COVID-19 vaccine impact on rates of SARS-CoV-2 cases and post vaccination strain sequences among healthcare workers at an urban academic medical center: a prospective cohort study

Death Reporting in Breakthrough and Unvaccinated SARS-CoV-2 Infection Cases

Vaccines are undeniably an important tool for controlling infectious disease outbreaks, and they are the most certain way to end the epidemic risk. This brief report describes the characteristics of coronavirus disease 2019 (COVID-19) deaths among breakthrough and unvaccinated cases hospitalized in Fars province in the south of Iran. This cross-sectional study was performed to compare breakthrough and unvaccinated death cases in Fars, Iran (February 2, to August 19, 2021). Among 444,728 fully vaccinated people, 60,800 breakthrough cases were detected. Thus, 501 died, of which 297 (297/501) cases were hospitalized and compared with the unvaccinated dead group. The median age for breakthrough and unvaccinated cases was estimated 79 and 65 y, respectively. All signs and symptoms of COVID-19 were more frequent in the unvaccinated group. Decreasing O₂ saturation (less than 93%) happened more often in the unvaccinated group significantly. Unvaccinated dead patients had significantly shorter hospital stays. These patients received 66.63% Sinopharm, 0.67% Sputnik, 0.67% COVIran Barekat, and 31.99% AstraZeneca vaccines. None of them were health-care staff. Equitable access to safe and effective vaccines is critical to ending the COVID-19 pandemic. As vaccine uptake increases, we observed a decrease in mortality and protection from severe forms of the disease.

Breakthrough SARS-CoV-2 infections after vaccination: a critical review

At the beginning of the current pandemic, it was believed that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection would induce lifelong immunity and that reinfections would be unlikely. However, after several cases of reinfection were documented in previously infected patients, this was understood to be a false assumption, and this waning humoral immunity has raised significant concerns. Accordingly, long-term and durable vaccine-induced antibody protection against infection have also become a challenge, as several breakthroughs of COVID-19 infection have been identified in individuals who were fully vaccinated. This review discusses the current evidence on breakthrough COVID-19 infections occurring after vaccination.

Seroprevalence of SARS-CoV-2 antibodies in vaccinated healthcare workers in Marrakech (Morocco)

INTRODUCTION

The SARS-CoV-2 pandemic has had a considerable impact, causing millions of deaths worldwide, including many healthcare workers (HCWs). The pharmaceutical industry has been working diligently since the start of the pandemic to develop various vaccines to fight the spread of the virus and protect the population.

OBJECTIVE

To study the seroprevalence of neutralizing anti-SARS-CoV-2 antibodies in vaccinated HCWs at the Mohamed VI University Hospital in Marrakech and to determine the parameters that can influence immune response.

METHODS

A cross-sectional study of 138 HCWs was performed between October and December 2021 by measuring IgG antibodies directed against the spike antigen of SARS-CoV-2 using an Abbott Architect^® SARS-CoV-2 IgG II assay.

RESULTS

The mean age was 31.42 years, the sex ratio was 2.94 women to each man, and the overall prevalence was 97%. We found 39.5% of the participants had experienced COVID-19 infections pre-vaccination, which decreased to 26.8% after vaccination. Neutralizing antibody titers were dependent on the type of vaccine: they were higher with the Pfizer-BioNTech vaccine, the number of doses (p < .001), and post-vaccine COVID-19 form. The post-vaccine COVID-19 infection rates were lower with the Sinopharm vaccine.

CONCLUSION

Heterologous vaccination with non-mRNA and mRNA vaccines and the consideration of post-vaccination COVID-19 infection as a booster could help optimize vaccine results while reducing potential side effects.

The effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19: A systematic review and meta-analysis

Background

Vaccination, one of the most important and effective ways of preventing infectious diseases, has recently been used to control the COVID-19 pandemic. The present meta-analysis study aimed to evaluate the effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19.

Methods

A systematic search was performed independently in Scopus, PubMed via Medline, ProQuest, and Google Scholar electronic databases as well as preprint servers using the keywords under study. We used random-effect models and the heterogeneity of the studies was assessed using I ² and χ² statistics. In addition, the Pooled Vaccine Effectiveness (PVE) obtained from the studies was calculated by converting based on the type of outcome.

Results

A total of 54 studies were included in this meta-analysis. The PVE against SARS-COV 2 infection were 71% [odds ratio (OR) = 0.29, 95% confidence intervals (CI): 0.23-0.36] in the first dose and 87% (OR = 0.13, 95% CI: 0.08-0.21) in the second dose. The PVE for preventing hospitalization due to COVID-19 infection was 73% (OR = 0.27, 95% CI: 0.18-0.41) in the first dose and 89% (OR = 0.11, 95% CI: 0.07-0.17) in the second dose. With regard to the type of vaccine, mRNA-1273 and combined studies in the first dose and ChAdOx1 and mRNA-1273 in the second dose had the highest effectiveness in preventing infection. Regarding the COVID-19-related mortality, PVE was 68% (HR = 0.32, 95% CI: 0.23-0.45) in the first dose and 92% (HR = 0.08, 95% CI: 0.02-0.29) in the second dose.

Conclusion

The results of this meta-analysis indicated that vaccination against COVID-19 with BNT162b2 mRNA, mRNA-1273, and ChAdOx1, and also their combination, was associated with a favorable effectiveness against SARS-CoV2 incidence rate, hospitalization, and mortality rate in the first and second doses in different populations. We suggest that to prevent the severe form of the disease in the future, and, in particular, in the coming epidemic picks, vaccination could be the best strategy to prevent the severe form of the disease.

Systematic review registration

PROSPERO International Prospective Register of Systematic Reviews: http://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42021289937].

Postvaccination SARS-CoV-2 infection among healthcare workers: A systematic review and meta-analysis

Healthcare workers (HCWs) remain on the front line of the battle against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) infection and are among the highest groups at risk of infection during this raging pandemic. We conducted a systematic review and meta-analysis to assess the incidence of postvaccination SARS-CoV-2 infection among vaccinated HCWs. We searched multiple databases from inception through August 2021 to identify studies that reported on the incidence of postvaccination SARS-CoV-2 infection among HCWs. Meta-analysis was performed to determine pooled proportions of COVID-19 infection in partially/fully vaccinated as well as unvaccinated individuals. Eighteen studies with 228 873 HCWs were included in the final analysis. The total number of partially vaccinated, fully vaccinated, and unvaccinated HCWs were 132 922, 155 673, and 17 505, respectively. Overall pooled proportion of COVID-19 infections among partially/fully vaccinated and unvaccinated HCWs was 2.1% (95% confidence interval [CI] 1.2-3.5). Among partially vaccinated, fully vaccinated and unvaccinated HCWs, pooled proportion of COVID-19 infections was 2.3% (CI 1.2-4.4), 1.3% (95% CI 0.6-2.9), and 10.1% (95% CI 4.5-19.5), respectively. Our analysis shows the risk of COVID-19 infection in both partially and fully vaccinated HCWs remains exceedingly low when compared to unvaccinated individuals. There remains an urgent need for all frontline HCWs to be vaccinated against SARS-CoV-2 infection.

Reported Adverse Effects and Attitudes among Arab Populations Following COVID-19 Vaccination: A Large-Scale Multinational Study Implementing Machine Learning Tools in Predicting Post-Vaccination Adverse Effects Based on Predisposing Factors

Background: The unprecedented global spread of coronavirus disease 2019 (COVID-19) has imposed huge challenges on the healthcare facilities, and impacted every aspect of life. This has led to the development of several vaccines against COVID-19 within one year. This study aimed to assess the attitudes and the side effects among Arab communities after receiving a COVID-19 vaccine and use of machine learning (ML) tools to predict post-vaccination side effects based on predisposing factors. Methods: An online-based multinational survey was carried out via social media platforms from 14 June to 31 August 2021, targeting individuals who received at least one dose of a COVID-19 vaccine from 22 Arab countries. Descriptive statistics, correlation, and chi-square tests were used to analyze the data. Moreover, extensive ML tools were utilized to predict 30 post vaccination adverse effects and their severity based on 15 predisposing factors. The importance of distinct predisposing factors in predicting particular side effects was determined using global feature importance employing gradient boost as AutoML. Results: A total of 10,064 participants from 19 Arab countries were included in this study. Around 56% were female and 59% were aged from 20 to 39 years old. A high rate of vaccine hesitancy (51%) was reported among participants. Almost 88% of the participants were vaccinated with one of three COVID-19 vaccines, including Pfizer-BioNTech (52.8%), AstraZeneca (20.7%), and Sinopharm (14.2%). About 72% of participants experienced post-vaccination side effects. This study reports statistically significant associations (p < 0.01) between various predisposing factors and post-vaccinations side effects. In terms of predicting post-vaccination side effects, gradient boost, random forest, and XGBoost outperformed other ML methods. The most important predisposing factors for predicting certain side effects (i.e., tiredness, fever, headache, injection site pain and swelling, myalgia, and sleepiness and laziness) were revealed to be the number of doses, gender, type of vaccine, age, and hesitancy to receive a COVID-19 vaccine. Conclusions: The reported side effects following COVID-19 vaccination among Arab populations are usually non-life-threatening; flu-like symptoms and injection site pain. Certain predisposing factors have greater weight and importance as input data in predicting post-vaccination side effects. Based on the most significant input data, ML can also be used to predict these side effects; people with certain predicted side effects may require additional medical attention, or possibly hospitalization.

SARS-CoV-2 E484K Mutation Narrative Review: Epidemiology, Immune Escape, Clinical Implications, and Future Considerations

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly over the world and claimed million lives. The virus evolves constantly, and a swarm of mutants is a now major concern globally. Distinct variants could have independently converged on same mutation, despite being detected in different geographic regions, which suggested it could confer an evolutionary advantage. E484K has rapidly emerged and has frequently been detected in several SARS-CoV-2 variants of concern. In this study, we review the epidemiology and impact of E484K, its effects on neutralizing effect of several monoclonal antibodies, convalescent plasma, and post-vaccine sera.

Tiwari R, Jain T, Baad S. COVID infections breakthrough post-vaccination: Systematic review

Introduction:

Materials and Methods:

Results:

Discussion:

Evaluation of protection by COVID-19 vaccines after deployment in low and lower-middle income countries

The availability and use of vaccines for the coronavirus disease 2019 (COVID-19) in low and middle-income countries (L/MICs) lags far behind more affluent countries, and vaccines currently used in L/MICs are predominantly of lower efficacy. As vaccines continue to be rolled out in L/MICs, successful control of COVID-19 by vaccines requires monitoring both of vaccine protection of vaccinees (effectiveness) and of the entire targeted populations, including vaccine herd protection of non-vaccinees (impact). To be of greatest relevance to L/MICs, there is the need to address the distinctive medical and demographic features of populations, health systems, and demography that may greatly affect vaccine performance in these settings. We identified 58 published studies that included 85 evaluations of the effectiveness of different COVID-19 vaccines globally. Only three were done in L/MICs, and no impact studies were identified in these settings. Post-deployment studies of the protection by COVID-19 vaccines rolled out in L/MICs constitute an important but currently neglected global priority.

Weak Cross-Lineage Neutralization by Anti SARS-CoV-2 Spike Antibodies after Natural Infection or Vaccination Is Rescued by Repeated Immunological Stimulation

After over one year of evolution, through billions of infections in humans, SARS-CoV-2 has evolved into a score of slightly divergent lineages. A few different amino acids in the spike proteins of these lineages can hamper both natural immunity against reinfection, and vaccine efficacy. In this study, the in vitro neutralizing potency of sera from convalescent COVID-19 patients and vaccinated subjects was analyzed against six different SARS-CoV-2 lineages, including the latest B.1.617.2 (or Delta variant), in order to assess the cross-neutralization by anti-spike antibodies. After both single dose vaccination, or natural infection, the neutralizing activity was low and fully effective only against the original lineage, while a double dose or a single dose of vaccine, even one year after natural infection, boosted the cross-neutralizing activity against different lineages. Neither binding, nor the neutralizing activity of sera after vaccination, could predict vaccine failure, underlining the need for additional immunological markers. This study points at the importance of the anamnestic response and repeated vaccine stimulations to elicit a reasonable cross-lineage neutralizing antibody response.

Progress of the COVID-19 vaccine effort: viruses, vaccines and variants versus efficacy, effectiveness and escape

Where 2020 saw the development and testing of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at an unprecedented pace, the first half of 2021 has seen vaccine rollout in many countries. In this Progress article, we provide a snapshot of ongoing vaccine efficacy studies, as well as real-world data on vaccine effectiveness and the impact of virus variants of concern. Where they have been deployed in a high proportion of the adult population, the currently approved vaccines have been extremely effective in preventing COVID-19, particularly severe disease. Nonetheless, there are still significant challenges in ensuring equitable vaccine access around the globe and lessons that can be learned for controlling this pandemic and for the next pandemic.