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Pasco R, Fox SJ, Lachmann M, Meyers LA. Effectiveness of interventions to reduce COVID-19 transmission in schools. Epidemics 2024; 47:100762. [PMID: 38489849 DOI: 10.1016/j.epidem.2024.100762] [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: 06/27/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/17/2024] Open
Abstract
School reopenings in 2021 and 2022 coincided with the rapid emergence of new SARS-CoV-2 variants in the United States. In-school mitigation efforts varied, depending on local COVID-19 mandates and resources. Using a stochastic age-stratified agent-based model of SARS-CoV-2 transmission, we estimate the impacts of multiple in-school strategies on both infection rates and absenteeism, relative to a baseline scenario in which only symptomatic cases are tested and positive tests trigger a 10-day isolation of the case and 10-day quarantine of their household and classroom. We find that monthly asymptomatic screening coupled with the 10-day isolation and quarantine period is expected to avert 55.4% of infections while increasing absenteeism by 104.3%. Replacing quarantine with test-to-stay would reduce absenteeism by 66.3% (while hardly impacting infection rates), but would require roughly 10-fold more testing resources. Alternatively, vaccination or mask wearing by 50% of the student body is expected to avert 54.1% or 43.1% of infections while decreasing absenteeism by 34.1% or 27.4%, respectively. Separating students into classrooms based on mask usage is expected to reduce infection risks among those who wear masks (by 23.1%), exacerbate risks among those who do not (by 27.8%), but have little impact on overall risk. A combined strategy of monthly screening, household and classroom quarantine, a 50% vaccination rate, and a 50% masking rate (in mixed classrooms) is expected to avert 81.7% of infections while increasing absenteeism by 90.6%. During future public health emergencies, such analyses can inform the rapid design of resource-constrained strategies that mitigate both public health and educational risks.
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Affiliation(s)
- Remy Pasco
- Integrative Biology, The University of Texas at Austin, Austin, TX,USA
| | - Spencer J Fox
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, GA, USA
| | - Michael Lachmann
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, GA, USA
| | - Lauren Ancel Meyers
- Integrative Biology, The University of Texas at Austin, Austin, TX,USA; Santa Fe Institute, Santa Fe, NM, USA.
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2
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Oktavianthi S, Lages AC, Kusuma R, Kurniasih TS, Trimarsanto H, Andriani F, Rustandi D, Meriyanti T, Yusuf I, Malik SG, Jo J, Suriapranata I. Whole-Genome Sequencing and Mutation Analyses of SARS-CoV-2 Isolates from Indonesia. Pathogens 2024; 13:279. [PMID: 38668234 PMCID: PMC11053823 DOI: 10.3390/pathogens13040279] [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: 11/06/2023] [Revised: 01/12/2024] [Accepted: 03/07/2024] [Indexed: 04/29/2024] Open
Abstract
The SARS-CoV-2 infection that caused the COVID-19 pandemic has become a significant public health concern. New variants with distinct mutations have emerged, potentially impacting its infectivity, immune evasion capacity, and vaccine response. A whole-genome sequencing study of 292 SARS-CoV-2 isolates collected from selected regions of Indonesia between January and October 2021 was performed to identify the distribution of SARS-CoV-2 variants and common mutations in Indonesia. During January-April 2021, Indonesian lineages B.1.466.2 and B.1.470 dominated, but from May 2021, Delta's AY.23 lineage outcompeted them. An analysis of 7515 published sequences from January 2021 to June 2022 revealed a decline in Delta in November 2021, followed by the emergence of Omicron variants in December 2021. We identified C241T (5'UTR), P314L (NSP12b), F106F (NSP3), and D614G (Spike) mutations in all sequences. The other common substitutions included P681R (76.4%) and T478K (60%) in Spike, D377Y in Nucleocapsid (61%), and I82T in Membrane (60%) proteins. Breakthrough infection and prolonged viral shedding cases were associated with Delta variants carrying the Spike T19R, G142D, L452R, T478K, D614G, P681R, D950N, and V1264L mutations. The dynamic of SARS-CoV-2 variants in Indonesia highlights the importance of continuous genomic surveillance in monitoring and identifying potential strains leading to disease outbreaks.
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Affiliation(s)
- Sukma Oktavianthi
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
- Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia;
| | - Aksar Chair Lages
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
| | - Rinaldy Kusuma
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
| | - Tri Shinta Kurniasih
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
| | - Hidayat Trimarsanto
- Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia;
- Menzies School of Health Research, Charles Darwin University, Darwin 0811, Australia
| | - Febi Andriani
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
| | - David Rustandi
- Siloam Hospital Lippo Village, Tangerang 15810, Indonesia; (D.R.); (T.M.)
| | - Tandry Meriyanti
- Siloam Hospital Lippo Village, Tangerang 15810, Indonesia; (D.R.); (T.M.)
| | - Irawan Yusuf
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
| | - Safarina G. Malik
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
- Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia;
| | - Juandy Jo
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
- Department of Biology, Faculty of Science and Technology, Universitas Pelita Harapan, Tangerang 15811, Indonesia
| | - Ivet Suriapranata
- Mochtar Riady Institute for Nanotechnology, Tangerang 15810, Indonesia; (S.O.); (A.C.L.); (R.K.); (T.S.K.); (F.A.); (I.Y.); (S.G.M.); (J.J.)
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3
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Bricker TL, Joshi A, Soudani N, Scheaffer SM, Patel N, Guebre-Xabier M, Smith G, Diamond MS, Boon ACM. Prototype and BA.5 protein nanoparticle vaccines protect against Omicron BA.5 variant in Syrian hamsters. J Virol 2024; 98:e0120623. [PMID: 38305154 PMCID: PMC10994816 DOI: 10.1128/jvi.01206-23] [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: 08/04/2023] [Accepted: 12/23/2023] [Indexed: 02/03/2024] Open
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with greater transmissibility or immune evasion properties has jeopardized the existing vaccine and antibody-based countermeasures. Here, we evaluated the efficacy of boosting pre-immune hamsters with protein nanoparticle vaccines (Novavax, Inc.) containing recombinant Prototype (Wuhan-1) or BA.5 S proteins against a challenge with the Omicron BA.5 variant of SARS-CoV-2. Serum antibody binding and neutralization titers were quantified before challenge, and viral loads were measured 3 days after challenge. Boosting with Prototype or BA.5 vaccine induced similar antibody binding responses against ancestral Wuhan-1 or BA.5 S proteins, and neutralizing activity of Omicron BA.1 and BA.5 variants. One and three months after vaccine boosting, hamsters were challenged with the Omicron BA.5 variant. Prototype and BA.5 vaccine-boosted hamsters had reduced viral infection in the nasal washes, nasal turbinates, and lungs compared to unvaccinated animals. Although no significant differences in virus load were detected between the Prototype and BA.5 vaccine-boosted animals, fewer breakthrough infections were detected in the BA.5-vaccinated hamsters. Thus, immunity induced by Prototype or BA.5 S protein nanoparticle vaccine boosting can protect against the Omicron BA.5 variant in the Syrian hamster model. IMPORTANCE As SARS-CoV-2 continues to evolve, there may be a need to update the vaccines to match the newly emerging variants. Here, we compared the protective efficacy of the updated BA.5 and the original Wuhan-1 COVID-19 vaccine against a challenge with the BA.5 Omicron variant of SARS-CoV-2 in hamsters. Both vaccines induced similar levels of neutralizing antibodies against multiple variants of SARS-CoV-2. One and three months after the final immunization, hamsters were challenged with BA.5. No differences in protection against the BA.5 variant virus were observed between the two vaccines, although fewer breakthrough infections were detected in the BA.5-vaccinated hamsters. Together, our data show that both protein nanoparticle vaccines are effective against the BA.5 variant of SARS-CoV-2 but given the increased number of breakthrough infections and continued evolution, it is important to update the COVID-19 vaccine for long-term protection.
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Affiliation(s)
- Traci L. Bricker
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Astha Joshi
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Nadia Soudani
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Suzanne M. Scheaffer
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Nita Patel
- Novavax Inc., Gaithersburg, Maryland, USA
| | | | - Gale Smith
- Novavax Inc., Gaithersburg, Maryland, USA
| | - Michael S. Diamond
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Microbiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Adrianus C. M. Boon
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Microbiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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4
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Sandoval X, Domínguez R, Recinos D, Zelaya S, Cativo P, Docena GH. Safety and immunogenicity of different booster vaccination schemes for COVID-19 used in El Salvador. Clin Exp Vaccine Res 2024; 13:35-41. [PMID: 38362366 PMCID: PMC10864880 DOI: 10.7774/cevr.2024.13.1.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/06/2023] [Accepted: 10/20/2023] [Indexed: 02/17/2024] Open
Abstract
Purpose The effectiveness of coronavirus disease 2019 (COVID-19) vaccination schemes and the combination of vaccines of various platforms for administering booster doses is still being studied since it will depend on the population's response to vaccines. We aimed to evaluate the safety, protection, and immunogenicity of the Salvadorean population's third dose booster COVID-19 vaccine and the potential benefit of homologous vs. heterologous regimens. Materials and Methods This is an analytical observational cohort study in a population aged 18 to 65 years that was primarily vaccinated with AstraZeneca, Sinovac, or Pfizer/BioNTech. Volunteers were recruited (n=223) and followed up for 3 months after receiving the 3rd vaccine (BNT162b2) as a booster. Adverse reactions were monitored, serum anti-spike immunoglobulin G (IgG) was assessed by chemiluminescence, and a polymerase chain reaction was carried out when subjects developed clinical signs. Results The cohorts finally included 199 participants, and we observed only mild adverse effects in all cohorts. A significant increase in specific IgG levels was found after the booster dose in all cohorts. The heterologous scheme with Sinovac showed the greatest increase in antibody titer, and a decrease was observed in all participants after 3 months. During the follow-up period, 30 participants showed symptomatology compatible with COVID-19, but only four were laboratory-confirmed and they showed mild clinical signs. Conclusion These findings indicate that the booster doses used were safe and promoted an immediate increase in immunogenicity, which decreased over time. The heterologous regimen showed stronger immunogenicity compared to the messenger RNA-based homologous scheme.
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Affiliation(s)
- Xochitl Sandoval
- Instituto Nacional de Salud de El Salvador, San Salvador, El Salvador
| | - Rhina Domínguez
- Instituto Nacional de Salud de El Salvador, San Salvador, El Salvador
| | - Delmy Recinos
- Instituto Nacional de Salud de El Salvador, San Salvador, El Salvador
| | - Susana Zelaya
- Instituto Nacional de Salud de El Salvador, San Salvador, El Salvador
| | - Patricia Cativo
- Facultad de Medicina, Universidad Dr. José Matías Delgado, San Salvador, El Salvador
| | - Guillermo Horacio Docena
- Instituto de Estudios Inmunológicos y Fisiopatológicos, CONICET, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
- Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
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5
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Das R, Hyer RN, Burton P, Miller JM, Kuter BJ. Emerging heterologous mRNA-based booster strategies within the COVID-19 vaccine landscape. Hum Vaccin Immunother 2023; 19:2153532. [PMID: 36629006 PMCID: PMC9980456 DOI: 10.1080/21645515.2022.2153532] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Messenger RNA (mRNA)-based vaccine platforms used for the development of mRNA-1273 and BNT162b2 have provided a robust adaptable approach to offer protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, as variants of concern (VoCs), such as omicron and associated sub-variants, emerge, boosting strategies must also adapt to keep pace with the changing landscape. Heterologous vaccination regimens involving the administration of booster vaccines different than the primary vaccination series offer a practical, effective, and safe approach to continue to reduce the global burden of coronavirus disease 2019 (COVID-19). To understand the immunogenicity, effectiveness, and safety of heterologous mRNA-based vaccination strategies, relevant clinical and real-world observational studies were identified and summarized. Overall, heterologous boosting strategies with mRNA-based vaccines that are currently available and those in development will play an important global role in protecting individuals from COVID-19 caused by emerging VoCs.
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Affiliation(s)
- Rituparna Das
- Infectious Diseases, Moderna, Inc., Cambridge, MA, USA,CONTACT Rituparna Das Moderna, Inc., 200 Technology Square, Cambridge, MA02139, USA
| | - Randall N. Hyer
- Experimental Therapeutics, Baruch S. Blumberg Institute, Doylestown, PA, USA
| | - Paul Burton
- Infectious Diseases, Moderna, Inc., Cambridge, MA, USA
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6
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Link-Gelles R, Britton A, Fleming-Dutra KE. Building the U.S. COVID-19 vaccine effectiveness program: Past successes and future directions. Vaccine 2023:S0264-410X(23)01435-4. [PMID: 38129285 DOI: 10.1016/j.vaccine.2023.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/08/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
COVID-19 vaccines were originally authorized in the United States in December 2020 on the basis of safety, immunogenicity, and clinical efficacy data from randomized controlled trials (RCTs). However, real-world vaccine effectiveness (VE) data are necessary to provide information on how the vaccines work in populations not included in the RCTs (e.g., nursing home residents), against new SARS-CoV-2 variants, with increasing time since vaccination, and in populations with increasing levels of prior infection. The goal of CDC's COVID-19 VE program is to provide timely and robust data to support ongoing policy decisions and implementation of vaccination and includes VE platforms to study the spectrum of illness, from infection to critical illness. Challenges to estimating VE include accurate ascertainment of vaccination history, outcome status, changing rates of prior infection, emergence of new variants, and appropriate interpretation of absolute and relative VE measures. CDC COVID-19 VE platforms have played a pivotal role in numerous vaccine policy decisions since 2021 and will continue to play a key role in future decisions as the vaccine program moves from an emergency response to a routine schedule.
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Affiliation(s)
- Ruth Link-Gelles
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Serivce Commission Corps, Rockville, MD, United States.
| | - Amadea Britton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Katherine E Fleming-Dutra
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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7
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Grage L, Cuellar MJ. Did text-based news-media coverage about the COVID-19 pandemic increase vaccine uptake? A population-based study in Alaska. Int J Circumpolar Health 2023; 82:2213913. [PMID: 37216574 DOI: 10.1080/22423982.2023.2213913] [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: 02/20/2023] [Revised: 04/18/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
COVID-19 vaccinations protect against severe infection, hospitalisation, and death. News media can be an important source of information for the public during a health crisis. This study explores the extent to which local or statewide text-based news coverage of the pandemic was related to the uptake of initial doses of COVID-19 vaccines among adults in Alaska. Multilevel modelling was employed to explore the association between news media intensity and vaccine uptake rates across boroughs and census areas, while controlling for relevant covariates. Results suggest that the intensity of news media did not significantly influence vaccine uptake during the majority of this time period and had a negative affect during the Delta-surge in the fall of 2021. However, the political lean and median age of boroughs or census areas were significantly associated with vaccine uptake. Race, poverty, or education were not significant determinants of vaccine uptake suggesting there are unique differences in Alaska compared to the U.S., particularly amongst Alaska Native people. The political environment in Alaska surrounding the pandemic was polarized. Future research in communications and channels that can cut through this polarized and politicized environment, and reach younger adults is needed.
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Affiliation(s)
- Laura Grage
- College of Health, Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Matthew J Cuellar
- College of Health, School of Social Work, University of Alaska Anchorage, Anchorage, Alaska, USA
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8
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Darnell WH, Daugherty CD, Hart ZP, Lambert South A. Exploring First Responder Beliefs and Decisions to Vaccinate Against SARS-COV-2. HEALTH COMMUNICATION 2023; 38:3316-3325. [PMID: 36636017 DOI: 10.1080/10410236.2022.2149065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
As frontline providers, first responders are not always thought of as patients with unique health beliefs. During early and continued distribution, many first responders in the United States chose to refuse vaccination. Guided by the health belief model and emerging research related to SARS-COV-2, the aim of this study was to further explore the complex message conditions that contributed to first responders' early vaccination decisions. An online survey was conducted between March 1 and March 31 2021, among first responders in the state of Kentucky, which has lagged behind most states in the percentage of the population who are fully vaccinated. The first responder sample included Firefighters, Emergency Medical Technicians (EMTs), and paramedics who completed a Qualtrics survey that included measures aimed at assessing health beliefs about SARS-COV-2, beliefs about SARS-COV-2 vaccines, source trustworthiness, and vaccine motivation. First responders were also asked to rank the importance of various information sources about SARS-COV-2 and its vaccines. Findings suggest significant differences exist among first responders who have chosen to receive SARS-COV-2 vaccines and those who have refused, including source preference, conspiracy beliefs, and perceived risk. Future directions, including the exploration of institutional mistrust as a health belief are discussed. These findings offer practical insights that may improve continuing approaches to discover and use preferred communication sources to reach the vaccine-hesitant.
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Affiliation(s)
| | | | - Zachary P Hart
- Department of Communication, Northern Kentucky University
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9
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Polivka L, Valyi-Nagy I, Szekanecz Z, Bogos K, Vago H, Kamondi A, Fekete F, Szlavik J, Surjan G, Surjan O, Nagy P, Schaff Z, Kiss Z, Müller C, Kasler M, Müller V. Waning of SARS-CoV-2 Vaccine Effectiveness in COPD Patients: Lessons from the Delta Variant. Vaccines (Basel) 2023; 11:1786. [PMID: 38140190 PMCID: PMC10747394 DOI: 10.3390/vaccines11121786] [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: 09/26/2023] [Revised: 10/23/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Although the COVID-19 pandemic is profoundly changing, data on the effect of vaccination and duration of protection against infection and severe disease can still be advantageous, especially for patients with COPD, who are more vulnerable to respiratory infections. The Hungarian COVID-19 registry was retrospectively investigated for risk of infection and hospitalization by time since the last vaccination, and vaccine effectiveness (VE) was calculated in adults with COPD diagnosis and an exact-matched control group during the Delta variant of concern (VOC) wave in Hungary (September-December 2021). For the matching, sex, age, major co-morbidities, vaccination status, and prior infection data were obtained on 23 August 2021. The study population included 373,962 cases divided into COPD patients (age: 66.67 ± 12.66) and a 1:1 matched group (age: 66.73 ± 12.67). In both groups, the female/male ratio was 52.2:47.7, respectively. Among the unvaccinated, there was no difference between groups in risk for infection or hospitalization. Regarding vaccinated cases, in the COPD group, a slightly faster decline in effectiveness was noted for hospitalization prevention, although in both groups, the vaccine lost its significant effect between 215 and 240 days after the last dose of vaccination. Based on a time-stratified multivariate Cox analysis of the vaccinated cases, the hazard was constantly higher in the COPD group, with an HR of 1.09 (95%: 1.05-1.14) for infection and 1.87 (95% CI: 1.59-2.19) for hospitalization. In our study, COPD patients displayed lower vaccine effectiveness against SARS-CoV-2 infection and hospitalization but a similar waning trajectory, as vaccines lost their preventive effect after 215 days. These data emphasize revaccination measures in the COPD patient population.
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Affiliation(s)
- Lörinc Polivka
- Department of Pulmonology, Semmelweis University, 1085 Budapest, Hungary;
| | - Istvan Valyi-Nagy
- South-Pest Hospital Centre, National Institute for Infectiology and Hematology, 1097 Budapest, Hungary (J.S.)
| | - Zoltan Szekanecz
- Department of Rheumatology, University of Debrecen, 4032 Debrecen, Hungary;
| | - Krisztina Bogos
- National Korányi Institute of Pulmonology, 1122 Budapest, Hungary;
| | - Hajnalka Vago
- Heart and Vascular Centre, Semmelweis University, 1122 Budapest, Hungary;
| | - Anita Kamondi
- National Institute of Mental Health, Neurology and Neurosurgery, 1145 Budapest, Hungary;
| | - Ferenc Fekete
- Heim Pál National Pediatric Institute, 1089 Budapest, Hungary;
| | - Janos Szlavik
- South-Pest Hospital Centre, National Institute for Infectiology and Hematology, 1097 Budapest, Hungary (J.S.)
| | - György Surjan
- National Public Health Center, 1097 Budapest, Hungary; (G.S.); (O.S.); (C.M.)
| | - Orsolya Surjan
- National Public Health Center, 1097 Budapest, Hungary; (G.S.); (O.S.); (C.M.)
| | - Peter Nagy
- National Institute of Oncology, 1122 Budapest, Hungary;
| | - Zsuzsa Schaff
- Department of Pathology and Forensic Medicine, Semmelweis University, 1091 Budapest, Hungary;
| | - Zoltan Kiss
- 2nd Department of Internal Medicine and Nephrological Center, University of Pécs, 7624 Pécs, Hungary;
| | - Cecilia Müller
- National Public Health Center, 1097 Budapest, Hungary; (G.S.); (O.S.); (C.M.)
| | | | - Veronika Müller
- Department of Pulmonology, Semmelweis University, 1085 Budapest, Hungary;
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10
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Ríos-Bracamontes EF, Iñiguez-Arias LE, Ochoa-Jiménez RJ, Guzmán-Esquivel J, Cárdenas-Rojas MI, Murillo-Zamora E. Risk of Testing Positive for COVID-19 among Healthcare and Healthcare-Related Workers. Vaccines (Basel) 2023; 11:1260. [PMID: 37515075 PMCID: PMC10385201 DOI: 10.3390/vaccines11071260] [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: 06/26/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Understanding the risk factors associated with COVID-19 infection among healthcare workers is crucial for infection prevention and control. The aim of this study was to examine the risk of testing positive for COVID-19 among a multicenter cohort of workers, taking into account their occupational roles (medical professionals, staff in operational and administrative roles, or laboratory personnel) in healthcare settings. The data analyzed in this study included 2163 individuals with suggestive COVID-19 symptoms who underwent laboratory testing. The incidence rate in the study sample was calculated to be 15.3 cases per 10,000 person-days. The results from the multiple regression model indicated that job roles were not significantly associated with the risk of testing positive. However, age and the duration of the pandemic were identified as significant risk factors, with increasing age and longer pandemic duration being associated with a higher risk of testing positive. Additionally, vaccination was found to reduce the risk of testing positive. These findings provide valuable insights into COVID-19 transmission among indoor healthcare workers, highlighting the influence of age, pandemic duration, and vaccination on infection risk. Further research is needed to develop evidence-based strategies aimed at protecting healthcare workers and preventing virus spread in healthcare settings.
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Affiliation(s)
- Eder Fernando Ríos-Bracamontes
- Departamento de Medicina Interna, Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Luz Elena Iñiguez-Arias
- Departamento de Medicina Interna, Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Rodolfo José Ochoa-Jiménez
- Departamento de Medicina Interna, Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - José Guzmán-Esquivel
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Martha Irazema Cárdenas-Rojas
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Efrén Murillo-Zamora
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
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11
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Ekram R, Khan WA, Khafagy AA, Mandora RM, Zamzami OS, Alzahrani MM, Alamri GE, Mandora RM, Garout MA, Almatrafi MA, Alwafi H, Naser AY, Salawati E, Samannodi M, Uz Zaman T. Attitudes and Practices of the Public Toward Precautionary Measures Post-COVID-19 Pandemic in Saudi Arabia. J Multidiscip Healthc 2023; 16:1943-1952. [PMID: 37484816 PMCID: PMC10356548 DOI: 10.2147/jmdh.s414424] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023] Open
Abstract
Objective This study aimed to assess the practices and attitudes of the general population towards coronavirus disease-2019 (COVID)-19 after the removal of precautionary and preventive measures in Saudi Arabia. Methods A cross-sectional study was conducted among the general population in all regions of the Kingdom of Saudi Arabia, from September 2022 to October, 2022 via a virtual survey to evaluate the practices, and attitudes of the general population towards COVID-19. A stratified random sampling technique was applied to collect the sample with inclusion criteria for all individuals who are Arabic language speakers using social media platforms. The individuals selected for this study were 18 years and older. Results A total of 2406 responses were received for the study questionnaire. Most of participants (66.3%) were females aged 18 to 29 years (61.8%). Half of the participants reported a positive history of COVID-19 infection. Nearly 90% of participants still wear masks, 80% attended a crowded event, and 60% often wash their hands even though the Saudi government has erased the precautions. Females, young (30-39 years) and elderly (60 years and over) individuals, singles, those with a postgraduate degree, those who are employed, and healthcare workers were more likely to adhere to COVID-19 precautionary measures (p<0.05). Conclusion The study's findings indicate that most of the population discontinued practicing precautionary measures after lifting the measures in Saudi Arabia. More public health initiatives should raise the scores of sanitary best practices to prevent the spread of viral illnesses.
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Affiliation(s)
- Rakan Ekram
- Department of Health Information Technology and Management, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, 21514, Saudi Arabia
| | - Wahaj A Khan
- Department of Occupational Health, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, 21514, Saudi Arabia
| | - Abdullah A Khafagy
- Department of Community Medicine and Pilgrims Healthcare, College of Medicine, Umm Al-Qura University, Makkah, 21514, Saudi Arabia
| | - Roaa M Mandora
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Osama S Zamzami
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Ghadeer E Alamri
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Razan M Mandora
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohammed A Garout
- Department of Community Medicine and Pilgrims Healthcare, College of Medicine, Umm Al-Qura University, Makkah, 21514, Saudi Arabia
| | | | - Hassan Alwafi
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Emad Salawati
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Samannodi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Tabrez Uz Zaman
- Department of Health Information Technology and Management, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, 21514, Saudi Arabia
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12
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Shin IS, Lee YP, Lee SH, Lee JY, Park JH, Chung YS. Effectiveness of the COVID-19 vaccine in the Honam region of the Republic of Korea. Osong Public Health Res Perspect 2023; 14:197-206. [PMID: 37415437 PMCID: PMC10522824 DOI: 10.24171/j.phrp.2022.0308] [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: 12/05/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND In 2021, the effectiveness of the COVID-19 vaccine was analyzed among people living in the Honam region (Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju) of the Republic of Korea. And we investigated changes in the dominant virus strain. METHODS This study used the data provided by the Korean Ministry of the Interior and Safety for individuals ≥12 years old in the Honam region, and the Integrated Disease and Health Management System of the Korea Centers for Disease Control and Prevention for COVID-19-vaccinated individuals as of December 31, 2021. Statistical analyzes were performed using IBM SPSS ver. 23.0. The occurrence of confirmed cases by vaccination status, the relative risk, and vaccine effectiveness by vaccine type were calculated. RESULTS In 2021, the COVID-19 vaccination rate in Honam was 88.6%. The overall vaccine effectiveness (after 2 and 3 doses) was 98.7% (p<0.001). and the breakthrough infection rate was 0.16%. From week 21 to week 27 of 2021 (June 27 to July 3), the genome sequencing results were mostly alpha variants. The Delta variant emerged as the dominant variant after 27 weeks and the Omicron variant was found at 50 weeks (December 5-11). CONCLUSION Vaccine effectiveness changed with the outbreak of new variants of the virus as well as over time as antibody levels decreased. that the prevention effectiveness of vaccination in Honam was >98%, and the effect among persons who received 2 doses was >90% regardless of the vaccine type. Although vaccine effectiveness decreased because of reduced antibody levels over time (as observed in breakthrough infections), receiving a booster dose restored the neutralizing antibody levels.
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Affiliation(s)
- In-Sook Shin
- Division of Control for Zoonotic and Vector Borne Disease, Korea Diseases Control and Prevention Agency, Cheongju, Republic of Korea
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Diseases Control and Prevention Agency, Gwangju, Republic of Korea
| | - Yong-Pyo Lee
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Diseases Control and Prevention Agency, Gwangju, Republic of Korea
| | - Seung-Hoon Lee
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Diseases Control and Prevention Agency, Gwangju, Republic of Korea
| | - Jae-Young Lee
- Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Diseases Control and Prevention Agency, Cheongju, Republic of Korea
| | - Jong-Ha Park
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Diseases Control and Prevention Agency, Gwangju, Republic of Korea
| | - Yoon-Seok Chung
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Diseases Control and Prevention Agency, Gwangju, Republic of Korea
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13
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Ponce-de-León S, Torres M, Soto-Ramírez LE, Calva JJ, Santillán-Doherty P, Carranza-Salazar DE, Carreño JM, Carranza C, Juárez E, Carreto-Binaghi LE, Ramírez-Martínez L, Paz De la Rosa G, Vigueras-Moreno R, Ortiz-Stern A, López-Vidal Y, Macías AE, Torres-Flores J, Rojas-Martínez O, Suárez-Martínez A, Peralta-Sánchez G, Kawabata H, González-Domínguez I, Martínez-Guevara JL, Sun W, Sarfati-Mizrahi D, Soto-Priante E, Chagoya-Cortés HE, López-Macías C, Castro-Peralta F, Palese P, García-Sastre A, Krammer F, Lozano-Dubernard B. Interim safety and immunogenicity results from an NDV-based COVID-19 vaccine phase I trial in Mexico. NPJ Vaccines 2023; 8:67. [PMID: 37164959 PMCID: PMC10170424 DOI: 10.1038/s41541-023-00662-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/14/2023] [Indexed: 05/12/2023] Open
Abstract
There is still a need for safe, efficient, and low-cost coronavirus disease 2019 (COVID-19) vaccines that can stop transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we evaluated a vaccine candidate based on a live recombinant Newcastle disease virus (NDV) that expresses a stable version of the spike protein in infected cells as well as on the surface of the viral particle (AVX/COVID-12-HEXAPRO, also known as NDV-HXP-S). This vaccine candidate can be grown in embryonated eggs at a low cost, similar to influenza virus vaccines, and it can also be administered intranasally, potentially to induce mucosal immunity. We evaluated this vaccine candidate in prime-boost regimens via intramuscular, intranasal, or intranasal followed by intramuscular routes in an open-label non-randomized non-placebo-controlled phase I clinical trial in Mexico in 91 volunteers. The primary objective of the trial was to assess vaccine safety, and the secondary objective was to determine the immunogenicity of the different vaccine regimens. In the interim analysis reported here, the vaccine was found to be safe, and the higher doses tested were found to be immunogenic when given intramuscularly or intranasally followed by intramuscular administration, providing the basis for further clinical development of the vaccine candidate. The study is registered under ClinicalTrials.gov identifier NCT04871737.
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Affiliation(s)
- Samuel Ponce-de-León
- Programa Universitario de Investigación en Salud (PUIS), Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Edif. de los Programas Universitarios, Planta Alta. Circuito de la Investigación Científica S/N Ciudad Universitaria, Ciudad de México, C.P. 04510, México
| | - Martha Torres
- Laboratorio de Inmunobiología de la tuberculosis, Instituto Nacional de Enfermedades Respiratorias (INER), Ismael Cossio Villegas, Calzada de Tlalpan 4502, Sección XVI, CP 14080, Tlalpan, México
| | - Luis Enrique Soto-Ramírez
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Belisario Dominguez, Sección XVI, 14080, Tlalpan, México
- Departamento de Infectología y Vigilancia Epidemiológica, Hospital Médica Sur, S.A.B. de C. V., Puente de Piedra 150, Toriello Guerra, 14050, Tlalpan, México
| | - Juan José Calva
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Belisario Dominguez, Sección XVI, 14080, Tlalpan, México
| | - Patricio Santillán-Doherty
- Instituto Nacional de Enfermedades Respiratorias (INER), Ismael Cossio Villegas, Calzada de Tlalpan 4502, Sección XVI, CP 14080, Tlalpan, México
| | - Dora Eugenia Carranza-Salazar
- ProcliniQ Investigación Clínica, S. A. de C. V., Renato Leduc 155 (Xontepec 91), Toriello Guerra, 14050, Tlalpan, México
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Claudia Carranza
- Laboratorio de Inmunobiología de la tuberculosis, Instituto Nacional de Enfermedades Respiratorias (INER), Ismael Cossio Villegas, Calzada de Tlalpan 4502, Sección XVI, CP 14080, Tlalpan, México
| | - Esmeralda Juárez
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias (INER), Ismael Cossio Villegas, Calzada de Tlalpan 4502, Sección XVI, CP 14080, Tlalpan, México
| | - Laura E Carreto-Binaghi
- Laboratorio de Inmunobiología de la tuberculosis, Instituto Nacional de Enfermedades Respiratorias (INER), Ismael Cossio Villegas, Calzada de Tlalpan 4502, Sección XVI, CP 14080, Tlalpan, México
| | - Luis Ramírez-Martínez
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Georgina Paz De la Rosa
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Rosalía Vigueras-Moreno
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Alejandro Ortiz-Stern
- iLS Clinical Research, S. C. (iLS), Matias Romero 102 - 205 Del Valle, Benito Juárez, CP 03100, CDMX, México
| | - Yolanda López-Vidal
- Programa de Inmunología Molecular Microbiana, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Av. Universidad 3000, Circuito Interior S/N. Ciudad Universitaria, Coyoacán, CP.04510, México
| | - Alejandro E Macías
- Departamento de Medicina, Universidad de Guanajuato, 20 de Enero 929, C.P 37000, León Guanajuato, México
| | - Jesús Torres-Flores
- Dirección Adjunta de Desarrollo Tecnológico, Vinculación e Innovación, Consejo Nacional de Ciencia y Tecnología (CONACYT), Insurgentes Sur 1582, Crédito Constructor, CP 03940, Benito Juárez, CDMX, México
| | - Oscar Rojas-Martínez
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Alejandro Suárez-Martínez
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Gustavo Peralta-Sánchez
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Hisaaki Kawabata
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Irene González-Domínguez
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - José Luis Martínez-Guevara
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Weina Sun
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - David Sarfati-Mizrahi
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Ernesto Soto-Priante
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Héctor Elías Chagoya-Cortés
- Consultora Mextrategy, S.A.S. de C. V. (Mextrategy), Insurgentes Sur 1079 P7-127, Nochebuena, CP 03720, CDMX, Mexico
| | - Constantino López-Macías
- Unidad de Investigación Médica en Inmunoquímica. Hospital de Especialidades del Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social (IMSS), Av. Cuauhtémoc 330, Doctores, C.P. 06720, Benito Juárez, CDMX, México
| | - Felipa Castro-Peralta
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico
| | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
- Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
- Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
| | - Bernardo Lozano-Dubernard
- Laboratorio Avi-Mex, S. A. de C. V. (Avimex), Maíz 18, Granjas Esmeralda, CP 09810, Iztapalapa, CDMX, Mexico.
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14
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Gaio V, Santos AJ, Amaral P, Faro Viana J, Antunes I, Pacheco V, Paiva A, Pinto Leite P, Antunes Gonçalves L, Araújo L, Silva A, Dias C, Kislaya I, Nunes B, Machado A. COVID-19 vaccine effectiveness among healthcare workers: a hospital-based cohort study. BMJ Open 2023; 13:e068996. [PMID: 37130692 PMCID: PMC10163328 DOI: 10.1136/bmjopen-2022-068996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES Healthcare workers (HCWs) were the first to be prioritised for COVID-19 vaccination. This study aims to estimate the COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 symptomatic infection among HCWs in Portuguese hospitals. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS We analysed data from HCWs (all professional categories) from three central hospitals: one in the Lisbon and Tagus Valley region and two in the central region of mainland Portugal, between December 2020 and March 2022. VE against symptomatic SARS-CoV-2 infection was estimated as one minus the confounder adjusted HRs by Cox models considering age group, sex, self-reported chronic disease and occupational exposure to patients diagnosed with COVID-19 as adjustment variables. RESULTS During the 15 months of follow-up, the 3034 HCWs contributed a total of 3054 person-years at risk, and 581 SARS-CoV-2 events occurred. Most participants were already vaccinated with a booster dose (n=2653, 87%), some are vaccinated with only the primary scheme (n=369, 12.6%) and a few remained unvaccinated (n=12, 0.4%) at the end of the study period. VE against symptomatic infection was 63.6% (95% CI 22.6% to 82.9%) for HCWs vaccinated with two doses and 55.9% (95% CI -1.3% to 80.8%) for HCWs vaccinated with one booster dose. Point estimate VE was higher for individuals with two doses taken between 14 days and 98 days (VE=71.9%; 95% CI 32.3% to 88.3%). CONCLUSION This cohort study found a high COVID-19 VE against symptomatic SARS-CoV-2 infection in Portuguese HCWs after vaccination with one booster dose, even after Omicron variant occurrence. The small sample size, the high vaccine coverage, the very low number of unvaccinated individuals and the few events observed during the study period contributed to the low precision of the estimates.
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Affiliation(s)
- Vânia Gaio
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana João Santos
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | | | | | - Isabel Antunes
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Vânia Pacheco
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Artur Paiva
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- University of Coimbra Institute for Clinical and Biomedical Research, Coimbra, Portugal
| | - Pedro Pinto Leite
- Directorate of Information and Analysis, Direção-Geral da Saúde, Lisbon, Portugal
| | | | - Lucília Araújo
- Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Adriana Silva
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Carlos Dias
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Irina Kislaya
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Baltazar Nunes
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Ausenda Machado
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- Public Health Research Center, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
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15
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Ashmawy R, Kamal E, Amin W, Sharaf S, Kabeel S, Albiheyri R, El-Maradny YA, Hassanin E, Elsaka N, Fahmy O, Awd A, Aboeldahab H, Nayle M, Afifi M, Ibrahim M, Rafaat R, Aly S, Redwan EM. Effectiveness and Safety of Inactivated SARS-CoV-2 Vaccine (BBIBP-CorV) among Healthcare Workers: A Seven-Month Follow-Up Study at Fifteen Central Hospitals. Vaccines (Basel) 2023; 11:vaccines11050892. [PMID: 37242996 DOI: 10.3390/vaccines11050892] [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: 04/02/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND During a pandemic, healthcare workers are at high risk of contracting COVID-19. To protect these important individuals, it is highly recommended that they receive the COVID-19 vaccine. Our study focused on evaluating the safety and efficacy of Egypt's first approved vaccine, the Sinopharm vaccine (BBIBP-CorV), and comparing these findings with other vaccines. METHODS An observational study was conducted in fifteen triage and isolation hospitals, from the 1st of March until the end of September 2021. The study included fully vaccinated and unvaccinated participants, and we measured vaccine effectiveness (using 1-aHR), the incidence rate of severely to critically ill hospitalized cases, COVID-19-related work absenteeism, and the safety of the vaccine as outcomes. RESULTS Of the 1364 healthcare workers who were interviewed, 1228 agreed to participate. After taking the hazard ratio into account, the vaccine effectiveness was found to be 67% (95% CI, 80-43%) for symptomatic PCR-confirmed cases. The incidence rate ratio for hospitalization was 0.45 (95% CI, 0.15-1.31) in the vaccinated group compared to the unvaccinated group, and there was a significant reduction in absenteeism among the vaccinated group (p < 0.007). Most adverse events were mild and well tolerated. Vaccinated pregnant and lactating mothers did not experience any sentinel adverse events. CONCLUSION Our study found that the BBIBP-CorV vaccine was effective in protecting healthcare workers from COVID-19.
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Affiliation(s)
- Rasha Ashmawy
- Clinical Research Department, Maamora Chest Hospital, MoHP, Alexandria 21923, Egypt
- Infectious Diseases Administration, Directorate of Health Affairs, MoHP, Alexandria 21554, Egypt
| | - Ehab Kamal
- Medical Research Division, National Research Center, Giza 12622, Egypt
| | - Wagdy Amin
- General Administration of Chest Diseases, MoHP, Cairo 11516, Egypt
| | - Sandy Sharaf
- Clinical Research Department, Maamora Chest Hospital, MoHP, Alexandria 21923, Egypt
| | - Samar Kabeel
- Clinical Research Department, Directorate of Health Affairs, MoHP, Damietta 34711, Egypt
| | - Raed Albiheyri
- Biological Science Department, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Centre of Excellence in Bio Nanoscience Research, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Yousra A El-Maradny
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), Alexandria 21934, Egypt
- Microbiology and Immunology, Faculty of Pharmacy, Arab Academy for Science, Technology and Maritime Transport (AASTMT), Alamein 51718, Egypt
| | - Ebtisam Hassanin
- Clinical Pathology Department, Faculty of Medicine, New Valley University, New Valley 72713, Egypt
| | - Noura Elsaka
- Clinical Research Department, Directorate of Health Affairs, MoHP, Sharkia 71529, Egypt
| | - Ola Fahmy
- Egyptian Drug Authority, Alexandria 21532, Egypt
| | - Ahmed Awd
- Physical Therapy Department, Kafr El-Sheikh General Hospital, MoHP, Kafr El-Sheikh 33511, Egypt
| | - Heba Aboeldahab
- Clinical Research Department, Kom El-Shokafa Chest Hospital, MoHP, Alexandria 21572, Egypt
| | - Mai Nayle
- Clinical Research Department, Kafr El-Sheikh Chest Hospital, MoHP, Kafr El-Sheikh 33511, Egypt
| | - Magda Afifi
- General Administration of Chest Diseases, MoHP, Cairo 11516, Egypt
| | - Marwa Ibrahim
- Clinical Research Department, Fakous Central Hospital, MoHP, Sharkia 71529, Egypt
| | - Raghda Rafaat
- Clinical Research Department, Fakous Central Hospital, MoHP, Sharkia 71529, Egypt
| | - Shahinda Aly
- Clinical Research Department, Maamora Chest Hospital, MoHP, Alexandria 21923, Egypt
| | - Elrashdy M Redwan
- Biological Science Department, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), Alexandria 21934, Egypt
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16
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O’Connor MA, Hawman DW, Meade-White K, Leventhal S, Song W, Randall S, Archer J, Lewis TB, Brown B, Fredericks MN, Sprouse KR, Tunggal HC, Maughan M, Iwayama N, Ahrens C, Garrison W, Wangari S, Guerriero KA, Hanley P, Lovaglio J, Saturday G, Veesler D, Edlefsen PT, Khandhar AP, Feldmann H, Fuller DH, Erasmus JH. A replicon RNA vaccine can induce durable protective immunity from SARS-CoV-2 in nonhuman primates after neutralizing antibodies have waned. PLoS Pathog 2023; 19:e1011298. [PMID: 37075079 PMCID: PMC10150980 DOI: 10.1371/journal.ppat.1011298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 05/01/2023] [Accepted: 04/11/2023] [Indexed: 04/20/2023] Open
Abstract
The global SARS-CoV-2 pandemic prompted rapid development of COVID-19 vaccines. Although several vaccines have received emergency approval through various public health agencies, the SARS-CoV-2 pandemic continues. Emergent variants of concern, waning immunity in the vaccinated, evidence that vaccines may not prevent transmission and inequity in vaccine distribution have driven continued development of vaccines against SARS-CoV-2 to address these public health needs. In this report, we evaluated a novel self-amplifying replicon RNA vaccine against SARS-CoV-2 in a pigtail macaque model of COVID-19 disease. We found that this vaccine elicited strong binding and neutralizing antibody responses against homologous virus. We also observed broad binding antibody against heterologous contemporary and ancestral strains, but neutralizing antibody responses were primarily targeted to the vaccine-homologous strain. While binding antibody responses were sustained, neutralizing antibody waned to undetectable levels in some animals after six months but were rapidly recalled and conferred protection from disease when the animals were challenged 7 months after vaccination as evident by reduced viral replication and pathology in the lower respiratory tract, reduced viral shedding in the nasal cavity and lower concentrations of pro-inflammatory cytokines in the lung. Cumulatively, our data demonstrate in pigtail macaques that a self-amplifying replicon RNA vaccine can elicit durable and protective immunity to SARS-CoV-2 infection. Furthermore, these data provide evidence that this vaccine can provide durable protective efficacy and reduce viral shedding even after neutralizing antibody responses have waned to undetectable levels.
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Affiliation(s)
- Megan A. O’Connor
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - David W. Hawman
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Kimberly Meade-White
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Shanna Leventhal
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Wenjun Song
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Samantha Randall
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- HDT Bio, Seattle, Washington, United States of America
| | - Jacob Archer
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- HDT Bio, Seattle, Washington, United States of America
| | - Thomas B. Lewis
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Brieann Brown
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Megan N. Fredericks
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Kaitlin R. Sprouse
- Department of Biochemistry, University of Washington, United States of America
| | - Hillary C. Tunggal
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Mara Maughan
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Naoto Iwayama
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Chul Ahrens
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - William Garrison
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Solomon Wangari
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Kathryn A. Guerriero
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Patrick Hanley
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Jamie Lovaglio
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Greg Saturday
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - David Veesler
- Department of Biochemistry, University of Washington, United States of America
| | - Paul T. Edlefsen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | | | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, United States of America
| | - Deborah Heydenburg Fuller
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- Washington National Primate Research Center, University of Washington, Seattle, Washington, United States of America
| | - Jesse H. Erasmus
- Department of Microbiology, University of Washington, Seattle, Washington, United States of America
- HDT Bio, Seattle, Washington, United States of America
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17
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Jeong S, Kim JS, Lee SK, Cho EJ, Hyun J, Song W, Kim HS. Tracking the Genomic Evolution of SARS-CoV-2 for 29 Months in South Korea. Viruses 2023; 15:873. [PMID: 37112852 PMCID: PMC10142693 DOI: 10.3390/v15040873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continued, with the persistent emergence of variants of concern (VOCs). Therefore, this study aimed to track the genomic evolution of SARS-CoV-2 strains by sequencing the spike protein for 29 months, which accounted for the majority of the COVID-19 pandemic period. A total of 109 swabs from patients with confirmed coronavirus disease 2019 (COVID-19) infection were randomly collected between March 2020 and July 2022. After genomic sequencing, we analyzed the naming systems and phylogenetic trees. Five surge peaks of COVID-19 cases have been reported in South Korea, resulting in 14,000,000 cumulative confirmed cases and 17,000 deaths. Among the sequenced samples, 34 wild-type strains and 75 VOCs, including 4 Alpha, 33 Delta, 2 Epsilon, and 36 Omicron VOCs, were identified. Omicron strains were comprised of 8 BA.1.1 (21 K), 27 BA.2 (21 L), and 1 BA.2.12.1 (22C). Phylogenetic analysis of the identified isolates and representative sequences of SARS-CoV-2 strains revealed clusters that presented the WHO VOCs. Specific or unique mutations for each VOC waxed and waned according to the variant waves. Our findings allowed recognition of the overall trends of SARS-CoV-2 isolates, which implicated replication advantage, immune evasion, and disease management.
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Affiliation(s)
- Seri Jeong
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Su Kyung Lee
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Eun-Jung Cho
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Jungwon Hyun
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
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18
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Effectiveness of Inactivated Vaccine against SARS-CoV-2 Delta Variant Infection in Xiamen, China—A Test-Negative Case-Control Study. Vaccines (Basel) 2023; 11:vaccines11030532. [PMID: 36992116 DOI: 10.3390/vaccines11030532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023] Open
Abstract
Objective: Vaccine effectiveness can measure herd immunity, but the effectiveness of inactivated vaccines in Xiamen remains unclear. Our study was designed to understand the herd immunity of the COVID-19 inactivated vaccine against the SARA-CoV-2 Delta variant in the real world of Xiamen. Methods: We carried out a test-negative case-control study to explore the vaccine’s effectiveness. Participants aged over 12 years were recruited. A logistic regression was used to estimate the odds ratio (OR) of the vaccine among cases and controls. Results: This outbreak began with factory transmission clusters, and spread to families and communities during the incubation period. Sixty percent of cases were confirmed in a quarantine site. A huge mass of confirmed cases (94.49%) was identified within three days, and nearly half of them had a low Ct value. Following an adjustment for age and sex, a single dose of inactivated SARS-CoV-2 vaccine yielded the vaccine effectiveness (VE) of the overall case, of 57.01% (95% CI: −91.44~86.39%), the fully VE was 65.72% (95% CI: −48.69~88.63%) against COVID-19, 59.45% against moderate COVID-19 and 38.48% against severe COVID-19, respectively. The VE of fully vaccinated individuals was significantly higher in females than in males (73.99% vs. 46.26%). The VE among participants aged 19~40 and 41~61 years was 78.75% and 66.33%, respectively, which exceeds the WHO’s minimal threshold. Nevertheless, the VE in people under 18 and over 60 years was not observed because of the small sample size. Conclusions: The single-dose vaccine had limited effectiveness in preventing infection of the Delta variant. The two doses of inactivated vaccine could effectively prevent infection, and clinical mild, moderate, and severe illness caused by the SARS-CoV-2 Delta variant in people aged 18–60 years in the real world.
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19
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A Statistical Synopsis of COVID-19 Components and Descriptive Analysis of Their Socio-Economic and Healthcare Aspects in Bangladesh Perspective. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:9738094. [PMID: 36815185 PMCID: PMC9940984 DOI: 10.1155/2023/9738094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/02/2023] [Accepted: 01/24/2023] [Indexed: 02/16/2023]
Abstract
The aim of the work is to analyze the socio-economic and healthcare aspects that arise in the contemporary COVID-19 situation from Bangladesh perspective. We elaborately discuss the successive COVID-19 occurrences in Bangladesh with consequential information. The components associated with the COVID-19 commencement and treatment policy with corresponding features and their consequences are patently delineated. The effect of troublesome issues related to the treatment is detailed with supporting real-time data. We elucidate the applications of modern technologies advancement in epidemiological aspects and their existent compatibility in Bangladesh. We statistically analyze the real-time data through figurative and tabular approaches. Some relevant measures of central tendency and dispersion are utilized to explore the data structure and its observable specifications. For a clear manifestation, Z- scores of the COVID-19 components are analyzed through the Box-Whisker plot. We have discovered that the gathered data exhibit features that are unsatisfactory for the normal distribution, are highly positively skewed, and are predominated by the earliest occurrences. Infections and deaths were initially lower than the global average, but they drastically rose in the first quarter of 2021 and persisted for the remainder of the year. Substantial preventive results were produced by the region-wisetime-worthy moves. In the fourth quarter of 2021, the infections and deaths noticeably decreased, and the number of recoveries was highly significant. In the middle of 2022, a lethal rise in infections was observed in Bangladesh and that was quickly stabilized, and the pandemic ingredients were under control. According to our assessment, some concluding remarks are made at the end of this work.
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20
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Adams JW, Jones K, Preiss S, Hadley E, Segelman M. Evaluating Policies to Decrease the Risk of Introducing SARS-CoV-2 Infections to Nursing Home Facilities. J Appl Gerontol 2023:7334648231155873. [PMID: 36749786 PMCID: PMC10360919 DOI: 10.1177/07334648231155873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
We used an individual-based microsimulation model of North Carolina to determine what facility-level policies would result in the greatest reduction in the number of individuals with SARS-CoV-2 entering the nursing home environment from 12/15/2021 to 1/3/2022 (e.g., Omicron variant surge). On average, there were 14,287 (Credible Interval [CI]: 13,477-15,147) daily visitors and 17,168 (CI: 16,571-17,768) HCW coming from the community into 426 nursing home facilities. Policies requiring a negative rapid test or vaccinated status for visitors resulted in the greatest reduction in the number of individuals with SARS-CoV-2 infection entering the nursing home environment with a 29.6% (26.9%-32.0%) and 24.0% (CI: 22.2%-25.5%) reduction, respectively. Policies halving visits (21.2% [20.0%-28.2%]), requiring all vaccinated HCW to receive a booster (7.8% [CI: 7.4%-8.7%]), and limiting visitation to a primary visitor (6.5% [CI: 3.5%-9.7%]) reduced infectious contacts to a lesser degree.
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Affiliation(s)
| | - Kasey Jones
- 6856RTI International, Research Triangle, NC, USA
| | - Sandy Preiss
- 6856RTI International, Research Triangle, NC, USA
| | - Emily Hadley
- 6856RTI International, Research Triangle, NC, USA
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21
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Hospital outbreak of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) delta variant in partially and fully vaccinated patients and healthcare workers in Toronto, Canada. Infect Control Hosp Epidemiol 2023; 44:328-331. [PMID: 34706787 PMCID: PMC8593380 DOI: 10.1017/ice.2021.471] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The severe acute respiratory coronavirus virus 2 (SARS-CoV-2) delta variant is highly transmissible, and current vaccines may have reduced effectiveness in preventing symptomatic infection. Using epidemiological and genomic analyses, we investigated an outbreak of the variant in an acute-care setting among partially and fully vaccinated individuals. Effective outbreak control was achieved using standard measures.
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22
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Rebmann T, Alvino RT, Lugo KA, Holdsworth JE, Gomel A. Infection preventionists' experiences during the second year of the COVID-19 pandemic: Findings from focus groups conducted with association for professionals in infection control & epidemiology (APIC) members. Am J Infect Control 2023; 51:121-128. [PMID: 36463974 PMCID: PMC9714080 DOI: 10.1016/j.ajic.2022.11.023] [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: 10/25/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION COVID-19 epidemiology changed dramatically in spring 2021 when vaccine became widely available and the Delta variant emerged. There was a need to identify current infection prevention challenges due to changing pandemic epidemiology. METHODS Six focus groups were conducted via Zoom with APIC members in November and December, 2021 to elicit infection preventionists' (IP) experiences with the COVID-19 pandemic after the Delta variant had emerged. Each focus group was audio recorded then transcribed verbatim. Content analysis was used to identify major themes. RESULTS In total, 90 IPs participated (average of 15 IPs per focus group). Participating IPs described multiple issues they have faced during the second year of the COVID-19 pandemic after the Delta variant emerged, including continuing challenges with personal protective equipment, changes in pandemic restrictions that caused confusion and pushback, the hope when vaccine first became available and then despair when there was more vaccine breakthrough than anticipated, staffing and medical supply shortages, overwhelming workloads, and anger towards health care personnel and IPs. However, IPs felt more valued by leadership, and reported greater internal collaboration and external coordination of care. CONCLUSIONS The second year of the pandemic brought ongoing and new challenges for IPs, but also better coordination of care. Strategic initiatives are needed to address the identified challenges, such as how to prioritize tasks when IPs are overwhelmed.
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Affiliation(s)
- Terri Rebmann
- Institute for Biosecurity, College for Public Health and Social Justice, Saint Louis University. St Louis, MO,Address correspondence to Terri Rebmann, PhD, RN, CIC, FAPIC, Institute for Biosecurity, Department of Epidemiology & Biostatistics, Saint Louis University, College for Public Health and Social Justice, 1 North Grand DuBourg Room 101A, Saint Louis, MO 63108
| | | | - Kaeli A. Lugo
- Institute for Biosecurity, College for Public Health and Social Justice, Saint Louis University. St Louis, MO
| | | | - Ashley Gomel
- Institute for Biosecurity, College for Public Health and Social Justice, Saint Louis University. St Louis, MO
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23
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Mavragani A, Bozio C, Butterfield K, Reynolds S, Reese SE, Ball S, Steffens A, Demarco M, McEvoy C, Thompson M, Rowley E, Porter RM, Fink RV, Irving SA, Naleway A. Accuracy of COVID-19-Like Illness Diagnoses in Electronic Health Record Data: Retrospective Cohort Study. JMIR Form Res 2023; 7:e39231. [PMID: 36383633 PMCID: PMC9848441 DOI: 10.2196/39231] [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: 05/03/2022] [Revised: 07/13/2022] [Accepted: 09/30/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Electronic health record (EHR) data provide a unique opportunity to study the epidemiology of COVID-19, clinical outcomes of the infection, comparative effectiveness of therapies, and vaccine effectiveness but require a well-defined computable phenotype of COVID-19-like illness (CLI). OBJECTIVE The objective of this study was to evaluate the performance of pathogen-specific and other acute respiratory illness (ARI) International Statistical Classification of Diseases-9 and -10 codes in identifying COVID-19 cases in emergency department (ED) or urgent care (UC) and inpatient settings. METHODS We conducted a retrospective observational cohort study using EHR, claims, and laboratory information system data of ED or UC and inpatient encounters from 4 health systems in the United States. Patients who were aged ≥18 years, had an ED or UC or inpatient encounter for an ARI, and underwent a SARS-CoV-2 polymerase chain reaction test between March 1, 2020, and March 31, 2021, were included. We evaluated various CLI definitions using combinations of International Statistical Classification of Diseases-10 codes as follows: COVID-19-specific codes; CLI definition used in VISION network studies; ARI signs, symptoms, and diagnosis codes only; signs and symptoms of ARI only; and random forest model definitions. We evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of each CLI definition using a positive SARS-CoV-2 polymerase chain reaction test as the reference standard. We evaluated the performance of each CLI definition for distinct hospitalization and ED or UC cohorts. RESULTS Among 90,952 hospitalizations and 137,067 ED or UC visits, 5627 (6.19%) and 9866 (7.20%) were positive for SARS-CoV-2, respectively. COVID-19-specific codes had high sensitivity (91.6%) and specificity (99.6%) in identifying patients with SARS-CoV-2 positivity among hospitalized patients. The VISION CLI definition maintained high sensitivity (95.8%) but lowered specificity (45.5%). By contrast, signs and symptoms of ARI had low sensitivity and positive predictive value (28.9% and 11.8%, respectively) but higher specificity and negative predictive value (85.3% and 94.7%, respectively). ARI diagnoses, signs, and symptoms alone had low predictive performance. All CLI definitions had lower sensitivity for ED or UC encounters. Random forest approaches identified distinct CLI definitions with high performance for hospital encounters and moderate performance for ED or UC encounters. CONCLUSIONS COVID-19-specific codes have high sensitivity and specificity in identifying adults with positive SARS-CoV-2 test results. Separate combinations of COVID-19-specific codes and ARI codes enhance the utility of CLI definitions in studies using EHR data in hospital and ED or UC settings.
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Affiliation(s)
| | - Catherine Bozio
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Sue Reynolds
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Andrea Steffens
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Mark Thompson
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Rachael M Porter
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Stephanie A Irving
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Allison Naleway
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, United States
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24
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Shah A, Coiado OC. COVID-19 vaccine and booster hesitation around the world: A literature review. Front Med (Lausanne) 2023; 9:1054557. [PMID: 36714110 PMCID: PMC9878297 DOI: 10.3389/fmed.2022.1054557] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
The development of COVID-19 vaccines has helped limit the extent of the pandemic, which over the past 2 years has claimed the lived of millions of people. The Moderna and Pfizer COVID-19 vaccines were the first to be manufactured using mRNA technology. Since then, other manufacturers have built their own vaccines which utilize adenovirus vector, whole inactivated coronavirus, and protein subunit methods. Given the continued mutation of the SARS-CoV-2 virus, a booster of the COVID-19 vaccine offers additional protection for citizens, especially those with comorbid conditions. However, uptake of the vaccine and booster has faced hurdles. This literature review aims to analyze the acceptance of the COVID-19 booster among different populations throughout the world. Keywords searched include "COVID-19 vaccine rates OR COVID-19 booster rates," "COVID-19 vaccine hesitancy," "COVID-19 booster hesitancy," "reasons against COVID-19 vaccine," "reasons for COVID-19 vaccine," and "COVID-19 vaccine acceptance" (for each country). Research articles indexed in PubMed, University of Illinois Urbana-Champaign Library, and Google Scholar were included. Despite the proven effectiveness of the COVID-19 booster, vaccine hesitancy is still causing suboptimal compliance to the primary vaccine and booster, thus slowing down control of the pandemic. Reasons for vaccine hesitancy differ by country and acceptance is affected by misinformation, political circumstances, and cultural values. Among the most common reasons found are distrust in the government, a lack of safety information, and fear of side effects. Uptake of the COVID-19 vaccine has also been delayed in low and middle income countries due to resource allocation and as a result, these countries have fallen behind vaccination benchmarks. The future of COVID-19 vaccination is unknown, but vaccine mandates and additional booster doses are a possibility. Determining the ethical impact that these policies could have will allow for the best implementation.
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Affiliation(s)
- Aashka Shah
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Olivia C. Coiado
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Biomedical and Translational Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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25
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Collatuzzo G, De Palma G, Violante FS, Porru S, Larese Filon F, Fabianova E, Violán C, Vimercati L, Leustean M, Rodriguez-Suarez MM, Sansone E, Sala E, Zunarelli C, Lodi V, Monaco MGL, Spiteri G, Negro C, Beresova J, Carrasco-Ribelles LA, Tafuri S, Asafo SS, Ditano G, Abedini M, Boffetta P. Temporal trends of COVID-19 antibodies in vaccinated healthcare workers undergoing repeated serological sampling: An individual-level analysis within 13 months in the ORCHESTRA cohort. Front Immunol 2023; 13:1079884. [PMID: 36713452 PMCID: PMC9875291 DOI: 10.3389/fimmu.2022.1079884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Short summary We investigated changes in serologic measurements after COVID-19 vaccination in 19,422 subjects. An individual-level analysis was performed on standardized measurements. Age, infection, vaccine doses, time between doses and serologies, and vaccine type were associated with changes in serologic levels within 13 months. Background Persistence of vaccine immunization is key for COVID-19 prevention. Methods We investigated the difference between two serologic measurements of anti-COVID-19 S1 antibodies in an individual-level analysis on 19,422 vaccinated healthcare workers (HCW) from Italy, Spain, Romania, and Slovakia, tested within 13 months from first dose. Differences in serologic levels were divided by the standard error of the cohort-specific distribution, obtaining standardized measurements. We fitted multivariate linear regression models to identify predictors of difference between two measurements. Results We observed a progressively decreasing difference in serologic levels from <30 days to 210-240 days. Age was associated with an increased difference in serologic levels. There was a greater difference between the two serologic measurements in infected HCW than in HCW who had never been infected; before the first measurement, infected HCW had a relative risk (RR) of 0.81 for one standard deviation in the difference [95% confidence interval (CI) 0.78-0.85]. The RRs for a 30-day increase in time between first dose and first serology, and between the two serologies, were 1.08 (95% CI 1.07-1.10) and 1.04 (95% CI 1.03-1.05), respectively. The first measurement was a strong predictor of subsequent antibody decrease (RR 1.60; 95% CI 1.56-1.64). Compared with Comirnaty, Spikevax (RR 0.83, 95% CI 0.75-0.92) and mixed vaccines (RR 0.61, 95% CI 0.51-0.74) were smaller decrease in serological level (RR 0.46; 95% CI 0.40-0.54). Conclusions Age, COVID-19 infection, number of doses, time between first dose and first serology, time between serologies, and type of vaccine were associated with differences between the two serologic measurements within a 13-month period.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesco S. Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy,Occupational Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Eleonora Fabianova
- Occupational Health Department, Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain,Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Barcelona, Spain,Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | | | - Marta Maria Rodriguez-Suarez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA) and Universitario Central de Asturias (HUCA), University of Oviedo, Oviedo, Spain
| | - Emanuele Sansone
- Occupational Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, ASST Ospedali Civili di Brescia, Brescia, Italy
| | - Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vittorio Lodi
- Occupational Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, Verona, Italy
| | - Corrado Negro
- Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Jana Beresova
- Occupational Health Department, Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - LucÌa A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Shuffield S. Asafo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy,Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States,*Correspondence: Paolo Boffetta,
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Nicolo M, Kawaguchi E, Ghanem-Uzqueda A, Kim AE, Soto D, Deva S, Shanker K, Rogers C, Lee R, Gilliland F, Van Orman S, Klausner J, Kovacs A, Conti D, Hu H, Unger JB. Correlates of COVID-19 vaccination status among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-3. [PMID: 36596228 PMCID: PMC10315412 DOI: 10.1080/07448481.2022.2157216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 06/17/2023]
Abstract
Objectives: Despite the widespread availability of COVID-19 vaccines in the United States, vaccine hesitancy remains high among certain groups. This study examined the correlates of being unvaccinated among a sample of students attending a single university (N = 2900) during the spring and summer of 2021, when the campus had been closed for over a year and students were preparing to return to in-person learning. Methods: Students responded to an email invitation and completed electronic surveys. Results: In multivariable logistic regression analyses, students were more likely to be unvaccinated if they were African American, identified with any political affiliation other than Democrat, were undergraduates or international students, had not traveled outside the Los Angeles during the pandemic, and/or had previously been ill with COVID-19. Conclusion: Findings indicate that culturally resonant educational interventions, and possibly vaccine requirements, are needed to promote vaccination among university students.
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Affiliation(s)
- Michele Nicolo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Eric Kawaguchi
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Angie Ghanem-Uzqueda
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
- Family Medicine, Keck Medicine of USC, Los Angeles, California
| | - Andre E. Kim
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Daniel Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Sohini Deva
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Kush Shanker
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Christopher Rogers
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Ryan Lee
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Frank Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Sarah Van Orman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
- Family Medicine, Keck Medicine of USC, Los Angeles, California
| | - Jeffrey Klausner
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Andrea Kovacs
- Keck School Medicine of USC, University of Southern California, Los Angeles California
| | - David Conti
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Howard Hu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles California
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Initial protection against SARS-CoV-2 omicron lineage infection in children and adolescents by BNT162b2 in Israel: an observational study. THE LANCET. INFECTIOUS DISEASES 2023; 23:67-73. [PMID: 36096146 PMCID: PMC9462831 DOI: 10.1016/s1473-3099(22)00527-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/11/2022] [Accepted: 07/26/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The BNT162b2 (Pfizer-BioNTech) two-dose vaccine regiment for children and the BNT162b2 third dose for adolescents were approved shortly before the SARS-CoV-2 omicron (B.1.1.529) outbreak in Israel. We aimed to estimate the effects of these vaccines on the rates of confirmed infection against the omicron variant in children and adolescents. METHODS In this observational cohort study, we extracted data for the omicron-dominated (sublineage BA.1) period. We compared rates of confirmed SARS-CoV-2 infection between children aged 5-10 years 14-35 days after receiving the second vaccine dose with an internal control group of children 3-7 days after receiving the first dose (when the vaccine is not yet effective). Similarly, we compared confirmed infection rates in adolescents aged 12-15 years 14-60 days after receiving a booster dose with an internal control group of adolescents 3-7 days after receiving the booster dose. We used Poisson regression, adjusting for age, sex, socioeconomic status, calendar week, and exposure. FINDINGS Between Dec 26, 2021, and Jan 8, 2022, we included 1 158 289 participants. In children aged 5-10 years, the adjusted rate of confirmed infection was 2·3 times (95% CI 2·0-2·5) lower in children who received a second dose than in the internal control group. The adjusted infection rate in children who received a second dose was 102 infections per 100 000 risk-days (94-110) compared with 231 infections per 100 000 risk-days (215-248) in the corresponding internal control cohort. In adolescents aged 12-15 years, the booster dose decreased confirmed infection rates by 3·3 times (2·8-4·0) compared with in the internal control group. The adjusted infection rate of the booster cohort was 70 per 100 000 risk-days (60-81) compared with 232 per 100 000 risk-days (212-254) in the internal control cohort. INTERPRETATION A recent two-dose vaccination regimen with BNT162b2 and a recent booster dose in adolescents substantially reduced the rate of confirmed infection compared with the internal control groups. Future studies are needed to assess the duration of this protection and protection against other outcomes such as paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 and long-COVID. FUNDING None.
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28
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Burrowes SAB, Casey SM, Dobbins S, Hall T, Ma M, Bano R, Drainoni ML, Schechter-Perkins EM, Garofalo C, Perkins RB, Pierre-Joseph N. Healthcare workers' perspectives on the COVID-19 vaccine and boosters for themselves, their patients, and their communities: a mixed methods study. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 32:1-14. [PMID: 36588660 PMCID: PMC9790765 DOI: 10.1007/s10389-022-01793-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/05/2022] [Indexed: 12/27/2022]
Abstract
Aim To examine experiences and attitudes of a diverse sample of clinical and non-clinical healthcare workers regarding COVID-19 vaccines and boosters for themselves, their patients, and their communities. Subject and methods We conducted a sequential exploratory mixed methods study; 52 healthcare workers participated in qualitative interviews between April 22 and September 7, 2021, and 209 healthcare workers completed surveys between February 17 and March 23, 2022. Interviews and survey questions asked about personal attitudes toward COVID-19 vaccination and boosters and experiences discussing vaccination with patients. Results Participants were predominantly White (56% and 73%, respectively) and female (79% and 81%, respectively). Factors motivating healthcare workers to take the vaccine were the belief that vaccination would protect themselves, their families, patients, and communities. Healthcare workers were accepting of and had high receipt of the booster, though some had diminished belief in its effectiveness after becoming infected with SARS-CoV-2 after initial vaccination. Race related mistrust, misinformation related to vaccine safety, and concerns about vaccine effects during pregnancy were the most common barriers that providers encountered among their patients and communities. Conclusions Healthcare workers' primary motivation to receive COVID-19 vaccines was the desire to protect themselves and others. Healthcare workers' perception was that concerns about safety and misinformation were more important barriers for their patients than themselves. Race-related medical mistrust amplified concerns about vaccine safety and hindered communication efforts.
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Affiliation(s)
- Shana A. B. Burrowes
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA USA
| | - Sharon M. Casey
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA 02118 USA
| | - Sidney Dobbins
- Boston University School of Public Health, Boston, MA USA
| | - Taylor Hall
- Graduate of Medical Sciences, Boston University Chobanian and Avedisian School of Medicine, Boston, MA USA
| | - Mengyu Ma
- Boston University School of Public Health, Boston, MA USA
| | - Ruqiyya Bano
- Boston University School of Public Health, Boston, MA USA
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA USA
- Department of Health Law Policy & Management, Boston University School of Public Health, Boston, MA USA
| | - Elissa M. Schechter-Perkins
- Department of Emergency Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA USA
| | - Christopher Garofalo
- Department of Family Medicine and Department of Obstetrics and Gynecology, Sturdy Memorial Hospital, Attleboro, MA USA
- Family Medicine Associates of South Attleboro, South Attleboro, MA USA
| | - Rebecca B. Perkins
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA 02118 USA
| | - Natalie Pierre-Joseph
- Department of Pediatrics, Boston University Chobanian and Avedisian School of Medicine, Boston, MA USA
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Full-Lung Prophylaxis against SARS-CoV-2 by One-Shot or Booster Intranasal Lentiviral Vaccination in Syrian Golden Hamsters. Vaccines (Basel) 2022; 11:vaccines11010012. [PMID: 36679857 PMCID: PMC9865670 DOI: 10.3390/vaccines11010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Following the breakthrough of numerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in recent months and the incomplete efficiency of the currently available vaccines, development of more effective vaccines is desirable. Non-integrative, non-cytopathic and non-inflammatory lentiviral vectors elicit sterilizing prophylaxis against SARS-CoV-2 in preclinical animal models and are particularly suitable for mucosal vaccination, which is acknowledged as the most effective in reducing viral transmission. Here, we demonstrate that a single intranasal administration of a vaccinal lentiviral vector encoding a stabilized form of the original SARS-CoV-2 Spike glycoprotein induces full-lung protection of respiratory tracts and strongly reduces pulmonary inflammation in the susceptible Syrian golden hamster model against the prototype SARS-CoV-2. In addition, we show that a lentiviral vector encoding stabilized Spike of SARS-CoV-2 Beta variant (LV::SBeta-2P) prevents pathology and reduces infectious viral loads in lungs and nasal turbinates following inoculation with the SARS-CoV-2 Omicron variant. Importantly, an intranasal boost with LV::SBeta-2P improves cross-seroneutralization much better in LV::SBeta-2P-primed hamsters than in their counterparts primed with an LV-encoding Spike from the ancestral SARS-CoV-2. These results strongly suggest that an immune imprint with the original Spike sequence has a negative impact on cross-protection against new variants. Our results tackle the issue of vaccine effectiveness in people who have already been vaccinated and have vanished immunity and indicate the efficiency of LV-based intranasal vaccination, either as a single dose or as booster.
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Gim H, Oh S, Lee H, Lee S, Seo H, Park Y, Park JH. Reduction in COVID-19 Vaccine Effectiveness against SARS-CoV-2 Variants in Seoul according to Age, Sex, and Symptoms: A Test-Negative Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16958. [PMID: 36554839 PMCID: PMC9779328 DOI: 10.3390/ijerph192416958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND We evaluated vaccine effectiveness (VE) against infections with SARS-CoV-2 variants of concern in Seoul, the capital of the Republic of Korea, having the highest population density in the country, under real-world conditions. METHODS We evaluated the reduction in the effectiveness of mRNA and viral-vector COVID-19 vaccines against infection by the SARS-CoV-2 delta variant in a subpopulation from April 2021 to July 2021 who visited screening clinics in Seoul using a test-negative case-control study design. Moreover, we conducted a case-control study matching the ten-year-old age group, sex, healthcare workers, and five districts of Seoul, which are considered confounding factors. RESULTS The full VE in the pre-delta-dominant period was 95.0% (95% confidence interval [CI]: 91.2-97.2); however, it decreased to 61.1% (95% CI: 53.2-67.6) during the delta-dominant period. Notably, we found that COVID-19 VE was significantly decreased in individuals aged ≥80 years (52.9%, 95% CI: -9.9-79.8), men (50.6 %, 95% CI: 39.4-59.8), and asymptomatic individuals (49.8%, 95% CI: 36.5-60.3) during the widespread SARS-CoV-2 delta variant circulation. CONCLUSIONS Vaccine-mediated protection drastically declined during the delta-dominant period and in vulnerable groups. This study suggests the requirement for additional countermeasures, such as the administration of a booster vaccine, in vulnerable groups based on age, sex, and symptomatic manifestation.
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Affiliation(s)
- Hyerin Gim
- Infectious Disease Research Center, Citizen’s Health Bureau, Seoul Metropolitan Government, 110, Sejong-daero, Jung-gu, Seoul 04524, Republic of Korea
| | - Soyoung Oh
- Infectious Disease Research Center, Citizen’s Health Bureau, Seoul Metropolitan Government, 110, Sejong-daero, Jung-gu, Seoul 04524, Republic of Korea
| | - Heeda Lee
- Infectious Disease Research Center, Citizen’s Health Bureau, Seoul Metropolitan Government, 110, Sejong-daero, Jung-gu, Seoul 04524, Republic of Korea
| | - Seul Lee
- Infectious Disease Research Center, Citizen’s Health Bureau, Seoul Metropolitan Government, 110, Sejong-daero, Jung-gu, Seoul 04524, Republic of Korea
| | - Haesook Seo
- Infectious Disease Research Center, Citizen’s Health Bureau, Seoul Metropolitan Government, 110, Sejong-daero, Jung-gu, Seoul 04524, Republic of Korea
| | - Yumi Park
- Citizen’s Health Bureau, Seoul Metropolitan Government, 110, Sejong-daero, Jung-gu, Seoul 04524, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea
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31
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Larkin A, Waitzkin H, Fassler E, Nayar KR. How missing evidence-based medicine indicators can inform COVID-19 vaccine distribution policies: a scoping review and calculation of indicators from data in randomised controlled trials. BMJ Open 2022; 12:e063525. [PMID: 36523237 PMCID: PMC9748517 DOI: 10.1136/bmjopen-2022-063525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/02/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Reports of efficacy, effectiveness and harms of COVID-19 vaccines have not used key indicators from evidence-based medicine (EBM) that can inform policies about vaccine distribution. This study aims to clarify EBM indicators that consider baseline risks when assessing vaccines' benefits versus harms: absolute risk reduction (ARR) and number needed to be vaccinated (NNV), versus absolute risk of the intervention (ARI) and number needed to harm (NNH). METHODS We used a multimethod approach, including a scoping review of the literature; calculation of risk reductions and harms from data concerning five major vaccines; analysis of risk reductions in population subgroups with varying baseline risks; and comparisons with prior vaccines. FINDINGS The scoping review showed few reports regarding ARR, NNV, ARI and NNH; comparisons of benefits versus harms using these EBM methods; or analyses of varying baseline risks. Calculated ARRs for symptomatic infection and hospitalisation were approximately 1% and 0.1%, respectively, as compared with relative risk reduction of 50%-95% and 58%-100%. NNV to prevent one symptomatic infection and one hospitalisation was in the range of 80-500 and 500-4000. Based on available data, ARI and NNH as measures of harm were difficult to calculate, and the balance between benefits and harms using EBM measures remained uncertain. The effectiveness of COVID-19 vaccines as measured by ARR and NNV was substantially higher in population subgroups with high versus low baseline risks. CONCLUSIONS Priorities for vaccine distribution should target subpopulations with higher baseline risks. Similar analyses using ARR/NNV and ARI/NNH would strengthen evaluations of vaccines' benefits versus harms. An EBM perspective on vaccine distribution that emphasises baseline risks becomes especially important as the world's population continues to face major barriers to vaccine access-sometimes termed 'vaccine apartheid'.
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Affiliation(s)
- Andrew Larkin
- Allende Program in Social Medicine, Albuquerque, New Mexico, USA
| | - Howard Waitzkin
- Allende Program in Social Medicine, Albuquerque, New Mexico, USA
- Locum Tenens Program, Health Sciences Center, and Department of Sociology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Ella Fassler
- Allende Program in Social Medicine, Albuquerque, New Mexico, USA
| | - Kesavan Rajasekharan Nayar
- Santhigiri Research Foundation, Thiruvananthapuram, Kerala, India
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India
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Cooper A, Sidaway A, Chandrashekar A, Latta E, Chakraborty K, Yu J, McMahan K, Giffin V, Manickam C, Kroll K, Mosher M, Reeves RK, Gam R, Arthofer E, Choudhry M, Henley T, Barouch DH. A genetically engineered, stem-cell-derived cellular vaccine. Cell Rep Med 2022; 3:100843. [PMID: 36480934 PMCID: PMC9727836 DOI: 10.1016/j.xcrm.2022.100843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/19/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022]
Abstract
Despite rapid clinical translation of COVID-19 vaccines in response to the global pandemic, an opportunity remains for vaccine technology innovation to address current limitations and meet challenges of inevitable future pandemics. We describe a universal vaccine cell (UVC) genetically engineered to mimic natural physiological immunity induced upon viral infection of host cells. Cells engineered to express the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike as a representative viral antigen induce robust neutralizing antibodies in immunized non-human primates. Similar titers generated in this established non-human primate (NHP) model have translated into protective human neutralizing antibody levels in SARS-CoV-2-vaccinated individuals. Animals vaccinated with ancestral spike antigens and subsequently challenged with SARS-CoV-2 Delta variant in a heterologous challenge have an approximately 3 log decrease in viral subgenomic RNA in the lungs. This cellular vaccine is designed as a scalable cell line with a modular poly-antigenic payload, allowing for rapid, large-scale clinical manufacturing and use in an evolving viral variant environment.
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Affiliation(s)
| | | | - Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | | | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Katherine McMahan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Victoria Giffin
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Cordelia Manickam
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kyle Kroll
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Matthew Mosher
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - R. Keith Reeves
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Rihab Gam
- Intima Bioscience, Inc., New York, NY, USA
| | | | - Modassir Choudhry
- Praesidium Bioscience, Inc., New York, NY, USA,Intima Bioscience, Inc., New York, NY, USA
| | - Tom Henley
- Praesidium Bioscience, Inc., New York, NY, USA,Intima Bioscience, Inc., New York, NY, USA,Corresponding author
| | - Dan H. Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA,Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA, USA,Corresponding author
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Ozdemir YE, Kizilcay B, Sonmezisik M, Tarhan MS, Borcak D, Sahin Ozdemir M, Bayramlar OF, Yesilbag Z, Senoglu S, Gedik H, Kumbasar Karaosmanoglu H, Kart Yasar K. Evaluation of clinical outcomes of vaccinated and unvaccinated patients with hospitalization for COVID-19. Acta Microbiol Immunol Hung 2022; 69:270-276. [PMID: 36129790 DOI: 10.1556/030.2022.01860] [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: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18-65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated.A total of 854 patients were included. Mean age was 47.9 ± 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n = 153) were vaccinated with CoronaVac and 33% (n = 77) were vaccinated with Pfizer-BioNTech. All patients (n = 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P = 0.028, 95% CI = 1.00-1.07, OR = 1.038) and higher Charlson Comorbidity Index (CCI) (P < 0.001, 95% CI = 1.20-1.69, OR = 1.425) were associated with increased mortality, while being fully vaccinated (P = 0.008, 95% CI = 0.23-0.80, OR = 0.435) was associated with survival in multivariate analysis. Full dose vaccination reduced the need for ICU admission by 49.7% (95% CI = 17-70) and mortality by 56.5% (95% CI = 20-77). When the fully vaccinated group was evaluated, we found that death was observed more frequent in patients with CCI>3 (19.1 vs 5.8%, P < 0.01, OR = 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index.
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Affiliation(s)
- Yusuf Emre Ozdemir
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Burak Kizilcay
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Muge Sonmezisik
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Muhammet Salih Tarhan
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Deniz Borcak
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Meryem Sahin Ozdemir
- 2Department of Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, 34098, Istanbul, Turkey
| | - Osman Faruk Bayramlar
- 3Department of Public Health, Bakirkoy District Health Directorate, 34140, Bakırköy, Istanbul, Turkey
| | - Zuhal Yesilbag
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Sevtap Senoglu
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Habip Gedik
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Hayat Kumbasar Karaosmanoglu
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
| | - Kadriye Kart Yasar
- 1Department of Infectious Diseases and Clinical Microbiology, Bakırkoy Dr. Sadi Konuk Training Research Hospital, 34140, Istanbul, Turkey
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Muacevic A, Adler JR, Bagali S, Karigoudar R, Wavare DS, P J, Kandi V, Suvvari TK, Mittal RJ, Jadhav M. Breakthrough Infections: Clinical Profile and Outcomes of COVID-19 Vaccinated and Unvaccinated People From a Tertiary Care Hospital. Cureus 2022; 14:e32089. [PMID: 36601158 PMCID: PMC9803927 DOI: 10.7759/cureus.32089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Despite the availability of a vaccine and extensive vaccination, breakthrough infections are commonly noted, which is jeopardizing the vaccine-based protection against COVID-19. The present study aims to evaluate COVID-19 breakthrough infections and to compare the clinical profile and outcomes of the vaccinated and unvaccinated populations. Methods A retrospective observational study was conducted for two months (March-April 2021), and all cases reported during the study period were included in the study. Socio-demographic details, COVID-19 profiles, clinical outcomes, vaccination statuses, and types of vaccine were collected from the patients. Further, COVID-19-positive samples were screened for lineages using next-generation sequencing (NGS). Results Of the total 103 patients included in the study, 79 (76.7%) were symptomatic and 24 (23.3%) were asymptomatic. Only 32% were vaccinated and 68% were unvaccinated. 29.2% were hospitalized due to COVID-19 and all of them were unvaccinated. The mortality among hospitalized patients was extremely high (60%). The time to positivity after complete vaccination was noted to be 37.09±23.74 days. The unvaccinated study participants showed lower Cycle threshold (Ct) values (E Gene/N Gene: 17.38±4.53) as compared to the vaccinated people (E Gene/N Gene: 22±4.25). The Delta (B. 1.1. 629) (76.7%) was the predominant variant among the study population followed by AY.4 (20.4%) and Kappa (2.9%) variants. Conclusion Although the vaccination does not restrict/avoid infection, it appears to protect the vaccinated people from severe forms of COVID-19. Also, the higher Ct values among vaccinated people indicate that the viral load among such people may be lower and, therefore, minimizes viral transmission.
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Fassler E, Larkin A, Rajasekharan Nayar K, Waitzkin H. Using absolute risk reduction to guide the equitable distribution of COVID-19 vaccines. BMJ Evid Based Med 2022; 27:330-333. [PMID: 35256457 PMCID: PMC9691808 DOI: 10.1136/bmjebm-2021-111789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Ella Fassler
- Allende Program in Social Medicine, Albuquerque, New Mexico, USA
| | - Andrew Larkin
- Allende Program in Social Medicine, Albuquerque, New Mexico, USA
| | - Kesavan Rajasekharan Nayar
- Global Institute of Public Health, Thiruvananthapuram, Kerala, India
- Santhigiri Research Foundation, Thiruvananthapuram, Kerala, India
| | - Howard Waitzkin
- Allende Program in Social Medicine, Albuquerque, New Mexico, USA
- Locum Tenens Program, Health Sciences Center; and Department of Sociology, University of New Mexico, Albuquerque, New Mexico, USA
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Nanishi E, Levy O, Ozonoff A. Waning effectiveness of SARS-CoV-2 mRNA vaccines in older adults: a rapid review. Hum Vaccin Immunother 2022; 18:2045857. [PMID: 35240940 PMCID: PMC9196671 DOI: 10.1080/21645515.2022.2045857] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/07/2022] [Accepted: 02/21/2022] [Indexed: 12/12/2022] Open
Abstract
The U.S. Centers for Disease Control and Prevention (CDC) and other health agencies have recently recommended a booster dose of COVID-19 vaccines for specific vulnerable groups including adults 65 years and older. There is limited evidence whether vaccine effectiveness (VE) in older adults decreases over time, especially against severe COVID-19. We performed a rapid review of published studies available through 4 November 2021 that provide effectiveness data on messenger RNA (mRNA) vaccines approved/licensed in the United States and identified eight eligible studies which evaluated VE in older adults. There is evidence of a decline in VE against both severe acute respiratory syndrome coronavirus 2 infection and severe COVID-19 in older adults among studies which analyzed data up to July-October 2021. Our findings suggest that VE diminishes in older adults, which supports the current recommendation for a booster dose in this population.
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Affiliation(s)
- Etsuro Nanishi
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT & Harvard, Cambridge, MA, USA
| | - Al Ozonoff
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT & Harvard, Cambridge, MA, USA
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Enhanced Vaccine Effectiveness during the Delta Phase of the COVID-19 Pandemic in the Medicare Population Supports a Multilayered Prevention Approach. BIOLOGY 2022; 11:biology11121700. [PMID: 36552210 PMCID: PMC9774613 DOI: 10.3390/biology11121700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
Throughout the pandemic, individuals 65 years and older have contributed most COVID-19 related deaths. To best formulate effective vaccination and other prevention policies to protect older adults, large scale observational studies of these higher risk individuals are needed. We conducted a Vaccine Effectiveness (VE) study during the B.1.617.2 Delta variant phase of the pandemic in July and August 2021 in a cohort of 17 million Medicare beneficiaries of which 5.7 million were fully vaccinated. We found that individuals fully vaccinated with the Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273 vaccines in January 2021 had 2.5 times higher breakthrough infections and hospitalizations than those fully vaccinated in March 2021, consistent with waning of vaccine-induced immunity. Measuring VE weekly, we found that VE against hospitalization, and even more so against infection, increased from July 2021 through August 2021, suggesting that in addition to the protective role of vaccination, increased masking or social distancing might have contributed to the unexpected increase in VE. Ongoing monitoring of Medicare beneficiaries should be a priority as new variants continue to emerge, and the VE of the new bivalent vaccines remains to be established. This could be accomplished with a large Medicare claims database and the analytics platform used for this study.
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Anderson EJ, Creech CB, Berthaud V, Piramzadian A, Johnson KA, Zervos M, Garner F, Griffin C, Palanpurwala K, Turner M, Gerber J, Bennett RL, Ali K, Ampajwala M, Berman G, Nayak J, Chronis C, Rizzardi B, Muller WJ, Smith CA, Fuchs G, Hsia D, Tomassini JE, DeLucia D, Reuter C, Kuter B, Zhao X, Deng W, Zhou H, Ramirez Schrempp D, Hautzinger K, Girard B, Slobod K, McPhee R, Pajon R, Aunins A, Das R, Miller JM, Schnyder Ghamloush S. Evaluation of mRNA-1273 Vaccine in Children 6 Months to 5 Years of Age. N Engl J Med 2022; 387:1673-1687. [PMID: 36260859 PMCID: PMC9634866 DOI: 10.1056/nejmoa2209367] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The safety, reactogenicity, immunogenicity, and efficacy of the mRNA-1273 coronavirus disease 2019 (Covid-19) vaccine in young children are unknown. METHODS Part 1 of this ongoing phase 2-3 trial was open label for dose selection; part 2 was an observer-blinded, placebo-controlled evaluation of the selected dose. In part 2, we randomly assigned young children (6 months to 5 years of age) in a 3:1 ratio to receive two 25-μg injections of mRNA-1273 or placebo, administered 28 days apart. The primary objectives were to evaluate the safety and reactogenicity of the vaccine and to determine whether the immune response in these children was noninferior to that in young adults (18 to 25 years of age) in a related phase 3 trial. Secondary objectives were to determine the incidences of Covid-19 and severe acute respiratory syndrome coronavirus 2 infection after administration of mRNA-1273 or placebo. RESULTS On the basis of safety and immunogenicity results in part 1 of the trial, the 25-μg dose was evaluated in part 2. In part 2, 3040 children 2 to 5 years of age and 1762 children 6 to 23 months of age were randomly assigned to receive two 25-μg injections of mRNA-1273; 1008 children 2 to 5 years of age and 593 children 6 to 23 months of age were randomly assigned to receive placebo. The median duration of follow-up after the second injection was 71 days in the 2-to-5-year-old cohort and 68 days in the 6-to-23-month-old cohort. Adverse events were mainly low-grade and transient, and no new safety concerns were identified. At day 57, neutralizing antibody geometric mean concentrations were 1410 (95% confidence interval [CI], 1272 to 1563) among 2-to-5-year-olds and 1781 (95% CI, 1616 to 1962) among 6-to-23-month-olds, as compared with 1391 (95% CI, 1263 to 1531) among young adults, who had received 100-μg injections of mRNA-1273, findings that met the noninferiority criteria for immune responses for both age cohorts. The estimated vaccine efficacy against Covid-19 was 36.8% (95% CI, 12.5 to 54.0) among 2-to-5-year-olds and 50.6% (95% CI, 21.4 to 68.6) among 6-to-23-month-olds, at a time when B.1.1.529 (omicron) was the predominant circulating variant. CONCLUSIONS Two 25-μg doses of the mRNA-1273 vaccine were found to be safe in children 6 months to 5 years of age and elicited immune responses that were noninferior to those in young adults. (Funded by the Biomedical Advanced Research and Development Authority and National Institute of Allergy and Infectious Diseases; KidCOVE ClinicalTrials.gov number, NCT04796896.).
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Affiliation(s)
- Evan J Anderson
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - C Buddy Creech
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Vladimir Berthaud
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Arin Piramzadian
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Kimball A Johnson
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Marcus Zervos
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Fredric Garner
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Carl Griffin
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Khozema Palanpurwala
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Mark Turner
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Jeffrey Gerber
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Richard L Bennett
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Kashif Ali
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Madhavi Ampajwala
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Gary Berman
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Jennifer Nayak
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Carey Chronis
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Barbara Rizzardi
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - William J Muller
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Christopher A Smith
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - George Fuchs
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Daniel Hsia
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Joanne E Tomassini
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Dianne DeLucia
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Caroline Reuter
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Barbara Kuter
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Xiaoping Zhao
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Weiping Deng
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Honghong Zhou
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Daniela Ramirez Schrempp
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Kelly Hautzinger
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Bethany Girard
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Karen Slobod
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Roderick McPhee
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Rolando Pajon
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Anne Aunins
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Rituparna Das
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Jacqueline M Miller
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
| | - Sabine Schnyder Ghamloush
- From the Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, and the Department of Pediatrics, Emory University School of Medicine, Atlanta (E.J.A.), and IResearch Atlanta, Decatur (K.A.J.) - all in Georgia; the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; OnSite Clinical Solutions, Charlotte, NC (A.P.); the Henry Ford Health System, Detroit (M.Z.); Pi-Coor Clinical Research, Burke, VA (F.G.); the Lynn Health Science Institute, Oklahoma City (C.G.); the Cyfair Clinical Research Center (K.P.) and the Texas Center for Drug Development (K.A.), Houston, and ACRC Trials, Frisco (M.A.) - all in Texas; Velocity Clinical Research, Meridian, ID (M.T.); Children's Hospital of Philadelphia Clinical Research Partners, Philadelphia (J.G.); Clinical Research Partners, Richmond, VA (R.L.B.); Clinical Research Institute, Minneapolis (G.B.); the University of Rochester Medical Center, Rochester (J.N.), and Certified Research Associates, Cortland (C.A.S.) - both in New York; Pediatric, Infant, and Adolescent Medicine, Ventura, CA (C.C.); Velocity Clinical Research, West Jordan, UT (B.R.); Ann and Robert H. Lurie Children's Hospital, Chicago (W.J.M.); the University of Kentucky, Lexington (G.F.); the Pennington Biomedical Research Center, Baton Rouge, LA (D.H.); and Moderna, Cambridge, MA (J.E.T., D.D., C.R., B.K., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., A.A., R.D., J.M.M., S.S.G.)
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Nickel KB, Fraser VJ, Babcock HM, Kwon JH. Coronavirus disease 2019 (COVID-19) vaccine breakthrough infections among healthcare personnel, December 2020-April 2021. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e169. [PMID: 36483397 PMCID: PMC9726500 DOI: 10.1017/ash.2022.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 06/17/2023]
Abstract
Coronavirus disease 2019 (COVID-19) vaccine effectiveness in the early months of vaccine availability was high among healthcare personnel (HCP) at 88.3% for 2-doses. Among those testing positive for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), those with breakthrough infection after vaccination were more likely to have had a non-work-related SARS-CoV-2 exposure compared to unvaccinated HCP.
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Affiliation(s)
- Katelin B. Nickel
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Victoria J. Fraser
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Hilary M. Babcock
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Jennie H. Kwon
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Lin XQ, Li AL, Zhang MX, Lv L, Chen Y, Chen HD, Tung TH, Zhu JS. Willingness of Older Adults with Chronic Diseases to Receive a Booster Dose of Inactivated Coronavirus Disease 2019 Vaccine: A Cross-Sectional Study in Taizhou, China. Vaccines (Basel) 2022; 10:vaccines10101665. [PMID: 36298530 PMCID: PMC9611491 DOI: 10.3390/vaccines10101665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/21/2022] Open
Abstract
Vaccination is an important measure to control the spread of COVID-19 among elderly high-risk groups; however, the propensity to receive COVID-19 vaccine boosters has not been evaluated in these populations. Here, we aimed to investigate the willingness to receive a COVID-19 vaccine booster among the elderly chronic disease population in Taizhou, China. A cross-sectional, hospital-based survey was conducted in the outpatient department of a tertiary care hospital between 6 July and 11 August 2021 in Taizhou, China, and the data were uploaded to Wen-Juan-Xing, one of the largest online platforms used to collect survey data in China. The targeted population was non-oncology chronic disease patients aged 60 years and above. The minimum sample size was 229, determined by the G*Power software (v3.1.9.2, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). A total of 254 patients with valid data were enrolled in this study, with a response rate of 82.5% (254/308). Chi-square tests and one-way binary regression were used to compare the proportions and the degree of influence of categorical factors. The magnitude of the effect for the comparisons was measured by Gramer’s V. A multivariate binary logistic regression model was used to correct for confounders and to identify factors. All data were analyzed using SPSS v24.0 (IBM Corporation, Armonk, NY, USA). A total of 198 respondents (77.9%) were willing to receive a COVID-19 vaccine booster dose, and 77.6% of respondents were willing to receive the primary dose. Age < 70 years (OR 2.82), stable disease control (OR 2.79), confidence in the effectiveness of the COVID-19 vaccine (OR 3.11), and vaccine recipient (OR 5.02) were significantly associated with the willingness to receive a COVID-19 vaccine booster dose. Promoting primary dose vaccination is essential for advancing booster vaccination, and it is important to focus on elderly patients’ confidence in the vaccine, in addition to strengthening health management and promoting disease stability. Follow-up studies should focus on elderly patients who belong to specific disease groups.
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Affiliation(s)
- Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
| | - A-Li Li
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
| | - Mei-Xian Zhang
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
| | - Li Lv
- Department of Infectious Diseases, Taizhou Hospital, Zhejiang University, Linhai 317000, China
| | - Yan Chen
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
| | - He-Dan Chen
- Department of Infectious Diseases, Taizhou Hospital, Zhejiang University, Linhai 317000, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
- Correspondence: (T.-H.T.); (J.-S.Z.)
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
- Correspondence: (T.-H.T.); (J.-S.Z.)
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Peled Y, Afek A, Kreiss Y, Rahav G, Nemet I, Kliker L, Indenbaum V, Ram E, Lavee J, Segev A, Matezki S, Sternik L, Raanani E, Lustig Y, Patel JK, Mandelboim M. Kinetics of cellular and humoral responses to third BNT162B2 COVID-19 vaccine over six months in heart transplant recipients - implications for the omicron variant. J Heart Lung Transplant 2022; 41:1417-1425. [PMID: 35710484 PMCID: PMC9128305 DOI: 10.1016/j.healun.2022.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/21/2022] [Accepted: 05/20/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The durability of the immune response following the 3-dose BNT162b2 vaccination is unknown. The complexity of the situation is enhanced by the threat that highly transmissible variants may further accelerate the decline in the protection afforded by mRNA vaccines. METHODS One hundred and three 3-dose-vaccinated heart transplant recipients were longitudinally assessed for the kinetics of variant-specific neutralization (Cohort 1, n = 60) and SARS-CoV-2-specific-T-cell response (Cohort 2, n = 54) over 6 months. Neutralization and T-cell responses were compared between paired samples at 2 time points, using the Kruskal-Wallis test followed by Dunn's multiple comparison test for continuous variables and McNemar's test for dichotomous variables. The Bonferroni method of p values adjustment for multiple comparison was applied. RESULTS The third dose induced high neutralization of the wild-type virus and delta variant (geometric mean titer [GMT], 137.2 [95% CI, 84.8-221.9] and 80.6, [95% CI, 49.3-132.0], respectively), and to a lesser degree of the omicron variant (GMT, 10.3 [95% CI, 5.9-17.9]). At 6 months, serum neutralizing activity declined but was still high for the wild-type virus and for the delta variant (GMTs 38.1 [95% CI, 21.2-69.4], p = 0.011; and 28.9 [95% CI, 16.6-52.3], p = 0.022, respectively), but not for the omicron variant (GMT 5.9 [95% CI, 3.4-9.8], p = 0.463). The percentages of neutralizing sera against the wild-type virus, delta and omicron variants increased from 70%, 65%, and 38%, before the third dose, to 93% (p < 0.001), 88% (p < 0.001), and 48% (p = 0.021) at 3 weeks after, respectively; and remained high through the 6 months for the wild-type (80%, p = 0.06) and delta (77%, p = 0.102). The third dose induced the development of a sustained SARS-CoV-2-specific-T-cell population, which persisted through 6 months. CONCLUSIONS The third BNT162b2 dose elicited a durable SARS-CoV-2-specific T-cell response and induced effective and durable neutralization of the wild-type virus and the delta variant, and to a lesser degree of the omicron variant.
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Affiliation(s)
- Yael Peled
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel,Reprint requests: Yael Peled, MD, Sheba Medical Center, Israel 52621. Telephone: 972-3-5302710. Fax: 972-3-5302410
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Israel,General Management, Sheba Medical Center, Israel
| | - Yitshak Kreiss
- Sackler Faculty of Medicine, Tel Aviv University, Israel,General Management, Sheba Medical Center, Israel
| | - Galia Rahav
- Sackler Faculty of Medicine, Tel Aviv University, Israel,Infectious Disease Unit, Sheba Medical Center, Israel
| | - Ital Nemet
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Limor Kliker
- Sackler Faculty of Medicine, Tel Aviv University, Israel,Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | | | - Eilon Ram
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Jacob Lavee
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Amit Segev
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Shlomi Matezki
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Leonid Sternik
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ehud Raanani
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Israel,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yaniv Lustig
- Sackler Faculty of Medicine, Tel Aviv University, Israel,Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Jignesh K. Patel
- Cedars-Sinai Heart Institute and David Geffen School of Medicine at the University of California, Los Angeles, California
| | - Michal Mandelboim
- Sackler Faculty of Medicine, Tel Aviv University, Israel,Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
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Schimmoller BJ, Trovão NS, Isbell M, Goel C, Heck BF, Archer TC, Cardinal KD, Naik NB, Dutta S, Rohr Daniel A, Beheshti A. COVID-19 Exposure Assessment Tool (CEAT): Exposure quantification based on ventilation, infection prevalence, group characteristics, and behavior. SCIENCE ADVANCES 2022; 8:eabq0593. [PMID: 36179034 PMCID: PMC9524836 DOI: 10.1126/sciadv.abq0593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/17/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) Exposure Assessment Tool (CEAT) allows users to compare respiratory relative risk to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for various scenarios, providing understanding of how combinations of protective measures affect risk. CEAT incorporates mechanistic, stochastic, and epidemiological factors including the (i) emission rate of virus, (ii) viral aerosol degradation and removal, (iii) duration of activity/exposure, (iv) inhalation rates, (v) ventilation rates (indoors/outdoors), (vi) volume of indoor space, (vii) filtration, (viii) mask use and effectiveness, (ix) distance between people (taking into account both near-field and far-field effects of proximity), (x) group size, (xi) current infection rates by variant, (xii) prevalence of infection and immunity in the community, (xiii) vaccination rates, and (xiv) implementation of COVID-19 testing procedures. CEAT applied to published studies of COVID-19 transmission events demonstrates the model's accuracy. We also show how health and safety professionals at NASA Ames Research Center used CEAT to manage potential risks posed by SARS-CoV-2 exposures.
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Affiliation(s)
- Brian J. Schimmoller
- Signature Science LLC, Austin, TX 78759, USA
- COVID-19 International Research Team, Medford, MA 02155, USA
| | - Nídia S. Trovão
- COVID-19 International Research Team, Medford, MA 02155, USA
- Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Chirag Goel
- COVID-19 International Research Team, Medford, MA 02155, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Benjamin F. Heck
- Bastion Technologies, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Tenley C. Archer
- COVID-19 International Research Team, Medford, MA 02155, USA
- Biomea Fusion Inc., Redwood City, CA 94063, USA
| | - Klint D. Cardinal
- Leidos Inc., NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Neil B. Naik
- Leidos Inc., NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Som Dutta
- COVID-19 International Research Team, Medford, MA 02155, USA
- Mechanical and Aerospace Engineering, Utah State University, Logan, UT 84332, USA
| | - Ahleah Rohr Daniel
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Afshin Beheshti
- COVID-19 International Research Team, Medford, MA 02155, USA
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
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43
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Reynolds MW, Secora A, Joules A, Albert L, Brinkley E, Kwon T, Mack C, Toovey S, Dreyer NA. Evaluating real-world COVID-19 vaccine effectiveness using a test-negative case-control design. J Comp Eff Res 2022; 11:1161-1172. [PMID: 36148919 PMCID: PMC9504802 DOI: 10.2217/cer-2022-0069] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: It is important to assess if clinical trial efficacy translates into real-world effectiveness for COVID-19 vaccines. Materials & methods: We conducted a modified test-negative design (TND) to evaluate the real-world effectiveness of three COVID-19 vaccines. We defined cases in two ways: self-reported COVID-19-positive tests, and self-reported positive tests with ≥1 moderate/severe COVID-19 symptom. Results: Any vaccination was associated with a 95% reduction in subsequently reporting a positive COVID-19 test, and a 71% reduction in reporting a positive test and ≥1 moderate/severe symptom. Conclusion: We observed high effectiveness across all three marketed vaccines, both for self-reported positive COVID-19 tests and moderate/severe COVID-19 symptoms. This innovative TND approach can be implemented in future COVID-19 vaccine and treatment real-world effectiveness studies. Clinicaltrials.gov identifier:NCT04368065. Evaluating real-world COVID-19 vaccine effectiveness. #COVID19 #Vaccines #TND #PRO #patientreportedoutcomes
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Affiliation(s)
| | - Alex Secora
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
| | - Alice Joules
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
| | - Lisa Albert
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
| | - Emma Brinkley
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
| | - Tom Kwon
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
| | - Christina Mack
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
| | - Stephen Toovey
- Pegasus Research, Neuschwaendistrasse 6, Engelberg, 6390, Switzerland
| | - Nancy A Dreyer
- IQVIA Real-World Solutions. 201 Broadway, Cambridge, MA 02139, USA
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44
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SARS-CoV-2 Variants, Current Vaccines and Therapeutic Implications for COVID-19. Vaccines (Basel) 2022; 10:vaccines10091538. [PMID: 36146616 PMCID: PMC9504858 DOI: 10.3390/vaccines10091538] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Over the past two years, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused hundreds of millions of infections, resulting in an unprecedented pandemic of coronavirus disease 2019 (COVID-19). As the virus spreads through the population, ongoing mutations and adaptations are being discovered. There is now substantial clinical evidence that demonstrates the SARS-CoV-2 variants have stronger transmissibility and higher virulence compared to the wild-type strain of SARS-CoV-2. Hence, development of vaccines against SARS-CoV-2 variants to boost individual immunity has become essential. However, current treatment options are limited for COVID-19 caused by the SARS-CoV-2 variants. In this review, we describe current distribution, variation, biology, and clinical features of COVID-19 caused by SARS-CoV-2 variants (including Alpha (B.1.1.7 Lineage) variant, Beta (B.1.351 Lineage) variant, Gamma (P.1 Lineage) variant, Delta (B.1.617.2 Lineage) variant, and Omicron (B.1.1.529 Lineage) variant and others. In addition, we review currently employed vaccines in clinical or preclinical phases as well as potential targeted therapies in an attempt to provide better preventive and treatment strategies for COVID-19 caused by different SARS-CoV-2 variants.
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45
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Patón M, Al-Hosani F, Stanciole AE, Aden B, Timoshkin A, Sadani A, Najim O, Cherian CA, Acuña JM, Rodríguez J. Model-based evaluation of the COVID-19 epidemiological impact on international visitors during Expo 2020. Infect Dis Model 2022; 7:571-579. [PMID: 35990534 PMCID: PMC9375731 DOI: 10.1016/j.idm.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 10/26/2022] Open
Abstract
The impact of the COVID-19 pandemic on large events has been substantial. In this work, an evaluation of the potential impact of international arrivals due to Expo 2020 in terms of potential COVID-19 infections from October 1st, 2021, until the end of April 2022 in the United Arab Emirates is presented. Our simulation results indicate that: (i) the vaccination status of the visitors appears to have a small impact on cases, this is expected as the small numbers of temporary visitors with respect to the total population contribute little to the herd immunity status; and (ii) the number of infected arrivals is the major factor of impact potentially causing a surge in cases countrywide with the subsequent hospitalisations and fatalities. These results indicate that the prevention of infected arrivals should take all precedence priority to mitigate the impact of international visitors with their vaccination status being of less relevance.
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Affiliation(s)
- Mauricio Patón
- Department of Epidemiology and Public Health, College of Medicine, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.,Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | | | | | - Bashir Aden
- Department of Health, Abu Dhabi, United Arab Emirates
| | | | - Amrit Sadani
- Department of Health, Abu Dhabi, United Arab Emirates
| | - Omar Najim
- Department of Health, Abu Dhabi, United Arab Emirates
| | - Cybill A Cherian
- Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Juan M Acuña
- Department of Epidemiology and Public Health, College of Medicine, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.,Abu Dhabi Health Services Company - SEHA, PO Box 109090, Abu Dhabi, United Arab Emirates
| | - Jorge Rodríguez
- Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
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46
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Deng B, Liu W, Guo Z, Luo L, Yang T, Huang J, Abudunaibi B, Zhang Y, Ouyang X, Wang D, Su C, Chen T. Natural history and cycle threshold values analysis of COVID-19 in Xiamen City, China. Infect Dis Model 2022; 7:486-497. [PMID: 35968394 PMCID: PMC9361627 DOI: 10.1016/j.idm.2022.07.007] [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: 06/12/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objective This study elaborated the natural history parameters of Delta variant, explored the differences in detection cycle thresholds (Ct) among cases. Methods Natural history parameters were calculated based on the different onset time and exposure time of the cases. Intergenerational relationships between generations of cases were calculated. Differences in Ct values of cases by gender, age, and mode of detection were analyzed statistically to assess the detoxification capacity of cases. Results The median incubation period was 4 days; the detection time for cases decreased from 25 to 7 h as the outbreak continued. The average generation time (GT), time interval between transmission generations (TG) and serial interval (SI) were 3.6 ± 2.6 days, 1.67 ± 2.11 days and 1.7 ± 3.0 days. Among the Ct values, we found little differences in testing across companies, but there were some differences in the gender of detected genes. The Ct values continuous to decreased with age, but increased when the age was greater than 60. Conclusion This epidemic was started from aggregation of factories. It is more reasonable to use SI to calculate the effective reproduction number and the time-varying reproduction number. And the analysis of Ct values can improve the positive detection rate and improve prevention and control measures.
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Affiliation(s)
- Bin Deng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Weikang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Zhinan Guo
- Xiamen Center for Disease Control and Prevention, Xiamen City, Fujian Province, People's Republic of China
| | - Li Luo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Tianlong Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Jiefeng Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Buasiyamu Abudunaibi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Yidun Zhang
- Xiamen Center for Disease Control and Prevention, Xiamen City, Fujian Province, People's Republic of China
| | - Xue Ouyang
- Xiamen Center for Disease Control and Prevention, Xiamen City, Fujian Province, People's Republic of China
| | - Demeng Wang
- Xiamen Center for Disease Control and Prevention, Xiamen City, Fujian Province, People's Republic of China
| | - Chenghao Su
- Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen City, Fujian Province, People's Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
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Estimate of undetected severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in acute-care hospital settings using an individual-based microsimulation model. Infect Control Hosp Epidemiol 2022:1-10. [PMID: 36047313 PMCID: PMC9433748 DOI: 10.1017/ice.2022.174] [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] [Indexed: 12/01/2022]
Abstract
Objective: Current guidance states that asymptomatic screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) prior to admission to an acute-care setting is at the facility’s discretion. This study’s objective was to estimate the number of undetected cases of SARS-CoV-2 admitted as inpatients under 4 testing approaches and varying assumptions. Design and setting: Individual-based microsimulation of 104 North Carolina acute-care hospitals Patients: All simulated inpatient admissions to acute-care hospitals from December 15, 2021, to January 13, 2022 [ie, during the SARS-COV-2 ο (omicron) variant surge]. Interventions: We simulated (1) only testing symptomatic patients, (2) 1-stage antigen testing with no confirmatory polymerase chain reaction (PCR) test, (3) 1-stage antigen testing with a confirmatory PCR for negative results, and (4) serial antigen screening (ie, repeat antigen test 2 days after a negative result). Results: Over 1 month, there were 77,980 admissions: 13.7% for COVID-19, 4.3% with but not for COVID-19, and 82.0% for non–COVID-19 indications without current infection. Without asymptomatic screening, 1,089 (credible interval [CI], 946–1,253) total SARS-CoV-2 infections (7.72%) went undetected. With 1-stage antigen screening, 734 (CI, 638–845) asymptomatic infections (67.4%) were detected, with 1,277 false positives. With combined antigen and PCR screening, 1,007 (CI, 875–1,159) asymptomatic infections (92.5%) were detected, with 5,578 false positives. A serial antigen testing policy detected 973 (CI, 845–1,120) asymptomatic infections (89.4%), with 2,529 false positives. Conclusions: Serial antigen testing identified >85% of asymptomatic infections and resulted in fewer false positives with less cost per identified infection compared to combined antigen plus PCR testing.
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48
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Spicer KB, Glick C, Cavanaugh AM, Thoroughman D. Association of Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination or a Prior Positive Test Result in Adolescents during the Delta Variant Surge in Kentucky. J Pediatr 2022; 248:119-121. [PMID: 35644225 PMCID: PMC9135495 DOI: 10.1016/j.jpeds.2022.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/10/2022] [Accepted: 05/24/2022] [Indexed: 11/06/2022]
Abstract
In a cross-sectional study of 89 736 adolescents in Kentucky, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination provided an estimated protection against infection of 81% when the highly transmissible Delta variant was predominant. Vaccination provided added benefit to those with a history of prior infection. These findings support the recommendation that all adolescents receive SARS-CoV-2 vaccination.
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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, Atlanta, GA,Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, KY
| | - Connor Glick
- Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, KY
| | - Alyson M. Cavanaugh
- Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, KY,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Douglas Thoroughman
- Kentucky Department for Public Health, Division of Epidemiology and Health Planning, Frankfort, KY,Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA
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49
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Ikuse T, Aizawa Y, Shobukawa Y, Tomiyama N, Nakayama H, Takahashi M, Muto K, Hasegawa S, Takahashi M, Kon M, Tamura T, Matsumoto H, Saito R, Saitoh A. Household Secondary Transmission of the Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant From a Community Cluster in a Nursery in Japan. Pediatr Infect Dis J 2022; 41:e358-e364. [PMID: 35703299 PMCID: PMC9359683 DOI: 10.1097/inf.0000000000003607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Spread of variants of concerns (VOCs) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to an increase in children with coronavirus disease 2019 (COVID-19). In February 2021, clusters of the Alpha variant of SARS-CoV-2 started to be reported in Niigata, Japan, including a large nursery cluster. We investigated the transmission routes and household secondary attack rates (SARs) in this cluster. METHODS Epidemiologic data related to a nursery cluster in Niigata, Japan, particularly child-origin and adult-origin SARs, were analyzed. VOCs were confirmed by whole-genome sequencing of virus from patients. RESULTS In total, 42 persons (22 children and 20 adults) in the cluster were infected with the Alpha variant. In the nursery, 13 of 81 children (16.0%) and 4 of 24 teachers (16.7%) were infected. SARS-CoV-2 later spread to 25 persons (10 children and 15 adults) outside the nursery. Child-origin and adult-origin household SARs were 27.7% (13/47) and 47.0% (8/17) ( P = 0.11), respectively, which were higher than rates attributable to non-VOCs in previous studies. CONCLUSIONS As compared with non-VOCs, the Alpha variant of SARS-CoV-2 exhibited high transmissibility among children and adults and may pose a high risk for household secondary transmission from SARS-CoV-2-infected children. Increased transmissibility of current or future VOCs could lead to greater transmission from children to adults or other children.
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Affiliation(s)
- Tatsuki Ikuse
- From the Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences
| | - Yuta Aizawa
- From the Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences
| | - Yugo Shobukawa
- Department of Active Ageing, Niigata University Graduate School of Medical and Dental Sciences
| | - Nobuko Tomiyama
- Department of Health and Welfare, Niigata Prefectural Office
| | | | | | | | - Satoshi Hasegawa
- Department of Patient Coordinate Center, Niigata Prefectural Office
| | | | - Miyako Kon
- Department of Virology, Niigata Prefectural Institute of Public Health and Environmental Science
| | - Tsutomu Tamura
- Department of Virology, Niigata Prefectural Institute of Public Health and Environmental Science
| | | | - Reiko Saito
- Department of International Health (Public Health), Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akihiko Saitoh
- From the Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences
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50
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He X, Su J, Ma Y, Zhang W, Tang S. A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines. Front Immunol 2022; 13:945930. [PMID: 36090988 PMCID: PMC9459021 DOI: 10.3389/fimmu.2022.945930] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
It is urgently needed to update the comprehensive analysis about the efficacy or effectiveness of COVID-19 vaccines especially during the COVID-19 pandemic caused by SARS-CoV-2 Delta and Omicron variants. In general, the current COVID-19 vaccines showed a cumulative efficacy of 66.4%, 79.7%, and 93.6% to prevent SARS-CoV-2 infection, symptomatic COVID-19, and severe COVID-19, respectively, but could not prevent the asymptomatic infection of SARS-CoV-2. Furthermore, the current COVID-19 vaccines could effectively prevent COVID-19 caused by the Delta variant although the incidence of breakthrough infection of the SARS-CoV-2 Delta variant increased when the intervals post full vaccination extended, suggesting the waning effectiveness of COVID-19 vaccines. In addition, one-dose booster immunization showed an effectiveness of 74.5% to prevent COVID-19 caused by the Delta variant. However, current COVID-19 vaccines could not prevent the infection of Omicron sub-lineage BA.1.1.529 and had about 50% effectiveness to prevent COVID-19 caused by Omicron sub-lineage BA.1.1.529. Furthermore, the effectiveness was 87.6% and 90.1% to prevent severe COVID-19 and COVID-19-related death caused by Omicron sub-lineage BA.2, respectively, while one-dose booster immunization could enhance the effectiveness of COVID-19 vaccines to prevent the infection and COVID-19 caused by Omicron sub-lineage BA.1.1.529 and sub-lineage BA.2. Two-dose booster immunization showed an increased effectiveness of 81.8% against severe COVID-19 caused by the Omicron sub-lineage BA.1.1.529 variant compared with one-dose booster immunization. The effectiveness of the booster immunization with RNA-based vaccine BNT162b2 or mRNA-1273 was over 75% against severe COVID-19 more than 17 weeks after booster immunization whereas the heterogenous booster immunization showed better effectiveness than homologous booster immunization. In summary, the current COVID-19 vaccines could effectively protect COVID-19 caused by Delta and Omicron variants but was less effective against Omicron variant infection. One-dose booster immunization could enhance protection capability, and two-dose booster immunization could provide additional protection against severe COVID-19.
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Affiliation(s)
- Xiaofeng He
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Institute of Evidence-Based Medicine, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Jiao Su
- Department of biochemistry, Changzhi Medical College, Changzhi, China
| | - Yu’nan Ma
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wenping Zhang
- Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Shixing Tang,
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