of booster VE. VE varied by variants, most notably against Omicron. It is necessary to ensure booster vaccination of everyone eligible for SARS-CoV-2 vaccines and continue monitoring virus evolution and VE. TRIAL REGISTRATION PROSPERO, CRD42022353272.
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Affiliation(s)
- Shiyao Xu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Jincheng Li
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Hongyuan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, National Immunization Programme, Beijing, China
| | - Zundong Yin
- Chinese Center for Disease Control and Prevention, National Immunization Programme, Beijing, China.
| | - Zhifeng Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
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16
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Arantes I, Bello G, Nascimento V, Souza V, da Silva A, Silva D, Nascimento F, Mejía M, Brandão MJ, Gonçalves L, Silva G, da Costa CF, Abdalla L, Santos JH, Ramos TCA, Piantham C, Ito K, Siqueira MM, Resende PC, Wallau GL, Delatorre E, Gräf T, Naveca FG. Comparative epidemic expansion of SARS-CoV-2 variants Delta and Omicron in the Brazilian State of Amazonas. Nat Commun 2023; 14:2048. [PMID: 37041143 PMCID: PMC10089528 DOI: 10.1038/s41467-023-37541-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/21/2023] [Indexed: 04/13/2023] Open
Abstract
The SARS-CoV-2 variants of concern (VOCs) Delta and Omicron spread globally during mid and late 2021, respectively. In this study, we compare the dissemination dynamics of these VOCs in the Amazonas state, one of Brazil's most heavily affected regions. We sequenced the virus genome from 4128 patients collected in Amazonas between July 1st, 2021, and January 31st, 2022, and investigated the viral dynamics using a phylodynamic approach. The VOCs Delta and Omicron BA.1 displayed similar patterns of phylogeographic spread but different epidemic dynamics. The replacement of Gamma by Delta was gradual and occurred without an upsurge of COVID-19 cases, while the rise of Omicron BA.1 was extremely fast and fueled a sharp increase in cases. Thus, the dissemination dynamics and population-level impact of new SARS-CoV-2 variants introduced in the Amazonian population after mid-2021, a setting with high levels of acquired immunity, greatly vary according to their viral phenotype.
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Affiliation(s)
- Ighor Arantes
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Gonzalo Bello
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil.
| | - Valdinete Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Victor Souza
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Arlesson da Silva
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Dejanane Silva
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Fernanda Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Matilde Mejía
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Maria Júlia Brandão
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
| | - Luciana Gonçalves
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
- Fundação de Vigilância em Saúde do Amazonas - Dra Rosemary Costa Pinto, Manaus, Brazil
| | - George Silva
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil
- Fundação Centro de Controle de Oncologia do Estado do Amazonas, Manaus, Brazil
| | - Cristiano Fernandes da Costa
- Fundação de Vigilância em Saúde do Amazonas - Dra Rosemary Costa Pinto, Manaus, Brazil
- Conselho de Secretários Municipais de Saúde do Amazonas COSEMS - AM, Manaus, Brazil
| | | | | | | | - Chayada Piantham
- Graduate School of Infectious Diseases, Hokkaido University, Hokkaido, Japan
| | - Kimihito Ito
- International Institute for Zoonosis Control, Hokkaido University, Hokkaido, Japan
| | - Marilda Mendonça Siqueira
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Paola Cristina Resende
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Gabriel Luz Wallau
- Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
- Department of Arbovirology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Edson Delatorre
- Departamento de Biologia, Centro de Ciências Exatas, Naturais e da Saúde, Universidade Federal do Espírito Santo, Alegre, Brazil
| | - Tiago Gräf
- Laboratório de Virologia Molecular, Instituto Carlos Chagas, Fiocruz, Curitiba, Brazil
| | - Felipe Gomes Naveca
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Brazil.
- Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil.
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Hybrid Immunity to SARS-CoV-2 from Infection and Vaccination-Evidence Synthesis and Implications for New COVID-19 Vaccines. Biomedicines 2023; 11:biomedicines11020370. [PMID: 36830907 PMCID: PMC9953148 DOI: 10.3390/biomedicines11020370] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
COVID-19 has taken a severe toll on the global population through infections, hospitalizations, and deaths. Elucidating SARS-CoV-2 infection-derived immunity has led to the development of multiple effective COVID-19 vaccines and their implementation into mass-vaccination programs worldwide. After ~3 years, a substantial proportion of the human population possesses immunity from infection and/or vaccination. With waning immune protection over time against emerging SARS-CoV-2 variants, it is essential to understand the duration of protection, breadth of coverage, and effects on reinfection. This targeted review summarizes available research literature on SARS-CoV-2 infection-derived, vaccination-elicited, and hybrid immunity. Infection-derived immunity has shown 93-100% protection against severe COVID-19 outcomes for up to 8 months, but reinfection is observed with some virus variants. Vaccination elicits high levels of neutralizing antibodies and a breadth of CD4+ and CD8+ T-cell responses. Hybrid immunity enables strong, broad responses, with high-quality memory B cells generated at 5- to 10-fold higher levels, versus infection or vaccination alone and protection against symptomatic disease lasting for 6-8 months. SARS-CoV-2 evolution into more transmissible and immunologically divergent variants has necessitated the updating of COVID-19 vaccines. To ensure continued protection against SARS-CoV-2 variants, regulators and vaccine technical committees recommend variant-specific or bivalent vaccines.
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18
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Bobrovitz N, Ware H, Ma X, Li Z, Hosseini R, Cao C, Selemon A, Whelan M, Premji Z, Issa H, Cheng B, Abu Raddad LJ, Buckeridge DL, Van Kerkhove MD, Piechotta V, Higdon MM, Wilder-Smith A, Bergeri I, Feikin DR, Arora RK, Patel MK, Subissi L. Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: a systematic review and meta-regression. THE LANCET. INFECTIOUS DISEASES 2023; 23:556-567. [PMID: 36681084 PMCID: PMC10014083 DOI: 10.1016/s1473-3099(22)00801-5] [Citation(s) in RCA: 218] [Impact Index Per Article: 218.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND The global surge in the omicron (B.1.1.529) variant has resulted in many individuals with hybrid immunity (immunity developed through a combination of SARS-CoV-2 infection and vaccination). We aimed to systematically review the magnitude and duration of the protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against infection and severe disease caused by the omicron variant. METHODS For this systematic review and meta-regression, we searched for cohort, cross-sectional, and case-control studies in MEDLINE, Embase, Web of Science, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, the WHO COVID-19 database, and Europe PubMed Central from Jan 1, 2020, to June 1, 2022, using keywords related to SARS-CoV-2, reinfection, protective effectiveness, previous infection, presence of antibodies, and hybrid immunity. The main outcomes were the protective effectiveness against reinfection and against hospital admission or severe disease of hybrid immunity, hybrid immunity relative to previous infection alone, hybrid immunity relative to previous vaccination alone, and hybrid immunity relative to hybrid immunity with fewer vaccine doses. Risk of bias was assessed with the Risk of Bias In Non-Randomized Studies of Interventions Tool. We used log-odds random-effects meta-regression to estimate the magnitude of protection at 1-month intervals. This study was registered with PROSPERO (CRD42022318605). FINDINGS 11 studies reporting the protective effectiveness of previous SARS-CoV-2 infection and 15 studies reporting the protective effectiveness of hybrid immunity were included. For previous infection, there were 97 estimates (27 with a moderate risk of bias and 70 with a serious risk of bias). The effectiveness of previous infection against hospital admission or severe disease was 74·6% (95% CI 63·1-83·5) at 12 months. The effectiveness of previous infection against reinfection waned to 24·7% (95% CI 16·4-35·5) at 12 months. For hybrid immunity, there were 153 estimates (78 with a moderate risk of bias and 75 with a serious risk of bias). The effectiveness of hybrid immunity against hospital admission or severe disease was 97·4% (95% CI 91·4-99·2) at 12 months with primary series vaccination and 95·3% (81·9-98·9) at 6 months with the first booster vaccination after the most recent infection or vaccination. Against reinfection, the effectiveness of hybrid immunity following primary series vaccination waned to 41·8% (95% CI 31·5-52·8) at 12 months, while the effectiveness of hybrid immunity following first booster vaccination waned to 46·5% (36·0-57·3) at 6 months. INTERPRETATION All estimates of protection waned within months against reinfection but remained high and sustained for hospital admission or severe disease. Individuals with hybrid immunity had the highest magnitude and durability of protection, and as a result might be able to extend the period before booster vaccinations are needed compared to individuals who have never been infected. FUNDING WHO COVID-19 Solidarity Response Fund and the Coalition for Epidemic Preparedness Innovations.
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Affiliation(s)
- Niklas Bobrovitz
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada; Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Harriet Ware
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Xiaomeng Ma
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Zihan Li
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Bioengineering, University of California, Berkeley, CA, USA
| | - Reza Hosseini
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Christian Cao
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Anabel Selemon
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mairead Whelan
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Zahra Premji
- Libraries, University of Victoria, Victoria, BC, Canada
| | - Hanane Issa
- Institute of Health Informatics, University College London, London, UK
| | - Brianna Cheng
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Laith J Abu Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | - David L Buckeridge
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montreal, QC, Canada
| | | | - Vanessa Piechotta
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Melissa M Higdon
- International Vaccine Access Center, Department of International Health, John Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Annelies Wilder-Smith
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland; Heidelberg Institute of Global Health, University of Heidelberg, Germany
| | - Isabel Bergeri
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Daniel R Feikin
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Rahul K Arora
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Minal K Patel
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Lorenzo Subissi
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
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19
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Lan FY, Kasteler SD, Sidossis A, Iliaki E, Buley J, Nathan N, Osgood R, Bruno-Murtha LA, Kales SN. Immunity Acquired From the First Wave of COVID-19 Against Reinfections Up to Omicron Predominance. Mayo Clin Proc 2023; 98:202-203. [PMID: 36603950 PMCID: PMC9640383 DOI: 10.1016/j.mayocp.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 10/02/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Fan-Yun Lan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Stephen D Kasteler
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA; Air Force Institute of Technology, Wright-Patterson AFB, OH
| | - Amalia Sidossis
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
| | - Eirini Iliaki
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Jane Buley
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Neetha Nathan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Rebecca Osgood
- Pathology, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Lou Ann Bruno-Murtha
- Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Stefanos N Kales
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
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20
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Carazo S, Skowronski DM, Brisson M, Barkati S, Sauvageau C, Brousseau N, Gilca R, Fafard J, Talbot D, Ouakki M, Gilca V, Carignan A, Deceuninck G, De Wals P, De Serres G. Protection against omicron (B.1.1.529) BA.2 reinfection conferred by primary omicron BA.1 or pre-omicron SARS-CoV-2 infection among health-care workers with and without mRNA vaccination: a test-negative case-control study. THE LANCET. INFECTIOUS DISEASES 2023; 23:45-55. [PMID: 36152671 PMCID: PMC9491856 DOI: 10.1016/s1473-3099(22)00578-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND There is a paucity of data on vaccine-induced or infection-induced (hybrid or natural) immunity against omicron (B.1.1.529) subvariant BA.2, particularly in comparing the effects of previous SARS-CoV-2 infection with the same or different genetic lineage. We aimed to estimate the protection against omicron BA.2 associated with previous primary infection with omicron BA.1 or pre-omicron SARS-CoV-2, among health-care workers with and without mRNA vaccination. METHODS We conducted a test-negative case-control study among health-care workers aged 18 years or older who were tested for SARS-CoV-2 in Quebec, Canada, between March 27 and June 4, 2022, when BA.2 was the predominant variant and was presumptively diagnosed with a positive test result. We identified cases (positive test during study period) and controls (negative test during study period) using the provincial laboratory database that records all nucleic acid amplification testing for SARS-CoV-2 in Quebec, and used the provincial immunisation registry to determine vaccination status. Logistic regression models compared the likelihood of BA.2 infection or reinfection (second positive test ≥30 days after primary infection) among health-care workers who had previous primary infection and none to three mRNA vaccine doses versus unvaccinated health-care workers with no primary infection. FINDINGS 258 007 SARS-CoV-2 tests were done during the study period. Among those with a valid result and that met the inclusion criteria, there were 37 732 presumed BA.2 cases (2521 [6·7%] reinfections following pre-omicron primary infection and 659 [1·7%] reinfections following BA.1 primary infection) and 73 507 controls (7360 [10·0%] had pre-omicron primary infection and 12 315 [16·8%] had BA.1 primary infection). Pre-omicron primary infection was associated with a 38% (95% CI 19-53) reduction in BA.2 infection risk, with higher BA.2 protection among those who had also received one (56%, 95% CI 47-63), two (69%, 64-73), or three (70%, 66-74) mRNA vaccine doses. Omicron BA.1 primary infection was associated with greater protection against BA.2 infection (risk reduction of 72%, 95% CI 65-78), and protection was increased further among those who had received two doses of mRNA vaccine (96%, 95-96), but was not improved with a third dose (96%, 95-97). INTERPRETATION Health-care workers who had received two doses of mRNA vaccine and had previous BA.1 infection were subsequently well protected for a prolonged period against BA.2 reinfection, with a third vaccine dose conferring no improvement to that hybrid protection. If this protection also pertains to future variants, there might be limited benefit from additional vaccine doses for people with hybrid immunity, depending on timing and variant. FUNDING Ministère de la Santé et des Services Sociaux du Québec.
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Affiliation(s)
- Sara Carazo
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada.
| | - Danuta M Skowronski
- Communicable Diseases and Immunization Services, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Marc Brisson
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Chantal Sauvageau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Nicholas Brousseau
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Rodica Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Manale Ouakki
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Vladimir Gilca
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Alex Carignan
- Department of Microbiology and Infectious Diseases, Sherbrook University, Sherbrook, QC, Canada
| | - Geneviève Deceuninck
- Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Philippe De Wals
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Gaston De Serres
- Biological Risks Unit, Institut National de Santé Publique du Québec, Quebec, QC, Canada; Social and Preventive Medicine Department, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Quebec, QC, Canada
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21
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Kirsebom FCM, Andrews N, Sachdeva R, Stowe J, Ramsay M, Lopez Bernal J. Effectiveness of ChAdOx1-S COVID-19 booster vaccination against the Omicron and Delta variants in England. Nat Commun 2022; 13:7688. [PMID: 36509743 PMCID: PMC9744366 DOI: 10.1038/s41467-022-35168-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Despite the availability of the ChAdOx1-S booster vaccine, little is known about the real-world effectiveness although clinical trials have demonstrated enhanced immunity following a ChAdOx1-S booster. In England 43,171 individuals received a ChAdOx1-S booster whilst 13,038,908 individuals received BNT162b2 in the same period. ChAdOx1-S booster recipients were more likely to be female (adjusted odds ratio (OR) 1.67 (1.64-1.71)), in a clinical risk group (adjusted OR 1.58 (1.54-1.63)), in the clinically extremely vulnerable group (adjusted OR 1.84 (1.79-1.89)) or severely immunosuppressed (adjusted OR 2.05 (1.96-2.13)). The effectiveness of the ChAdOx1-S and BNT162b2 boosters is estimated here using a test-negative case-control study. Protection against symptomatic disease with the Omicron variant peaks at 66.1% (16.6 to 86.3%) and 68.5% (65.7 to 71.2%) for the ChAdOx1-S and BNT162b2 boosters in older adults. Protection against hospitalisation peaks at 82.3% (64.2 to 91.3%) and 90.9% (88.7 to 92.7%). For Delta, effectiveness against hospitalisation is 80.9% (15.6% to 95.7%) and 93.9% (92.8% to 94.9%) after ChAdOx1-S and BNT162b2 booster vaccination. This study supports the consideration of ChAdOx1-S booster vaccination for protection against severe COVID-19 in settings yet to offer boosters and suggests that individuals who received a ChAdOx1-S booster do not require re-vaccination ahead of others.
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Affiliation(s)
| | - Nick Andrews
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK ,grid.8991.90000 0004 0425 469XNIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, UK
| | - Ruchira Sachdeva
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK
| | - Julia Stowe
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK
| | - Mary Ramsay
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK ,grid.8991.90000 0004 0425 469XNIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, UK
| | - Jamie Lopez Bernal
- grid.515304.60000 0005 0421 4601UK Health Security Agency, London, UK ,grid.8991.90000 0004 0425 469XNIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, UK ,grid.7445.20000 0001 2113 8111NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK
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22
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Skowronski DM, Kaweski SE, Irvine MA, Kim S, Chuang ESY, Sabaiduc S, Fraser M, Reyes RC, Henry B, Levett PN, Petric M, Krajden M, Sekirov I. Serial cross-sectional estimation of vaccine-and infection-induced SARS-CoV-2 seroprevalence in British Columbia, Canada. CMAJ 2022; 194:E1599-E1609. [PMID: 36507788 PMCID: PMC9828974 DOI: 10.1503/cmaj.221335] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The evolving proportion of the population considered immunologically naive versus primed for more efficient immune memory response to SARS-CoV-2 has implications for risk assessment. We sought to chronicle vaccine- and infection-induced seroprevalence across the first 7 waves of the COVID-19 pandemic in British Columbia, Canada. METHODS During 8 cross-sectional serosurveys conducted between March 2020 and August 2022, we obtained anonymized residual sera from children and adults who attended an outpatient laboratory network in the Lower Mainland (Greater Vancouver and Fraser Valley). We used at least 3 immunoassays per serosurvey to detect SARS-CoV-2 spike and nucleocapsid antibodies. We assessed any seroprevalence (vaccineor infection-induced, or both), defined by positivity on any 2 assays, and infection-induced seroprevalence, also defined by dual-assay positivity but requiring both antinucleocapsid and antispike detection. We used estimates of infection-induced seroprevalence to explore underascertainment of infections by surveillance case reports. RESULTS By January 2021, we estimated that any seroprevalence remained less than 5%, increasing with vaccine rollout to 56% by May-June 2021, 83% by September-October 2021 and 95% by March 2022. Infection-induced seroprevalence remained less than 15% through September-October 2021, increasing across Omicron waves to 42% by March 2022 and 61% by July-August 2022. By August 2022, 70%-80% of children younger than 20 years and 60%-70% of adults aged 20-59 years had been infected, but fewer than half of adults aged 60 years and older had been infected. Compared with estimates of infection-induced seroprevalence, surveillance case reports underestimated infections 12-fold between September 2021 and March 2022 and 92-fold between March 2022 and August 2022. INTERPRETATION By August 2022, most children and adults younger than 60 years had evidence of both SARS-CoV-2 vaccination and infection. As previous evidence suggests that a history of both exposures may induce stronger, more durable hybrid immunity than either exposure alone, older adults - who have the lowest infection rates but highest risk of severe outcomes - continue to warrant prioritized vaccination.
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Samantha E Kaweski
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Michael A Irvine
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Shinhye Kim
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Erica S Y Chuang
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Mieke Fraser
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Romina C Reyes
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Bonnie Henry
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Paul N Levett
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Martin Petric
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Mel Krajden
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
| | - Inna Sekirov
- British Columbia Centre for Disease Control, Communicable Diseases and Immunization Services (Skowronski, Kim, Chuang); University of British Columbia, School of Population and Public Health (Skowronski, Henry); BC Centre for Disease Control, Public Health Laboratory (Kaweski, Sabaiduc, Levett, Krajden, Sekirov); BC Centre for Disease Control, Data and Analytic Services (Irvine, Fraser), Vancouver, BC; Simon Fraser University, Faculty of Health Sciences (Irvine), Burnaby, BC; University of British Columbia, Department of Pathology and Laboratory Medicine (Reyes, Levett, Petric, Krajden, Sekirov), Vancouver, BC; LifeLabs (Reyes), Burnaby, BC; Office of the Provincial Health Officer (Henry), Ministry of Health, Victoria, BC
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23
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Hammad NM, Kadry HM, Malek MM, Bahgat SM, Abdelsalam NM, Afifi AHM, Abo-alella DA. Maintenance of Antibody Response in Egyptian Healthcare Workers Vaccinated with ChAdOx1 nCoV-19 Vaccine during Delta and Omicron Variants Pandemic: A Prospective Study. Vaccines (Basel) 2022; 10:vaccines10101706. [PMID: 36298571 PMCID: PMC9608749 DOI: 10.3390/vaccines10101706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a constantly evolving virus, resulting in an increased burden on the existing COVID-19 vaccines. Healthcare workers (HCWs) are the first line of defense against the coronavirus disease 2019 (COVID-19) pandemic and have been prioritized among the risk categories receiving the COVID-19 vaccine. This work aimed to investigate the maintenance of antibody response of the Oxford−AstraZeneca vaccine (ChAdOx1/nCoV-19). Methods: Anti-spike immunoglobulin G (IgG) was measured at baseline point (immediately prior to vaccination) and 12- and 24-week (w) points following vaccination. Adverse reactions to the vaccine were reported. Participants were followed up for the incidence of COVID-19 during the 12 w interval between vaccination doses for 24 w after the second dose. Results: A total of 255 HCWs participated in the study. Prior to vaccination, 54.1% experienced COVID-19, 88.2% were seropositive after the first dose, while seropositivity reached 95.7% after the second dose. Following the first and second doses, the anti-spike IgG serum level was significantly higher in subjects with past COVID-19 than in others (p < 0.001 and =0.001, respectively). Conclusions: The Oxford−AstraZeneca vaccine is generally safe and provides a highly effective long-term humoral immune response against the Delta and Omicron variants of SARS-CoV-2.
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Affiliation(s)
- Noha M. Hammad
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
- Viral Infection Working Group of International Society of Antimicrobial Chemotherapy (VIWG/ISAC), England and Wales, UK
- Correspondence: ; Tel.: +20-1224264909
| | - Heba M. Kadry
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Mai M. Malek
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Shereen Mohamed Bahgat
- Department of Family Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Noha M. Abdelsalam
- Department of Community Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | | | - Doaa Alhussein Abo-alella
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
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24
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Florentino PTV, Alves FJO, Cerqueira-Silva T, Oliveira VDA, Júnior JBS, Jantsch AG, Penna GO, Boaventura V, Werneck GL, Rodrigues LC, Pearce N, Barral-Netto M, Barreto ML, Paixão ES. Vaccine effectiveness of CoronaVac against COVID-19 among children in Brazil during the Omicron period. Nat Commun 2022; 13:4756. [PMID: 35963844 PMCID: PMC9375192 DOI: 10.1038/s41467-022-32524-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/03/2022] [Indexed: 01/07/2023] Open
Abstract
Although severe COVID-19 in children is rare, they may develop multisystem inflammatory syndrome, long-COVID and downstream effects of COVID-19, including social isolation and disruption of education. Data on the effectiveness of the CoronaVac vaccine is scarce during the Omicron period. In Brazil, children between 6 to 11 years are eligible to receive the CoronaVac vaccine. We conducted a test-negative design to estimate vaccine effectiveness using 197,958 tests from January 21, 2022, to April 15, 2022, during the Omicron dominant period in Brazil among children aged 6 to 11 years. The estimated vaccine effectiveness for symptomatic infection was 39.8% (95% CI 33.7–45.4) at ≥14 days post-second dose. For hospital admission vaccine effectiveness was 59.2% (95% CI 11.3–84.5) at ≥14 days. Two doses of CoronaVac in children during the Omicron period showed low levels of protection against symptomatic infection, and modest levels against severe illness. There is limited evidence of the effectiveness of the CoronaVac vaccine for children against the Omicron SARS-CoV-2 variant. Here, the authors use data from Brazil for children aged 6–11 years and estimate effectiveness of 40% against infection and 59% against severe disease at least two weeks after the second dose.
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Affiliation(s)
- Pilar T V Florentino
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil. .,Biomedical Science Institute, University of São Paulo, São Paulo, Brazil.
| | - Flávia J O Alves
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil
| | - Thiago Cerqueira-Silva
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil.,Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Vinicius de Araújo Oliveira
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil.,Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Juracy B S Júnior
- Public Health Institute, Federal University of Bahia, Salvador, Brazil
| | - Adelson G Jantsch
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil
| | - Gerson O Penna
- Tropical Medicine Centre, University of Brasília, Fiocruz School of Government, Brasília, Brazil
| | - Viviane Boaventura
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil.,Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Guilherme L Werneck
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Institute of Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Neil Pearce
- London School of Hygiene and Tropical Medicine, London, UK
| | - Manoel Barral-Netto
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil.,Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Mauricio L Barreto
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador, Brazil
| | - Enny S Paixão
- London School of Hygiene and Tropical Medicine, London, UK
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